agilon health Q4 2023 Earnings Report
Key Takeaways
agilon health reported a 72% increase in revenue to $1.06 billion for Q4 2023. However, the company faced challenges with rising medical costs, leading to a gross profit of negative $95 million and a net loss of $230 million. The company is implementing a targeted action plan to address these issues and expects the Class of 2025 to add at least 60,000 Medicare Advantage members.
Revenue increased by 72% to $1.06 billion compared to Q4 2022.
Medicare Advantage membership increased by 68% to 388,400.
Total members on the agilon platform grew to 477,700.
Gross profit was negative $95 million, compared to $16 million in Q4 2022.
agilon health
agilon health
agilon health Revenue by Segment
Forward Guidance
agilon health's updated guidance assumes that the higher medical cost trend from 2023 will continue in 2024. Revised guidance assumes a medical cost trend of approximately 6.6% in 2024 for Year 2+ markets, which is 250 bps above the company’s prior expectation and compares to the 7.0% medical cost trend observed in 2023.
Positive Outlook
- Expanding onboarding support for newer primary care physicians (PCPs) in mature markets.
- Refining payor partnerships.
- Improving data visibility and analytics.
- Accelerating operating efficiency.
- Class of 2025 new partners will include at least 5 physician groups with more than 60,000 new Medicare Advantage (MA) members.
Challenges Ahead
- Updated guidance assumes that the higher medical cost trend from 2023 will continue in 2024.
- Revised guidance assumes a medical cost trend of approximately 6.6% in 2024 for Year 2+ markets, which is 250 bps above the company’s prior expectation and compares to the 7.0% medical cost trend observed in 2023.
- Medical Margin of $299 million was approximately $51 million below the midpoint of the company’s guidance of range of $340 million to $360 million provided on January 5, 2024.
- The company estimates approximately $38 million of the lower Medical Margin is from costs and revenue attributable to the fourth quarter and $13 million of the lower Medical Margin is attributable to costs and revenue attributable previous periods.
- First, as the company completed the financial closing process in February, it received updated data including relatively complete claims data from its largest payors, and additional information such as seasonality factors and census data.
Revenue & Expenses
Visualization of income flow from segment revenue to net income