agilon health, inc. (NYSE:AGL) Q4 2023 Earnings Call Transcript

Elizabeth Anderson: Hi, guys. Thanks so much for the question. I appreciate all the additional color on what you’re seeing in the data visibility. I remember a couple of weeks ago you were talking about some of your sort of percent completion for 2Q, for 3Q, for 4Q in terms of data visibility, can you kind of give us an update on sort of, I don’t know whether it’s changed since the beginning of January in terms of that or sort of where your expectations of where you’ll be, say, at the end of ‘24? Thanks.

Tim Bensley: She’s talking about the financial data pipeline?

Steve Sell: So the financial data pipeline, Elizabeth, that I talked about in my remarks that we’re standing up this year, we are receiving claims already from our largest payer, and we’ll have many more of our largest payers talked about in Q1, that’ll be north of 50% of our members will be covered within that. And by Q2, we’ll have 75% of those based on our seven largest national payers. What that does for us is it gives us the ability to really have a very consistent data set across three quarters of our members. It allows us to be faster with it and to be far more detailed at the cost of care category level than we have been able to historically, because you’re kind of wrestling very different data sets. And so, it effectively becomes our data set that as soon as it’s updated, we have that ability to just move with it that much more rapidly.

And so, I think that’s what you’re referencing is where we’re at on that progression, and we’re on track and encouraged by that. And that will be a component as we come back and start talking to you in future calls on the assessments we’re making.

Elizabeth Anderson: Got it. That’s super helpful. Thank you.

Operator: Thank you. We now have Sean Dodge of RBC Capital Markets. Your line is now open.

Sean Dodge: Yeah. Thanks. For the Class of 2025, if we look at the composition of that, can you kind of help us compare and contrast that to the ‘24 Class? Should we think about this being a group that also launches with relatively strong year one medical margins? Or will these, again, given the composition, should we think about this being more like the ‘23 Class?

Steve Sell: So we – thanks, Sean, for the question. We have a really strong Class of ‘25, very excited to be implementing them right now. As I said, it’s at least five groups and 60,000 senior patients, and it will be at least one new state for us. If you think about it in sort of comparison to the Class of ‘23 and ‘24, you’re going to see a greater concentration of these new groups in existing states and markets than what we’ve seen. We think that’s really prudent. You’re able to leverage existing contracts, clinical programs, infrastructure around that, so that helps a lot. It is also in contrast, like, the Class ‘23 and ‘24, it’s less diverse. You’ve got more sort of multispecialty groups and primary care, and not as many different types of groups within those.

And then, as we just talked about, kind of the geo entry costs really account for the potential for more membership than that 60,000 I talked about in the Class of ‘25 or in the longer implementation cycles for the Class of ‘26. So some early onboarding costs for that. So that’s sort of the complexion of that group. And we’ll be sharing details on each one of these groups here in the coming period.

Sean Dodge: Okay. And maybe just quickly on that last point, should we think about this being kind of what the Class of ‘25 ends up looking like? Is it prudent given kind of the backdrop to pause here or just be a lot more selective in who you’re including? Or do you think ‘25 could continue to grow?

Steve Sell: Well, I think so ‘25 is that we said at least, right, so five groups and 60,000. So there is the potential for that to grow. I do think we’re very prudent in terms of, in particular, our payer contracts. Now, this class is in the footprint that we sit in today, so you’re able to leverage a lot of existing footprints. So there’s probably not as much of a dynamic on that. But a big part of this is sort of the pull through on these groups. But that’s sort of where we’re at right now. At least five groups, at least 60,000.

Sean Dodge: Okay, great. Thanks again.

Operator: We now have Stephen Baxter of Wells Fargo on the line.

Stephen Baxter: Yeah. Hey, thanks. So I just wanted to ask, at this point, as you look back at sort of the cohort progressions, especially the older cohorts, has there been anything that structurally changes your view of the company’s ability to get back to these economics over time? I mean, one thing that we’ve been thinking about is that, on the health plan side, they have two levers to really deal with this. First, they have kind of the repricing, but then they’re also seemingly cutting a lot of corporate overheads. So they might not even be necessarily getting back to the same medical margins that they would have had on a pre-COVID basis. So as we sort of think about it, just wondering if you could provide some thoughts around the potential achievability of those economics. And I guess what looks like it’ll be a pretty different environment going forward? Thanks.

Steve Sell: Yeah, Stephen, I mean, it definitely is a dynamic environment and you’ve got the elevated utilization. I appreciate you’re asking about the cohort data. I mean I think clearly elevated costs impacted the member cohorts and the market cohorts that are in the deck that’s on the investor website. I think we’re encouraged when you look at the member cohort data, which is basically members that came on at ‘18, kind of how they’re performing across time. ‘19, same thing. If you look at the classes of ‘18, ‘19 and ‘20, they are progressing or sustaining near $150 PMPM. That’s on the low side, but we’ve talked about that 150 to 200 is sort of where we’re shooting for, and obviously we’ve got some that are north above that.