Alignment Healthcare, Inc. (NASDAQ:ALHC) Q3 2023 Earnings Call Transcript

So, we’re really seeing a nice traction across the board, and we’ll continue to try to drive a balanced mix of growth across all products in the future.

Scott Fidel: Okay, thank you.

Operator: Thank you. And I show our next question comes from the line of Nathan Rich from Goldman Sachs. Please go ahead.

Nathan Rich: Hey, good afternoon. Thanks so much for taking the questions. John, I wonder if you could maybe provide a little bit more color on the relative funding advantage you called out, I guess, particularly in California and maybe where you invested in the business. And I guess as it relates to retention as well, what you’re expecting for 2024 relative to 2023, I think you saw some improvement this year that helped. So, just be curious what your expectations are for next year. And then, just as a follow-up, how should we be thinking about MBR next year, just in light of the growth expectations that you have that should result in what seems to be some market share gains? Thank you.

John Kao: Yes, sure. Hey, Nate, good to hear from you. With respect to the relative funding advantage, what I’m really talking about is the revenue PMPM associated with Stars. And obviously that’s going to be something that impacts everyone in the sector on the Stars that we just were notified on in heading into 2025. But I think that combined with the V28 risk model changes and the two together, we think are material advantages to us. And so what I mean by that is getting the stars advantage is pretty significant. I think we’re one of four health plans in California that have four stars or higher. And two of those other health plans are essentially vertically integrated health systems. And the third one is really interesting, got a four star rating, but only 20% of their membership actually resides in California.

And the H number is actually outside of California. And so, the significance of that is that the way in which we work with our delivery system is a competitive advantage. And it’s all about provider engagement and making our contracted provider network more successful. And whether that’s in the form of IPAs, medical groups, or directly contracted providers. And so, that’s starting to manifest itself through the Star ratings. And I think that’s going to continue to be just a competitive advantage. On V28, we’ve said this before, we have not run the business at a very high RAF number. We’ve been very, very conservative, and compliant, and we’ll continue to do so. And I would say others have been more aggressive. And I think the relative advantage we have with some of the headwinds on V28 are significantly to our favor.

Those two, I would expect to be reflected in the upcoming, not only in the upcoming 2024 bids for 2025, but also we predicted a lot of this in the ’23 bids for 2024. And it’s starting to all manifest itself. Last thing I’d say is kind of the financial discipline we’ve exhibited to protect margin is going to start paying off. And I think that’s one of the underlying reasons why I feel so confident that we’re going to get to our margin profile and get to at least EBITDA break even next year. And those are the two big drivers. And our bid strategies were spot on and I’m feeling very, very comfortable with where we are two weeks in. And, we’ll share a lot more in January. That helped, Nate? Did I answer all of it? Or did I miss on or two?

Nathan Rich: That’s helpful. Maybe just a follow-up on just the MBR and how we should think about that next year, any color or early thoughts?