Latest news with #agilonhealth
Yahoo
a day ago
- Health
- Yahoo
New Research Underscores the Important Role of Value-Based Care (VBC) in Improving Primary Care Access for Traditional Medicare Patients
Study also sheds light on how agilon health's VBC model can enable primary care physicians to provide high-quality care for all seniors, including those with Traditional Medicare WESTERVILLE, Ohio, June 09, 2025--(BUSINESS WIRE)--agilon health (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, today announced new research demonstrating the promising role of value-based care (VBC) in maintaining primary care for senior patients when supported by agilon health, a VBC-enablement company. The study was published in the May 2025 issue of Health Affairs Scholar. "Primary care is foundational for Medicare beneficiaries, especially those with chronic conditions. Despite its importance, many senior patients, particularly ones with Traditional Medicare (TM), have difficulties finding a primary care provider (PCP) and establishing this enormously critical longitudinal relationship," said Karthik Rao, MD, chief medical officer, agilon health. "As PCPs play a key role in providing comprehensive care to patients, we wanted to examine the role of VBC in improving primary care access in this population." Using claims data, researchers compared two groups of PCPs with TM patients in their panels: one group that received support from agilon health to adopt a VBC model and one group that maintained prevailing payment structures, primarily fee-for-service (FFS). Unlike FFS models that reward volume, VBC incentivizes PCPs to spend more time with patients and focus on their quality of care. The following results were observed in the study: After shifting to VBC, PCPs saw eight more new TM patients per year compared to the matched cohort of physicians who did not transition to the full-risk model, representing an approximate 35% relative increase in new TM patient volume, a statistically significant finding (P < 0.001). PCPs shifting to VBC kept their practices open to new TM patients for 0.7 more months per year on average – nearly one full month annually – compared to the other group (P < 0.001), a statistically meaningful increase in availability in the context of shrinking access and PCP workforce shortages nationally. "This study provides timely, independent validation of agilon health's VBC approach, confirming its role in increasing availability of primary care access for Medicare patients, including TM patients who historically face more limited options," added Dr. Rao. "While agilon's model is built around supporting physicians in full-risk arrangements through Medicare Advantage (MA) and ACO REACH contracts, this study shows that our model can have an even greater impact on communities by helping PCPs improve access to care across all of their Medicare patients." Study design Using FFS claims data from 2019 to 2023, researchers compared two groups of PCPs with at least 50 TM patients in their panels: 208 PCPs who received support to adopt a VBC model for TM and MA patients in 2022 ("adopters"), and 3,657 similar PCPs who maintained their existing payment models (FFS) ("nonadopters"). Researchers evaluated changes in two key outcomes between the two groups each year before, during and after VBC adoption. These outcomes included the number of new TM patients seen annually and the number of months each year that physician panels remained open to new TM patients. Researchers used difference-in-differences statistical methods to isolate the effect of joining the VBC model while accounting for other time-based trends. The primary study limitation was the nonexperimental design with a self-selected group of VBC-adopting PCPs. National trends in primary care and the promising role of VBC Access to primary care remains insufficient, despite its critical role in the U.S. healthcare system. Many areas are at risk of becoming "primary care deserts," and even well-resourced health systems have started restricting the acceptance of new patients, regardless of insurance type. Additionally, a national shortage of PCPs is projected to reach 57,000 by 2040. Compounding the issue, Medicare payments have dropped by 29% since 2001 after adjusting for physician practice costs. In response, some PCPs have been limiting new patient intake for TM beneficiaries. VBC models offer a promising path forward, leading to high-quality, cost-effective care. The Center for Medicare & Medicaid Innovation (CMMI) recently announced its goal to increase the share of Medicare beneficiaries in two-sided risk models. Unlike traditional FFS models, full-risk VBC arrangements provide PCPs with fixed payments based on patient demographics and complexity. In exchange, PCPs are held accountable for total medical spending and quality of care. These arrangements incentivize PCPs to proactively manage healthcare needs through efficient team-based approaches. By supporting care delivery transformation, it may also expand PCPs' capacity to serve more patients while maintaining high-quality care. About agilon health agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,200+ primary care physicians that allow its physician partners to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30 diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information, visit and connect with us on LinkedIn. View source version on Contacts Investor Contacts Evan Smith, CFASVP, Investor Leland Thomasinvestors@ Media Contacts Stephanie LawSenior Director, Marketing & Maureen MerkleCorporate Communicationsmedia@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
20-05-2025
- Business
- Yahoo
AGL Q1 Earnings Call: Membership Declines, Technology Investments, and Cautious Outlook for 2025
Healthcare services company Agilon Health (NYSE:AGL) reported Q1 CY2025 results topping the market's revenue expectations , but sales fell by 4.5% year on year to $1.53 billion. The company expects next quarter's revenue to be around $1.47 billion, close to analysts' estimates. Its non-GAAP profit of $0.03 per share was $0.02 above analysts' consensus estimates. Is now the time to buy AGL? Find out in our full research report (it's free). Revenue: $1.53 billion vs analyst estimates of $1.51 billion (4.5% year-on-year decline, 1.8% beat) Adjusted EPS: $0.03 vs analyst estimates of $0.01 ($0.02 beat) Adjusted EBITDA: $20.57 million vs analyst estimates of $17.42 million (1.3% margin, 18.1% beat) The company slightly lifted its revenue guidance for the full year to $5.94 billion at the midpoint from $5.93 billion EBITDA guidance for the full year is -$75 million at the midpoint, above analyst estimates of -$78.29 million Operating Margin: -1.4%, in line with the same quarter last year Free Cash Flow was -$35.84 million compared to -$50.92 million in the same quarter last year Customers: 491,000, down from 527,000 in the previous quarter Market Capitalization: $1.01 billion Agilon Health's first quarter results were shaped by ongoing efforts to optimize its Medicare Advantage member base and improve operating efficiency. Management attributed the reported revenue and margin performance to disciplined growth, partner and payer exits, and execution on clinical initiatives, while acknowledging that persistent cost pressures—especially in inpatient and drug spending—remained a headwind. CEO Steve Sell noted, "These results reflect the benefit of our previously disclosed partnership and payer exits, continued execution on quality and clinical initiatives, and better payer contracting terms to reduce Medicare Part D exposure." Looking ahead, agilon health's forward guidance is influenced by expectations for a more stable operating environment and ongoing initiatives to lower risk exposure and enhance clinical quality. The company highlighted opportunities stemming from favorable regulatory changes in 2026 and continued investments in technology and clinical programs. Management characterized 2025 as a transition year, emphasizing its focus on profitability, cash management, and negotiating improved payer terms to support long-term financial stability. Management's commentary highlighted the deliberate approach to managing growth and risk, as well as the continued rollout of technology and clinical programs designed to support quality care and operational efficiency. Disciplined Membership Strategy: The company's focus remained on measured growth, with membership essentially flat year over year after deliberate market and payer exits. Management explained that these actions were intended to limit underwriting risk and prioritize profitability. Reduced Part D Exposure: Agilon health further decreased its exposure to Medicare Part D (the prescription drug benefit), with less than 30% of members now carrying Part D risk. Management described this as a key step in reducing variability in financial results, noting ongoing negotiations to lower this figure further in upcoming contract cycles. Technology and Data Platform Investments: The company continued to invest in technology, such as the integration of its mphrX acquisition and enhancements to data pipelines. These upgrades have improved data visibility and analytics, supporting care coordination and real-time performance tracking across clinical programs. Expansion of Clinical Pathways: Agilon health scaled its heart failure and palliative care programs, aiming for earlier disease detection and better chronic disease management. Management reported that the palliative care initiative led to a material increase in advanced illness management enrollment and a reduction in hospital admissions per 1,000 patients. Margin Management Initiatives: The company reported progress on quality incentive programs and clinical cost management, which are expected to drive financial improvements over time. Management stated that these initiatives would provide a stronger foundation for operating leverage and long-term performance, particularly as external cost trends stabilize. Management expects 2025 to be a year of financial transition, with profitability supported by a mix of cautious member growth, lower risk exposure, and investments in quality and technology. Contract Negotiations and Rate Environment: Upcoming payer contract renewals covering roughly half of the membership are expected to drive improved terms and lower Part D risk, with management citing the 2026 CMS (Centers for Medicare & Medicaid Services) rate notice as a meaningful positive catalyst for revenue yield and margin. Clinical Program Maturation: The rollout of disease management pathways for heart failure and palliative care is expected to show greater financial and clinical impact in 2026 and beyond, as patient identification and intervention efforts mature. Cost Control and Operating Discipline: Ongoing efforts to reduce supplemental benefit risk, optimize cash management, and leverage new data systems are seen as key to maintaining margin stability despite persistent utilization pressures in inpatient and drug costs. Stephen Baxter (Wells Fargo): Asked about the V-28 risk model transition's impact on 2025 and whether it differed from prior expectations. Management responded that risk adjustment impacts were in line with projections and that prior preparation minimized disruption. Elizabeth Anderson (Evercore ISI): Questioned lingering effects from previously exited markets on current results. CFO Jeff Schwaneke indicated that most negative development from exited markets was contained to 2024, with minimal ongoing impact. Jailendra Singh (Truist Securities): Sought clarity on how the favorable 2026 CMS rate notice will flow through to agilon's contracts and when renewal terms would be finalized. Management explained that percentage-of-premium contracts would benefit directly, with most renewals still in progress. Lisa Gill (JPMorgan): Inquired about medical cost trend visibility and the drivers of elevated inpatient and drug spending. Management detailed new data pipelines improving claims visibility, and noted that inpatient admissions were higher early in the quarter but moderated by March. Matthew Shea (Needham): Asked about the potential margin impact of new clinical programs in heart failure, dementia, and COPD. Management said these programs are in early stages, with costs reflected in 2025 and benefits expected to build in 2026. In the coming quarters, the StockStory team will be tracking (1) progress on payer contract negotiations and further reductions in Part D risk exposure; (2) measurable results from the expansion of heart failure and palliative care pathways, including their impact on hospital utilization; and (3) the company's ability to maintain cost discipline and improve forecasting accuracy through its enhanced data platform. Execution on these initiatives will shape agilon health's ability to stabilize margins and position for growth in 2026. agilon health currently trades at a forward price-to-sales ratio of 0.2×. Should you double down or take your chips? See for yourself in our free research report. Market indices reached historic highs following Donald Trump's presidential victory in November 2024, but the outlook for 2025 is clouded by new trade policies that could impact business confidence and growth. While this has caused many investors to adopt a "fearful" wait-and-see approach, we're leaning into our best ideas that can grow regardless of the political or macroeconomic climate. Take advantage of Mr. Market by checking out our Top 5 Growth Stocks for this month. This is a curated list of our High Quality stocks that have generated a market-beating return of 176% over the last five years. Stocks that made our list in 2020 include now familiar names such as Nvidia (+1,545% between March 2020 and March 2025) as well as under-the-radar businesses like the once-micro-cap company Tecnoglass (+1,754% five-year return). Find your next big winner with StockStory today. Sign in to access your portfolio
Yahoo
19-05-2025
- Business
- Yahoo
agilon health to Participate in Bernstein's 41st Annual Strategic Decisions Conference
WESTERVILLE, Ohio, May 19, 2025--(BUSINESS WIRE)--agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, announced that it will participate in the Bernstein 41st Annual Strategic Decisions Conference including a fireside chat presentation on Wednesday, May 28 at 4:30 PM Eastern Time. Interested investors and other parties may listen to a simultaneous webcast of the presentation by visiting the "Events & Presentations" section of agilon health's investor relations website at Replays will be available for on-demand listening shortly after the completion of the presentation. About agilon health agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,200+ primary care physicians (PCPs) that allow its physician partners to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30 diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information visit and connect with us on LinkedIn. View source version on Contacts Investor Contacts Evan Smith, CFASVP Investor Leland Thomasinvestors@ Media Contacts Stephanie LawSenior Director, Marketing & Communications Maureen MerkleCorporate Communicationsmedia@
Business Wire
19-05-2025
- Health
- Business Wire
agilon health to Participate in Bernstein's 41st Annual Strategic Decisions Conference
WESTERVILLE, Ohio--(BUSINESS WIRE)--agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, announced that it will participate in the Bernstein 41st Annual Strategic Decisions Conference including a fireside chat presentation on Wednesday, May 28 at 4:30 PM Eastern Time. Interested investors and other parties may listen to a simultaneous webcast of the presentation by visiting the 'Events & Presentations' section of agilon health's investor relations website at Replays will be available for on-demand listening shortly after the completion of the presentation. About agilon health agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,200+ primary care physicians (PCPs) that allow its physician partners to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30 diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information visit and connect with us on LinkedIn.
Yahoo
07-05-2025
- Business
- Yahoo
Why agilon health (AGL) Stock Is Nosediving
What Happened? Shares of healthcare services company Agilon Health (NYSE:AGL) fell 24.9% in the afternoon session after the company reported weak first quarter 2025 results as new customer additions fell short. On the other hand, revenue and EBITDA for the full-year exceeded Wall Street's estimates. That said, with Medicare Advantage members down 6%, growth is clearly cooling. Zooming out, we think this was a decent quarter featuring some areas of strength but also some blemishes. The stock market overreacts to news, and big price drops can present good opportunities to buy high-quality stocks. Is now the time to buy agilon health? Access our full analysis report here, it's free. What The Market Is Telling Us agilon health's shares are extremely volatile and have had 78 moves greater than 5% over the last year. But moves this big are rare even for agilon health and indicate this news significantly impacted the market's perception of the business. The previous big move we wrote about was 29 days ago when the stock gained 29.9% on the news that Bernstein upgraded the stock's rating from Hold to Buy with a price target of $8.5. The firm noted that new data on AGL drove increased confidence in its turnaround plans and cash position. agilon health is up 84.1% since the beginning of the year, but at $3.54 per share, it is still trading 53% below its 52-week high of $7.52 from July 2024. Investors who bought $1,000 worth of agilon health's shares at the IPO in April 2021 would now be looking at an investment worth $114.03. Here at StockStory, we certainly understand the potential of thematic investing. Diverse winners from Microsoft (MSFT) to Alphabet (GOOG), Coca-Cola (KO) to Monster Beverage (MNST) could all have been identified as promising growth stories with a megatrend driving the growth. So, in that spirit, we've identified a relatively under-the-radar profitable growth stock benefiting from the rise of AI, available to you FREE via this link.
