Latest news with #valuebasedcare
Associated Press
20-05-2025
- Business
- Associated Press
Pharmacy Quality Solutions (PQS) by Innovaccer Launches EQUIPP Copilot™, Industry-First Zero-Click Intelligent Platform to Empower Pharmacies in Value-Based, Collaborative Care
SAN FRANCISCO--(BUSINESS WIRE)--May 20, 2025-- Pharmacy Quality Solutions (PQS), an Innovaccer company and leader in pharmacy-payer performance technology, today announced the launch of EQUIPP Copilot ™, the industry's first workflow-integrated intelligence platform designed to help pharmacies expand clinical services, boost productivity, and connect seamlessly with the broader healthcare ecosystem. By embedding real-time insights and automation directly into daily pharmacy operations, EQUIPP Copilot ™ redefines how pharmacists engage in value-based care, care coordination, and patient outcomes, without disrupting their workflow. The announcement was made at the Pharmacy Quality Alliance Annual Meeting where EQUIPP Copilot ™ was introduced as the industry's first AI-enabled real-time digital copilot designed to help pharmacies participate in value-based care (VBC) and enhance operational efficiency. 'Community pharmacies are on the front lines of the value-based care evolution,' said Todd Sega, Managing Director, Pharmacy, Innovaccer. 'They face mounting pressures in the core, historical business model of dispensing medications, while needing to diversify and focus on value and patient care services in a changing payer and provider landscape. EQUIPP Copilot ™ meets this moment by delivering exactly what pharmacists need: real-time guidance and automation woven into their day-to-day workflow. It's like having a digital assistant in the pharmacy system, surfacing actionable insights and automating tasks so teams can spend more time on patients and growing revenue through clinical services.' Pharmacies are increasingly expected to support clinical initiatives and participate in value-based care programs, but often lack the tools to do so efficiently. EQUIPP Copilot ™ solves this by embedding actionable intelligence and automation directly into their workflow, streamlining tasks, eliminating administrative burden, and enhancing patient outcomes. Unlike standalone apps or portals, EQUIPP Copilot ™ overlays Pharmacy Management Systems (PMSs), using smart pop-ups, embedded alerts, and intelligent task automation to guide pharmacists through quality interventions at the point of care. The key innovations of EQUIPP Copilot ™ include: 'Pharmacies are one of the most underutilized assets in value-based care,' said Abhinav Shashank, CEO of Innovaccer. 'By embedding intelligence and automation directly into their daily workflow, EQUIPP Copilot ™ turns every pharmacy into a proactive care hub. This is a key step toward a more connected, collaborative healthcare system, one where data drives smarter decisions and better outcomes at every touchpoint.' The launch of EQUIPP Copilot ™ arrives as pharmacies face growing pressure to expand their clinical roles amid staffing constraints, shifting incentives, and the decentralization of care. The solution is purpose-built to support independent pharmacies, chains and health plans seeking scalable, real-time engagement tools. EQUIPP Copilot ™ pre-registrations are open now with general availability in Q3 2025. The platform is offered to existing customers via a flexible freemium model, with advanced capabilities available à la carte to fit pharmacies of all sizes and needs. About PQS by Innovaccer PQS by Innovaccer aligns healthcare payers and pharmacies to achieve their shared goals of better patient outcomes and healthcare quality performance. As a neutral, trusted intermediary supporting the evolution of value-based care, PQS facilitates nationwide pharmacy-based care through our partners and the EQUIPP ® platform. Utilizing deep clinical pharmacy knowledge and over a decade of performance management experience, we help clients develop strategies, implement quality improvement programs, and optimize the quality of healthcare for their populations served. For more information on how PQS can support you, please visit View source version on CONTACT: Press Contact: Arushi Awasthi Innovaccer Inc. [email protected] 415-562-2139 KEYWORD: UNITED STATES NORTH AMERICA CALIFORNIA INDUSTRY KEYWORD: SOFTWARE MANAGED CARE GENERAL HEALTH PHARMACEUTICAL DATA MANAGEMENT PAYMENTS APPS/APPLICATIONS TECHNOLOGY HOSPITALS ARTIFICIAL INTELLIGENCE PRACTICE MANAGEMENT HEALTH SOURCE: Innovaccer Inc. Copyright Business Wire 2025. PUB: 05/20/2025 08:15 AM/DISC: 05/20/2025 08:14 AM
Associated Press
19-05-2025
- Health
- Associated Press
Greater Good Health Appoints Value-Based Care Expert Derek Chao, MD as Independent Board Member
EL SEGUNDO, Calif.--(BUSINESS WIRE)--May 19, 2025-- Greater Good Health, a premier partner to risk-bearing organizations in managing total cost of care, is pleased to announce the appointment of Derek Chao, MD as its newest independent board member. Dr. Chao, who currently serves as the Chief Executive Officer of Optum West, brings more than two decades of expertise in value-based care strategy. He has held multiple key leadership positions at Optum, DaVita Medical Group and Healthcare Partners. With a proven track record of driving growth and innovation, Dr. Chao will play a pivotal role in guiding Greater Good Health's strategic direction and ensuring its continued success in delivering high-quality healthcare services and managing total cost of care. This press release features multimedia. View the full release here: Derek Chao, MD joins Greater Good Health Board as Independent Board Member 'Derek's experience in guiding all elements of value-based care is invaluable as Greater Good Health continues to scale and drive medical cost management,' said Tyler Jung, MD, Chief Medical Officer of Greater Good Health. 'A trailblazer in managing the true cost of care, his clinical background as a nephrologist and hospitalist, coupled with his deep knowledge of the key levers in managing complex populations across the country, make him an incredible fit for our team.' Greater Good Health Chief Executive Officer, Sylvia Hastanan adds, 'I am thrilled to have Derek join our Board and I know that his impact on Greater Good Health will be significant.' Greater Good Health is a clinical care organization that enables longitudinal care through value-based care to optimize medical cost management. Through its nurse practitioner-led models, it is directly solving the challenges of rising medical costs and an increasing primary care physician shortage across the country. As part of its comprehensive suite of services, Greater Good Health partners with health plans in access-starved markets and operates its own primary care clinics for seniors. 'Across the industry, healthcare organizations are struggling with medical expenses, total cost of care and sub-optimal outcomes, and the team at Greater Good Health has demonstrated an unwavering focus on pragmatically solving these problems,' said Dr. Chao. 'Our shared commitment to expanding value-based care makes this a natural fit for me. l look forward to collaborating with the Board and management team to drive strategic initiatives that will enhance Greater Good Health's impact on our healthcare system.' About Greater Good Health Greater Good Health is a premier partner for risk-bearing organizations in managing total cost of care. The company is enabling and expanding access to value-based primary care through its innovative suite of clinical solutions and its own primary care clinics for seniors in underserved communities. Greater Good Health's proven Nurse Practitioner-led model reduces unnecessary costs, improves clinical outcomes and delivers a best-in-class patient experience. For more information, visit View source version on CONTACT: Matt Gagalis Chief Commercial Officer Greater Good Health [email protected] KEYWORD: UNITED STATES NORTH AMERICA CALIFORNIA INDUSTRY KEYWORD: MANAGED CARE HOSPITALS HEALTH SOURCE: Greater Good Health Copyright Business Wire 2025. PUB: 05/19/2025 10:43 AM/DISC: 05/19/2025 10:42 AM
Globe and Mail
15-05-2025
- Business
- Globe and Mail
New FTI Consulting Survey Reveals Mounting Challenges Continue for U.S. Hospitals
WASHINGTON, May 15, 2025 (GLOBE NEWSWIRE) -- FTI Consulting, Inc. (NYSE: FCN) today announced findings from its annual Hospital Operations Outlook Survey of more than 200 senior executives across all types of hospitals. The survey found rising costs, patient wait times, workforce challenges and persistent cybersecurity threats are among the top issues highlighted by hospital leaders. These issues — bundled with an increasingly complex operating environment shaped by regulatory changes, such as potential Medicaid cuts from the federal government, inflationary pressures and growing patient demand — make adaptability and nimbleness in an organization's ability to quickly respond to these challenges critical. Moreover, clear and strategic communications to stakeholders about the mounting pressures and plans to address them are more important than ever to maintain support inside and outside the hospital. To protect their reputation and fulfill their mission, hospital leaders must stay closely connected with stakeholders while embracing value-based care, digital innovation, workforce investment and proactive cybersecurity risk mitigation as part of a broader strategic plan. 'Healthcare leaders are at a crossroads, juggling financial pressures with the need to deliver high-quality care, support hospital staff and improve patient outcomes,' said Lauren Crawford Shaver, Head of Healthcare & Life Sciences for the Americas within the Strategic Communications segment at FTI Consulting. 'At the same time, adaptation to the digital era demands investment in modern infrastructure, robust cybersecurity and AI-driven efficiencies. And with the regulatory landscape in constant flux, staying ahead requires more than strategy and vision. It takes agility to lead in a world that won't stand still.' Key findings from the survey: Workforce management costs dominate financial concerns, with 34% of respondents citing recruitment, retention and agency staffing expenses as critical stressors. Cybersecurity threats remain top of mind, identified by half of respondents (50%) as their top digital concern, driven primarily by the concern for potential data breaches and operational disruptions. Workforce shortages persist, with 48% of executives feeling their hospitals are unprepared for current patient volumes, particularly in specialist (49%) and nursing roles (46%). Hospitals continue shifting toward value-based care, with hospitals reporting 42% of patient populations now participate in value-based care models due to better care coordination and improved patient outcomes as reported by 91% of respondents. 'Hospital executives are seeing promising, sustainable results when it comes to value-based care. This model is increasingly viewed as a smart, strategic approach in today's evolving healthcare environment given ongoing challenges such as market pressures and a shifting regulatory landscape,' said Paul Dioguardi, a Managing Director in FTI Consulting's Healthcare Risk Management & Advisory practice. 'In today's fast-evolving healthcare landscape, hospital leaders must make decisions that build resilient organizations,' said Rebecca Ayer Pitt, a Managing Director in FTI Consulting's Corporate Reputation practice within the Strategic Communications segment. 'This means investing in their workforce and value-based care as well as strengthening digital and cybersecurity capabilities. Most importantly, communicating proactively and transparently about strategic decisions and actions will build and maintain stakeholder confidence and support. In doing so, health systems will be better positioned to face the demands of the current healthcare environment without losing sight of what matters most — delivering exceptional care and patient outcomes.' About the Survey This research was conducted online by FTI Consulting's Strategic Communications segment between March 3, 2025 and March 12, 2025, with more than 200 senior executives across all types of hospitals and 17 mid-level leaders of academic hospitals. Overall, 60 respondents represent academic hospitals, 96 are part of a health system and 47 are hospitals not affiliated with health systems. 'FTI Consulting's Hospital Operations Outlook Survey offers healthcare leaders valuable insights into the headwinds and tailwinds being experienced by hospital and health system executives,' said James Condon, a Managing Director and Head of Research for the Americas in the Strategic Communications segment at FTI Consulting. 'The survey is designed to provide a holistic perspective on current industry pressures, and highlights innovative, forward-thinking, technology-driven solutions that are being leveraged by hospitals to adapt to and overcome these hardships.' The full survey report is available here. About FTI Consulting FTI Consulting, Inc. is a leading global expert firm for organizations facing crisis and transformation, with more than 8,100 employees located in 33 countries and territories as of March 31, 2025. In certain jurisdictions, FTI Consulting's services are provided through distinct legal entities that are separately capitalized and independently managed. The Company generated $3.70 billion in revenues during fiscal year 2024. More information can be found at FTI Consulting, Inc. 555 12 th Street NW Washington, DC 20004 +1.202.312.9100 Investor Contact: Mollie Hawkes +1.617.747.1791 Media Contact: Matthew Bashalany +1.617.897.1545
Forbes
13-05-2025
- Business
- Forbes
Back As UnitedHealth Group CEO, Hemsley Says Issues Can Be Resolved
UnitedHealth Group chief executive officer Stephen J. Hemsley, returning to the healthcare giant's top job after Andrew Witty abruptly stepped down Tuesday said the company has the right strategy in place 'for the era ahead.' Though the 72-year-old Hemsley never really left UnitedHealth when he stepped down as CEO in 2017, remaining chairman of the board now through two of his successors, his leadership was known for calm and steady financial performance. Seldom did UnitedHealth under Hemsley's 13 years as CEO surprise Wall Street analysts and investors with anything other than meeting or beating quarterly earnings expectations. In a memo Tuesday morning to employees, Hemsley said UnitedHealth has "the right strategy and structure for the era ahead, especially in the face of a health system that can be disconnected, inconsistent and inequitable.' 'Our mission, our culture, our diverse business model and our value-based care approaches have made meaningful progress to overcome these issues; our task now is to execute even more urgently and precisely along this path moving forward," Hemsley added. "We are also well along in critical efforts to drive innovation, breakthrough AI applications and distinctive consumer capabilities. These and other modernization and simplification efforts should play powerfully into our future.' UnitedHealth, which owns the nation's largest health insurance company in UnitedHealthcare, is also a nationwide provider of medical care services under the Optum umbrella, which includes Optum Rx, Optum Health and its various outpatient clinics, centers and doctor practices as well as other healthcare services. But in the last two years, UnitedHealth hit rocky times under Witty even though a lot of the problems were out of his control. Last year ended following the December 4 shooting death of UnitedHealthcare chief executive Brian Thompson, which unleashed a barrage of scrutiny on health insurer denials of medical care and certain other business practices from social media trolls and industry critics including some in Congress who say they'd like to see reform. UnitedHealth, along with most other rival health insurers, have largely remained dark ever since the shooting of Thompson with few press releases and have stripped executive pictures, biographies and other information from their websites. The shooting came just as UnitedHealth was recovering from a February 2024 cyberattack on the company's Change Healthcare business that triggered chaos for physicians and medical care providers across the country, paralyzing Change Healthcare's massive billing and payment system. The attack triggered a shutdown of parts of Change Healthcare's electronic system, leaving doctors and other providers of medical care without the ability to get insurance approval of patient services. Hemsley praised Witty's performance in the memo to UnitedHealth employees. 'It is a great honor for me to follow Andrew Witty in this role,' Hemsley wrote. 'The way he has guided UnitedHealth Group showed he was the right leader for an extremely difficult time. Andrew's character, compassion and commitment shine through every day. Throughout some of the most challenging years this company has faced, Andrew has remained focused on how best to support our customers, consumers, employees and owners.' Hemsley, who will turn 73 years old in June, retired in 2017 after 13 years and was replaced by Dave Wichmann, who was picked internally and was UnitedHealth CEO until Witty was elevated to the top job in February of 2021. Witty, who had been on UnitedHealth's board and already run the British drug giant GlaxoSmithKline, had been hired in 2018 to run Optum. Despite the cyberattack and the shooting of Thompson, UnitedHealth continued to churn out billions of dollars in profits with all businesses growing across the company. In April, however, UnitedHealth lowered its '2025 performance outlook established in December 2024 to net earnings of $24.65 to $25.15 per share and adjusted earnings of $26 to $26.50 per share.' That compares to a forecast affirmed in January that said net earnings would be '$28.15 to $28.65 per share." UnitedHealth's share price took a major hit in April after disclosing the lowered guidance even though the company's health insurance plans and Optum businesses are growing with the company, reporting more than $6 billion in first quarter profits. On Tuesday, UnitedHealth surprised investors and Wall Street analysts again by suspendeding its 2025 outlook 'as care activity continued to accelerate while also broadening to more types of benefit offerings than seen in the first quarter, and the medical costs of many Medicare Advantage beneficiaries new to UnitedHealthcare remained higher than expected,' the company said. 'The company expects to return to growth in 2026.' In his memo to employees, Hemsley said he is 'optimistic' about the company's 'future since many of the issues standing in the way of achieving our goals are within our capacity to resolve. 'I know we will approach them with humility, rigor and urgency, guided as always by our mission to help people live healthier lives and help make the health system work better for everyone,' Hemsley said. 'UnitedHealth Group, UnitedHealthcare and Optum share an exceptional mission and role in our society,' Hemsley said. 'We have an exceptionally capable organization to advance that mission, which deserves a performance that is up to the full potential of our enterprise — the hearts and minds and spirit of all of us, every day, in everything we do. If we can harness that, we will all be part of a legacy of remarkable contributions to our society, from the individual needing care to the national health system whose resources we all depend upon.'
Yahoo
08-05-2025
- Business
- Yahoo
NeueHealth Reports First Quarter 2025 Results
Delivered strong first quarter performance as care model continues to resonate with consumers, providers, and payors across the healthcare industry Drove positive Adjusted EBITDA for the fifth consecutive quarter, providing a strong foundation for continued success in 2025 and beyond Served approximately 709,000 consumers, an increase of 51% over the first quarter of 2024 DORAL, Fla., May 08, 2025--(BUSINESS WIRE)--NeueHealth, Inc. ("NeueHealth" or the "Company") (NYSE: NEUE), the value-driven healthcare company, today reported financial results for its first quarter ended March 31, 2025. "We are starting 2025 in a very strong position, generating substantial growth in the number of consumers we serve and delivering another quarter of Adjusted EBITDA profitability," said Mike Mikan, President and CEO of NeueHealth. "Our value-driven, consumer-centric care model is compelling, and we continue to see it resonate with the market as we align interests to create a seamless, more coordinated care experience for consumers, providers, and payors. This year, we are focused on driving long-term, sustainable growth and building on the relationships we have formed across the industry. I am excited for all we will achieve in 2025 and beyond." Key Metrics As of March 31, 2025 2024 Consumer and Patient Metrics Value-Based Consumers served 571,000 360,000 Enablement Services Lives 138,000 109,000 Three Months Ended ($ in thousands) March 31, 2025 2024 Financial Metrics Revenue $ 215,787 $ 245,095 Net Loss $ (10,848 ) $ (4,177 ) Net Income (Loss) from Continuing Operations $ (1,438 ) $ 5,688 Adjusted EBITDA (non-GAAP) $ 13,478 $ 3,657 See the table at the end of this release for additional information and a reconciliation of the non-GAAP measures used in the table above. See table at the end of this release for more detail. Earnings Conference Call As previously announced, NeueHealth will discuss the Company's results, strategy, and outlook on a conference call with investors at 8:00 a.m. Eastern Time today. NeueHealth will host a live webcast of this conference call which can be accessed from the Investor Relations page of the Company's website ( Following the call, a webcast replay will be available on the same site. This earnings release and the Form 8-K filed May 8, 2025 can be accessed on the Investor Relations page of the Company's website. We routinely post important information on our website, including corporate and investor presentations and financial information. We intend to use our website as a means of disclosing material, non-public information and for complying with our disclosure obligations under Regulation FD. Such disclosures will be included in the Investor Relations section of our website. Accordingly, investors should monitor this portion of our website, in addition to following our press releases, U.S. Securities and Exchange Commission ("SEC") filings and public conference calls and webcasts. About NeueHealth NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, NeueHealth helps to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid. NeueHealth delivers high-quality clinical care to over 700,000 health consumers through owned clinics and unique partnerships with over 3,000 affiliated providers. We also enable independent providers and medical groups to thrive in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. We believe our value-driven, consumer-centric care model can transform the healthcare experience and maximize value across the healthcare system. For more information, visit: Important Additional Information and Where to Find It On December 23, 2024, the Company entered into an Agreement and Plan of Merger (the "Merger Agreement") with NH Holdings 2025, Inc. ("Parent"), pursuant to which, if all applicable conditions are satisfied or waived, the Company will become a wholly owned subsidiary of Parent (the "Transaction"). Parent is indirectly controlled by private investment funds affiliated with New Enterprise Associates, Inc. ("NEA"). In connection with the Transaction, the Company has filed with the U.S. Securities and Exchange Commission a preliminary proxy statement on Schedule 14A (the "Proxy Statement"), the definitive version of which has been sent or provided to Company stockholders. The Company, affiliates of the Company and affiliates of NEA have jointly filed a transaction statement on Schedule 13E-3 (the "Schedule 13E-3") with the SEC. The Company has also filed or may also file other documents with the SEC regarding the transaction. This release is not a substitute for the Proxy Statement, the Schedule 13E-3 or any other document which the Company has filed or may file with the SEC. INVESTORS AND SECURITY HOLDERS ARE URGED TO READ THE PROXY STATEMENT, THE SCHEDULE 13E-3 AND ANY OTHER RELEVANT DOCUMENTS THAT ARE FILED OR WILL BE FILED WITH THE SEC, AS WELL AS ANY AMENDMENTS OR SUPPLEMENTS TO THESE DOCUMENTS, CAREFULLY AND IN THEIR ENTIRETY BEFORE MAKING ANY VOTING OR INVESTMENT DECISION WITH RESPECT TO THE COMPANY OR THE TRANSACTION BECAUSE THESE DOCUMENTS CONTAIN OR WILL CONTAIN IMPORTANT INFORMATION ABOUT THE TRANSACTION AND RELATED MATTERS. Investors and security holders may obtain free copies of the Proxy Statement, the Schedule 13E-3 and other documents that are filed or will be filed with the SEC by the Company, when such documents become available, through the website maintained by the SEC at or through the Company's website at The Transaction will be implemented solely pursuant to the Merger Agreement, which contains the full terms and conditions of the transaction. Participants in the Solicitation The Company and certain of its directors, executive officers and employees may be deemed to be participants in the solicitation of proxies from stockholders of the Company in connection with the proposed transaction. Information regarding the Company's directors and executive officers is available in the definitive proxy statement for the 2025 annual meeting of stockholders of the Company, which was filed by the Company with the SEC on April 30, 2025 (the "Annual Meeting Proxy Statement"). Please refer to the sections captioned "Executive Compensation," "Director Compensation," and "Security Ownership of Certain Beneficial Owners and Management" in the Annual Meeting Proxy Statement and the section captioned "Security Ownership of Certain Beneficial Owners and Management" in the Proxy Statement. Other information regarding the participants in the proxy solicitation and a description of their direct and indirect interests, by security holdings or otherwise, may be contained in other relevant materials to be filed with the SEC in connection with the proposed Transaction when they become available. Free copies of the Proxy Statement and such other materials may be obtained as described in the preceding paragraph. Forward-Looking Statements This release contains certain "forward-looking statements" within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Statements made in this release that are not statements of historical fact, including statements about our beliefs and expectations, are forward-looking statements and should be evaluated as such. Forward-looking statements include information concerning possible or assumed future results of operations, including descriptions of our business plan and strategies, as well as statements regarding timing, completion, and effects of the Transaction. These statements often include words such as "anticipate," "expect," "plan," "believe," "intend," "project," "forecast," "estimates," "projections," "outlook," "ensure," and other similar expressions. These forward-looking statements include any statements regarding our plans and expectations. Such forward-looking statements are subject to various risks, uncertainties and assumptions. Accordingly, there are or will be important factors that could cause actual outcomes or results to differ materially from those indicated in these statements. Factors that might materially affect such forward-looking statements include: the failure to complete the Transaction on the anticipated terms and within the anticipated timeframe, including as a result of failure to obtain required stockholder or regulatory approvals or to satisfy other closing conditions; potential litigation relating to the Transaction that could be instituted against NEA, the Company or their respective affiliates, directors, managers, officers or employees, and the effects of any outcomes related thereto; potential adverse reactions or changes to our business relationships or operating results resulting from the announcement, pendency or completion of the Transaction; the risk that our stock price may decline significantly if the Transaction is not consummated; certain restrictions during the pendency of the Transaction that may impact our ability to pursue certain business opportunities or strategic transactions; costs associated with the Transaction, which may be significant; the occurrence of events, changes or other circumstances that could give rise to the termination of the Merger Agreement, including in circumstances requiring us to pay a termination fee; our ability to continue as a going concern; expectations and outcomes related to the NEA Merger Agreement; our ability to comply with the terms of our credit facility or any credit facility into which we enter in the future; our ability to obtain any short or long term debt or equity financing needed to operate our business; our ability to quickly and efficiently complete the wind down of our remaining Individual and Family Plan ("IFP") businesses and MA businesses outside of California, including by satisfying liabilities of those businesses when due and payable; potential disruptions to our business due to the Transaction or corporate restructuring and any resulting headcount reduction; our ability to accurately estimate and effectively manage the costs relating to changes in our business offerings and models; a delay or inability to withdraw regulated capital from our subsidiaries; a lack of acceptance or slow adoption of our business model; our ability to retain existing consumers and expand consumer enrollment; our and our Care Partner's abilities to obtain and accurately assess, code, and report risk adjustment factor scores; our ability to contract with care providers and arrange for the provision of quality care; our ability to accurately estimate medical expenses; our ability to obtain claims information timely and accurately; the impact of any pandemic or epidemic on our business and results of operations; the risks associated with our reliance on third-party providers to operate our business; the impact of modifications or changes to the U.S. health insurance markets; the impact of changes to federal funding for government healthcare programs; our ability to manage any growth of our business; our ability to operate, update or implement our technology platform and other information technology systems; our ability to retain key executives; our ability to successfully pursue acquisitions and integrate acquired businesses and divest businesses as needed; the occurrence of severe weather events, catastrophic health events, natural or man-made disasters, and social and political conditions or civil unrest; our ability to prevent and contain data security incidents and the impact of data security incidents on our members, patients, employees and financial results; our ability to comply with requirements to maintain effective internal controls; the outcome of threatened or pending litigation and risks of future legal disputes; the impacts resulting from new (or change to existing) laws, regulations and executive actions; our ability to mitigate risks associated with our ACO REACH and related businesses, including any unanticipated market or regulatory developments; and the other factors set forth under the heading "Risk Factors" in the Company's reports on Form 10-K, Form 10-Q, and Form 8-K (including all amendments to those reports) and our other filings with the SEC. Except as required by law, we undertake no obligation to update publicly any forward-looking statements for any reason after the date of this release to conform these statements to actual results or changes in our expectations. NeueHealth, Inc. and Subsidiaries Consolidated Balance Sheets (in thousands, except share and per share data) (Unaudited) March 31, 2025 December 31, 2024 Assets Current assets: Cash and cash equivalents $ 138,101 $ 83,295 Short-term investments 7,004 9,871 Accounts receivable, net of allowance of $24 and $27, respectively 41,716 36,594 ACO REACH performance year receivable 468,346 95,075 Current assets of discontinued operations 94,467 173,006 Prepaids and other current assets 38,572 36,807 Total current assets 788,206 434,648 Other assets: Property, equipment and capitalized software, net 11,108 11,240 Intangible assets, net 68,576 71,064 Other non-current assets 27,790 27,431 Total other assets 107,474 109,735 Total assets $ 895,680 $ 544,383 Liabilities, Redeemable Noncontrolling Interest, Redeemable Preferred Stock and Shareholders' Equity (Deficit) Current liabilities: Medical costs payable $ 113,850 $ 124,360 Accounts payable 5,451 6,298 Short-term borrowings 1,000 2,000 ACO REACH performance year obligation 382,478 — Current liabilities of discontinued operations 335,181 344,651 Risk share payable to deconsolidated entity 123,981 123,981 Warrant liability 27,089 29,738 Other current liabilities 75,022 79,200 Total current liabilities 1,064,052 710,228 Long-term borrowings 207,400 202,614 Other liabilities 17,200 17,649 Total liabilities 1,288,652 930,491 Commitments and contingencies Redeemable noncontrolling interests 47,769 48,580 Redeemable Series A preferred stock, 0.0001 par value; 750,000 shares authorized in 2025 and 2024; 750,000 shares issued and outstanding in 2025 and 2024 747,481 747,481 Redeemable Series B preferred stock, 0.0001 par value; 175,000 shares authorized in 2025 and 2024; 175,000 shares issued and outstanding in 2025 and 2024 172,936 172,936 Shareholders' equity (deficit): Common stock, 0.0001 par value; 3,000,000,000 shares authorized in 2025 and 2024; 8,927,758 and 8,320,959 shares issued and outstanding in 2025 and 2024, respectively 1 1 Additional paid-in capital 3,105,109 3,099,423 Accumulated deficit (4,454,268 ) (4,442,529 ) Accumulated other comprehensive loss — — Treasury stock, at cost, 31,526 shares at December 31, 2025 and 2024 (12,000 ) (12,000 ) Total shareholders' equity (deficit) (1,361,158 ) (1,355,105 ) Total liabilities, redeemable noncontrolling interests, redeemable preferred stock and shareholders' equity (deficit) $ 895,680 $ 544,383 NeueHealth, Inc. and Subsidiaries Consolidated Statements of Income (Loss) (in thousands, except share and per share data) (Unaudited) Three Months Ended March 31, 2025 2024 Revenue: Capitated revenue $ 80,987 $ 61,466 ACO REACH revenue 124,040 171,811 Service revenue 9,834 11,615 Investment income 926 203 Total revenue 215,787 245,095 Operating expenses: Medical costs 160,894 196,874 Operating costs 48,673 66,761 Depreciation and amortization 3,559 4,562 Total operating expenses 213,126 268,197 Operating income (loss) 2,661 (23,102 ) Interest expense 6,637 2,930 Warrant income (2,649 ) (2,072 ) Gain on troubled debt restructuring — (30,311 ) (Loss) Income from continuing operations before income taxes (1,327 ) 6,351 Income tax expense 111 663 Net loss (income) from continuing operations (1,438 ) 5,688 Loss from discontinued operations, net of tax (9,410 ) (9,865 ) Net Loss (10,848 ) (4,177 ) Net income from continuing operations attributable to noncontrolling interests (891 ) (11,737 ) Series A preferred stock dividend accrued (10,729 ) (10,294 ) Series B preferred stock dividend accrued (2,407 ) (2,310 ) Net loss attributable to NeueHealth, Inc. common shareholders $ (24,875 ) $ (28,518 ) Basic and loss income per share attributable to NeueHealth, Inc. common shareholders Continuing operations $ (1.80 ) $ (2.31 ) Discontinued operations (1.10 ) (1.22 ) Basic and diluted loss per share (2.90 ) (3.53 ) Basic and diluted weighted-average common shares outstanding 8,570 8,079 NeueHealth, Inc. and Subsidiaries Consolidated Statements of Cash Flows (in thousands) (Unaudited) Three Months Ended March 31, 2025 2024 Cash flows from operating activities: Net loss $ (10,848 ) $ (4,177 ) Adjustments to reconcile net loss to net cash provided by operating activities: Depreciation and amortization 3,559 4,562 Share-based compensation 5,565 18,627 Payment-In-Kind ("PIK") Interest 4,371 — Gain on troubled debt restructuring — (30,311 ) Net accretion of investments (181 ) (34 ) Loss on disposal of property, equipment, and capitalized software 87 245 Other, net 493 2 Changes in assets and liabilities, net of acquired assets and liabilities: Accounts receivable (5,122 ) (850 ) ACO REACH performance year receivable (373,271 ) (530,749 ) Other assets (120 ) (3,507 ) Medical cost payable (15,495 ) (13,263 ) Risk adjustment payable (4,996 ) (11,224 ) Accounts payable and other liabilities (4,920 ) (5,612 ) Unearned revenue — (11 ) Warrant liability (2,649 ) (2,072 ) Risk share payable to deconsolidated entity 382,478 529,657 Net cash used in operating activities (21,049 ) (48,717 ) Cash flows from investing activities: Purchases of investments (1,195 ) — Proceeds from sales, paydown, and maturities of investments 4,258 2,321 Purchases of property and equipment (1,026 ) (64 ) Proceeds from sale of business, net 61,139 196,130 Net cash provided by investing activities 63,176 198,387 Cash flows from financing activities: Repayments of short-term borrowings (1,000 ) (273,636 ) Distributions to noncontrolling interest holders (1,702 ) (1,884 ) Net cash used in financing activities (2,702 ) (275,520 ) Net increase (decrease) in cash and cash equivalents 39,425 (125,850 ) Cash and cash equivalents – beginning of year $ 185,405 $ 375,280 Cash and cash equivalents – end of period $ 224,830 $ 249,430 NeueHealth, Inc. and Subsidiaries Segment Information (in thousands) (Unaudited) NeueCare ($ in thousands) Three Months Ended March 31, Statement of income (loss) and operating data: 2025 2024 Revenue: Capitated revenue $ 80,987 $ 61,466 Service revenue 6,264 9,530 Investment income 357 — Total unaffiliated revenue 87,608 70,996 Affiliated revenue 2,909 2,627 Total segment revenue 90,517 73,623 Operating expenses Medical Costs 37,518 27,436 Operating Costs 27,210 32,589 Depreciation and amortization 2,782 3,786 Total operating expenses 67,510 63,811 Operating income (loss) $ 23,007 $ 9,812 NeueSolutions ($ in thousands) Three Months Ended March 31, Statement of income (loss) and operating data: 2025 2024 Revenue: ACO REACH revenue $ 124,040 $ 171,811 Service revenue 3,570 2,085 Total segment revenue 127,610 173,896 Operating expenses Medical Costs 126,285 172,065 Operating Costs 4,317 4,763 Total operating expenses 130,602 176,828 Operating income (loss) $ (2,992 ) $ (2,932 ) Non-GAAP Financial Measures We use the non-GAAP financial measures Adjusted EBITDA and Adjusted Operating Cost Ratio. We define Adjusted EBITDA as Net Loss excluding loss from discontinued operations, interest expense, income taxes, depreciation and amortization, transaction costs, share-based and other long-term compensation expense, impact of troubled debt restructuring, restructuring and contract termination costs, impairment of goodwill and long-lived assets, losses related to the bankruptcy of one of our ACO REACH partners, impact of classifying certain of our operations as held-for-sale, and changes in the fair value of derivatives. We define Adjusted Operating Cost Ratio as Operating Cost Ratio excluding share-based compensation expense. These non-GAAP measures have been presented in this quarterly Earnings Release or in the earnings conference call and related materials as supplemental measures of financial performance that are not required by or presented in accordance with GAAP because we believe they assist management and investors in comparing our operating performance across reporting periods on a consistent basis by excluding and including items that we do not believe are indicative of our core operating performance. Management believes these measures are useful to investors in highlighting trends in our operating performance, while other measures can differ significantly depending on long-term strategic decisions regarding capital structure, the tax jurisdictions in which we operate and capital investments. Management uses Adjusted EBITDA and Adjusted Operating Cost Ratio to supplement GAAP measures of performance in the evaluation of the effectiveness of our business strategies, to make budgeting decisions, to establish discretionary annual incentive compensation and to compare our performance against that of other peer companies using similar measures. Management supplements GAAP results with non-GAAP financial measures to provide a more complete understanding of the factors and trends affecting the business than GAAP results alone. Adjusted EBITDA is not a recognized term under GAAP and should not be considered as an alternative to Net Income (Loss) as a measure of financial performance or any other performance measure derived in accordance with GAAP. Additionally, Adjusted EBITDA is not intended to be a measure of free cash flow available for management's discretionary use as it does not consider certain cash requirements such as interest payments, tax payments and debt service requirements. The presentation of Adjusted EBITDA has limitations as an analytical tool and should not be considered in isolation or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentation of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company. Adjusted Operating Cost Ratio is not a recognized term under GAAP and should not be considered as an alternative to Operating Cost Ratio as a measure of financial performance or any other performance measure derived in accordance with GAAP. The presentation of Adjusted Operating Cost Ratio has limitations as an analytical tool and should not be considered in isolation or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentation of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company. The following table provides a reconciliation of net loss to Adjusted EBITDA for the periods presented: Three Months Ended March 31, ($ in thousands) 2025 2024 Net Loss $ (10,848 ) $ (4,177 ) Loss from Discontinued Operations 9,410 9,865 EBITDA adjustments from continuing operations Interest expense 6,637 2,930 Income tax expense 111 663 Depreciation and amortization (g) 3,559 4,067 Transaction costs (a) 1,614 1,121 Share-based and other long-term incentive compensation expense (b) 5,644 18,627 Gain on troubled debt restructuring — (30,311 ) Change in fair value of warrant liability (c) (2,649 ) (2,072 ) Restructuring and contract termination costs (d) — (58 ) Held-for-sale operations (e) — 1,623 ACO REACH care partner bankruptcy (f) — 1,248 Impairment of goodwill and long-lived assets — 131 EBITDA adjustments from continuing operations $ 14,916 $ (2,031 ) Adjusted EBITDA $ 13,478 $ 3,657 (a) Transaction related costs include accounting, tax, valuation, consulting, legal and investment banking fees directly relating to financing initiatives and acquisitions or dispositions. These costs can vary from period to period and impact comparability, and we do not believe such transaction costs reflect the ongoing performance of our business. (b) Represents non-cash compensation expense related to stock option and restricted stock unit award grants, which can vary from period to period based on several factors, including the timing, quantity and grant date fair value of the awards. Also includes $0.1 million of compensation expense that was recognized for the cancellation of P-Unit Awards in relation to our purchase of the minority interest in Centrum for the three months ended March 31, 2025. There was no equivalent compensation expense included within for the three months ended March 31, 2024. (c) Represents the non-cash change in the fair value of the warrant liability established for warrants included in our financing arrangements, which are remeasured at fair value each reporting period. (d) Restructuring and contract termination costs represent severance costs as part of a workforce reduction, amounts paid for early termination of leases, and impairment of certain long-lived assets primarily relating to our decision to exit the Commercial business for the 2023 plan year. (e) Beginning in the second quarter of 2024, Adjusted EBITDA excludes the impact of our operations classified as held-for-sale that were subsequently sold in November 2024; the comparable 2024 period has been recast to exclude these impacts. (f) Represents the costs expected to be incurred as a result of one of our ACO REACH care partners filing for bankruptcy; includes the full allowance established for the outstanding receivable and ongoing costs incurred to manage and provide service to members attributed to the care partner that would have otherwise been reimbursed prior to the care partner's bankruptcy. (g) Adjustment has been updated to remove the impact of our held-for-sale operations that are adjusted for in their entirety as described in (e). The following table provides a reconciliation of Adjusted Operating Cost Ratio for the periods presented: Three Months Ended March 31, 2025 2024 Operating Cost Ratio 22.6 % 27.2 % Impact of share-based and other long-term incentive compensation expense (a) (2.6) % (7.6) % Impact of held-for-sale operations (b) 0.0 % (2.4) % Impact of transaction related costs (c) (0.7) % (0.5) % Adjusted Operating Cost Ratio 19.3 % 16.7 % (a) Represents non-cash compensation expense related to stock option and restricted stock unit award grants, which can vary from period to period based on several factors, including the timing, quantity and grant date fair value of the awards. Also includes $0.1 million of compensation expense that was recognized for the cancellation of P-Unit Awards in relation to our purchase of the minority interest in Centrum for the three months ended March 31, 2025. There was no equivalent compensation expense included within for the three months ended March 31, 2024. (b) Represents the impact of revenue and operating costs related to our operations classified as held-for-sale beginning in the second quarter of 2024. The sale was completed in November 2024. (c) Transaction related costs include accounting, tax, valuation, consulting, legal and investment banking fees directly relating to financing initiatives and acquisitions or dispositions. These costs can vary from period to period and impact comparability, and we do not believe such transaction costs reflect the ongoing performance of our business. View source version on Contacts Investor Contact: IR@ Media Contact: media@
