agilon health Reports Fourth Quarter and Full Year Fiscal 2025 Results
WESTERVILLE, Ohio--( BUSINESS WIRE)--agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, today announced results for the fourth quarter and fiscal year ended December 31, 2025.
“2025 was a pivotal year for agilon. We confronted challenges head-on and focused our actions to accelerate meaningful transformation across the company — enhancing execution, improving operating discipline, and fundamentally strengthening the economics of our model,” stated Ronald A. Williams, Executive Chair. "While we were not satisfied by our 2025 financial performance, the transformation initiatives are delivering tangible benefits which support our expectation for material improvement in 2026. Based on the progress we have made and the momentum we are carrying into 2026, I am confident in our trajectory and firmly believe agilon and our partners are entering the next phase with a stronger foundation, a more resilient model, and a clear path to sustainable value creation."
Fourth Quarter and Fiscal Year 2025 Results:
Key Financial and Operating Metrics ($M):
(Fourth Quarter 2025 vs. 2024)
Three Months
Ended December 31,
Change
2025
2024
% YoY
Medicare Advantage Members 1
511,000
527,000
(3%)
ACO Model Members 1, 2
114,000
132,000
(14%)
Total Members Live on Platform 1, 2
625,000
659,000
(5%)
Avg. Medicare Advantage Members
540,000
527,000
2%
Total Revenues
$1,569
$1,522
3%
Gross Profit (Loss)
($91)
($38)
(137%)
Medical Margin
($74)
$1
NM
Net Income (Loss)
($189)
($106)
(79%)
Adjusted EBITDA 3
($142)
($84)
(69%)
Geography Entry Costs
$9
$11
(18%)
Key Financial and Operating Metrics ($M):
(Fiscal Year 2025 vs. 2024)
Twelve Months
Ended December 31,
Change
2025
2024
% YoY
Medicare Advantage Members 1
511,000
527,000
(3%)
ACO Model Members 1, 2
114,000
132,000
(14%)
Total Members Live on Platform 1, 2
625,000
659,000
(5%)
Avg. Medicare Advantage Members
510,000
522,000
(2%)
Total Revenues
$5,933
$6,061
(2%)
Gross Profit (Loss)
$(160)
$5
NM
Medical Margin
$(57)
$205
(128%)
Net Income (Loss)
($391)
($260)
(50%)
Adjusted EBITDA 3
($296)
($154)
(92%)
Geography Entry Costs
$26
$34
(24%)
Capital Position and Balance Sheet:
agilon health’s balance sheet as of December 31, 2025 included cash, cash equivalents and marketable securities of $285 million and total debt of $35 million. At the end of the quarter, agilon health had $91 million of cash associated with the Company’s unconsolidated ACO model entities.
First Quarter and Fiscal Year 2026 Guidance and Assumptions
Guidance ($M):
Quarter Ended
March 31, 2026
Year Ended
December 31, 2026
Low
High
Low
High
Medicare Advantage Members 1
431,000
441,000
425,000
435,000
ACO Model Members 1, 2
105,000
110,000
100,000
105,000
Total Members Live on Platform 1
536,000
551,000
525,000
540,000
Avg. Medicare Advantage Members
430,000
440,000
427,000
437,000
Total Revenues
$1,350
$1,390
$5,410
$5,580
Medical Margin
$115
$130
$300
$350
Adjusted EBITDA 3
$35
$45
($15)
$15
Geography Entry Costs 4
$3
$3
$15
$15
Underlying Assumptions:
Footnotes to assumptions –
The Company has not reconciled guidance for medical margin to gross profit (loss) or adjusted EBITDA to net income (loss), the most comparable GAAP measures, and has not provided forward-looking guidance for gross profit (loss) or net income (loss) in each case because of the uncertainty around certain items that may impact gross profit (loss) or net income (loss), including non-cash stock-based compensation, which cannot be predicted without unreasonable effort.
Webcast and Conference Call:
agilon health will host a conference call to discuss fourth quarter 2025 results on Wednesday, February 25, 2026, at 4:30 PM Eastern Time. The conference call can be accessed by dialing (833) 470-1428 for U.S. participants and +1 (404) 975-4839 for international participants and referencing participant code 868078. A simultaneous listen-only, live webcast can be accessed by visiting the “Events & Presentations” section of agilon’s Investor Relations website at https://investors.agilonhealth.com. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call.
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 approximately 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 approximately 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 www.agilonhealth.com and connect with us on LinkedIn.
Forward-Looking Statements
Statements in this release that are not historical factual statements are “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include, among other things, statements regarding our and our officers’ intent, belief or expectation as identified by the use of words such as “believes,” “expects,” “may,” “will,” “shall,” “should,” “would,” “could,” “seeks,” “aims,” “projects,” “is optimistic,” “intends,” “plans,” “estimates,” “anticipates” or the negative versions of these words or other comparable terms. Examples of forward-looking statements include, among other things: statements regarding our transformation initiatives and their anticipated benefits, expectations related to operating and financial results and the next phase of our business, expected revenue, medical costs, net income and gross profit, total and average membership, Adjusted EBITDA, Medical Margin, geography entry costs and other financial projections and assumptions, including our first quarter of fiscal year 2026 guidance. Forward-looking statements reflect our current expectations and views about future events and are subject to risks and uncertainties that could significantly affect our future financial condition and results of operations. While forward-looking statements reflect our good faith belief and assumptions we believe to be reasonable based upon current information, we can give no assurance that our expectations or forecasts will be attained. Forward-looking statements are subject to known and unknown risks and uncertainties, many of which may be outside our control. These risks and uncertainties that could cause actual results and outcomes to differ from those reflected in forward-looking statements include, but are not limited to: our history of net losses and the expectation that our expenses will increase in the future; failure to identify and develop successful new geographies, physician partners and payors, or execute upon our growth initiatives; success in executing our operating strategies or achieving results consistent with our historical performance; medical expenses incurred on behalf of our members may exceed revenues we receive; our ability to maintain and secure additional contracts with Medicare Advantage payors on favorable terms, if at all; our ability to grow new physician partner relationships sufficient to recover startup costs; availability of additional capital, on acceptable terms or at all, to support our business in the future; significant reduction in our membership; transition to a Total Care Model may be challenging for physician partners; public health crises, such as pandemics or epidemics, could adversely affect us; inaccuracy in estimates of our members’ risk adjustment factors, medical services expense, incurred but not reported claims, and earnings pursuant to payor contracts; the impact of restrictive clauses or exclusivity provisions in some of our contracts with physician partners; our ability to hire and retain qualified personnel; our ability to realize the full value of our intangible assets; security breaches, cybersecurity attacks, loss of data and other disruptions to our information systems; our ability to protect the confidentiality of our know-how and other proprietary and internally developed information; our reliance on our subsidiaries to perform and fund their operations; our use of artificial intelligence and machine learning in our business and challenges with properly managing the development and use of these technologies; our reliance on a limited number of key payors; the limited terms of contracts with our payors and our ability to renew them upon expiration; our ability to navigate the changing healthcare payor market; our reliance on our payors, physician partners and other providers to operate our business; our ability to obtain accurate and complete diagnosis data; our reliance on third-party software, data, infrastructure and bandwidth; consolidation and competition in the healthcare industry; the impact of changes to, and dependence on, federal government healthcare programs; uncertain or adverse economic and macroeconomic conditions, including a downturn or decrease in government expenditures; regulation of the healthcare industry and our and our physician partners’ ability to comply with such laws and regulations; federal and state investigations, audits and enforcement actions; repayment obligations arising out of payor audits; negative publicity regarding the managed healthcare industry generally; our use, disclosure and processing of personally identifiable information, protected health information, and de-identified data; failure to obtain or maintain an insurance license, a certificate of authority or an equivalent authorization; changes in tax laws and regulations, or changes in related judgments or assumptions; our indebtedness and our potential to incur more debt; our dependence on our subsidiaries for cash to fund all of our operations and expenses; provisions in our governing documents; our ability to achieve a return on investment depends on appreciation in the price of our common stock; lawsuits not covered by insurance and securities class action litigation; sustainability issues; our stock price may be volatile; non-compliance with the New York Stock Exchange could result in a delisting of our securities; and risks related to management transitions, including the search for a permanent Chief Executive Officer, and our ability to effectively manage leadership changes; and risks related to other factors discussed in our filings with the Securities and Exchange Commission (the “SEC”), including the factors discussed under “Risk Factors” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2025, which can be found at the SEC’s website at www.sec.gov. Additionally, ongoing implementation of performance initiatives, leadership changes, and dynamic market conditions create additional uncertainty regarding our future operating and financial performance. Except as required by law, we do not undertake, and hereby disclaim, any obligation to update any forward-looking statements, which speak only as of the date on which they are made.
agilon health, inc.
Consolidated Balance Sheets
In thousands, except per share data
December 31,
2025
2024
ASSETS
Current assets:
Cash and cash equivalents
$
173,713
$
188,231
Restricted cash and equivalents
—
5,629
Marketable securities
111,429
211,737
Receivables, net
673,793
1,017,040
Prepaid expenses and other current assets, net
137,762
35,137
Total current assets
1,096,697
1,457,774
Property, equipment, and capitalized software, net
25,417
28,169
Intangible assets, net
65,725
72,771
Goodwill
—
24,133
Other assets
83,451
151,136
Total assets
$
1,271,290
$
1,733,983
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT)
Current liabilities:
Medical claims and related payables
$
929,770
$
931,664
Accounts payable and accrued expenses
127,477
220,342
Current portion of long-term debt
19,238
—
Total current liabilities
1,076,485
1,152,006
Long-term debt, net of current portion
15,750
34,904
Other liabilities
52,321
76,121
Total liabilities
1,144,556
1,263,031
Commitments and contingencies
Stockholders' equity (deficit):
Common stock, $0.01 par value: 2,000,000 shares authorized; 414,728 and 412,194 shares issued and outstanding, respectively
4,147
4,122
Additional paid-in capital
2,099,995
2,053,895
Accumulated deficit
(1,978,324
)
(1,586,977
)
Accumulated other comprehensive income (loss)
916
(88
)
Total stockholders’ equity (deficit)
126,734
470,952
Total liabilities and stockholders’ equity (deficit)
$
1,271,290
$
1,733,983
agilon health, inc.
Consolidated Statements of Operations
In thousands, except per share data
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2025
2024
2025
2024
(unaudited)
Revenues:
Medical services revenue
$
1,566,986
$
1,519,244
$
5,921,341
$
6,047,715
Other operating revenue
2,505
3,242
11,235
12,815
Total revenues
1,569,491
1,522,486
5,932,576
6,060,530
Expenses:
Medical services expense
1,641,315
1,518,678
5,977,906
5,842,530
Other medical expenses
18,846
42,063
114,691
213,159
General and administrative
60,101
59,755
238,536
268,912
Depreciation and amortization
6,969
6,494
28,594
24,463
Impairments
36,085
3,596
36,085
3,596
Total expenses
1,763,316
1,630,586
6,395,812
6,352,660
Income (loss) from operations
(193,825
)
(108,100
)
(463,236
)
(292,130
)
Other income (expense):
Income (loss) from equity method investments
(33,052
)
(2,694
)
(1,835
)
14,992
Other income (expense), net
41,035
7,695
67,616
34,489
Interest expense
(1,716
)
(1,574
)
(6,641
)
(6,177
)
Income (loss) before income taxes
(187,558
)
(104,673
)
(404,096
)
(248,826
)
Income tax benefit (expense)
(1,324
)
(1,757
)
(1,251
)
(1,451
)
Income (loss) from continuing operations
(188,882
)
(106,430
)
(405,347
)
(250,277
)
Discontinued operations:
Income (loss) before gain (loss) on sales
—
640
—
(1,061
)
Gain (loss) and adjustments on sales of assets, net
—
—
14,000
(8,763
)
Total discontinued operations
—
640
14,000
(9,824
)
Net income (loss)
(188,882
)
(105,790
)
(391,347
)
(260,101
)
Noncontrolling interests’ share in (earnings) loss
—
—
—
(50
)
Net income (loss) attributable to common shares
$
(188,882
)
$
(105,790
)
$
(391,347
)
$
(260,151
)
Net income (loss) per common share, basic and diluted
Continuing operations
$
(0.46
)
$
(0.26
)
$
(0.98
)
$
(0.61
)
Discontinued operations
$
—
$
—
$
0.03
$
(0.02
)
Weighted average shares outstanding, basic and diluted
414,617
412,044
413,969
410,966
agilon health, inc.
Consolidated Statements of Cash Flows
In thousands
Year Ended December 31,
2025
2024
Cash flows from operating activities:
Net income (loss)
$
(391,347
)
$
(260,101
)
Adjustments to reconcile net income (loss) to net cash used in operating activities:
Depreciation and amortization
28,594
24,463
Stock-based compensation expense
49,119
50,657
Impairments
36,085
3,596
Loss (income) from equity method investments
1,835
(14,992
)
Distributions of earnings from equity method investments
—
3,340
Gain (loss) and adjustments on sales of assets, net
(14,000
)
3,784
Other, net
(5,518
)
887
Changes in operating assets and liabilities:
Receivables, net
344,585
(74,580
)
Prepaid expense and other current assets
(65,439
)
8,405
Other assets
(133
)
6
Medical claims and related payables
(1,894
)
193,941
Accounts payable and accrued expenses
(85,585
)
4,635
Other liabilities
(2,065
)
(1,818
)
Net cash provided by (used in) operating activities
(105,763
)
(57,777
)
Cash flows from investing activities:
Purchase of property and equipment
(13,242
)
(13,251
)
Purchase of intangible assets
(29,866
)
(28,034
)
Investment in loans receivable and other
(2,000
)
(13,733
)
Investments in marketable securities
(60,154
)
(12,006
)
Proceeds from maturities of marketable securities and other
193,872
206,915
Net cash provided by (used in) investing activities
88,610
139,891
Cash flows from financing activities:
Proceeds from (payments for) equity issuances, net
(2,994
)
1,167
Repayments of long-term debt
—
(3,750
)
Net cash provided by (used in) financing activities
(2,994
)
(2,583
)
Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents
(20,147
)
79,531
Cash, cash equivalents and restricted cash and equivalents, beginning of year
193,860
114,329
Cash, cash equivalents and restricted cash and equivalents, end of year
$
173,713
$
193,860
agilon health, inc.
Key Operating Metrics
In thousands
(unaudited)
GROSS PROFIT (LOSS)
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2025
2024
2025
2024
Total revenues
$
1,569,491
$
1,522,486
$
5,932,576
$
6,060,530
Medical services expense
(1,641,315
)
(1,518,678
)
(5,977,906
)
(5,842,530
)
Other medical expenses (1)
(18,846
)
(42,063
)
(114,691
)
(213,159
)
Gross profit (loss)
$
(90,670
)
$
(38,255
)
$
(160,021
)
$
4,841
______________________________________________________________
(1)
Represents physician compensation expense related to surplus sharing and other care management expenses that help to create medical cost efficiency. Includes costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended December 31, 2025 and 2024, costs incurred in implementing geographies were $2.8 million and $3.4 million, respectively. For the twelve months ended December 31, 2025 and 2024, costs incurred in implementing geographies were $3.7 million and $5.4 million, respectively.
GENERAL AND ADMINISTRATIVE COSTS, INCLUDING PLATFORM SUPPORT COSTS
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2025
2024
2025
2024
Platform support costs
$
39,673
$
39,650
$
159,986
$
169,402
Geography entry costs (1)
6,539
7,335
22,156
28,517
Severance and related costs
1,339
(159
)
6,075
4,577
Stock-based compensation expense
9,520
2,282
49,119
50,657
Other (2)
3,030
10,647
1,200
15,759
General and administrative
$
60,101
$
59,755
$
238,536
$
268,912
______________________________________________________________
(1)
Represents direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets.
(2)
Includes transaction-related costs.
Our platform support costs, which include regionally-based support personnel and other operating costs to support our geographies, are expected to decrease over time as a percentage of revenue as our physician partners add members and our revenue grows. Our operating expenses at the enterprise level include resources and technology to support payor contracting, clinical program development, quality, data management, finance, and legal and compliance functions.
agilon health, inc.
Non-GAAP Financial Measures
In thousands
(unaudited)
MEDICAL MARGIN
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2025
2024
2025
2024
Gross profit (loss) (1)
$
(90,670
)
$
(38,255
)
$
(160,021
)
$
4,841
Other operating revenue
(2,505
)
(3,242
)
(11,235
)
(12,815
)
Other medical expenses
18,846
42,063
114,691
213,159
Medical margin
$
(74,329
)
$
566
$
(56,565
)
$
205,185
______________________________________________________________
(1)
Gross profit (loss) is defined as total revenues less medical services expense and other medical expenses.
ADJUSTED EBITDA
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2025
2024
2025
2024
Net income (loss) (1)
$
(188,882
)
$
(105,790
)
$
(391,347
)
$
(260,101
)
(Income) loss from discontinued operations, net of income taxes
—
(640
)
(14,000
)
9,824
Interest expense
1,716
1,574
6,641
6,177
Income tax expense (benefit)
1,324
1,757
1,251
1,451
Depreciation and amortization
6,969
6,494
28,594
24,463
Impairments
36,085
3,596
36,085
3,596
Severance and related costs
1,339
(159
)
6,075
4,577
Stock-based compensation expense
9,520
2,282
49,119
50,657
EBITDA adjustments related to equity method investments (2)
27,127
2,557
43,304
17,582
Other (3)
(37,095
)
4,359
(61,877
)
(12,441
)
Adjusted EBITDA
$
(141,897
)
$
(83,970
)
$
(296,155
)
$
(154,215
)
(1)
Includes direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended December 31, 2025 and 2024, (i) $2.8 million and $3.4 million, respectively, are included in other medical expenses and (ii) $6.5 million and $7.3 million, respectively, are included in general and administrative expenses. For the twelve months ended December 31, 2025 and 2024, (i) $3.7 million and $5.4 million, respectively, are included in other medical expenses and (ii) $22.2 million and $28.5 million, respectively, are included in general and administrative expenses.
(2)
Includes elimination of certain administrative services provided by agilon health, inc. to equity method investments.
(3)
Includes interest income, transaction-related costs and elimination of certain administrative services provided by agilon health, inc. to equity method investments.
agilon health, inc.
Supplemental Financial Information
In thousands
(unaudited)
Three Months Ended
December 31, 2025
Twelve Months Ended
December 31, 2025
Medicare
Advantage
(Consolidated)
CMS ACO Models
(Unconsolidated)
Medicare
Advantage
(Consolidated)
CMS ACO Models
(Unconsolidated)
Medical services revenue
$
1,566,986
$
386,456
$
5,921,341
$
1,693,036
Other operating revenue
2,505
—
11,235
—
Total revenues
1,569,491
386,456
5,932,576
1,693,036
Medical services expense
(1,641,315
)
(384,258
)
(5,977,906
)
(1,539,486
)
Other medical expenses
(18,846
)
(2,751
)
(114,691
)
(90,501
)
Gross profit (loss)
(90,670
)
(553
)
(160,021
)
63,049
Other operating revenue
(2,505
)
—
(11,235
)
—
Other medical expenses
18,846
2,751
114,691
90,501
Medical margin
$
(74,329
)
$
2,198
$
(56,565
)
$
153,550
Certain of our operations are not consolidated for the period presented because we do not have the ability to control certain activities due to another party’s control of the entities’ board of directors. Although revenues of the unconsolidated operations are not recorded as revenues by us, income (loss) from equity method investments is nonetheless a significant portion of our overall earnings. See Note 17 to the Consolidated Financial Statements in the Annual Report on Form 10-K for the period ended December 31, 2025 for additional discussion on our equity method investments.
In addition to providing results that are determined in accordance with GAAP, we present Medical Margin and Adjusted EBITDA, which are non-GAAP financial measures.
We define Medical Margin as medical services revenue after medical services expense is deducted. Medical services expense represents costs incurred for medical services provided to our members. As our platform matures over time, we expect Medical Margin to increase in absolute dollars. However, Medical Margin per member per month (PMPM) may vary as the percentage of new members brought onto our platform fluctuates. New membership added to the platform is typically dilutive to Medical Margin PMPM. We believe this metric provides insight into the economics of our capitation arrangements as it includes all medical services expense directly associated with our members’ care.
We define Adjusted EBITDA as net income (loss) adjusted to exclude: (i) income (loss) from discontinued operations, net of income taxes, (ii) interest expense, (iii) income tax expense (benefit), (iv) depreciation and amortization, (v) stock-based compensation expense, (vi) severance and related costs, and (vii) certain other items that are not considered by us in the evaluation of ongoing operating performance. We reflect our share of Adjusted EBITDA for equity method investments by applying our actual ownership percentage for the period to the applicable reconciling items on an entity-by-entity basis.
Gross profit is the most directly comparable GAAP measure to Medical Margin. Net income (loss) is the most directly comparable GAAP measure to Adjusted EBITDA.
We believe Medical Margin and Adjusted EBITDA help identify underlying trends in our business and facilitate evaluation of period-to-period operating performance of our operations by eliminating items that are variable in nature and not considered by us in the evaluation of ongoing operating performance, allowing comparison of our recurring core business operating results over multiple periods. We also believe Medical Margin and Adjusted EBITDA provide useful information about our operating results, enhance the overall understanding of our past performance and future prospects, and allow for greater transparency with respect to key metrics we use for financial and operational decision-making. We believe Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures are widely used by investors, securities analysts, ratings agencies, and other parties in evaluating companies in our industry as a measure of financial performance. Other companies may calculate Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures differently from the way we calculate these metrics. As a result, our presentation of Medical Margin and Adjusted EBITDA may not be comparable to similarly titled measures of other companies, limiting their usefulness as comparative measures.