agilon health, inc.
Key statistics
from XBRL data in SEC filingsAI briefing
from the latest 10-K, 10-Q and 8-K eventsagilon health is a value-based care enablement company that partners with physician groups to manage Medicare Advantage and ACO model populations.
What they do
agilon health partners with physician groups to build and operate total care models, primarily for Medicare Advantage and ACO REACH populations. It provides infrastructure, data analytics, and risk-bearing contract management to align physician incentives with value-based care. The company generates revenue from medical margin under capitated contracts and also supports unconsolidated ACO model entities.
Revenue drivers
- Medicare Advantage membership — Core business: 437,000 MA members as of Q2 2026, down 12% YoY; drives most of total revenue through capitated contracts with MA payors.
- ACO model beneficiaries — 112,000 ACO model beneficiaries (unconsolidated) as of Q2 2026; contributes to Adjusted EBITDA but not consolidated revenue.
- Total revenue per member — Higher burden of illness performance, payor contracting, and improved pricing offset membership declines; total revenue rose 7% YoY despite 10% fewer total members.
Recent performance
For Q2 2026, total revenue was $1.49B, up 7% YoY, while gross profit swung to $107M from a loss of $52M. Medical margin was $197M versus negative $53M, and Adjusted EBITDA was $70M versus negative $83M. Net income was $18M versus a net loss of $104M. Full-year 2025 revenue was $5.93B with a net loss of $391.3M.
Strategy
Management emphasizes disciplined contracting focused on profitability, including exiting certain markets and a measured approach to growth. It is executing on burden of illness initiatives to improve risk adjustment and medical cost trends. The company is raising guidance, citing stronger execution and continued operating discipline under its Total Care Model.
Risks
- Membership decline — Total members fell 10% YoY to 549,000, driven by disciplined contracting and market exits.
- Dependence on few payors — The company relies on a limited number of key Medicare Advantage payors; contract terms are limited and renewal is uncertain.
- Persistent net losses — agilon has reported annual net losses every year since 2021, including -$391.3M in 2025.
- Medical costs could exceed revenue — The business model assumes medical expenses stay below capitated revenue; adverse cost trends could harm profitability.
Outlook
For FY2026, management raised guidance to total revenue of $5.775B-$5.860B, medical margin of $465M-$505M, and Adjusted EBITDA of $75M-$95M. They expect Medicare Advantage members of 435,000-445,000 by year-end and ACO REACH members of 100,000-105,000. ACO model entities are expected to contribute approximately $25-$30M to Adjusted EBITDA.