agilon health Reports Fourth Quarter and Full Year Fiscal 2025 Results

Issues 2026 Guidance Highlighting Expected Breakeven Adjusted EBITDA Midpoint

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.

Agilon Logo FullColor Horiz PNG
Agilon Logo FullColor Horiz PNG

“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:

  • Total members on the agilon platform decreased to 625,000 as of December 31, 2025, comprising 511,000 Medicare Advantage members and 114,000 ACO model beneficiaries. Year-over-year changes to membership reflect previously disclosed market exits.
  • Total revenue of $1.57 billion in the fourth quarter 2025 increased 3% compared to $1.52 billion in the fourth quarter 2024. For the fiscal year 2025, total revenue of $5.93 billion decreased 2% compared to $6.06 billion in 2024. Revenue reflects membership growth in new markets and same geography growth more than offset by the impact from market exits.
  • Gross loss of $91 million in the fourth quarter 2025 compared to gross loss of $38 million in the fourth quarter 2024. For the fiscal year 2025, gross loss was $160 million compared to gross profit of $5 million in 2024. Net loss was $189 million in the fourth quarter of 2025 compared to a net loss of $106 million in the fourth quarter of 2024. For the fiscal year 2025, net loss of $391 million compared to a net loss of $260 million in 2024.
  • Medical margin was negative $74 million during the fourth quarter 2025, compared to earnings of $1 million in the fourth quarter 2024. For the fiscal year 2025, medical margin was negative $57 million, compared to earnings of $205 million in 2024. Medical margin includes cost trend for Medicare Advantage members reserved at approximately 7.4% for the fourth quarter, in line with 7.2% in the third quarter and approximately 6.5% for the full year.
  • Adjusted EBITDA loss was $142 million in the fourth quarter 2025, compared to an Adjusted EBITDA loss of $84 million in the fourth quarter 2024. For the fiscal year 2025, Adjusted EBITDA loss of $296 million, compared to Adjusted EBITDA loss of $154 million in the fiscal year 2024.

Key Financial and Operating Metrics ($M):

(Fourth Quarter 2025 vs. 2024)

 

Three Months

Ended December 31,

 

 

Change

 

2025

 

2024

 

% YoY

Medicare Advantage Members1

511,000

 

527,000

 

(3%)

ACO Model Members1, 2

114,000

 

132,000

 

(14%)

Total Members Live on Platform1, 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 EBITDA3

($142)

 

($84)

 

(69%)

Geography Entry Costs

$9

 

$11

 

(18%)

 
  1. Membership metrics reflect end of period results.
  2. agilon’s ACO model entities are not included within its consolidated financial results.
  3. agilon’s ACO model entities contributed losses of $6 million and earnings of $42 thousand to Adjusted EBITDA during the fourth quarter 2025 and fourth quarter 2024, respectively.

Key Financial and Operating Metrics ($M):

(Fiscal Year 2025 vs. 2024)

 

Twelve Months

Ended December 31,

 

 

Change

 

2025

 

2024

 

% YoY

Medicare Advantage Members1

511,000

 

527,000

 

(3%)

ACO Model Members1, 2

114,000

 

132,000

 

(14%)

Total Members Live on Platform1, 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 EBITDA3

($296)

 

($154)

 

(92%)

Geography Entry Costs

$26

 

$34

 

(24%)

 
  1. Membership metrics reflect end of period results.
  2. agilon’s ACO model entities are not included within its consolidated financial results.
  3. agilon’s ACO model entities contributed $41 million and $33 million to Adjusted EBITDA during the fiscal year 2025 and fiscal year 2024, respectively.

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 Members1

431,000

 

441,000

 

425,000

 

435,000

ACO Model Members1, 2

105,000

 

110,000

 

100,000

 

105,000

Total Members Live on Platform1

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 EBITDA3

$35

 

$45

 

($15)

 

$15

Geography Entry Costs4

$3

 

$3

 

$15

 

$15

 
  1. Membership reflects management’s outlook for end of period.
  2. agilon’s partnered ACO model entities are not consolidated within its financial results.
  3. Adjusted EBITDA contribution from ACO model is expected to be approximately $20-$25 million for fiscal year 2026.
  4. Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for Adjusted EBITDA.

Underlying Assumptions:

  • Membership reflects payor contract exits of approximately 50,000 members and previously announced market exits of approximately 34,000 members. Membership also includes approximately 25,000 members in a no downside care coordination fee model including the impact of payor contract changes and new PCP partnerships.
  • Elevated medical cost trend1 for 2026 is expected to remain slightly above 2025 with an estimated gross cost trend of 7.5% and 7.0% net. The 50bps difference reflects the estimated effect of payor bids.
  • Part D exposure reduced to less than 15% of membership.
  • Selling, general and administrative expenses is expected to be approximately $234 million2 which reflects the impact of approximately $35 million reduction in operating expenses executed in 2025, and stock-based compensation of approximately $64 million.
  • Geographic entry costs of approximately $15 million reflect the company’s measured growth strategy to better align growth and performance in the current rate and elevated cost environment.

Footnotes to assumptions –

  1. Medical cost trend includes the impact of the company’s clinical programs and excludes the impact from non-medical costs (e.g., supplemental benefits), which is expected to drive less impact to cost trend in 2026 compared to 2025.
  2. Inclusive of additional investments in technology and new clinical programs.

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

Contacts

Investor Contacts
Evan Smith, CFA

SVP Investor Relations

[email protected]

Megan Cagle

[email protected]

Media Contacts
Stephanie Law

Corporate Communications

[email protected]

Read full story here

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