agilon health (AGL) Q1 2026 earnings summary

Executive summary

• First quarter 2026 results exceeded expectations, with strong operational discipline, improved data and AI integration, and early positive outcomes from expanded clinical programs in congestive heart failure, COPD, and dementia.

• Revenue for Q1 2026 was $1.42 billion, down 7% year-over-year due to lower Medicare Advantage membership and market exits, but profitability improved significantly.

• Net income rose to $49 million from $12 million in Q1 2025, with Adjusted EBITDA increasing to $54 million from $21 million year-over-year.

• Tim O'Rourke was appointed CEO and President, effective May 7, 2026, to advance the mission and strategy.

• A 1-for-25 reverse stock split was completed, restoring NYSE compliance.

Financial highlights

• Q1 2026 revenue was $1.42 billion, down from $1.53 billion year-over-year, with medical margin up to $149 million and gross profit rising to $65 million.

• Adjusted EBITDA reached $54 million, up from $21 million year-over-year, and ACO REACH Adjusted EBITDA was $27 million, $5 million above expectations.

• Net income margin improved to 3.4%, and basic EPS for Q1 2026 was $2.95, up from $0.73 in Q1 2025.

• Cash, cash equivalents, and marketable securities totaled $303 million at quarter-end.

• Medical services expense decreased 9% to $1.27 billion, and general and administrative expenses fell 18% to $54.2 million.

Outlook and guidance

• Full-year 2026 guidance raised: revenue expected at $5.68–$5.81 billion, medical margin at $350–$400 million, and Adjusted EBITDA at $10–$40 million.

• Q2 2026 guidance: revenue of $1.44–$1.48 billion, medical margin of $115–$130 million, and Adjusted EBITDA of $15–$25 million.

• ACO REACH Adjusted EBITDA contribution for 2026 expected at $25–$30 million.

• Maintains a conservative net cost trend outlook of 7% for 2026 and is optimistic about continued improvement beyond 2026.

• Existing liquidity and borrowing capacity are expected to cover working capital and capital expenditures for at least the next 12 months.