agilon health (AGL) Q4 2025 earnings summary

Executive summary

• Fiscal year 2025 revenue was $5.93B, with a net loss of $391M and negative Adjusted EBITDA of $296M, reflecting higher medical costs and transformation expenses.

• Membership optimization and exits from underperforming partnerships led to a 5% decline in platform membership to 625,000, with a focus on profitability and margin durability for 2026.

• Transformation initiatives improved execution, operating discipline, and model economics, with enhanced data analytics and quality programs supporting long-term value-based care.

• Strategic shift prioritized economic sustainability over membership growth, including exiting unprofitable contracts and restructuring arrangements.

• 2026 guidance projects a return to positive medical margin ($300M–$350M) and near-breakeven Adjusted EBITDA (–$15M to +$15M), driven by cost reductions and favorable contracting.

Financial highlights

• Q4 2025 revenue was $1.57B, with a net loss of $189M and Adjusted EBITDA of –$142M; full year 2025 revenue was $5.93B, both impacted by lower risk adjustment revenue and market exits.

• Full year 2025 medical margin was –$57M, with a gross loss of $160M and a medical cost trend of 6.5% due to higher inpatient utilization.

• Adjusted EBITDA loss for 2025 was $296M, a 92% increase from 2024.

• Year-end 2025 cash and marketable securities totaled $285M, with $91M off-balance sheet in ACO entities and $35M in total debt.

• $35M in operating expense reductions executed in 2025, exceeding prior targets.

Outlook and guidance

• 2026 revenue guidance: $5.41B–$5.58B; medical margin: $300M–$350M; adjusted EBITDA: –$15M to +$15M (breakeven midpoint).

• Year-end 2026 membership expected at 525,000–540,000, including 427,000–437,000 Medicare Advantage and 103,000 ACO members.

• Gross cost trend assumption for 2026: 7.5%; net cost trend: 7% after payer bid benefits.

• G&A/SG&A expense for 2026 projected at $234M, reflecting $35M in cost reductions.

• Expect to end 2026 with at least $125M in cash, supported by an extended credit facility.