agilon health (AGL) Q4 2025 earnings summary

Executive summary

• Fiscal year 2025 focused on operational discipline and foundational transformation, with progress in clinical pathways, quality programs, and payer relations to support long-term value-based care.

• FY2025 saw total revenues of $5.93B, a 2% decline due to market exits, and a net loss of $391M, reflecting higher medical costs and transformation expenses.

• Membership optimization and exits from underperforming partnerships were completed, reducing platform membership by 5% to 625,000 and focusing on profitability and margin durability for 2026.

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

• Transformation initiatives were implemented to improve execution, operating discipline, and model economics, with expectations for material improvement in 2026.

Financial highlights

• Q4 2025 revenue: $1.57B; full year 2025 revenue: $5.93B, both impacted by lower risk adjustment revenue and market exits.

• Q4 2025 medical margin: -$74M; full year: -$57M, reflecting elevated cost trends and risk adjustment impacts.

• Adjusted EBITDA: -$142M for Q4 and -$296M for full year 2025; ACO REACH contributed $41M for the year.

• Year-end cash, cash equivalents, and marketable securities totaled $285M, ahead of expectations by $66M.

• Full year 2025 gross loss was $160M, with net loss margin at 6.6% of revenue.

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, with 427,000–437,000 Medicare Advantage and 103,000 ACO model members.

• Gross cost trend assumption for 2026: 7.5%, net 7% after payer bid benefits; SG&A expense projected at $234M, reflecting $35M in cost reductions.

• Expect to end 2026 with at least $125M in cash; credit facility extended by two years to 2028.

• Medical margin improvement driven by favorable contracting, positive CMS rates, and cost initiatives.