agilon health, inc.
For the period ended Sep 30, 2025. Filed Nov 4, 2025.
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Sep 30, 2025 · Filed Nov 4, 2025
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Notes to the Condensed Consolidated Financial Statements
(Unaudited)
NOTE 1. Business
Description of Business
agilon health, inc., together with its consolidated subsidiaries and VIEs (the “Company”), through its partnerships and platform, provides the necessary capabilities, capital, and business model for existing physician groups to create a Medicare-centric, globally capitated line of business. As of September 30, 2025, the Company, through its contracted physician networks, provided care to approximately 502,800 Medicare Advantage members enrolled with private health plans. Additionally, the Company participates in the Centers for Medicare & Medicaid Services' (“CMS”) Accountable Care Organization Realizing Equity, Access, and Community Health (“ACO REACH”) Model and Medicare Shared Savings Program (“MSSP,” and together with ACO REACH, the “CMS ACO Models”) through its equity method investments.
See Note 14 for additional discussions related to the Company’s involvement with VIEs.
The Company’s largest shareholder is an investment fund associated with Clayton Dubilier & Rice, LLC (“CD&R”), a private equity firm. All funds affiliated with CD&R are considered related parties.
NOTE 2. Summary of Significant Accounting Policies
Basis of Presentation
The accompanying condensed consolidated financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). The condensed consolidated financial statements include the accounts of agilon health, inc., its wholly-owned subsidiaries, and joint ventures and VIEs that it controls through voting rights or other means. Intercompany transactions and balances have been eliminated upon consolidation. All adjustments (consisting of normal recurring adjustments unless otherwise indicated), which the Company considers necessary to present fairly its financial position, results of operations, and cash flows, have been included. Operating results for the three and nine months ended September 30, 2025 are not necessarily indicative of the results that may be expected for the year ending December 31, 2025. The accompanying condensed consolidated financial information should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2024 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.
Use of Estimates
Management is required to make estimates and assumptions in the preparation of financial statements. These estimates and assumptions affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant estimates can include, among other things, those used to determine revenues and related receivables from risk adjustments, medical services expense and related payables (including the reserve for incurred but not reported (“IBNR”) claims), and the valuation and related recognition of impairments of long-lived assets, including goodwill. Management’s estimates for revenue recognition, medical services expense, and other estimates, judgments, and assumptions, may be materially and adversely different from actual results. These estimates are based on knowledge of current events and anticipated future events, and accordingly, actual results may ultimately differ materially from those estimates.
Property and Equipment
As of September 30, 2025 and December 31, 2024, the Company’s gross carrying amount of property and equipment was $59.0 million and $52.9 million, with accumulated depreciation of $32.9 million and $24.7 million, respectively. For the three months ended September 30, 2025 and 2024, the Company recognized $3.8 million and $3.1 million, respectively, in depreciation expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations. For the nine months ended September 30, 2025 and 2024, the Company recognized $11.5 million and $8.9 million, respectively, in depreciation expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations.
Income Taxes
The Company determines the income tax provision for interim periods using an estimate of the Company’s annual effective tax rate, applied to year-to-date results, adjusted for discrete items arising in that quarter. In each quarter, the Company updates its estimated annual effective tax rate, and if the estimated annual effective tax rate changes, a cumulative catch-up adjustment is recorded in that quarter. The Company applied the intra-period tax allocation rules to allocate income taxes between continuing operations and discontinued operations as prescribed in U.S. GAAP, where the tax effect of income (loss) before income taxes from continuing operations is computed without regard to the tax effects of income (loss) before income taxes from the other categories.
On July 4, 2025, the “One Big Beautiful Bill Act” was signed into law in the U.S., which contains a broad range of tax reform provisions. The One Big Beautiful Bill Act did not have a material impact to the Company's effective tax rate for the nine months ended September 30, 2025; however, the Company will continue to monitor developments and evaluate any potential future impacts.
Segment Reporting
The Company operates a Medicare-centric, capitated line of business and is organized as a single operating and reportable segment based on the manner in which the Company’s Chief Operating Decision Maker (“CODM”) evaluates performance and makes decisions about how to allocate resources. The Company’s CODM is the Office of the Chairman. Segment asset information, which is presented on the consolidated balance sheet, is not used by the CODM to assess performance and make decisions about how to allocate resources. The Company's segment measure of profit or loss is consolidated net income (loss). The CODM uses the segment measure of profit or loss to assess performance and make resource allocation decisions, primarily through periodic budgeting and company performance reviews. Significant expense categories included within the segment measure of profit or loss that are regularly provided to the CODM include medical services expense, other medical expense, and platform support costs. Medical services expense and other medical expense amounts are included in the consolidated statements of operations. Platform support costs were $38.7 million and $42.4 million for the three months ended September 30, 2025 and 2024, respectively. For the three months ended September 30, 2025 and 2024, other segment items, which consists of general and administrative expenses (excluding platform support costs), depreciation and amortization, other income (expense), net, income tax benefit (expense), and results from discontinued operations, were $3.9 million and $11.1 million, respectively. Platform support costs were $120.3 million and $129.8 million for the nine months ended September 30, 2025 and 2024, respectively. For the nine months ended September 30, 2025 and 2024, other segment items, which consists of general and administrative expenses (excluding platform support costs), depreciation and amortization, other income (expense), net, income tax benefit (expense), and results from discontinued operations, were $12.8 million and $67.7 million, respectively.
Recent Accounting Pronouncements
In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures(“ASU 2023-09”), which amends certain disclosure requirements related to income taxes. The amendments in ASU 2023-09 require public business entities on an annual basis to: (i) disclose specific categories in the rate reconciliation and (ii) provide additional information for reconciling items that meet a quantitative threshold. The amendments in ASU 2023-09 are effective for annual periods beginning after December 15, 2024. The amendments in ASU 2023-09 can be applied on a prospective basis or retrospective application. Early adoption is permitted. The new guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations, cash flows, or disclosures.
In November 2024, the FASB issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses(“ASU 2024-03”). In January 2025, the FASB issued Accounting Standards Update (“ASU”) 2025-01, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Clarifying the Effective Date (“ASU 2025-01”). The amendments in ASU 2024-03 require public business entities to disclose, on an annual and interim basis, disaggregated information about certain income statement expense line items by breaking down certain expense line items into specified natural expense categories, including purchases of inventory, employee compensation, deprecation, intangible asset amortization, and depletion. The amendments in ASU 2024-03 are effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. The amendments in ASU 2024-03 can be applied on a prospective basis or retrospective basis and early adoption is permitted. The amendments in ASU 2025-01 clarify the effective date of ASU 2024-03 stating that all public business entities are required to adopt the update in annual reporting periods beginning after December 15, 2026, and interim periods within annual reporting periods beginning after December 15, 2027. ASU 2025-01 does not change the effective date of ASU 2024-03 but was issued to provide clarity on the effective date for public business entities that do not have a calendar year-end. The Company is currently evaluating the potential impact of the adoption of ASU 2024-03 and ASU 2025-01 on its disclosures.
In September 2025, the FASB issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software (“ASU 2025-06”). The amendments in ASU 2025-06 modernize the guidance in Subtopic 350-40 to reflect the software development approaches currently used as software is not always developed in a linear manner. To clarify how the guidance applies to both linear and nonlinear software development, the amendments in ASU 2025-06 remove all references to the “development stages” from Subtopic 350-40 and instead requires that software development costs be capitalized when (i) management, with relevant authority, commits to funding a computer software project, and (ii) it is probable that the project will be completed and the software will be used to perform the function intended. The amendments in ASU 2025-06 also provide new guidance on how to evaluate whether the probable-to-complete recognition threshold has been met and specifies that the disclosure requirements in Subtopic 360-10, Property, Plant, and Equipment—Overall, are required for all capitalized internal-use software costs. The amendments in ASU 2025-06 are effective for annual reporting periods beginning after December 31, 2027, and interim reporting periods within those annual reporting periods. The amendments in ASU 2025-06 can be applied on a prospective, retrospective, or modified transition approach basis. The new guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations, cash flows, or disclosures.
NOTE 3. Revenue, Receivables, and Concentration of Credit Risk
Medical services revenue consists of capitation fees under contracts with various Medicare Advantage payors (“payors”). Under the typical capitation arrangement, the Company is entitled to monthly per-member, per-month (“PMPM”) fees to provide a defined range of healthcare services for Medicare Advantage health plan members (“members”) attributed to the Company’s contracted primary care physicians. In certain of the Company’s payor arrangements, it is also financially responsible for Medicare Part D pharmaceutical costs for prescriptions rendered to members. PMPM fees are determined as a percent of the premium payors receive from CMS for these members. The Company generally accepts full financial risk for members attributed to its contracted primary care physicians and therefore is responsible for the cost of all healthcare services required by those members. Fees are generally recorded gross in revenue because the Company is acting as a principal in coordinating and controlling the range of services provided (other than clinical decisions) under its capitation contracts with payors. Capitation contracts with payors are generally multi-year arrangements and have a single performance obligation that constitutes a series, as defined by Accounting Standards Codification (“ASC”) 606, Revenue From Contracts With Customers (“ASC 606”), to stand ready on a monthly basis to provide all aspects of necessary medical care to members for the contracted period. The Company recognizes revenue in the month in which eligible members are entitled to receive healthcare benefits during the contract term.
The transaction price for the Company’s capitation contracts is variable, as the PMPM fees to which the Company is entitled are subject to periodic adjustment under CMS’s risk adjustment payment methodology. CMS deploys a risk adjustment model that determines premiums paid to all payors according to each member’s health status and certain demographic factors. Under this risk adjustment methodology, CMS calculates the risk adjusted premium payment using diagnosis data from various settings. The Company and healthcare providers collect and submit the necessary and available diagnosis data to payors and such data is utilized by the Company to estimate risk adjustment payments to be received in subsequent periods. Risk adjustment-related revenues are estimated using the most likely amount methodology and amounts are only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. PMPM fees are also subject to adjustment for incentives or penalties based on the achievement of certain quality metrics defined in the Company’s contracts with payors. The Company recognizes incentive revenue as earned using the most likely amount methodology and only to the extent that it is probable that a significant reversal of incentive revenue will not occur once any uncertainty is resolved.
Neither the Company nor any of its affiliates is a registered insurance company because state law in the states in which it operates does not require such registration for risk-bearing providers.
Receivables
Receivables primarily consist of amounts due under capitation contracts with various payors. Receivables due under capitation contracts are recorded monthly based on reports received from payors and management’s estimate of risk adjustment payments to be received in subsequent periods for open performance years. Receivables are recorded at the amount expected to be realized.
Concentration
The Company contracts with various payors whereby the Company is entitled to monthly PMPM fees to provide a defined range of healthcare services for members attributed to its contracted primary care physicians. The Company generally accepts full financial risk for such members and therefore is responsible for the cost of all healthcare services required by them. Substantially all of the Company’s receivable balances are from a small number of payors. Revenue from Medicare Advantage payors constitutes substantially all of the Company’s total revenue for the three and nine months ended September 30, 2025 and 2024.
The following table provides the Company’s revenue concentration with respect to major payors as a percentage of the Company’s total revenues:
| Three Months EndedSeptember 30, | Nine Months EndedSeptember 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Payor A | 15% | 20% | 15% | 21% |
| Payor B | 17% | 20% | 16% | 18% |
| Payor C | 14% | 11% | 13% | 10% |
| Payor E | 11% | * | 11% | * |
*Less than 10% of total revenues.
The following table provides the Company’s concentration of credit risk with respect to major payors as a percentage of receivables, net:
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Payor B | * | 11% |
| Payor C | 12% | 12% |
| Payor D | 14% | 13% |
| Payor E | 13% | 15% |
*Less than 10% of total receivables.
NOTE 4. Marketable Securities and Fair Value Measurements
Marketable Securities
The following table summarizes the Company’s marketable securities (in thousands):
| September 30, 2025 | December 31, 2024 | |||||||
|---|---|---|---|---|---|---|---|---|
| Amortized Cost | Gross Unrealized Gains | Gross Unrealized Losses | Fair Value | Amortized Cost | Gross Unrealized Gains | Gross Unrealized Losses | Fair Value | |
| Corporate debt securities | $22,296 | $11 | $— | $22,307 | $110,820 | $91 | $(204) | $110,707 |
| U.S. Treasury notes | 116,105 | 769 | (11) | 116,863 | 101,059 | 184 | (213) | 101,030 |
| $138,401 | $780 | $(11) | $139,170 | $211,879 | $275 | $(417) | $211,737 | |
For the three months ended September 30, 2025, the Company recognized total interest income (included in other income (expense), net in the condensed consolidated statements of operations) of $3.8 million, of which $2.3 million was related to its marketable securities investments and $1.5 million was related to interest on cash and cash equivalent balances. For the three months ended September 30, 2024, the Company recognized total interest income (included in other income (expense), net in the condensed consolidated statements of operations) of $4.6 million, of which $3.1 million was related to its marketable securities investments and $1.5 million was related to interest on cash and cash equivalent balances. For the nine months ended September 30, 2025, the Company recognized total interest income (included in other income (expense), net in the condensed consolidated statements of operations) of $11.7 million, of which $8.0 million was related to its marketable securities investments and $3.7 million was related to interest on cash and cash equivalent balances. For the nine months ended September 30, 2024, the Company recognized total interest income (included in other income (expense), net in the condensed consolidated statements of operations) of $14.9 million, of which $10.3 million was related to its marketable securities investments and $4.6 million was related to interest on cash and cash equivalent balances.
The following table summarizes the Company’s marketable securities maturity as of September 30, 2025 (in thousands):
| Year | Amortized Cost | Fair Value |
|---|---|---|
| 2025 | $23,285 | $23,285 |
| 2026 | 62,571 | 62,843 |
| 2027 | 27,969 | 28,218 |
| 2028 | 24,576 | 24,824 |
| $138,401 | $139,170 |
The following table summarizes the Company’s marketable securities with gross unrealized losses by security type aggregated by the length of time the investments have been in a continuous unrealized loss position as of September 30, 2025 (in thousands):
| Less Than 12 Months | 12 Months or Greater | |||
|---|---|---|---|---|
| Fair Value | Gross Unrealized Losses | Fair Value | Gross Unrealized Losses | |
| U.S. Treasury notes | $12,974 | $3 | $12,820 | $8 |
The following table summarizes the Company’s marketable securities with gross unrealized losses by security type aggregated by the length of time the investments have been in a continuous unrealized loss position as of December 31, 2024 (in thousands):
| Less Than 12 Months | 12 Months or Greater | |||
|---|---|---|---|---|
| Fair Value | Gross Unrealized Losses | Fair Value | Gross Unrealized Losses | |
| Corporate debt securities | $— | $— | $73,128 | $204 |
| U.S. Treasury notes | 25,295 | 104 | 38,787 | 109 |
| $25,295 | $104 | $111,915 | $313 | |
The Company’s unrealized losses from marketable securities as of September 30, 2025 and December 31, 2024 were caused primarily by interest rate increases. As of September 30, 2025, all of the Company’s marketable securities carry an investment grade rating by nationally recognized statistical rating organizations. The Company does not intend to sell marketable securities that are in an unrealized loss position, and it is not more likely than not that the Company will be required to sell the investments before recovery of their amortized cost bases, which may be maturity. There wasno allowance for credit losses on available-for-sale marketable securities at September 30, 2025 or December 31, 2024.
Fair Value Measurements
The Company’s financial instruments consist of cash and cash equivalents, restricted cash and equivalents, marketable securities, receivables, other liabilities, accounts payable, certain accrued expenses, and borrowings which consist of a term loan and a revolving credit facility. The carrying values of the financial instruments classified as current in the consolidated balance sheets approximate their fair values due to their short-term maturities. The fair values of the term loan and revolving credit facility approximate the carrying values because the interest rates on such borrowings approximate market rates as of the reporting date. Such borrowings are classified within Level 2 of the fair value hierarchy. During the three and nine months ended September 30, 2025 and 2024, there were no material transfers of financial assets or liabilities within the fair value hierarchy.
The Company measures and discloses the fair value of nonfinancial and financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect the Company’s market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:
Level 1—quoted prices for identical instruments in active markets;
Level 2—quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and
Level 3—fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.
The table below summarizes the Company’s financial instruments measured at fair value on a recurring basis (in thousands):
| September 30, 2025 | December 31, 2024 | |||||
|---|---|---|---|---|---|---|
| Level 1 | Level 2 | Level 3 | Level 1 | Level 2 | Level 3 | |
| Marketable securities: | ||||||
| Corporate debt securities | $— | $22,307 | $— | $— | $110,707 | $— |
| U.S. Treasury notes | 116,863 | — | — | 101,030 | — | — |
| $116,863 | $22,307 | $— | $101,030 | $110,707 | $— | |
NOTE 5. Other Assets
The following table summarizes the Company’s other assets (in thousands):
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Loans to physician partners | $21,116 | $63,155 |
| Health plan deposits | 2,077 | 2,051 |
| Equity method investments(1) | 90,469 | 61,756 |
| Right-of-use lease assets | 3,936 | 8,783 |
| Other | 15,084 | 15,391 |
| $132,682 | $151,136 |
(1)See Note 14 for additional discussion related to the Company's equity method investments.
Loans to Physician Partners
Loans to physician partners primarily represent loans in connection with taxes payable on shares distributed to them in connection with the Company’s initial public offering. These loans mature between 2026 and 2031 with nominal interest compounding annually and no prepayment penalties. At September 30, 2025, $32.3 million of these loans were reclassed to Prepaid expenses and other current assets, net on the condensed consolidated balance sheet as the maturities were less than 12 months. Such loans are stated at the amount expected to be collected.
NOTE 6. Medical Claims and Related Payables
Medical services expense represents costs incurred for medical services provided to members by physicians, hospitals and other ancillary providers for which the Company is financially responsible and are paid by payors with whom the Company has contracted. Medical services expenses are recognized in the period in which services are provided and include estimates of claims that have been incurred but have either not yet been received, processed, or paid and as such, not reported.
Such estimates are developed using actuarial methods commonly used by health insurance actuaries that include a number of factors and assumptions including medical service utilization trends, changes in membership, observed medical cost trends, historical claim payment patterns and other factors. Generally, for the most recent months, the Company estimates claim costs incurred by applying observed medical cost trend factors to the average PMPM medical costs incurred in prior months for which more complete claims data are available.
Each period, the Company re-examines previously established medical claims payable estimates based on actual claim submissions and other changes in facts and circumstances. As more complete claims information becomes available, the Company adjusts its estimates and recognizes those changes in estimates in the period in which the change is identified. The difference between the estimated liability and the actual settlements of claims is recognized in the period the claims are settled. The Company’s medical claims payable balance represents management’s best estimate of its liability for unpaid medical costs as of September 30, 2025 and 2024. The Company uses judgment to determine the appropriate assumptions for developing the required estimates.
The following table presents the components of changes in medical claims and related payables (in thousands):
| September 30, | ||
|---|---|---|
| 2025 | 2024 | |
| Medical claims and related payables, beginning of the year | $918,395 | $723,071 |
| Components of incurred costs related to: | ||
| Current year | 4,301,370 | 4,291,930 |
| Prior years | 35,221 | 31,922 |
| 4,336,591 | 4,323,852 | |
| Claims paid related to: | ||
| Current year | (3,267,115) | (3,158,273) |
| Prior years | (957,756) | (709,936) |
| (4,224,871) | (3,868,209) | |
| Medical claims and related payables, end of the period | $1,030,115 | $1,178,714 |
Medical claims and related payables also include $29.3 million and $13.3 million, as of September 30, 2025 and December 31, 2024, respectively, that is recoverable from other parties under risk sharing arrangements and is presented as prepaid expenses and other current assets, net in the condensed consolidated balance sheets.
NOTE 7. Other Liabilities
The following table summarizes the Company’s other liabilities (in thousands):
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Other long-term contingencies(1) | $35,000 | $49,000 |
| Lease liabilities, long-term | 2,155 | 6,599 |
| Equity method liabilities – CMS ACO Models(2) | 9,786 | 12,290 |
| Other | 3,346 | 8,232 |
| $50,287 | $76,121 |
(1)Represents unasserted claims.
(2)See Note 14 for additional discussion related to the Company's equity method liabilities related to its CMS ACO Models investments.
NOTE 8. Debt
On February 18, 2021, the Company executed a credit facility agreement (as amended by the First Amendment to Credit Agreement, dated as of March 1, 2021 and the Second Amendment to Credit Agreement, dated as of May 25, 2023, the “Credit Agreement”), which includes: (i) a $100.0 million secured term loan facility (the “Secured Term Loan Facility,” and together with the Secured Term Loan Facility, the “Credit Facility”) and (ii) a $100.0 million senior secured revolving credit facility (the “Secured Revolving Facility”) with a capacity to issue standby letters of credit in certain circumstances up to a maximum of $100.0 million. Subject to specified conditions and receipt of commitments, the Secured Term Loan Facility may be expanded (or a new term loan facility, revolving credit facility or letter of credit facility added) by up to (i) $50.0 million plus (ii) an additional amount determined in accordance with a formula tied to repayment of certain of the Company’s indebtedness. The maturity date of the Credit Facility is February 18, 2026.
As of September 30, 2025, the Company had $35.0 million outstanding under the Secured Term Loan Facility and availability under the Secured Revolving Facility was $16.8 million, as the Company had outstanding letters of credit totaling $83.2 million. The standby letters of credit are automatically extended without amendment forone-year periods, unless the Company notifies the institution in advance of the expiration date that the letter will be terminated. No amounts have been drawn on the outstanding letters of credit as of September 30, 2025.
Effective with the Second Amendment to Credit Agreement on May 25, 2023, the Company transitioned to the Secured Overnight Financing Rate (“SOFR”) as a benchmark interest rate used in the Credit Agreement. At the Company’s option, borrowings under the Credit Facility can be either: (i) Term SOFR Rate Loans, (ii) Daily Simple SOFR Rate Loans, or (iii) Base Rate Loans, each as defined in the Credit Agreement. Daily Simple SOFR Rate Loans and Term SOFR Rate Loans bear interest at a rate equal to the sum of 3.50% and the higher of (a) SOFR, as defined in the Credit Agreement, and (b)0%. Base Rate Loans bear interest at a rate equal to the sum of 2.50% and the highest of: (a)0.50% in excess of the overnight federal funds rate, (b) the prime rate established by the administrative agent from time to time, (c) the one-month SOFR rate (adjusted for maximum reserves) plus 1.00% and (d)0%. Additionally, the Company pays a commitment fee on the unfunded Secured Revolving Facility amount of 0.375%. The Company must also pay customary letter of credit fees. As of September 30, 2025, the effective interest rate on the Secured Term Loan Facility was 8.272%.
The Credit Facility is guaranteed by certain of the Company’s subsidiaries, including those identified as VIEs, and contain customary covenants including, among other things, limitations on restricted payments including: (i) dividends and distributions from restricted subsidiaries, (ii) requirements of minimum financial ratios, and (iii) limitation on additional borrowings based on certain financial ratios. Failure to meet any of these covenants could result in an event of default under the Credit Agreement. If an event of default occurs, the lenders could elect to declare all amounts outstanding under the Credit Agreement to be immediately due and payable. As of September 30, 2025, the Company was in compliance with all covenants under the Credit Facility.
As of September 30, 2025, the Company had $9.5 million outstanding surety bonds related to health plan payor risk-bearing capital contributions.
NOTE 9. Commitments and Contingencies
Legal Proceedings
From time to time, the Company is a party to, or has a significant relationship to, legal proceedings, lawsuits, and other claims that arise in the ordinary course of the Company's business. Except as described in this Note 9, the Company is not aware of any other legal proceedings or claims that it believes may have, individually or taken together, a material adverse effect on the Company's business, prospects, financial condition, results of operations or cash flows. The Company’s policy is to expense legal costs as they are incurred.
In February and March 2024, three class action lawsuits were filed and later consolidated as one matter captioned In re agilon health, inc. Securities Litigation, 1:24-cv-00297 (W.D. Tex.) (the “Consolidated Securities Matter”). The Consolidated Securities Matter names the Company and certain current and former members of the Company’s executive team and Board of Directors as defendants, among others. The Consolidated Securities Matter generally asserts securities fraud claims under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and under Sections 11, 12(a)(2) and 15 of the Securities Act of 1933, as amended (the “Securities Act”), in connection with statements made between April 2021 and February 2024 in the Company’s annual and quarterly reports, investor presentations, and earnings releases related to, among other things, the Company’s financial guidance, medical margin and Adjusted EBITDA results, growth strategy, and data management. The Consolidated Securities Matter seeks compensatory damages, judgment interest, attorney’s fees and costs, and other unspecified equitable and/or injunctive relief. The Company and other defendants filed motions to dismiss the complaint on November 8, 2024. On or about August 15, 2025, the Court issued an order on the motion to dismiss, dismissing some of the claims against the defendants and allowing others to proceed into the discovery phase of litigation. The Company intends to vigorously oppose the complaint, but is unable to predict the outcome or estimate any ultimate individual or aggregate amount of monetary liability or financial impact due to the early stages of the litigation.
In May and October 2024, two putative stockholder derivative class action lawsuits were filed: (1)Douglas v. Steven J. Sell et al., 1:24-cv-00531 (W.D. Tex.) and (2)Bingham v. Steven J. Sell et al., 1:24-cv-01181 (W.D. Tex.) (the “Derivative Matters”). The Derivative Matters name the Company and certain current and former members of the Company’s executive team and Board of Directors as defendants. The Derivative Matters generally assert claims under Sections 14(a) and 10(b) of the Exchange Act, as well as common law claims including breach of fiduciary duty, among others, in connection with statements made between April 2021 and February 2024 in the Company’s annual and quarterly reports, investor presentations, and earnings releases related to, among other things, the Company’s financial guidance, medical margin and Adjusted EBITDA results, growth strategy, and data management. The Douglas lawsuit also asserts claims under Section 20(a) of the Exchange Act in connection with the same allegations and seeks contribution under Section 11(f) of the Securities Act and Section 21D of the Exchange Act. The Derivative Matters seek compensatory damages, restitution, punitive damages, attorney’s fees and costs, and other relief. The plaintiff in the Douglas action also seeks corporate governance reforms. The Derivative Matters were consolidated in November 2024 into In Re agilon health, inc. Shareholder Derivative Litigation, 1:24-cv-00531-DII. The Derivative Matters are currently stayed during the discovery period for the Consolidated Securities Matter. On or about September 18, 2025, a third putative stockholder derivative class action lawsuit was filed in federal court in Ohio, titled Bushansky v. Steven J. Sell et al., 2:25-cv-01068 (S.D. Ohio). The allegations in this lawsuit are substantially the same as those asserted in the Derivative Matters. The Company plans to file a motion to transfer the matter to Texas to be consolidated with the pending Derivative Matters. The Company intends to vigorously oppose the Derivative Matters and the Bushansky lawsuit, but is unable to predict the outcome or estimate any ultimate individual or aggregate amount of monetary liability or financial impact due to the early stage of the litigation.
NOTE 10. Common Stock
Common Stock
During the three months ended September 30, 2025, the Company issued approximately 0.3 million shares of common stock primarily in connection with vesting of stock-based awards. During the nine months ended September 30, 2025, the Company issued approximately 2.4 million shares of common stock primarily in connection with vesting of stock-based awards.
During the three months ended September 30, 2024, the Company issued approximately 0.5 million shares of common stock primarily in connection with exercises and vesting of stock-based awards. During the nine months ended September 30, 2024, the Company issued approximately 3.6 million shares of common stock primarily in connection with exercises and vesting of stock-based awards. Additionally, during the nine months ended September 30, 2024, the
Company issued approximately 2.0 million shares of common stock to settle liabilities related to the exchange of common stock for reduced physician partner compensation percentage in certain ACO REACH entities.
NOTE 11. Net Income (Loss) Per Common Share
Basic net income (loss) per common share (“EPS”) is computed based upon the weighted average number of common shares outstanding. Diluted net income (loss) per common share is computed based upon the weighted average number of common shares outstanding plus the impact of common shares issuable from the assumed conversion of stock options, certain performance restricted stock units, and unvested restricted stock units. Only those instruments having a dilutive impact on basic net income (loss) per share are included in diluted net income (loss) per share during the periods presented.
The following table illustrates the computation of basic and diluted EPS (in thousands, except per share amounts):
| Three Months EndedSeptember 30, | Nine Months EndedSeptember 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Numerator | ||||
| Income (loss) from continuing operations | $(110,207) | $(116,432) | $(216,465) | $(143,847) |
| Noncontrolling interests’ share in (earnings) loss from continuing operations | — | — | — | (50) |
| Net income (loss) attributable to common stockholders before discontinued operations | (110,207) | (116,432) | (216,465) | (143,897) |
| Income (loss) from discontinued operations | — | (1,183) | 14,000 | (10,464) |
| Net income (loss) attributable to common stockholders | $(110,207) | $(117,615) | $(202,465) | $(154,361) |
| Denominator | ||||
| Weighted average shares outstanding – basic and diluted | 414,465 | 411,591 | 413,751 | 410,604 |
| Net income (loss) per share attributable to common stockholders | ||||
| Net income (loss) per common share from continuing operations, basic and diluted | $(0.27) | $(0.29) | $(0.52) | $(0.35) |
| Net income (loss) per common share from discontinued operations, basic and diluted | $— | $— | $0.03 | $(0.03) |
The following table provides the potential shares of common stock that were excluded from the calculation of diluted net income (loss) per share attributable to common stockholders because their effect would have been anti-dilutive (in thousands):
| September 30, | ||
|---|---|---|
| 2025 | 2024 | |
| Stock options | 19,463 | 16,690 |
| Restricted stock units | 22,583 | 18,695 |
NOTE 12. Goodwill and Amortizable Intangible Assets
As of both September 30, 2025 and December 31, 2024, the Company’s goodwill balance was $24.1 million. There were no events or circumstances that warranted an interim impairment test for goodwill during the nine months ended September 30, 2025.
As of September 30, 2025 and December 31, 2024, the Company’s gross carrying amount of amortizable intangible assets was $136.0 million and $123.8 million, respectively, with accumulated amortization of $60.7 million and
$51.0 million, respectively. For the three months ended September 30, 2025 and 2024, the Company recognized $3.6 million and $3.1 million, respectively, in amortization expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations. For the nine months ended September 30, 2025 and 2024, the Company recognized $10.1 million and $9.1 million, respectively, in amortization expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations.
NOTE 13. Supplemental Cash Flow Information
The following table provides supplemental cash flow information (in thousands):
| Nine Months EndedSeptember 30, | ||
|---|---|---|
| 2025 | 2024 | |
| Supplemental cash flow information: | ||
| Interest paid | $4,774 | $3,263 |
| Income taxes paid | 669 | 548 |
| Supplemental disclosure of non-cash investing and financing activities: | ||
| Right-of-use asset obtained in exchange for new operating lease liability | 1,602 | 326 |
| Settlement of liabilities through issuance of stock | — | 15,230 |
The following table summarizes cash, cash equivalents and restricted cash equivalents (in thousands):
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Cash and cash equivalents | $171,684 | $188,231 |
| Restricted cash and equivalents(1) | — | 5,629 |
| Cash, cash equivalents and restricted cash equivalents | $171,684 | $193,860 |
(1)Restricted cash and equivalents primarily consist of amounts used as collateral to secure letters of credit that the Company is required to maintain pursuant to contracts with payors.
NOTE 14. Variable Interest Entities
Consolidated Variable Interest Entities
agilon health, inc.’s consolidated assets and liabilities as of September 30, 2025 and December 31, 2024 include certain assets of VIEs that can only be used to settle the liabilities of the related VIE. The VIE creditors do not have recourse to agilon health, inc.
agilon health, inc.’s consolidated assets and liabilities include VIE assets and liabilities as follows (in thousands):
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Assets | ||
| Cash and cash equivalents | $59,378 | $78,650 |
| Restricted cash equivalents | — | 5,627 |
| Receivables, net | 946,571 | 1,015,753 |
| Prepaid expenses and other current assets, net | 33,296 | 17,725 |
| Property and equipment, net | 707 | 1,255 |
| Intangible assets, net | 54,021 | 49,406 |
| Other assets, net | 4,330 | 4,790 |
| Liabilities | ||
| Medical claims and related payables | 1,059,398 | 931,664 |
| Accounts payable and accrued expenses | 124,634 | 199,432 |
| Other liabilities | 1,351 | 2,270 |
Risk-bearing Entities. At September 30, 2025, the Company operates 33 wholly-owned risk-bearing entities (“RBEs”) for the purpose of entering into risk-bearing contracts with payors. Each RBE’s equity at risk is considered insufficient to finance its activities without additional support, and, therefore, each RBE is considered a VIE. The Company consolidates the RBEs as it has determined that it is the primary beneficiary because it has: (i) the ability to control the activities that most significantly impact the RBEs’ economic performance; and (ii) the obligation to absorb losses or right to receive benefits that could potentially be significant to the RBEs. Specifically, the Company has the unilateral ability and authority, through the RBE governance and management agreements, to make significant decisions about strategic and operating activities of the RBEs, including negotiating and entering into risk-bearing contracts with payors, and approving the RBEs’ annual operating budgets. The Company also has the obligation to fund losses of the RBEs and the right to receive a significant percentage of any financial surplus generated by the RBEs. The assets of the RBEs primarily consist of cash and cash equivalents, receivables, net, intangible assets, net, and other assets. Its obligations primarily consist of medical claims and related payables as well as operating expenses of the RBEs (accounts payable and accrued expenses), including incentive compensation obligations to the Company’s physician partners. On February 18, 2021, the Company executed the Credit Facility, which is guaranteed by certain of the Company’s VIEs. Assets generated by the RBEs (primarily from medical services revenues) may be used, in certain limited circumstances, to settle the Company’s contractual debt obligations.
Unconsolidated Variable Interest Entities
As of September 30, 2025, the Company had 12 equity method investments (liabilities), including 10 wholly-owned CMS ACO Models entities discussed below, that were deemed to be VIEs. The Company has determined that the activities that most significantly impact the performance of these VIEs consist of the allocation of resources to and other decisions related to clinical activities and provider contracting decisions. Because the Company does not have the ability to control these activities due to another party’s control of the VIEs’ board of directors, the Company has determined that it is not the primary beneficiary of and therefore does not consolidate these VIEs. The Company provided support to assist its CMS ACO Models investments in obtaining surety bonds related to risk-bearing capital contributions to CMS. As of September 30, 2025 and December 31, 2024, the CMS ACO Models investments had $131.6 million and $65.2 million, respectively, of outstanding surety bonds. The Company's maximum loss exposure as a result of the Company’s involvement with the unconsolidated VIEs cannot be quantified as the Company has the obligation to provide ongoing operational support to the unconsolidated VIEs, as needed.
Equity Method Investments
The following table summarizes the Company’s equity method investees (in thousands):
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Equity method investments - Other(1) | $9,369 | $9,365 |
| Equity method investments - CMS ACO Models(1) | 81,100 | 52,391 |
| Equity method liabilities - CMS ACO Models(2) | (9,786) | (12,290) |
(1)Included in Other assets, net in the condensed consolidated balance sheets.
(2)Included in Other liabilities in the condensed consolidated balance sheets.
The Company is a partner in 10 wholly-owned CMS ACO Models investments in collaboration with 13 of its physician group partners operating in 12 geographies. The combined summarized operating results of the Company’s CMS ACO Models investments are as follows (in thousands):
| Three Months EndedSeptember 30, | Nine Months EndedSeptember 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Medical services revenue | $458,309 | $454,410 | $1,306,580 | $1,341,484 |
| Medical services expense | (401,473) | (413,189) | (1,155,228) | (1,218,902) |
| Other medical expenses(1) | (33,660) | (23,817) | (87,750) | (71,490) |
| Income (loss) from operations(2) | 15,321 | 3,786 | 37,930 | 24,643 |
| Net income (loss)(3) | 13,141 | 2,014 | 31,213 | 17,566 |
(1)The three months ended September 30, 2025 and 2024, includes physician incentive expenses of $26.6 million and $16.5 million, respectively. The nine months ended September 30, 2025 and 2024, includes physician incentive expenses of $63.2 million and $47.0 million, respectively.
(2)The three months ended September 30, 2025 and 2024, includes operating expenses for services provided by the Company of $3.7 million and $9.1 million, respectively. The nine months ended September 30, 2025 and 2024, includes operating expenses for services provided by the Company of $12.1 million and $11.7 million, respectively.
(3)Included in Income (loss) from equity method investments in the condensed consolidated statements of operations.
The combined summarized balance sheet of the Company’s CMS ACO Models investments are as follows (in thousands):
| September 30,2025 | December 31,2024 | |
|---|---|---|
| Current assets | $307,345 | $444,963 |
| Noncurrent assets | 1,894 | 1,894 |
| Total assets | 309,239 | 446,857 |
| Current and total liabilities | 237,926 | 406,756 |
NOTE 15. Discontinued Operations
Discontinued operations is a component of an entity that has either been disposed of or is deemed held-for-sale and, (i) the operations and cash flows of the component have been or will be eliminated from ongoing operations as a result of the disposal transaction, and (ii) the entity will not have any significant continuing involvement in the operations of the component after the disposal transaction. On October 31, 2023, the Company completed the disposition of MDX Hawaii, Inc. and its related operations. The Company’s decision to exit Hawaii and the Independent Practice Association line of business represented a strategic shift that had a major effect on its operations and financial results. As such, the Company’s Hawaii operations are reflected in the condensed consolidated financial statements as discontinued operations for all periods presented.
The results of discontinued operations are as follows (in thousands):
| Three Months EndedSeptember 30, | Nine Months EndedSeptember 30, | |||
|---|---|---|---|---|
| 2025 | 2024 | 2025 | 2024 | |
| Expenses: | ||||
| Other medical expenses | — | 1,420 | — | 1,420 |
| General and administrative | $— | $(237) | $— | $281 |
| Income (loss) from operations | — | (1,183) | — | (1,701) |
| Adjustments on sale of assets, net | — | — | 14,000 | (8,763) |
| Net income (loss) from discontinued operations attributable to common shares | $— | $(1,183) | $14,000 | $(10,464) |
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.