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November 2021 Investor Presentation

10/29/2021 | 04:44pm EST

November 2021

Disclaimers and Forward-Looking Statements


Statements in this presentation that are not historical facts 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 "may," "will," "project," "expect," "believe," "intend," "anticipate," "seek," "target," "forecast," "plan," "potential," "estimate," "could," "would," "should," and other comparable and derivative terms or the negatives thereof. Examples of forward-looking statements include, among other things: (i) statements regarding timing, outcomes and other details relating to current, pending or contemplated new markets, new partnership structures, financing activities, dispositions, or other transactions discussed in this release; and (ii) statements regarding growth opportunities, ability to deliver sustainable long-term value, business environment, long term opportunities and strategic growth plan including without limitation with respect to expected revenue and net income, total and average membership, Adjusted EBITDA, and other financial projections and assumptions, as well as comparable statements included in other sections of this release. 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. Further, we cannot guarantee the accuracy of any such forward-looking statement contained in this presentation, and such forward-looking statements are subject to known and unknown risks and uncertainties that are difficult to predict. 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 our ability to achieve or maintain profitability in an environment of increasing expenses; our ability to identify and develop successful new geographies, physician partners and payors, or to execute upon our growth initiatives; our ability to execute our operation strategies or to achieve results consistent with our historical performance; our expectation that our expenses will increase in the future and the risk that medical expenses incurred on behalf of members may exceed the amount of medical revenues we receive; our ability to secure contracts with Medicare Advantage payors or to secure Medicare Advantage at favorable financial terms; our ability to recover startup costs incurred during the initial stages of development of our physician partner relationships and program initiatives; significant reductions in our membership; challenges for our physician partners in the transition to a Total Care Model; inaccuracies in the estimates and assumptions we use to project the size, revenue or medical expense amounts of our target market; the spread of, and response to, the novel coronavirus, or COVID-19, and the inability to predict the ultimate impact on us; security breaches, loss of data or other disruptions to our data platforms; the impact of devoting significant attention and resources to the provision of certain transition services in connection with the disposition of our California operations; our subsidiaries' lack of performance or ability to fund their operations, which could require us to fund such losses; our dependence on a limited number of key payors; the limited terms of our contracts with payors and that they may not be renewed upon their expiration; our reliance on our payors for membership attribution and assignment, data and reporting accuracy and claims payment; our dependence on physician partners and other providers to effectively manage the quality and cost of care and perform obligations under payor contracts; our dependence on physician partners to accurately, timely and sufficiently document their services and potential False Claims Act or other liability if any diagnosis information or encounter data are inaccurate or incorrect; reductions in reimbursement rates or methodology applied to derive reimbursement from, or discontinuation of, federal government healthcare programs, from which we derive substantially all of our total revenue; statutory or regulatory changes, administrative rulings, interpretations of policy and determinations by intermediaries and governmental funding restrictions, and their impact on government funding, program coverage and reimbursements; regulatory proposals directed at containing or lowering the cost of healthcare and our participation in such proposed models; the impact on our revenue of CMS modifying the methodology used to determine the revenue associated with MA members; our substantial indebtedness and the potential that we may incur additional indebtedness; and risks related to other factors discussed under "Risk Factors" in our Registration Statement on Form S-1. 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.


This presentation includes references to non‐GAAP financial measures, including but not limited to Adjusted EBITDA and network contribution. Management believes network contribution and Adjusted EBITDA help identify underlying trends in agilon's business and facilitate evaluation of period-to-period operating performance of agilon's live geographies by eliminating items that are variable in nature and not considered by the Company in the evaluation of ongoing operating performance, allowing comparison of agilon's recurring core business operating results over multiple periods. The Company also believes network contribution and Adjusted EBITDA provide useful information about agilon's operating results, enhance the overall understanding of past performance and future prospects, and allow for greater transparency with respect to key metrics used for financial and operational decision-making. Management believes network contribution and Adjusted EBITDA or similarly titled non-GAAP measures are widely used by investors, securities analysts, ratings agencies, and other parties in evaluating companies in agilon's industry as a measure of financial performance. Other companies may calculate network contribution and Adjusted EBITDA or similarly-titlednon-GAAP measures differently from the way the Company calculates these metrics. As a result, the Company's presentation of network contribution and Adjusted EBITDA may not be comparable to similarly titled measures of other companies, limiting their usefulness as comparative measures. Adjusted EBITDA and network contribution have limitations as analytical tools and should not be considered in isolation or as an alternative to GAAP measures or other financial statement data presented in agilon's consolidated financial statements. Reconciliation of such non-GAAP measures to the applicable GAAP measures are set forth in the appendix.


All rights to the trademarks included herein, other than the Company's trademarks, belong to their respective owners and our use hereof does not imply any endorsement by the owners of these trademarks.

Copyright © 2021 agilon health. Confidential internal document containing proprietary information. Do not distribute.


Who We Are

We Are…

Unlocking Medicare Advantage growth and value-based care at scale by partnering with leading independent physician groups

We Enable…

Existing physicians to quarterback their patients' total health


Creating a…

Highly aligned and efficient model

Resulting in…

A rapidly growing network of likeminded partners generating better outcomes for patients, physicians, and communities




Year exclusive

Diverse geographies

Medicare Advantage


among live and

members including live

implementing markets

and implementing


50k+ $1.2B


Direct Contracting

2020 revenue


members across 5

revenue CAGR

Direct Contracting


Note: Implementing markets refers to partners in geographies for which we are contracted to go-live in 2021 and 2022; 2020 numbers are unaudited and reflect continuing operations

Copyright © 2021 agilon health. Confidential internal document containing proprietary information. Do not distribute.


Investment Highlights

Large, Growing

First Mover

Long-Term Alignment with

Addressable Market


Local Physician Leaders

Unlocking Diverse &

Physicians Are


Non-Traditional Geographies


Growth Model

Copyright © 2021 agilon health. Confidential internal document containing proprietary information. Do not distribute.


Structural Changes Define the Future

Senior Population

Is Growing

Total Medicare Enrollment

Healthcare Now

Focused on Outcomes

Primary Care


PCPs influence up to 90% of costs

Medicare Advantage Enrollment







of Healthcare

Spending is


(or 25%)


of Health Plans

High Value PCP:

"Netflix" / PMPM





Believe Value-

Based Payments

Will Increase





2010 2020 2030P

% MA 24%




of MA Payments

Use Population-

Based Models

Traditional PCP:

"Blockbuster"/ FFS Transactional

Sources: CMS, CBO, Institutes of Medicine, KHN, Health Care Payment Learning & Action Network, Mercer

Copyright © 2021 agilon health. Confidential internal document containing proprietary information. Do not distribute.


This is an excerpt of the original content. To continue reading it, access the original document here.


agilon health Inc. published this content on 29 October 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 29 October 2021 20:43:07 UTC.

© Publicnow 2021
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