agilon health inc (AGL) 2025 Q3 法說會逐字稿

Good afternoon, and thank you all for attending the Agilon Health third-quarter 2025 earnings conference call. My name is Brika, and I will be your moderator for today. All lines will be muted during the presentation portion of the call, with an opportunity for questions and answers at the end.

下午好，感謝各位參加 Agilon Health 2025 年第三季財報電話會議。我叫布里卡，我將擔任今天的主持人。在會議演示環節，所有線路都會靜音，最後會留出問答環節。

I would now like to pass the conference over to your host, Evan Smith, Investor Relations at Agilon Health. Thank you. You may proceed, Evan.

現在我將把會議交給主持人，Agilon Health 的投資者關係負責人 Evan Smith。謝謝。你可以繼續了，艾文。

Thank you, operator. Good afternoon, and welcome to the call. With me are Executive Chairman Ron Williams and our CFO, Jeff Schwaneke. Following our prepared remarks, we will conduct a Q&A session.

謝謝接線生。下午好，歡迎參加電話會議。陪同我的是執行董事長羅恩·威廉斯和我們的財務長傑夫·施瓦內克。在發言結束後，我們將進行問答環節。

Before we begin, I would like to remind you that our remarks and responses to questions may include forward-looking statements. Actual results may differ materially from those stated or implied by forward-looking statements due to risks and uncertainties associated with our business. These risks and uncertainties are discussed in our SEC filings. Please note that we assume no obligation to update any forward-looking statements.

在開始之前，我想提醒各位，我們的發言和對問題的回答可能包含前瞻性陳述。由於與我們業務相關的風險和不確定性，實際結果可能與前瞻性聲明中明示或暗示的結果有重大差異。這些風險和不確定性已在我們的美國證券交易委員會文件中進行了討論。請注意，我們不承擔更新任何前瞻性陳述的義務。

Additionally, certain financial measures we will discuss in this call are non-GAAP financial measures. We believe that providing these measures helps investors gain a better and more complete understanding of our financial results, and it's consistent with how management views our financial results. A reconciliation of these non-GAAP financial measures to the most comparable GAAP measures is available in the earnings press release and Form 8-K filed with the SEC.

此外，我們將在本次電話會議中討論的某些財務指標是非GAAP財務指標。我們相信，提供這些措施有助於投資者更好、更全面地了解我們的財務業績，這與管理層對財務業績的看法是一致的。這些非GAAP財務指標與最可比較的GAAP指標的調節表可在獲利新聞稿和提交給美國證券交易委員會的8-K表格中找到。

And with that, let me turn the call over to Ron.

那麼，現在讓我把電話交給羅恩。

Thank you, Evan. Good afternoon, everyone, and thank you for joining us. I'm pleased to be with all of you today. For the third quarter, we reported revenue of $1.44 billion, medical margin of negative $57 million, and adjusted EBITDA of negative $91 million. We are also reinitiating 2025 guidance. While the quarter benefited from the execution of our clinical and quality programs as well as cost discipline, we nevertheless were impacted by lower-than-expected in-year RAF contribution as well as continued high costs from exited markets.

謝謝你，埃文。各位下午好，感謝各位的參與。今天能和大家在一起，我感到很高興。第三季度，我們公佈的營收為 14.4 億美元，醫療利潤為負 5,700 萬美元，調整後的 EBITDA 為負 9,100 萬美元。我們也將重新啟動 2025 年指導。雖然本季度受益於我們臨床和品質計劃的執行以及成本控制，但我們仍然受到低於預期的年度 RAF 貢獻以及退出市場帶來的持續高成本的影響。

As we look forward, we believe 2026 is shaping up to be a strong stepping stone in our transformation, with positive development in the first half, the enhanced financial data pipeline ramping to 80% in membership, and Part D exposure potentially moving to the low 30%. We believe we are establishing a solid 2026 baseline. We expect to have improved forecasting and lower volatility as well as significant internal and market-driven tailwinds. These tailwinds include our burden of illness and clinical pathways, initiatives driving broader identification and diagnosis of high-risk conditions, increased incentives for our quality performance, and more disciplined and favorable contracting. This is further supported by more favorable payer bids, including increased premiums, maximum out-of-pocket, and deductibles, benefiting Agilon’s financial performance.

展望未來，我們相信 2026 年將成為我們轉型的重要一步，上半年將取得積極進展，增強的財務數據管道將覆蓋 80% 的會員，而 D 部分風險敞口可能會降至 30% 左右。我們相信，我們正在為2026年奠定堅實的基礎。我們預計預測準確度將有所提高，波動性將降低，同時也將面臨顯著的內部和市場利好因素。這些有利因素包括我們的疾病負擔和臨床路徑、推動更廣泛地識別和診斷高風險疾病的措施、提高我們品質績效的激勵措施，以及更規範和更有利的合約。此外，支付方提出的更有利的報價也進一步支持了這一點，包括提高保費、最高自付額和免賠額，從而有利於 Agilon 的財務表現。

And last, we believe we are establishing a more efficient platform to drive additional operating leverage and have reduced our operating costs by $30 million. With increased visibility, we have reinstated our 2025 guidance. At the midpoint, we expect revenue of $5.82 billion, medical margin of $5 million, and adjusted EBITDA of negative $258 million, which includes the impact of lower-than-expected risk scores for 2025 and costs related to exited markets, partially offset by positive development in first-half medical cost, strong performance in ACO REACH, and continued operating cost discipline. Jeff will provide more detail in a moment.

最後，我們相信我們正在建立一個更有效率的平台，以推動更大的營運槓桿，並且已經減少了 3000 萬美元的營運成本。隨著市場前景更加明朗，我們恢復了 2025 年的業績指引。我們預計，在中間點，收入為 58.2 億美元，醫療利潤為 500 萬美元，調整後 EBITDA 為負 2.58 億美元，其中包括 2025 年風險評分低於預期以及退出市場相關成本的影響，部分被上半年醫療成本的積極發展、ACO REACH 的強勁表​​現以及持續的運營成本控制所抵消。傑夫稍後會提供更多細節。

Our focus is on executing a strong finish to 2025 and a quick start in 2026. Our organization is executing with precision and purpose. Our strategic initiatives are tightly aligned with our mission and partners and centered on embedding urgency, focus, operational rigor, clinical excellence, and data-driven executional accountability across the enterprise, which we believe will translate into improved performance in 2026. Through investment in technology and efforts to expand our access to richer and more timely data, Agilon is leveraging data analytics and AI-driven insights to support delivery with a focus to improve the visibility and predictability of our financial performance.

我們的目標是在 2025 年取得圓滿成功，並在 2026 年迅速開啟新的篇章。我們的組織正在以精準和目標明確的方式執行任務。我們的策略性舉措與我們的使命和合作夥伴緊密一致，以在整個企業中嵌入緊迫感、專注力、營運嚴謹性、臨床卓越性和數據驅動的執行責任為中心，我們相信這將在 2026 年轉化為更好的業績。透過對科技的投資和努力擴大我們獲取更豐富、更及時的數據的途徑，Agilon 正在利用數據分析和人工智慧驅動的洞察力來支援交付，重點是提高我們財務績效的可見性和可預測性。

Through our enhanced data pipeline, which went live in the first quarter, we now have more timely direct payer data feeds with validated and highly correlated member-level clinical and claims data as well as member-level risk scores on approximately 80% of our members. We expect the increased visibility and alignment of our financial and operational data will enable us to more quickly identify and drive improvements. We remain extremely focused on the performance optimization initiatives we previously laid out. These are centered on improving the near-term profitability of the business, allowing us to drive improved medical margin, adjusted EBITDA, and cash flow performance in 2026.

透過我們在第一季上線的增強型數據管道，我們現在擁有更及時的直接支付方數據饋送，其中包含經過驗證且高度相關的會員級臨床和理賠數據，以及約 80% 會員的會員級風險評分。我們預計，財務和營運數據的可視性和一致性的提高將使我們能夠更快地發現並推動改進。我們將繼續高度重視先前製定的績效優化計畫。這些措施旨在提高公司近期的獲利能力，使我們能夠在 2026 年提高醫療利潤率、調整後 EBITDA 和現金流表現。

With respect to improved contract economics, we are currently in active negotiation with our payer partners for 2026. Based on our discussions to date, we are making strong progress on several fronts. First, further reduction in Part D exposure; second, an expansion in quality incentives; third, improved economic terms for Part C. And fourth, we expect continued narrowing of risk from supplemental benefits through better information. Based on the public commentary and initial review of payer bids, we expect more favorable bid design focused on MA profitability, including improved pricing, reduced benefits, increased deductibles, and maximum out-of-pockets which is expected to have a positive impact on Agilon’s medical margin in 2026.

關於改善合約經濟效益，我們目前正在與支付方合作夥伴積極協商 2026 年的相關事宜。根據我們迄今為止的討論，我們在多個方面都取得了顯著進展。首先，進一步降低D部分醫療保險的風險敞口；其次，擴大品質激勵措施；第三，改善C部分醫療保險的經濟條款；第四，我們預期透過更完善的信息，補充福利帶來的風險將持續降低。根據公眾評論和對支付方投標的初步審查，我們預計會有更多有利於 MA 盈利能力的投標設計，包括改善定價、減少福利、增加免賠額和最高自付費用，預計這將對 Agilon 在 2026 年的醫療利潤率產生積極影響。

We are also taking a very disciplined approach to contracting, and for those payers with benefit designs and pricing that are inconsistent with market dynamics, we are prepared to take decisive action. While this may result in reduced membership, we are focused on profitable growth and earning the appropriate economics for the value we are delivering. With respect to quality or Stars, approximately 75% of health plans’ Star ratings are directly impacted by the PCP, making our success in delivering four Stars in a majority of our markets critical for payers. Our programs enable care gap closure rates that exceed the overall MA average on key Star measures such as cancer screening and chronic condition management.

我們對合約簽訂也採取了非常嚴謹的態度，對於那些福利設計和定價與市場動態不符的付款方，我們準備採取果斷行動。雖然這可能會導致會員人數減少，但我們專注於獲利成長，並為我們所提供的價值獲得相應的財務回報。就品質或星級而言，約 75% 的健康計劃的星級評定直接受到 PCP 的影響，因此，我們在大多數市場成功獲得四星級對支付方至關重要。我們的計畫能夠實現護理缺口消除率，在癌症篩檢和慢性病管理等關鍵星級指標上，其比率超過了馬薩諸塞州的整體平均值。

To further enhance our Stars performance, we are leveraging our enhanced analytics capabilities and collaborating with our partners to further improve condition identification, diagnosis, and screening, leading to documenting and closing of gaps in care through treatment such as medication adherence. In early October, CMS released the 2026 Stars ratings, which will impact 2027. Approximately 75% of Agilon members are expected to be in 4-plus Star plans, an increase from 71% in the 2026 payment year. This also compares favorably to 65% in the overall Medicare Advantage market. In addition, for the 2026 Star ratings, Agilon achieved a consolidated average of 4.2 Stars across our markets. This supports our efforts for improved payer economics that are better aligned with Agilon's strong quality performance.

為了進一步提升我們的星級表現，我們正在利用我們增強的分析能力，並與我們的合作夥伴合作，進一步改進疾病識別、診斷和篩檢，從而記錄和彌補護理方面的差距，例如透過藥物依從性等治療手段。10月初，CMS發布了2026年星級評定，該評定將對2027年產生影響。預計約 75% 的 Agilon 會員將加入 4 星及以上計劃，比 2026 年付款年度的 71% 有所增加。與整個 Medicare Advantage 市場 65% 的比例相比，這一比例也相當可觀。此外，在 2026 年星級評定中，Agilon 在我們各市場的平均綜合評級為 4.2 顆星。這有助於我們改善支付方的經濟效益，使其與 Agilon 的卓越品質表現更加契合。

Our BOI program is also contributing to improvements in early and accurate identification, assessment, and documentation of a patient's comprehensive health conditions. By connecting the burden of illness assessment to our quality and care delivery programs, we can more effectively manage high-acuity, chronic disease categories like heart failure. We are on track for our palliative program and clinical pathways. Based on the performance to date, we believe this will positively contribute to our financial results in 2026.

我們的 BOI 計劃也有助於早期、準確地識別、評估和記錄患者的全面健康狀況。透過將疾病負擔評估與我們的品質和護理服務計劃聯繫起來，我們可以更有效地管理心臟衰竭等高風險慢性疾病類別。我們的安寧療護計畫和臨床路徑正在按計劃進行。根據目前的表現，我們相信這將對我們 2026 年的財務表現產生正面影響。

As a reminder, these patient-focused, physician-driven, and technology-enabled clinical pathways have been developed in collaboration with our physician partners and national experts. They enable our teams to close care gaps by looking at some of the highest prevalence chronic conditions which affect our patient population. With respect to our heart failure pathway, we are seeing encouraging results. By identifying and diagnosing these conditions earlier in the outpatient setting, our physician partners are better able to manage the progression of each illness and improve the quality of care for the patient.

再次提醒大家，這些以病人為中心、以醫生為主導、以技術為支撐的臨床路徑，都是與我們的醫師合作夥伴和國家級專家共同開發的。它們使我們的團隊能夠透過關注影響我們患者群體的一些最普遍的慢性疾病來彌補護理方面的差距。就我們的心臟衰竭治療方案而言，我們看到了令人鼓舞的結果。透過在門診環境中更早發現和診斷這些疾病，我們的醫生合作夥伴能夠更好地控制每種疾病的進展，並提高患者的照護品質。

We have reduced new inpatient heart failure diagnosis rates from 18% in 2024 to 5% in 2025 across our MA population. In markets where our virtual pharmacy solutions are active, about 50% of patients with heart failure and reduced ejection fraction are receiving guideline-directed medication therapy. This is approximately 30% higher than the national average. Similarly, when virtual pharmacy solutions are combined with transitions of care cardiology, we have seen 30-day readmission rates fall below 5%, as compared to the national average of approximately 20%. This performance is expected to continue as we expand the programming and we move into 2026 as more partners fully implement the program.

我們已將馬薩諸塞州人口中新確診的住院心臟衰竭患者比例從 2024 年的 18% 降低到 2025 年的 5%。在我們虛擬藥房解決方案活躍的市場中，約有 50% 的心臟衰竭和射血分數降低的患者正在接受指南指導的藥物治療。這比全國平均高出約 30%。同樣，當虛擬藥房解決方案與心臟病護理過渡相結合時，我們發現 30 天再入院率降至 5% 以下，而全國平均約為 20%。隨著我們擴大專案規模，並進入 2026 年，隨著更多合作夥伴全面實施該計劃，預計這種良好勢頭將繼續下去。

With respect to our palliative care program, we continue to make progress in our education, market penetration, and enrollment. By focusing on providing care in a hospice or home setting, we see better care satisfaction for the member and their families and less hospital admissions. As we move into 2026, in addition to existing programs, we are beginning to expand our COPD and dementia pilots and anticipate further adoption. In the quarter, we have also taken steps to optimize our cost structure to align with current market dynamics, including a more balanced near-term growth outlook.

在我們的安寧療護課程方面，我們在教育、市場滲透和招生方面不斷取得進展。透過專注於在臨終關懷中心或家庭環境中提供護理，我們發現患者及其家人對護理的滿意度更高，住院率也更低。進入 2026 年，除了現有的項目外，我們還將開始擴大 COPD 和癡呆症試點項目，並期待進一步推廣。本季度，我們也採取了措施來優化成本結構，以適應當前的市場動態，包括更平衡的近期成長前景。

The leadership team is working to strategically realign our organizational structure. We have made thoughtful decisions to streamline certain teams while simultaneously investing in other areas that will help drive our next chapter of innovation. Through the centralization of certain functions, implementation of technology, and alignment with our PCP partners, we have reduced our headcount and streamlined our capital requirements and third-party costs, all to gain greater operating leverage from the platform and support our growth objectives. These operating expense initiatives are expected to reduce our costs by approximately $30 million in 2026.

領導團隊正在努力對我們的組織結構進行策略性調整。我們經過深思熟慮，決定精簡某些團隊，同時投資其他領域，以推動我們下一個創新篇章的到來。透過集中某些職能、實施技術以及與我們的 PCP 合作夥伴保持一致，我們減少了員工人數，簡化了資本需求和第三方成本，所有這些都是為了從平台獲得更大的營運槓桿，並支持我們的成長目標。這些營運費用控制措施預計將在 2026 年為我們節省約 3,000 萬美元的成本。

Finally, while we are making progress in our search for a CEO with the skills, experience, and relationships that are aligned to our new path, we remain committed to moving decisively now to enhance performance and Agilon's position for sustainable value creation. Thank you for your continued support during this transition period.

最後，雖然我們在尋找一位具備與我們新發展方向相符的技能、經驗和人脈的首席執行官方面取得了進展，但我們仍然致力於現在就採取果斷行動，以提高業績和 Agilon 在可持續價值創造方面的地位。感謝您在此過渡時期給予的持續支持。

With that, I'll turn it over to Jeff.

接下來，我將把麥克風交給傑夫。

Thanks, Ron, and good afternoon. As Ron touched on, 2025 is a transformational year. We are advancing strategic initiatives that we started putting in place last year to improve our contract economics, reduce our risk, and optimize our cost structure. We believe the increased visibility gained from the enhanced data pipeline, advances we have made in our BOI and clinical pathways programs, a $30 million reduction in operating expenses, and a more disciplined approach to growth are expected to have a positive impact in 2026. For today's discussion, I will cover four key areas.

謝謝你，羅恩，下午好。正如羅恩所提到的，2025 年是一個具有變革意義的年份。我們正在推動去年開始實施的策略性舉措，以改善合約經濟效益、降低風險並優化成本結構。我們相信，增強的數據管道帶來的更高可見度、我們在 BOI 和臨床路徑計劃方面取得的進展、3000 萬美元的營運費用減少以及更嚴謹的成長方法，預計將在 2026 年產生積極影響。今天的討論，我將涵蓋四個關鍵領域。

First, I will walk through our third-quarter results. Second, I will provide details on our reinstated 2025 guidance and a bridge to our jumping-off point for 2026. Third, I will provide color on a significant number of tailwinds we believe will support improvement in our 2026 performance. And finally, I will discuss the strength of our capital position based on our expectations for 2026 and a more disciplined near-term growth outlook.

首先，我將介紹我們第三季的業績。其次，我將詳細介紹我們恢復的 2025 年指導方針，並為我們 2026 年的起點建立橋樑。第三，我將重點放在我們認為有助於提升 2026 年業績的許多好因素。最後，我將根據我們對 2026 年的預期以及更穩健的近期成長前景，討論我們資本狀況的實力。

Moving to our financial performance for the third quarter, starting with membership, Medicare Advantage membership at the end of Q3 2025 was 503,000 members compared to 525,000 members in Q3 2024. Our ACO REACH membership for Q3 was 115,000 members, compared to 132,000 members in the same period of 2024. As we discussed previously, our decision to take a measured approach to membership growth has resulted in a slight year-over-year decline, driven by previously disclosed partner exits and a smaller 2025 class. Total revenue for the third quarter 2025 was $1.44 billion compared to $1.45 billion in the same period of 2024. Our year-over-year revenue comparison continues to be impacted by lower-than-expected risk adjustment as well as the impact from market and payer contract exits.

接下來來看我們第三季的財務業績，首先是會員人數，截至 2025 年第三季末，Medicare Advantage 會員人數為 503,000 人，而 2024 年第三季末為 525,000 人。第三季我們的 ACO REACH 會員人數為 11.5 萬人，而 2024 年同期會員人數為 13.2 萬人。正如我們之前討論過的，我們決定採取穩健的會員增長策略，導致會員數量同比略有下降，這是由於之前披露的合夥人退出以及 2025 年會員人數較少所致。2025 年第三季總營收為 14.4 億美元，而 2024 年同期為 14.5 億美元。由於風險調整低於預期，以及市場和支付方合約退出帶來的影響，我們的年比收入比較結果持續受到影響。

During the third quarter, we received the remainder of the 2024 risk adjustment data and substantially all the mid-year 2025 risk adjustment data from our payer partners. This indicated the 2025 risk adjustment for the remaining 28% of members we did not include in our prior results was lower than the average. The third quarter reflects the impact of lower-than-expected revenue associated with 2025 risk adjustment scores of $73 million, including a nine-month true-up of approximately $50 million for the remaining 28%. We now estimate the full-year impact to medical margin for lower-than-expected risk adjustment is approximately $150 million.

第三季度，我們從支付方合作夥伴收到了 2024 年剩餘的風險調整資料和 2025 年中風險調整資料的大部分。這表明，對於我們先前結果中未包括的剩餘 28% 的成員，2025 年的風險調整低於平均值。第三季反映了與 2025 年風險調整評分相關的收入低於預期 7300 萬美元的影響，其中包括對剩餘 28% 的約 5000 萬美元的九個月調整。我們現在估計，低於預期的風險調整對全年醫療利潤的影響約為 1.5 億美元。

The larger-than-average impact for the remaining 28% is primarily driven by one payer representing a new market in 2024, where we also did not have data for 2023. This payer is now in our data pipeline, which provides us with confidence in establishing our risk adjustment baseline and potential for 2026. In addition, exited markets negatively impacted the quarter by $20 million.

其餘 28% 的受影響程度高於平均水平，主要是因為有一家支付方代表了 2024 年的新市場，而我們也沒有該市場 2023 年的數據。該付款方現在已納入我們的數據管道，這讓我們有信心確定我們的風險調整基準以及 2026 年的潛力。此外，退出市場也對本季造成了 2,000 萬美元的負面影響。

First-half cost trends continue to develop favorably and were approximately 5.7%. We took a prudent approach in the current quarter and recorded cost trends at a little over 6%. As we have previously stated, we have limited paid claims visibility at this point post quarter closed. Medical margin this quarter was negative $57 million compared to negative $58 million in Q3 2024. The current quarter reflects continued elevated cost trends in line with our expectations for the year.

上半場成本趨勢持續向好發展，約 5.7%。本季我們採取了謹慎的做法，成本趨勢略高於 6%。正如我們之前所述，季度結束後，目前我們對已支付索賠的可見性有限。本季醫療利潤為負 5,700 萬美元，而 2024 年第三季為負 5,800 萬美元。本季成本持續走高，與我們對全年的預期一致。

In addition, this includes the previously mentioned risk adjustment and exited market impact. Adjusted EBITDA for the quarter was negative $91 million compared to negative $96 million in the third quarter of 2024. The third quarter reflects the items I already highlighted, partially offset by lower geography entry costs and benefit from continued operating cost discipline.

此外，這也包括前面提到的風險調整和退出市場的影響。本季調整後 EBITDA 為負 9,100 萬美元，而 2024 年第三季為負 9,600 萬美元。第三季反映了我之前重點提到的那些問題，部分被較低的地域准入成本和持續的營運成本控制所帶來的好處所抵消。

We are very pleased with our strong ACO REACH performance during the quarter, including our final 2024 reconciliation. Adjusted EBITDA related to this program this quarter was ahead of expectations at $18 million. ACO REACH continues to demonstrate the value creation Agilon can deliver and is shaping the way we are transforming our MA business, reducing our exposure for things outside of our control like Part D and supplemental benefits while focusing on improved economics and incentives for Agilon's quality, clinical, and medical cost performance.

我們對本季度 ACO REACH 的強勁表​​現非常滿意，包括我們最終的 2024 年對帳。本季與該項目相關的調整後 EBITDA 超出預期，達到 1800 萬美元。 ACO REACH持續展現 Agilon 能夠創造的價值，並塑造我們轉型 MA 業務的方式，減少我們對 Part D 和補充福利等我們無法控制的因素的風險敞口，同時專注於提高 Agilon 在品質、臨床和醫療成本績效方面的經濟效益和激勵措施。

On the balance sheet, we ended the quarter with $311 million in cash and marketable securities, and $172 million of off-balance sheet cash held by our ACO entities. Next, let's move to our medical cost trend outlook and reinstated 2025 guidance.

從資產負債表來看，本季末我們擁有 3.11 億美元的現金和有價證券，以及由我們的 ACO 實體持有的 1.72 億美元的表外現金。接下來，我們來看看醫療成本趨勢展望以及重新發布的 2025 年指引。

Managing medical cost trends remains a top priority. For the first half of 2025, medical cost trends have been stable but elevated in areas such as inpatient and Part B oncology drugs and restated favorably relative to our expectations. We anticipate the medical cost trend to remain in line with our expectations.

控制醫療成本趨勢仍是重中之重。2025 年上半年，醫療成本趨勢保持穩定，但住院和 B 部分腫瘤藥物等領域的成本有所上升，並且相對於我們的預期而言，情況有所好轉。我們預期醫療成本趨勢將與我們的預期保持一致。

Now moving to guidance, with greater visibility as we head into the year-end, we are reinstating our full-year 2025 guidance. I will also provide some color on our expectations for 2026 based on our actions to date and initial review of payer bids and contracting efforts. For the full year 2025, we expect Medicare Advantage membership in the range of 503,000 to 506,000 with ACO model membership projected to be between 113,000 to 115,000. We expect revenue for 2025 to be in the range of $5.81 billion to $5.83 billion, reflecting the impact of membership shifts and improved revenue yield from payer contracts.

現在，隨著年底臨近，前景更加明朗，我們將重新發布 2025 年全年業績指引。我還會根據我們迄今為止的行動以及對付款方投標和合約工作的初步審查，對 2026 年的預期做一些說明。預計到 2025 年全年，Medicare Advantage 會員人數將在 503,000 至 506,000 人之間，而 ACO 模式會員人數預計在 113,000 至 115,000 人之間。我們預計 2025 年的收入將在 58.1 億美元至 58.3 億美元之間，這反映了會員結構變化和支付方合約收入提高的影響。

Revenue outlook also reflects lower-than-expected 2025 risk adjustment performance of approximately $150 million, prior year development to date of $70 million, and exited markets of approximately $60 million. Full-year medical margins are projected to be between negative $5 million to $15 million and adjusted EBITDA guidance range of negative $270 million to negative $245 million. We expect to end the year with approximately $310 million of cash on our balance sheet, including approximately $65 million held off balance sheet by our ACO entities.

收入前景也反映出低於預期的 2025 年風險調整績效（約 1.5 億美元）、前一年迄今的發展（約 7,000 萬美元）以及退出市場（約 6,000 萬美元）。預計全年醫療業務利潤率為負 500 萬美元至負 1,500 萬美元，調整後 EBITDA 預期範圍為負 2.7 億美元至負 2.45 億美元。我們預計年底資產負債表上的現金約為 3.1 億美元，其中包括我們 ACO 實體持有的表外現金約 6,500 萬美元。

We have provided a bridge in the earnings presentation we issued today that walks from the current guide for 2025 to our jumping-off point for 2026. The expected $135 million medical margin jumping-off point for 2026 includes approximately $150 million of lower-than-expected risk adjustment contribution for 2025.

我們在今天發布的盈利報告中提供了一座橋樑，從目前的 2025 年指導方針過渡到我們 2026 年的起點。預計 2026 年醫療利潤率的起始點為 1.35 億美元，其中包括 2025 年低於預期風險調整貢獻的約 1.5 億美元。

Now let me provide some color on 2026. While we are not prepared to provide specific 2026 guidance at this time, I will walk through why we are optimistic about next year as illustrated on slide 7 of our earnings presentation. We see several tailwinds, including macro factors like the 9% benchmark rate increase, better aligned payer contracts, and the disciplined cost actions Ron outlined that we believe will both drive material improvement in our performance in 2026 and establish a path for consistent improvement as we move beyond next year.

現在讓我來展望一下2026年。雖然我們目前還無法提供具體的 2026 年業績指引，但我將按照我們收益報告第 7 頁幻燈片中的內容，解釋我們為何對明年持樂觀態度。我們看到了一些有利因素，包括宏觀因素，例如 9% 的基準費率增長、更協調的支付方合約以及 Ron 概述的嚴格的成本控制措施，我們相信這些因素都將推動我們在 2026 年的業績得到實質性改善，並為我們明年及以後的持續改進奠定基礎。

First, in the third quarter, we completed restructuring actions to improve our operating expenses. We rationalized other medical expenses, including better alignment of incentives with our PCP partners, reduced overhead and vendor costs in line with the current revenue run rate, and a more balanced growth outlook. We estimate that this will drive $30 million in cost and adjusted EBITDA benefit in 2026, with additional opportunities for savings in 2027.

首先，在第三季度，我們完成了重組措施，以改善我們的營運費用。我們對其他醫療費用進行了合理化調整，包括更好地與我們的 PCP 合作夥伴協調激勵機制，降低管理費用和供應商成本以符合當前的收入運作率，以及更平衡的成長前景。我們預計這將在 2026 年帶來 3000 萬美元的成本和調整後 EBITDA 收益，並在 2027 年帶來更多節省的機會。

Second, we have taken a more disciplined approach to payer contracting, which includes incremental percentage of premium and enhanced quality incentives from payers for the value we deliver. This is expected to drive revenue growth on a PMPM basis potentially greater than the 9% CMS Final Rate Notice for 2026. We have reviewed payer bids across our markets, and on average, we see payers bidding for profitability with benefit design changes, including increases in premiums, deductibles, and maximum out-of-pocket expenses, and a reduction in supplemental benefits. This is expected to be a positive offset to cost trend in 2026.

其次，我們對支付方合約採取了更嚴謹的態度，包括提高保費百分比，並提高支付方對我們所提供的價值的品質激勵。預計這將推動按人均月均收入成長，增幅可能超過 2026 年 CMS 最終費率通知中規定的 9%。我們已經審查了我們各個市場的付款方投標，平均而言，我們發現付款方為了盈利而進行投標，透過改變福利設計來實現盈利，包括提高保費、免賠額和最高自付費用，以及減少補充福利。預計這將對 2026 年的成本趨勢起到積極的抵消作用。

As a reminder, 2025 included a 1% benefit from payer bids. As part of our disciplined contracting strategy, we are taking decisive action market by market with payer contracts that do not meet a minimum threshold for profitability. While our contracting for 2026 is not final, if we cannot come to appropriate economic terms in certain markets, we may not contract with specific payers in these markets.

提醒一下，2025 年的收益包括支付方競標的 1%。作為我們嚴謹的合約策略的一部分，我們正在逐個市場地對那些未達到最低獲利門檻的付款方合約採取果斷行動。雖然我們 2026 年的合約尚未最終確定，但如果我們無法在某些市場達成適當的經濟條款，我們可能不會與這些市場中的特定付款方簽訂合約。

As part of our discussions, we may also transition some of these members to a care coordination fee with additional performance incentives. Depending on the outcome, this may reduce our overall membership in 2026, though this impact may be mitigated if a member shifts to another payer with more favorable economics for Agilon or moves to a coordinated care fee arrangement. This disciplined approach is expected to be favorable to medical margin and adjusted EBITDA in 2026 and beyond.

作為討論的一部分，我們可能還會將部分成員的收費方式改為收取護理協調費，並輔以額外的績效獎勵。根據結果，這可能會減少我們 2026 年的會員總數，但如果會員轉向對 Agilon 經濟效益更有利的其他付款方或轉向協調護理費用安排，則這種影響可能會減輕。這種嚴謹的方法有望在 2026 年及以後對醫療利潤率和調整後 EBITDA 產生正面影響。

Our contracting efforts also include additional steps to reduce variability in our performance by effectively managing multi-year contract terms to reduce our exposure to macro cost trend volatility, interim payer benefit design changes, and pricing that may be detrimental to our capitated economics. This includes reducing our payer contract term length if needed or adding additional material adverse change clauses to the contracts. In addition, all our exposure to Part D in 2025 was primarily related to carved-out or exited markets. We are continuing to further reduce our exposure.

我們的合約工作還包括採取其他措施來減少業績波動，透過有效管理多年合約條款來降低我們面臨的宏觀成本趨勢波動、臨時支付方福利設計變更以及可能損害我們按人頭付費經濟效益的定價風險。這包括在必要時縮短與付款方的合約期限，或在合約中增加其他重大不利變更條款。此外，我們在 2025 年對 Part D 的所有敞口主要與剝離或退出的市場有關。我們將繼續進一步降低風險敞口。

With respect to BOI, we are confident that the enhanced data pipeline, which now includes the outlier payer from the remaining 28% of our members, AI advances for high-risk member identification and diagnosis in our BOI program, and execution on clinical pathways will deliver results over and above the final year of V28. Our confidence is based on a review of validated codes in our data pipeline and our ability to deliver results above the impact of V28.

關於 BOI，我們相信，增強的數據管道（現在包括了剩餘 28% 會員中的異常支付者）、用於 BOI 計劃中高風險會員識別和診斷的 AI 進步以及臨床路徑的執行，將帶來比 V28 最後一年更好的結果。我們的信心源於對資料管道中已驗證程式碼的審查，以及我們能夠交付超出 V28 影響的結果的能力。

Last, on our cash outlook, with the anticipated performance improvement in 2026 from our initiatives and the macro factors I just walked through, combined with our focus on working capital management, we expect to end 2025 with approximately $310 million in cash and 2026 with at least $100 million in cash on our balance sheet, including cash held in our ACO REACH entities. Before I close, given our current stock price, we anticipate pursuing a reverse stock split and expect to seek stockholder approval at our Annual General Meeting in 2026.

最後，關於我們的現金前景，鑑於我們的各項舉措和剛才我提到的宏觀因素預計將在 2026 年帶來業績改善，再加上我們對營運資本管理的重視，我們預計到 2025 年底將擁有約 3.1 億美元的現金，到 2026 年資產負債表上將至少擁有 1 億美元的現金，其中包括我們持有的現金，其中包括我們持有的現金，其中包括我們持有的現金，其中包括我們持有的現金，其中包括 1 億美元的現金，其中包括我們持有的現金。最後，鑑於我們目前的股價，我們預計將進行反向股票分割，並希望在 2026 年的年度股東大會上尋求股東批准。

In summary, while we continue to operate in a challenging environment, the actions we are taking to refine our strategy, improve operational execution and financial visibility, and strengthen our financial position are expected to have a positive impact on our performance in 2026 and beyond. We remain confident in the value we bring to our members, PCP partners and payers, and our ability to navigate the near-term headwinds while positioning Agilon for long-term success.

總而言之，儘管我們繼續在充滿挑戰的環境中運營，但我們為完善策略、提高營運執行力和財務透明度以及加強財務狀況而採取的行動，預計將對我們 2026 年及以後的業績產生積極影響。我們仍然對我們為會員、PCP合作夥伴和付款人帶來的價值充滿信心，並且我們有能力應對近期的不利因素，同時為Agilon的長期成功奠定基礎。

With that, operator, let's move to the Q&A portion of the call.

那麼，接線員，我們進入問答環節。

(Operator Instructions) Michael Ha, Baird.

（操作說明）Michael Ha，Baird。

I see on your slide that you have ACO REACH as a negative impact for next year, and I know the risk corridors are narrowing next year to a 10% savings rate. I think Agilon’s at 13%. If on our back-of-the-envelope math, we’re getting somewhere around $10 million to $15 million of EBITDA impact. Is that the right ballpark to frame it? Is that what you’re highlighting in your slide? Are you able to offset it?

我從你的幻燈片上看到，ACO REACH 對明年產生了負面影響，而且我知道明年的風險走廊將收窄至 10% 的節省率。我認為 Agilon 佔 13%。根據我們粗略的估算，EBITDA 影響大約在 1000 萬美元到 1500 萬美元之間。這樣概括是否恰當？這就是你在投影片中重點強調的內容嗎？你能抵銷這部分損失嗎？

Does this narrowing of the savings rate create any friction with your ACO REACH partners? Just thoughts here would be great.

降低儲蓄率是否會為您的 ACO REACH 合作夥伴帶來任何摩擦？歡迎大家分享想法。

This is Jeff. I actually think the re-baselining of the risk adjustment is actually more meaningful for us. And so yes, what we are reflecting here is that there were several changes to the ACO REACH program, and I think we’ve commented about this before that we do expect lower economics from the program while still contributing, I would say, very good margin. And we’re reviewing our ACOs right now determining what model is actually better, and I think we’ve made the decision on some of our ACOs to move them to the MSSP program as we think about 2026 because the economics would be better in that program.

這是傑夫。我認為重新確定風險調整基準對我們來說實際上更有意義。所以，是的，我們在這裡反映的是 ACO REACH 計劃發生了一些變化，我認為我們之前已經評論過，我們預計該計劃的經濟效益會降低，但仍然會貢獻非常好的利潤。我們現在正在審查我們的 ACO，以確定哪種模式更好，我認為我們已經決定將一些 ACO 轉移到 MSSP 計劃，因為考慮到 2026 年，該計劃的經濟效益會更好。

Not going to really size the impact right now, we’re getting a little ahead here on the '26 guide, but you are correct. It’s really driven by those changes.

現在還不能真正評估其影響，我們在這裡在 2026 年的指南上稍微超前了一些，但你是對的。這確實是由這些變化所驅動的。

Jack Slevin, Jefferies.

傑克‧斯萊文，傑富瑞集團。

I guess, this might be a little high level because I acknowledge it’s a bit early, but I just wanted to frame some of your commentary around potential further exits from payer contracts. And maybe I’ll just broaden it out to say, are you contemplating, I guess, one, are market exits on the table at this point or is it really just specific payers?

我知道現在討論這個問題可能有點超前，因為我意識到現在討論這個問題還為時過早，但我只是想圍繞支付方合約可能進一步退出這一問題來展開你的一些評論。也許我應該把問題擴大到其他方面，例如，您是否正在考慮，我想，第一，目前市場退出是否在考慮範圍內，還是僅僅針對特定的支付方？

And then two, if there's any way to get a sense of the order of magnitude that might be at play here, just trying to frame out sort of what we might be looking at going forward. Any thoughts or sort of qualitative color would be really helpful.

其次，如果有什麼方法可以了解這裡可能的規模，只是想大致了解我們未來可能會看到的情況。任何想法或對顏色的定性描述都將非常有幫助。

You're right, it is a little early. We're kind of midstream on the contracting here as we think about 2026. I think the takeaway for you would be, listen, we are taking a very disciplined approach, and where the economics don't make sense for the value that we're delivering, ultimately, we don't have to do business with that payer. Some of those members may move to another payer in that market, or we may enter into a care management deal or care coordination fee with upside for quality and things like that.

你說得對，現在確實有點早。我們現在正處於合約簽訂的中期階段，同時也在考慮2026年的情況。我認為你應該明白的是，我們採取的是非常嚴謹的態度，如果經濟效益與我們提供的價值不符，那麼最終，我們不必與該付款方開展業務。這些會員中的一些可能會轉投該市場的其他支付方，或者我們可能會達成護理管理協議或護理協調費協議，從而提高護理品質等等。

I think the point I would take away is, any potential reduction in membership would be beneficial to the medical margin and the EBITDA for Agilon. And that's really what we're focused on. So unfortunately, I can't size it for you right now, but any reduction would ultimately be to the benefit of the bottom line.

我認為，會員人數的任何潛在減少都將有利於 Agilon 的醫療利潤率和 EBITDA。而這正是我們真正關注的重點。所以很遺憾，我現在無法幫您確定尺寸，但任何降價最終都會有利於利潤。

Yeah, I would just add -- Ron here -- that we have been very clear with the payers about the value that our physician partners create, both in terms of the Stars program as well as closing gaps in care. And I think we've been very clear that we are contracting for tomorrow and not the historical relationship that we've had in a more normalized trend, more normalized utilization. I think the good news is that we've been working with some of our partners who understand this, who are exhibiting an attitude that's supportive of the kinds of objectives that we have. So we're very clear. This is about being profitable and achieving the kind of margin that we want, and we're committed to working through that.

是的，我還要補充一點——我是 Ron——我們已經非常明確地向支付方說明了我們的醫生合作夥伴所創造的價值，無論是在“星級計劃”方面，還是在彌合醫療差距方面。而且我認為我們已經非常明確地表明，我們簽訂的是面向未來的合同，而不是面向過去那種更正常化趨勢、更正常化利用率的歷史關係。我認為好消息是我們一直在與一些理解這一點的合作夥伴合作，他們表現出支持我們目標的態度。所以我們非常清楚。這關乎獲利和實現我們想要的利潤率，我們將致力於實現這一目標。

Jailendra Singh, Truist Securities.

賈倫德拉辛格，Truist Securities。

Hi, this is Peyton Engle on for Indra Singh. Thank you for taking my question. I guess just to start, is there any type of update you can provide on the CEO search and how that's going, and if you guys have made a decision between internal and external candidates?

大家好，我是佩頓恩格爾，代我為英德拉辛格報道。感謝您回答我的問題。首先，您能否提供CEO遴選工作的最新進展，以及您是否已經決定由內部候選人還是外部候選人擔任？

Yeah, I would say that I've been spending a good deal of time. I think I'm pleased to say that we have some very good candidates coming forward. The process is open to all candidates who are interested in applying for the opportunity, and I would say that we feel good about where we are in pace and timing. I certainly wouldn't forecast a conclusion here.

是的，可以說我花了不少時間。我很高興地告訴大家，我們有一些非常優秀的候選人。所有有興趣申請該職位的候選人都可以申請，我認為我們目前在進度和時間表方面都感到滿意。我當然不會預測這裡會有什麼結論。

I think the most important thing for you to know is that while we don't have a permanent CEO, I am 100% focused on what we need to do to improve performance in the business. I meet regularly on a daily basis. The Office of the Executive Chairman meets every day. We focus on the critical priorities and objectives with the goal of having a very strong finish to the year and a strong start for next year. So while no timeline on the process, this is not caretaking. This is active engagement and focused execution.

我認為您最需要了解的是，雖然我們目前還沒有正式的首席執行官，但我會百分之百專注於我們需要做些什麼來提高公司的業績。我每天都會定期見面。執行主席辦公室每天開會。我們專注於關鍵優先事項和目標，目標是為今年畫下一個圓滿的句號，並為明年打下一個好的開始。所以，雖然沒有給出具體時間表，但這並不是照顧。這是積極參與和專注執行。

Yeah, and if you don't mind if I could squeeze in just a quick follow-up. Thank you for all the color on the medical cost trends. Is there just anything to call out in terms of what you saw in Q3 in areas that were maybe high or cooling off a little bit? And then also if there's any color you can provide into 2024?

是的，如果您不介意的話，我可以再補充一個簡單的問題嗎？感謝您對醫療成本趨勢的詳細分析。您在第三季觀察到的一些領域，例如某些領域，價格可能很高，或者價格略有下降，您有什麼需要特別指出的嗎？那麼，您能否為 2024 年提供一些色彩靈感呢？

Yeah, I think it's the same issues we've highlighted in the past quarters. Really, it's inpatient Part B drug spend specifically oncology. Inpatient continues to run a little bit high as well. I think those have been consistent over the last several quarters, so nothing new here. I would say that the first-half medical cost trends have all restated favorably.

是的，我認為這和我們過去幾季強調的問題是一樣的。實際上，這是住院患者 B 部分藥物支出，專門用於腫瘤治療。住院人數也仍然略高。我認為這些情況在過去幾季一直都很穩定，所以沒有什麼新鮮事。我認為上半年的醫療成本趨勢都已重回正軌。

So Q1's come down, Q2 has come down since we last spoke, which is good, and it's just a little bit over the mid-5% range. And again, for Q3 we just took what I call a relatively conservative approach in the low 6s. Ultimately, we don't have a lot of paid claims for that, and so we'll have to see how that estimate plays out as we get into the fourth quarter.

所以第一季下降了，第二季自從我們上次談話以來也下降了，這是好事，而且現在略高於 5% 的中段範圍。同樣，對於第三季度，我們採取了我所謂的相對保守的做法，定價在 6 分左右。最終，我們在這方面並沒有很多已支付的索賠，所以我們需要看看到了第四季度，這個估計會如何發展。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

I think I heard you say there's about $65 million currently at the ACO entity level. I guess, is there a minimum amount of cash you need to have allocated to the REACH entities, and in the year-end 2026 balance for cash, what's contemplated at the ACO REACH level?

我好像聽您說過，目前 ACO 實體層面大約有 6,500 萬美元。我想問的是，是否需要為 REACH 實體分配最低現金額？在 2026 年底的現金餘額中，ACO REACH 層級考慮了哪些事項？

Yeah. So actually, at the end of the quarter, we had $172 million in the REACH entities, and there's cash settlements that happen in the fourth quarter. And so the way we think about it is once those settlements are processed in Q4, we'll roughly be at the $60 million to $65 million. And as you think about the year-end balance, the $310 million we quoted, it includes that $65 million. So we expect to end the year roughly at $310 million, and that includes $65 million from REACH.

是的。所以實際上，到本季末，我們在 REACH 實體中有 1.72 億美元，並且在第四季度會發生現金結算。因此，我們認為，一旦這些和解協議在第四季度處理完畢，我們的金額將大致達到 6,000 萬美元至 6,500 萬美元。考慮到年末餘額，我們之前提到的 3.1 億美元，其中就包括了那 6,500 萬美元。因此，我們預計今年年底的營收將達到 3.1 億美元左右，其中包括來自 REACH 的 6,500 萬美元。

I would say there's no requirement to hold those dollars in the REACH entities. It's more from a tax perspective because they're outside of our consolidated umbrella. There are some tax efficiencies gained by leaving it there and then monetizing that over time, but we have access to that if we needed it.

我認為沒有規定必須將這些資金存放在 REACH 實體中。這比較是從稅務角度考慮的，因為他們不在我們合併後的體系內。如果把錢留在那裡，然後隨著時間的推移將其變現，可以獲得一些稅收優惠，但如果我們需要的話，我們也可以動用這筆錢。

Okay, great. And then on the sort of higher-than-average impact on the risk revenue for the remaining 28% of the enrollment, I guess, is there any particular reason you expect these members to have higher scores with that accrual driven, incomplete coding. Just trying to understand the potential implications for 2026.

好的，太好了。那麼，對於剩餘 28% 的受保人員而言，風險收入受到的影響高於平均水平，我想問的是，您是否有什麼特別的理由認為，這些參保人員由於累積驅動、不完整的編碼方式，得分會更高？只是想了解這對 2026 年可能的影響。

Yeah, I think we highlighted that in the prepared remarks. It's really, I would say, that the higher-than-average is really driven by one payer that was new to us in 2024. We did not have data for them in 2023, so I think that made the estimation, call it, more challenging obviously because you have to have '23 and '24 to really determine the increase in actual risk scores. The good news is that that payer is now on our enhanced data pipeline.

是的，我想我們在準備好的演講稿中已經強調了這一點。我認為，高於平均的真正原因是 2024 年我們新加入的一家付款方。2023 年我們沒有他們的數據，所以我認為這顯然使估算更具挑戰性，因為你必須有 2023 年和 2024 年的數據才能真正確定實際風險評分的成長。好消息是，該付款方現已加入我們改進後的資料管道。

And what I will say is, sitting here today, we actually have the ability to calculate member-level risk scores. We did not have that ability a year ago. And so if you think about what happened in the second quarter, we were able to calculate member-level risk scores that tied -- or that agreed, highly correlated, with the mid-year data from CMS and the final year risk scores as well. And so we're in a much better position this year to calculate member-level risk scores.

我想說的是，今天我們坐在這裡，實際上有能力計算成員級別的風險評分。一年前我們還沒有這種能力。因此，如果你回顧第二季度發生的事情，我們能夠計算出成員級別的風險評分，這些評分與 CMS 的年中數據以及最終年度風險評分相符，或者說高度相關。因此，今年我們更有能力計算會員層面的風險評分。

That's all been driven by the process change associated with the enhanced data pipeline. So we feel pretty good that we have a solid foundation in order, I would say, set a foundation for this year obviously project forward as we think about the 2026 guide.

這一切都是由與增強型資料管道相關的流程變更所驅動的。因此，我們感覺我們已經打下了堅實的基礎，可以說，為今年奠定了基礎，顯然也為展望未來，因為我們正在考慮 2026 年的指導方針。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Hi, this is Dean Rosales on for Justin. Is there any color you can give on what CMS is estimating for fee-for-service trend in 2025 within the ACO REACH program? And then my second question is, in your earnings presentation, you stated that you expect payer bids to act as a tailwind in '26. Is there any color on the benefit designs that you're seeing that you could share? Would you say reduction of benefits is largely consistent across your payers?

大家好，我是迪恩‧羅薩萊斯，替賈斯汀為您報道。您能否透露一下CMS對2025年ACO REACH計畫中按服務收費趨勢的預測？我的第二個問題是，在您的收益報告中，您表示預計付款人競標將在 2026 年起到推動作用。您看到的福利設計圖上是否有任何顏色可以分享？您認為各支付方的福利削減情況大致上是否一致？

Yeah, first I'll handle the REACH question. The latest data I think we have is fee-for-service cost trends are 8.5%. So that's the latest information we have on the cost trends in the fee-for-service business. And then as far as the bid detail, it is different by payer is what I would say, and obviously, everybody kind of reads the public announcements from all of our payer partners.

好的，首先我來處理 REACH 問題。我認為我們掌握的最新數據顯示，按服務收費的成本趨勢為 8.5%。以上就是我們掌握的有關按服務收費業務成本趨勢的最新資訊。至於競標細節，我認為因付款方而異，而且顯然，每個人都會閱讀我們所有付款方合作夥伴發布的公開公告。

But generally, I would say it's different. But broadly across our network, what we've seen is really pricing for margin. And it's maximum out-of-pockets, it's all the things and the levers that the payers have in the bid design. So across our book, generally I would say what we see is pricing for margin, which we believe is going to be a tailwind for us as we head into '26. So not all payers are the same, but across our footprint and our network, it's going to be a positive for next year.

但總的來說，我認為情況有所不同。但從我們整個網路來看，我們看到的其實是利潤定價。而且，這是最大的自付費用，也是出價設計中付款方擁有的所有因素和手段。因此，總的來說，我認為我們看到的是利潤率定價，我們相信這將在我們邁向 2026 年之際成為我們的順風。所以並非所有付款方都一樣，但就我們的業務範圍和網路而言，這對明年來說將是一個積極的信號。

Craig Jones, Bank of America.

克雷格瓊斯，美國銀行。

So looking at your palliative and heart failure programs, I think you've rolled those out in most of your geographies now. For 2025, what kind of savings do you expect from those, either PMPM or millions. And then as you think about these catch programs going forward, once you kind of get installed in all your geographies, is this sort of like a one-time boost and then kind of oscillates up and down based on participation, or is it sort of an annual continued margin accretion?

所以，從你們的安寧療護和心臟衰竭計畫來看，我認為你們現在已經在大部分地區推廣這些計畫了。對於 2025 年，您預計這些措施可以節省多少費用，以每百萬英鎊或每月每百萬英鎊計算。那麼，當你考慮這些捕撈計劃的未來發展時，一旦你在所有地區都實施了這些計劃，這會是一次性的增長，然後根據參與情況上下波動，還是會是持續的年度利潤增長呢？

Yeah, I would say just to go back, we implemented a lot of these clinical programs, I would say, late in 2024, early in 2025, so there certainly is a ramp period, and some of that benefit will accrue to 2026 given the long-tail nature of our business. We're not going to get into any specific PMPM savings, but I think Ron highlighted in his prepared remarks some of the outcomes that we're seeing from those programs. They've been very successful. Ultimately, it is reducing medical expense and improving, I would say, the identification of disease burden for our members so that we can get them into the appropriate treatment programs.

是的，我想說的是，我們實施了很多臨床項目，我想說，是在 2024 年底或 2025 年初，所以肯定有一個過渡期，考慮到我們業務的長期性，其中一些益處將持續到 2026 年。我們不會深入討論具體的每人每月節省金額，但我認為羅恩在他的準備好的演講稿中重點介紹了我們從這些項目中看到的一些成果。他們非常成功。最終，我認為，這可以降低醫療費用，並改善我們成員的疾病負擔識別，以便我們能夠讓他們接受適當的治療方案。

And so we look to, I would say, continue the evolution of these programs as we exit '25 into '26, and they will be permanent programs, so they will continuously derive value, and we would continue to iterate on these programs to continue to make them successful.

因此，我認為，我們將繼續推進這些項目，從 2025 年過渡到 2026 年，它們將成為永久性項目，從而不斷創造價值，我們將繼續迭代這些項目，使其繼續取得成功。

Yeah, probably the only thing I would add is that we will continue to enrich the datasets and the AI algorithms that we use to identify potential suspects and the burden of illness in patients that has not yet been detected, along with other diagnostic techniques that our medical groups have invested in, and we've supported. So I think you can expect that this will continue some level of progression into the future, while at the same time, we expect to ramp up other programs that our medical groups have determined represent good clinical care for their patients.

是的，我可能唯一要補充的是，我們將繼續豐富數據集和人工智慧演算法，以識別潛在嫌疑人和尚未發現的患者疾病負擔，以及我們醫療團隊投資和支援的其他診斷技術。因此，我認為可以預見，這種情況在未來會繼續發展下去，同時，我們也希望能夠加快推進其他一些項目，這些項目已被我們的醫療團隊認定為能夠為他們的患者提供良好的臨床護理。

Daniel Augustine, Citi.

丹尼爾奧古斯丁，花旗集團。

I think you've covered the changes you're making to payer contracting well, but correct me if I'm wrong, I may have misheard this, I think I heard in your prepared remarks that you're also altering how you're contracting on the provider side. Can you just provide a little bit more detail on how, if at all, your provider contracts are changing, particularly with regard to risk sharing and how this may shift receptivity on the provider side to contracting?

我認為您已經很好地介紹了您正在對支付方合約進行的更改，但如果我錯了請糾正我，我可能聽錯了，我好像在您的準備好的發言稿中聽到您也在改變與提供方簽訂合約的方式。您能否詳細說明您的供應商合約是否有所變化，以及變化的具體方式，特別是風險分擔方面的變化，以及這可能會如何影響供應商對合約的接受程度？

Yeah, on the provider side, we're not changing any of the contracts on the provider side. I think what you're referring to is, there was a comment about the $30 million of operating savings really executed on for next year. I think part of that was aligning the incentives with our physician partners, so we did take a fresh look at incentive alignment, and that was a component of that $30 million.

是的，就服務提供者而言，我們不會更改服務提供者方面的任何合約。我想你指的是，有人提到明年將真正實現 3000 萬美元的營運成本節約。我認為其中一部分原因是與我們的醫生合作夥伴的激勵機制保持一致，所以我們重新審視了激勵機制的一致性，這也是那 3000 萬美元的一部分。

Okay, can you provide a bit more detail on what that means in practice? What incentive alignment, or what incentives are changing?

好的，您能詳細解釋一下這在實踐中意味著什麼嗎？激勵機制發生了哪些變化？或者說，哪些激勵機制正在改變？

Probably not here. I mean, it wasn't a substantial piece of the $30 million is what I would say. And so, as you think about that $30 million, I would say half was generally corporate -- what I call corporate overhead costs, and then the other half would have been, I would say, more market operating costs that we are looking at. So the physician incentive piece was relatively small.

可能不在這裡。我的意思是，這筆錢在3000萬美元中佔比並不大。所以，當你考慮這 3000 萬美元時，我認為其中一半通常是公司開支——我稱之為公司管理費用，而另一半則是我們正在關注的市場營運成本。因此，醫師激勵機制相對較小。

Andrew Mok, Barclays.

Andrew Mok，巴克萊銀行。

I want to follow up on the payer contract discussion. When you see benefit misalignment with your payer partners, is that concentrated more in small regional health plans or large national carriers? And how much of your current membership is already contracted for next year, and how much is still outstanding?

我想跟進一下付款方合約的討論。當您發現與支付方合作夥伴的福利不一致時，這種情況更多地集中在小型區域性健康計劃還是大型全國性保險公司？您目前的會員中有多少已經簽訂了明年的會員合同，還有多少尚未簽訂？

Yeah, I guess what I would say is it's a market-by-market item, right? So it's not just broadly across one payer or this payer. You have to go into each specific market and understand the benefit designs that impact us, and ultimately, it's part of our contracting process. We get the bid information, we analyze that, and that is a key component of our request on economics, as you can imagine. So I would say it's a little more nuanced than what you're saying.

是的，我想說的是，這取決於具體的市場情況，對吧？所以，這不僅僅是針對某個付款方或這個付款方的普遍問題。你必須深入了解每個特定的市場，了解影響我們的福利設計，最終，這是我們合約簽訂流程的一部分。我們會獲取投標信息，進行分析，正如您所想，這是我們經濟評估請求的關鍵組成部分。所以我覺得這件事比你說的複雜一些。

And then the second part of your question, what was that?

那麼，你問題的第二部分是什麼呢？

How much of your membership is already contracted for next year when you think about what's left outstanding?

考慮到還有哪些會員尚未簽約，您認為明年您的會員合約中已經包含多少？

Yeah, I would say it's kind of hard to put a pin on exactly how much is where the ink is dry, if you will. I think we've come to business terms with a lot. Remember, we had about 50% of our contracts open for renewal. We've come to relative agreement on a substantial portion of that, but obviously you have to dot the I's and cross the T's, and that matters.

是的，我覺得很難準確地指出墨水乾透的程度。我認為我們已經就很多事情達成了商業共識。請記住，我們大約有 50% 的合約處於待續約狀態。我們已經就其中相當一部分達成了相對一致的意見，但顯然你必須把細節都考慮周全，這很重要。

So I would hesitate to say right now at this point how much, but obviously, we're going to work through the bulk of this in the fourth quarter, and we'll have an update for you when we do our year-end call.

所以我現在還不好說具體金額，但顯然，我們將在第四季解決大部分問題，並在年終電話會議上向大家報告最新情況。

Yeah, the only thing I would add is that the negotiations have really been extensively supported by our physician partners because they are in that community. They have the relationship with the patient, and so they have been really actively at the table with us in markets to assist in delivering the important messages to payers who may not have heard us as clearly as we had hoped.

是的，我唯一要補充的是，談判確實得到了我們醫生合作夥伴的大力支持，因為他們就在這個群體中。他們與患者建立了聯繫，因此他們一直積極參與到市場談判中，幫助我們向那些可能沒有像我們希望的那樣清楚地聽到我們聲音的支付方傳遞重要訊息。

Great. And if I could sneak in one additional question. I'd love to follow up on Stars. Appreciate the comment that bonus year 2027 Star scores will increase, but as we think about bonus year 2026 and some of the volatility there to the extent some of your payer partners have a reduction in Stars, can you help us understand whether this headwind flows downstream to you, or are you getting a fair premium increase to offset that Stars headwind?

偉大的。我還能再問一個問題嗎？我很想繼續關注《星光》。感謝您提到 2027 年獎勵年度的星級評分將會提高，但考慮到 2026 年獎勵年度的一些波動性，以及您的一些付款合作夥伴的星級評分有所下降，您能否幫助我們了解這種不利因素是否會向下影響到您，或者您是否獲得了合理的保費增長來抵消這種星級評分的不利影響？

Yeah, obviously that's another key component of what we're talking about when we're doing our contracting. So again, I would say we are looking for total overall economics that make sense for our partners and Agilon, and that's what we're focused on. And that's when we said we're taking a disciplined approach. That would be part of that equation.

是的，顯然這是我們在簽訂合約時所討論的另一個關鍵組成部分。所以，我再次強調，我們追求的是對我們的合作夥伴和 Agilon 都合理的整體經濟效益，這也是我們關注的重點。那時我們就表示，我們將採取嚴謹的態度。那將是其中的一部分。

Matthew Shea, Needham.

馬修·謝伊，尼德姆。

I wanted to hit on the clinical programs again and the broader COPD and dementia rollout. What is the staging or timing of going from a pilot to permanent program look like? And based on your success with palliative, how long do these broader launches tend to take to ramp towards meaningful savings? With that, I guess, given the early success from your existing programs and some of your commentary, do you plan on rolling out incremental programs or piloting new specialty areas in 2026, or how should we think about clinical programs evolving from here?

我想再次強調臨床項目以及更廣泛的慢性阻塞性肺病和癡呆症推廣計劃。從試點計畫到永久計畫的過渡階段或時間安排是怎樣的？根據您在緩解措施方面的成功經驗，這些更廣泛的推廣活動通常需要多長時間才能實現顯著的成本節約？鑑於您現有專案的早期成功以及您的一些評論，我想，您是否計劃在 2026 年推出漸進式專案或試點新的專業領域？或者我們應該如何看待臨床計畫從現在開始的發展？

Yeah, I would say you're getting down the correct path. The first thing we typically do is pilot some of these programs and validate that ultimately it's improving the care for the member. So we would pilot those. You have to have enough data, obviously, to make sure that that's happening. So I'd say the pilot phase is relatively six to eight months, could be longer, then ultimately, we would roll that out.

是的，我覺得你正走在正確的道路上。我們通常做的第一件事就是試行這些項目，並驗證它們最終是否能改善會員的照護。所以我們會進行試點。顯然，你必須有足夠的數據來確保這種情況發生。所以我認為試點階段大概需要六到八個月，可能會更長，然後最終我們會全面推廣。

And of course, you can't roll it out to everyone at all times, so we roll it out market by market, starting with the markets that we believe would provide the most value. And so, yes, I would say we plan to take the pilots of COPD and dementia, and I think we're going to roll those out to more markets in 2026. And yes, obviously potential new pilots are on the table, and we're thinking about those as we think about our 2026 guide and what we're planning on doing for next year.

當然，你不可能一直向所有人推廣，所以我們逐一市場地推廣，首先從我們認為能夠提供最大價值的市場開始。所以，是的，我想說我們計劃開展 COPD 和癡呆症的試點項目，我認為我們將在 2026 年將這些試點項目推廣到更多市場。是的，顯然我們正在考慮引進新的飛行員，我們在製定 2026 年指南和明年計劃時也會考慮這些因素。

All of these programs are developed in consultation with our partners, and we have a network advisory board where the leaders of the principal medical groups come and advise, review the evidence, and support and endorse these types of initiatives as good patient care for their members. And so we do have some teed up as Jeff described, and we feel like as we've implemented congestive heart failure, we've learned a lot about that process of diffusion of both the clinical evidence, technology, training, and support of the physicians.

所有這些項目都是與我們的合作夥伴協商制定的，我們還有一個網絡諮詢委員會，主要醫療集團的領導人會來這裡提供建議、審查證據，並支持和認可這些類型的舉措，認為它們是對其成員的良好患者護理。正如傑夫所描述的那樣，我們已經做好了一些準備，而且我們覺得，隨著我們對充血性心臟衰竭的認識不斷加深，我們對臨床證據、技術、培訓以及對醫生的支持等各個方面的擴散過程有了很多了解。

David Larsen, BTIG.

David Larsen，BTIG。

Hi, this is Jenny Shen on for David. Thanks for taking my question. I just wanted to ask about the Big Beautiful Bill Act. Do you expect that, on the Medicare side, to have any impact on your business at all? And if you do, what do you expect those impacts to be?

大家好，我是Jenny Shen，替David為您報道。謝謝您回答我的問題。我只是想問一下關於《大美好法案》的問題。您認為醫療保險單的調整會對您的業務產生任何影響嗎？如果這樣做，你預期會產生哪些影響？

Yeah, we don't expect it to have a meaningful impact on the business, and I guess we'll just leave it at that.

是的，我們預計它不會對業務產生實質影響，我想我們就到此為止。

(Operator Instructions) [Amir Barney] Evercore.

（操作說明）[Amir Barney] Evercore。

Hey guys, good afternoon. Thanks for taking my question. So Humana is one of your largest payer partners, I believe, and it looks like they're focused on benefit stability for '26. So I guess I'm trying to get a sense for how you think this impacts your medical cost for next year. Some numbers around that would be very helpful. And if I could squeeze in a quick follow-up, what do you see as minimum working capital for your business?

各位，下午好。謝謝您回答我的問題。所以，我相信 Humana 是你們最大的支付方合作夥伴之一，而且他們似乎專注於 2026 年的福利穩定性。所以我想了解一下，您認為這會對您明年的醫療費用產生什麼影響。如果能提供一些相關數據就太好了。如果我能擠出一點時間問您一個後續問題，您認為貴公司所需的最低營運資金是多少？

Yeah, so real quick, I think we've kind of covered this maybe. The first question, as far as Humana, I think we covered this in the contracting phase, which is ultimately we get the benefits for each of our markets, we get the plan designs, and we analyze that. And that's part of our overall contracting efforts, looking for the economics that we think make sense for us. And so I would say that's just one, you're just talking specifically about one payer, but the process is the same across all payers. So I think that's where we are from that standpoint. It's part of the overall contracting process and the economics we look for.

是的，簡單來說，我想我們已經大致討論過這個問題了。關於 Humana 的第一個問題，我認為我們在合約階段已經討論過了，最終我們會獲得每個市場的福利，我們會獲得計劃設計，然後我們會進行分析。這是我們整體合約簽訂工作的一部分，目的是尋找我們認為對我們有意義的經濟方案。所以我覺得這只是一個例子，你只是具體談到了一個付款方，但所有付款方的流程都是一樣的。所以我覺得從這個角度來看，我們目前的情況就是這樣。這是整個合約流程和我們所追求的經濟效益的一部分。

And your second question on minimum working capital. I don't know what you're trying to really get at there. I don't have a number off the top of my head for what you're trying to pinpoint, but we can certainly follow up.

關於您提出的第二個問題，即最低營運資金。我不知道你到底想表達什麼。我一時想不出您要找的具體數字，但我們當然可以跟進。

(Operator Instructions) I can confirm that does conclude the question-and-answer session here, and I would like to hand it back to Ron Williams for some final closing comments.

（操作員說明）我可以確認，問答環節到此結束，現在我想把發言權交還給 Ron Williams，讓他做一些最後的總結發言。

Well, thank you for joining us today. Agilon will close 2025 with a sharpened focus and momentum driven by a suite of high-impact initiatives that are fundamentally reshaping our operating discipline and executional rigor. I want to thank our employees and our partners who may be listening, and I also want to thank you for your dedication and partnership with us. You're playing a crucial role in the healthcare industry, helping to transform healthcare for our employees and empowering our primary care physicians to focus on the entire health of their patients. We will continue to fulfill this mission with our employees.

謝謝您今天收看我們的節目。Agilon 將在 2025 年底迎來更加明確的目標和強勁的發展勢頭，這得益於一系列具有重大影響的舉措，這些舉措從根本上重塑了我們的營運紀律和執行嚴謹性。我要感謝可能正在收聽的員工和合作夥伴，我也要感謝你們對我們的奉獻和合作。您在醫療保健行業中扮演著至關重要的角色，幫助改變我們員工的醫療保健方式，並使我們的第一線醫生能夠專注於患者的整體健康。我們將繼續與員工一起完成這項使命。

Thank you. Have a good evening.

謝謝。祝你晚上愉快。

Thank you. I can confirm that does conclude the Agilon Health third-quarter 2025 earnings conference call. Thank you all for your participation. You may now disconnect, and please enjoy the rest of your day.

謝謝。我可以確認，Agilon Health 2025 年第三季財報電話會議到此結束。感謝各位的參與。現在您可以斷開連接了，請享受餘下的時光。