agilon health, inc. (AGL) 2026 Q1 法說會逐字稿

Hello, everyone. Thank you for joining us and welcome to agilon health first-quarter 2026 earnings call. (Operator Instructions) I will now hand the conference over to Evan Smith, senior Vice President, Investor relations. Please go ahead.

各位好。感謝各位加入，歡迎參加 agilon health 2026 年第一季財報電話會議。（接線員指示）現在我將把會議交給資深副總裁、投資人關係 Evan Smith。請開始。

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

謝謝，接線員。各位下午好，歡迎參加本次電話會議。與我一同出席的有我們的執行董事長 Ron Williams，以及我們的財務長 Jeff Schwaneke。在我們的準備發言之後，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. Additionally, certain financial measures we will discuss in this call our non-GAAP financial measures, non-GAAP measures are supplemental and not substitute for GAAP results.

在開始之前，我想提醒各位，我們的發言以及對問題的回應可能包含前瞻性陳述。實際結果可能與前瞻性陳述所明示或暗示者存在重大差異，原因在於與我們業務相關的風險與不確定性。這些風險與不確定性已在我們向 SEC 提交的文件中討論。請注意，我們不承擔更新任何前瞻性陳述的義務。此外，我們在本次電話會議中將討論的某些財務衡量指標為非 GAAP 財務指標；非 GAAP 指標僅為補充資訊，並非 GAAP 結果的替代。

However, we believe that providing these non-GAAP measures helps investors gain a better and more complete understanding of our financial results and are consistent with how management views our financial results. A reconciliation of these non-GAAP financial measures for the most comparable GAAP measures is available in the earnings press release and f or 8-K filed with the SEC today.

然而，我們相信提供這些非 GAAP 指標可協助投資人更好且更完整地理解我們的財務結果，並且與管理層看待財務結果的方式一致。最可比 GAAP 指標與這些非 GAAP 財務指標之間的調節表，已載於今日發布的財報新聞稿以及向 SEC 提交的 Form 8-K 中。

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

接下來，讓我把電話交給 Ron。

Thank you, Evan, and good afternoon, everyone. In 2026, we remain focused on disciplined execution. And building a durable foundation for sustainable long-term performance. We are advancing the same strategy and mission, empowering best in class physicians through long-term partnerships to deliver high-quality, cost-effective patient care that delivers value for all of our stakeholders. In 2025, we made meaningful progress across all of our initiatives, which translated into strong first quarter performance and increased expectations for our full year 2026 outlook.

謝謝你，Evan，各位下午好。2026 年，我們仍專注於有紀律的執行，並建立可支撐長期永續表現的穩固基礎。我們持續推進相同的策略與使命：透過長期合作夥伴關係賦能一流醫師，提供高品質、具成本效益的病患照護，為所有利害關係人創造價值。2025 年，我們在各項倡議上取得實質進展，轉化為強勁的第一季表現，並提高了我們對 2026 全年展望的預期。

As we announced last week, we are excited to welcome Tim O'Rourke as our new CEO beginning tomorrow, May 7th. Tim brings significant experience across the pair and provider space with a deep understanding of what is needed to succeed in value-based care. Tim is fully committed to furthering our mission and strategy. To continue driving improvement in agilon's performance for all of our stakeholders.

如同我們上週宣布的，我們很高興歡迎 Tim O'Rourke 自明天 5 月 7 日起擔任新任執行長。Tim 在保險支付方與醫療提供者領域擁有豐富經驗，並對在價值導向照護中成功所需條件有深刻理解。Tim 完全致力於推進我們的使命與策略，持續改善 agilon 對所有利害關係人的表現。

In the first quarter, we delivered results that were above our expectations. Our performance demonstrates operational discipline. The strengths of our long-term physician partnerships, and early benefits from the strategic decisions we made last year. Operationally, we are building upon several key initiatives you've heard me discuss before the enhanced data pipeline and improved actuarial visibility, enabling earlier identification and validation of trans, continued advancement of our clinical and quality programs with our congestive heart failure program now scaled broadly across the network, and ongoing execution of disciplined paer contracting and operating expense optimization focused on profitability and sustainability.

第一季，我們交出高於預期的成果。我們的表現展現了營運紀律、長期醫師合作夥伴關係的優勢，以及我們去年所做策略決策帶來的初步效益。在營運面，我們持續推進幾項我先前提過的關鍵倡議：強化資料管線並提升精算可視性，使我們能更早辨識並驗證趨勢；持續推進臨床與品質計畫，我們的充血性心衰竭計畫目前已在整個網路中廣泛擴展；以及持續執行有紀律的支付方合約管理與營運費用最佳化，聚焦獲利能力與永續性。

Each of these efforts are designed to improve predictability and alignment with our opposition partners, reduce variability, and support durable margin expansion over time. With the enhanced data pipeline, 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 85% of our members. The internal and national data enable us to more quickly identify and drive improvements.

上述各項工作旨在提升可預測性並與我們的支付方合作夥伴更一致、降低波動性，並隨時間推進可持續的利潤率擴張。透過強化後的資料管線，我們現在取得更即時的支付方直接資料串流，並擁有已驗證且高度相關的會員層級臨床與理賠資料，以及約 85% 會員的會員層級風險分數。內部與全國性資料使我們能更快速地辨識並推動改善。

As Jeff will discuss in more detail, this has enabled us to increase our revenue and adjusted EBIT expectations in part due to better progress on the validation of our burden of illness initiatives. Going forward, we will continue to enhance the data pipeline to support clinically actionable insights, as well as improved network design and care model innovation.

如 Jeff 將更詳細說明，這使我們得以提高營收與調整後 EBIT 的預期，部分原因是我們在「疾病負擔」倡議的驗證方面取得更佳進展。展望未來，我們將持續強化資料管線，以支援可落地的臨床洞察，以及更佳的網路設計與照護模式創新。

In combination with opposition reviewers, we are integrating generative AI-based insights directly into clinical workflows to drive more informed physician decision making at the point of care. And we are seeing encouraging results. This capability is helping physicians intervene at the most appropriate points of care earlier. We are continuing to increase our focus on high-risk patients and increasingly important focus for all constituents in the Medicare space.

我們與支付方審查團隊合作，將以生成式 AI 為基礎的洞察直接整合到臨床工作流程中，協助醫師在照護當下做出更明智的決策。我們看到令人鼓舞的成果。這項能力正協助醫師更早在最適當的照護節點介入。我們也持續加大對高風險病患的關注，這對 Medicare 領域的所有參與者而言都愈發重要。

We have grown the richness of our member-level data and are now aligning it better with PCP actions. This is helping physicians improve the quality of their intervention with higher risk patients, identifying gaps in care and leveraging industry standard guideline effected clinical pathways. Greater access to timely and high integrity data, has also improved the quality of our forecasting. As demonstrated in the ongoing development of our 2025 cost strengths, we have favorable medical cost in development from the second half of 2025 and are seeing slight moderation within patient senses so far in 2026.

我們已提升會員層級資料的豐富度，並且現在能更好地與 PCP 的行動對齊。這正協助醫師提升對高風險病患介入的品質，找出照護缺口，並運用業界標準、以指引為依據的臨床路徑。更即時且高完整性的資料取得，也提升了我們預測的品質。從我們持續發展的 2025 年成本趨勢可見，我們在 2025 年下半年形成的醫療成本發展有利，且在 2026 年迄今我們也看到病患嚴重度略有趨緩。

With that said, given it is early in the year, we believe it remains prudent to maintain our net cost trend outlook of approximately 7% for full year 2026. Our full risk total care model is delivering clinical and quality outcomes and driving strong patient and PCP net promoter scores, while demonstrating the ability to effectively manage utilization and medical cost training.

儘管如此，鑑於目前仍是年初，我們認為維持 2026 全年約 7% 的淨成本趨勢展望仍屬審慎。我們的全風險總照護模式正在交付臨床與品質成果，並帶動強勁的病患與 PCP 淨推薦值（NPS），同時展現有效管理利用率與醫療成本趨勢的能力。

Next, let me discuss clinical and quality programs focusing primarily on our clinical execution, which is a court driver for our model. As a reminder, the congestive heart failure, or CHF program, remains the most mature pathway deployed across 90% of our markets.

接下來，我將討論臨床與品質計畫，主要聚焦於我們的臨床執行，這是我們模式的核心驅動因素。提醒各位，充血性心衰竭（CHF）計畫仍是最成熟的路徑，已在我們 90% 的市場中部署。

Let me start with why this program is important to patients. Approximately 40% to 50% of patients nationally are diagnosed at the time of first admission to the hospital. That means missed opportunities for earlier detection, leading to less than ideal care and unnecessary hospital cost. The second thing we know about heart failure is that less than 10% of patients are actually on the right therapies. Through a proactive and guideline-directed approach, our position partners have been able to shift CHF diagnosis to earlier in the care continuum. With inpatient first, diagnosis rates, improving from approximately 25% to less than 5%.

我先說明為何這項計畫對病患很重要。全國約有 40% 到 50% 的病患是在首次住院時才被診斷出來。這代表錯失更早期偵測的機會，導致照護不夠理想並產生不必要的住院成本。關於心衰竭，我們知道的第二件事是：實際接受正確治療的病患不到 10%。透過主動且依循指引的做法，我們的醫師合作夥伴已能將 CHF 診斷往照護連續體的更早端移動；以住院為首次診斷的比率已從約 25% 改善至低於 5%。

So less than 5% of heart failure diagnoses are now in the inpatient setting. Additionally, we are expanding our pharmacy integrated management approach for heart failure patients across the network and observing positive trends and guideline-directed therapy rates, which we expect to improve functional outcomes for patients and prevent downstream complications of disease that leads to admissions.

因此，目前心衰竭診斷在住院情境下發生的比例已低於 5%。此外，我們正在全網路擴大針對心衰竭病患的藥事整合管理方法，並觀察到依指引治療比率呈現正向趨勢；我們預期這將改善病患的功能性結果，並預防會導致住院的疾病下游併發症。

Current results reflect the combination of our early detection and diagnosis, supported by in-office or increase access to diagnostics, structured and physician-supported clinical protocols, snd ongoing patient engagement, including virtual pharmacy support. These pathways are increasingly informed by AI-driven risk stratification and early detection models, enabling more proactive intervention with this high-risk population.

目前成果反映了我們早期偵測與診斷的綜合效益，並由診所內或提升的診斷可近性、結構化且由醫師支持的臨床流程，以及持續的病患互動（包含虛擬藥事支持）所支撐。這些路徑也愈來愈多地由 AI 驅動的風險分層與早期偵測模型提供資訊，使我們能對這個高風險族群進行更主動的介入。

We plan to utilize this evidence-based approach, while rapidly scaling COPD in broader lung health pathways through 2026. The initial focus for these programs will be earlier identification of COPD expanded lung cancer screenings. And increased use of advanced diagnostics by our physician groups, each of which is designed to drive earlier intervention, improved treatment adherence, or prevent avoidable complications and hospitalizations.

我們計畫運用這種以實證為基礎的方法，並在 2026 年期間快速擴大 COPD 以及更廣泛的肺部健康路徑。這些計畫的初期重點將是更早辨識 COPD、擴大肺癌篩檢，以及提高我們醫師團體對先進診斷的使用；每一項都旨在推動更早介入、提升治療依從性，或避免可預防的併發症與住院。

In addition, we're seeing good engagement as we continue to roll out the dementia program in conjunction with the opposition partners. Increased healthcare costs and the caregivers is being driven by the approximately 50% of dementia patients across the broad population that go undiagnosed, increasing both healthcare costs and the burden on caregivers. We are working with partners to deploy enhanced caregiver models, structured early-stage pathways, and virtual diagnostics.

此外，隨著我們與支付方合作夥伴共同推動失智症計畫的落地，我們也看到良好的參與度。約有 50% 的失智症病患在廣泛族群中未被診斷，這推升了醫療成本並加重照護者負擔。我們正與合作夥伴部署強化的照護者支持模式、結構化的早期階段路徑，以及虛擬診斷。

Moving to our quality and stars performance. agilon star's performance is a result of a highly integrated quality operating model that combines data infrastructure, position engagement, and payer alignment. Operation quality performance starts with our ability to identify care gaps early and deliberate actionable insights directly to our position partners. Because we are working closely with our position partners, quality measures are embedded into their everyday clinical workflows. Our partners and their care teams have clear visibility into their performance, and the actions needed to efficiently close care gaps for their patients.

接著談我們的品質與星級（Stars）表現。agilon 的星級表現來自高度整合的品質營運模式，結合資料基礎設施、醫師參與，以及與支付方的對齊。營運品質表現始於我們能及早辨識照護缺口，並將可執行的洞察直接傳遞給我們的醫師合作夥伴。由於我們與醫師合作夥伴密切合作，品質衡量指標已嵌入其日常臨床工作流程中。我們的合作夥伴及其照護團隊能清楚掌握自身表現，以及為其病患有效率地補齊照護缺口所需採取的行動。

Looking ahead, we expect to see continued opportunity to expand our performance through deeper data integration and earlier intervention, leveraging analytics to identify patients at risk of missing key quality measures earlier in the measurement year. Ultimately, our approach is about building durable infrastructure that supports physician in delivering high-quality care that is aligned in key objectives of the Medicare Advantage Program, while ensuring performance is accurately measured and rewarded.

展望未來，我們預期透過更深度的資料整合與更早期的介入，仍有持續擴大表現的機會；我們將運用分析工具，在衡量年度更早辨識可能錯過關鍵品質指標的病患。最終，我們的方法在於建立可長期支撐的基礎設施，協助醫師提供高品質照護，並與 Medicare Advantage 計畫的關鍵目標一致，同時確保績效能被準確衡量並獲得回饋。

Now, let me move on to ACO REACH. As evidence in the quarter's results, we continue to demonstrate the strength of our model and the ability to deliver superior performance across both Medicare fee-for-service programs and Medicare Advantage. In addition, their pleas that CMS took a pragmatic approach to addressing fraudulent claims related to urinary catheter and suspect skin substitute claims for 2025.

現在，讓我接著談 ACO REACH。從本季業績可見，我們持續展現我們模式的強韌性，以及在 Medicare 按服務計費（fee-for-service）計畫與 Medicare Advantage 兩大領域交付優異表現的能力。此外，對於 2025 年與導尿管及疑似皮膚替代物（skin substitute）相關的詐欺性理賠，CMS 採取務實作法加以處理，這也回應了各方的訴求。

Finally, we have finalized 2026 payer contracts, which Jeff will discuss in a moment. We're beginning our 2027 payer contracting process, but we plan to take the same disciplines and partnership-oriented approach with our payers focused on shared profitability and durable margin expansion.

最後，我們已完成 2026 年的付款方合約，Jeff 稍後會進一步說明。我們也正開始 2027 年的付款方簽約流程，但我們計畫延續相同的紀律與以夥伴關係為導向的作法，與付款方聚焦於共享獲利能力與可持續的利潤率擴張。

In closing, we have had a strong start to 2026 and feel good about the progress we are making. We're seeing it across all areas that matter: payer contract, burden of illness, clinical quality initiatives, and cost discipline.

總結來說，我們在 2026 年有一個強勁的開局，並對目前取得的進展感到樂觀。我們在所有關鍵面向都看得到成果：付款方合約、疾病負擔（burden of illness）、臨床品質計畫，以及成本紀律。

First, the work we have done with our position partners around burden of illness initiatives and clinical pathways is starting to show up more clearly than our clinical results and financial performance. Second, our AI enabled tech technology platform and enhanced data capabilities deployed in very close proximity to the physician are allowing us to identify opportunities earlier, act faster, and manage performance with greater precision. We're beginning to see the benefits of AI more deeply into both position and operational workflows. Third, discipline we applied, particularly around contracting and cost structure is starting to come through.

第一，我們與醫師夥伴在疾病負擔計畫與臨床路徑（clinical pathways）方面所做的工作，開始比以往更清楚地反映在臨床結果與財務表現上。第二，我們的 AI 賦能技術平台與強化後的資料能力，部署在非常貼近醫師端的位置，使我們能更早辨識機會、更快採取行動，並以更高精準度管理績效。我們也開始看到 AI 更深入滲透到醫師端與營運端的工作流程中所帶來的效益。第三，我們所採取的紀律，特別是在簽約與成本結構方面，正開始顯現成效。

We are raising our outlook for financial performance this year, due to the early impact of these initiatives and remained confident in the long-term strength of our unique partnership model.

基於這些計畫的早期成效，我們上調今年的財務表現展望，並仍對我們獨特夥伴模式的長期優勢充滿信心。

With that, it will turn the call over to Jeff to go through the financials.

接下來，我把電話會議交給 Jeff，請他說明財務表現。

Thank you, Ron, and good afternoon. As Ron mentioned, we are very pleased that we exceeded our guidance for the first quarter and are increasing our expectations for the full year. The positive results and increase to our full year guidance we're driven by the strategic actions we took throughout 2025 and the continued strong work of our position partners across the country. These include the significant improvement in our data visibility and estimation process, execution of our clinical and quality programs across our network, cost management, and discipline payer contracting, all of which were focused on improving our operations and creating a strong foundation for durable and predictable performance this year and beyond.

謝謝你，Ron，大家午安。如 Ron 所提，我們非常高興第一季表現超越指引，並上調全年預期。本季的正向成果以及我們對全年指引的上調，主要來自我們在 2025 年期間採取的策略性行動，以及全國各地醫師夥伴持續強勁的執行力。這些行動包括：我們在資料可視性與估算流程上的顯著改善、在整個網路中推動臨床與品質計畫的落地、成本管理，以及在付款方簽約上的紀律；所有這些都聚焦於改善營運，並為今年及未來建立可持續且可預測的強健基礎。

During our call today, I will cover three key areas of our financials. First, I will discuss our financial performance for the first quarter. Second, I will provide an update on cost and macroeconomic trends, including the recently announced final rate notice for 2027. And finally, I'll discuss our second quarter in revised full year 2026 outlook along with key assumptions we have made.

在今天的電話會議中，我將涵蓋財務的三個重點領域。第一，我會說明第一季的財務表現。第二，我會更新成本與總體經濟趨勢，包括近期公布的 2027 年最終費率公告（final rate notice）。最後，我會說明第二季與修訂後的 2026 全年展望，以及我們所採用的關鍵假設。

Moving to our financial performance for the first quarter of 2026. We exceeded the top end of our guidance range for total revenue, medical margin, and adjusted EBITDA. The performance in the quarter was driven by higher than expected revenue from risk adjustment, an additional full risk contract with a new payer in an existing market, and strong performance in ACO REACH.

接著看 2026 年第一季的財務表現。我們在總營收、醫療利潤（medical margin）與調整後 EBITDA 方面，均超越指引區間上緣。本季表現主要由以下因素帶動：風險調整（risk adjustment）收入高於預期、在既有市場與新付款方新增一份全風險（full risk）合約，以及 ACO REACH 的強勁表現。

Starting with membership Medicare Advantage. Membership at the end of the quarter was 426,000 compared to 491,000 in Q1 2025. Our ACO REACH membership for Q1 was 110,000 members compared to 114,000 in the same period of 2025. As a reminder, Medicare Advantage membership was affected by our measured approach to growth previously disclosed market exits which were finalized as of January 1, 2026, and payer exits in certain markets which were a result of our discipline and profitabilityfoed contracting efforts. Additionally, a subset of our members are under care coordination fees. These contracts are primarily net neutral to agilon health, with financial opportunity based upon strong quality and cost performance.

先從 Medicare Advantage 會員數開始。截至季末，會員數為 426,000 人，較 2025 年第一季的 491,000 人下降。我們 ACO REACH 在第一季的會員數為 110,000 人，較 2025 年同期的 114,000 人略降。提醒一下，Medicare Advantage 會員數受到我們先前揭露的審慎成長策略影響，包括已退出市場的措施（於 2026 年 1 月 1 日完成），以及在部分市場中因我們在簽約上強調紀律與獲利導向而導致的付款方退出。此外，我們有一部分會員採用照護協調費（care coordination fees）模式。這些合約對 agilon health 的財務影響主要為淨中性（net neutral），其財務機會取決於強勁的品質與成本表現。

Next, revenue for the first quarter was approximately $1.42 billion compared to $1.53 billion in the same period of 2025. Our year-over-year revenue decrease is driven by the membership decline I just mentioned, partially offset by more constructive rates for 2026 from both the CMS benchmark and favorable payer contracting methods, as well as increased revenue from higher estimated risk scores from our previous expectations.

接下來，第一季營收約為 14.2 億美元，較 2025 年同期的 15.3 億美元下降。我們年對年營收下滑主要由我剛提到的會員數下降所致，但部分被以下因素抵銷：2026 年 CMS 基準（benchmark）較具建設性的費率、較有利的付款方簽約方式，以及因估計風險分數高於先前預期而帶來的營收增加。

Revenue for the first quarter was higher than our expectations, driven by the execution of an additional full risk contract in an existing market and the estimated benefit of higher than expected risk scores. Using the enhanced data pipeline for a meaningful portion of our membership, we calculated memberle risk scores for the mid-year data period. This enhanced data is based on claims data, as well as MAO-004 and MMR data that our pairer partners receive from CMS. These data files are both claims and plan-submitted encounters that are accepted for risk adjustment.

第一季營收高於我們預期，主要來自在既有市場新增一份全風險合約的執行，以及估計風險分數高於預期所帶來的效益。針對我們相當比例的會員，我們使用強化後的資料管線（data pipeline），在年中資料期間計算會員層級的風險分數。這些強化資料包含理賠資料，以及我們的付款方夥伴自 CMS 取得的 MAO-004 與 MMR 資料。這些資料檔同時涵蓋理賠與由計畫提交且被接受用於風險調整的就診紀錄（encounters）。

As a reminder, we did not have this increased visibility into member-level clinical and claims data, as well as member-level risk scores until the pipeline went live at the end of the first quarter of 2025. Our revised estimate for the increase in risk scores over 2025 for the full year is now 1.5%, which is above our previous estimate of 0.4% for the full year 2026, both net of the v28 impact. This was driven by the improvement in our data and forecasting capabilities, as well as the operational process improvements we put in place over the past 18 months.

提醒一下，在該資料管線於 2025 年第一季末上線之前，我們並沒有這種對會員層級臨床與理賠資料、以及會員層級風險分數的提升可視性。我們目前對全年風險分數相較 2025 年的增幅修訂估計為 1.5%，高於先前對 2026 全年的 0.4% 估計；兩者皆已扣除 v28 影響（net of the v28 impact）。這主要由我們資料與預測能力的提升，以及過去 18 個月所導入的營運流程改善所驅動。

Moving on to medical expense. The cost trends for the second half of 2025 continue to develop favorably, further demonstrating our ability to effectively manage medical costs. The full year 2025 cost trend is now estimated at 6.2%, down from the 6.5% we estimated when we reported our 2025 full year results.

接著看醫療費用（medical expense）。2025 年下半年的成本趨勢持續朝有利方向發展，進一步證明我們有效管理醫療成本的能力。2025 全年成本趨勢目前估計為 6.2%，低於我們在公布 2025 全年業績時所估計的 6.5%。

The favorable development for 2025 medical expense was offset by additional reserves related to Part D costs for 2025, which as a reminder, are recorded net in premium revenue. Given the lack of data for 2025 Part D costs, we continue to take a prudent approach to Part D reserving, as we won’t get final reconciliations of the cost typically until the third quarter of this year. Given we have limited paid claims visibility for the first quarter of 2026, we recorded a cost trend of 7.4% for the quarter.

2025 年醫療費用的有利發展，被與 2025 年 Part D 成本相關的額外準備金（reserves）所抵銷；提醒一下，這些成本在保費收入中以淨額（net）方式入帳。由於 2025 年 Part D 成本資料不足，我們在 Part D 準備金提列上仍採取審慎作法，因為通常要到今年第三季才會取得最終的成本對帳（final reconciliations）。鑑於我們在 2026 年第一季對已支付理賠（paid claims）的可視性有限，我們在本季記錄的成本趨勢為 7.4%。

I would note that based on our census data, cost trends remain in line with what has been mentioned nationally by our payer partners and others. Given our limited paid claims visibility early in the year, we took what we believe is a conservative approach in the quarter.

我也要指出，根據我們的人口普查（census）資料，成本趨勢仍與我們的付款方夥伴及其他機構在全國層面所提及的情況一致。由於年初對已支付理賠的可視性有限，我們在本季採取了我們認為較為保守的作法。

Medical margin for the first quarter was $149 million, compared to $128 million in the first quarter of 2025, which exceeded the high end of guidance. This was driven by higher revenue, as I previously discussed, and lower overall medical expenses in the quarter.

第一季醫療利潤為 1.49 億美元，較 2025 年第一季的 1.28 億美元增加，並超越指引上緣。這主要由較高的營收（如我先前所述）以及本季整體醫療費用較低所帶動。

ACO REACH Adjusted EBITDA for the first quarter was $27 million and ahead of our expectations by approximately $5 million.The favorable performance was primarily driven by CMS’s removal of fraudulent urinary catheter and suspect skin substitute costs from our 2025 performance and the corresponding benchmark changes.

第一季 ACO REACH 調整後 EBITDA 為 2,700 萬美元，較我們預期高出約 500 萬美元。此一有利表現主要來自 CMS 將與詐欺性導尿管及疑似皮膚替代物相關的成本自我們 2025 年績效中剔除，以及相應的基準（benchmark）調整。

Adjusted EBITDA was $54 million as compared to $21 million in the same period of the prior year. The favorable overall performance reflects higher medical margin, OpEx discipline, and the favorable ACO REACH performance I previously highlighted. As Ron mentioned, ACO REACH results underscore our confidence in our model and the potential for driving continued value creation as we look forward to the advancement of both the MSSP and CMS lead model in 2027. On the balance sheet, we ended the quarter with $303 million in cash and marketable securities and $47 million of off-balance sheet cash held by our ACO entities.

調整後 EBITDA 為 5,400 萬美元，較去年同期的 2,100 萬美元增加。整體有利表現反映了較高的醫療利潤、營運費用（OpEx）紀律，以及我先前強調的 ACO REACH 有利表現。如 Ron 所提，ACO REACH 的結果凸顯我們對自身模式的信心，以及在展望 2027 年 MSSP 與 CMS 主導模式（CMS lead model）推進之際，持續創造價值的潛力。在資產負債表方面，本季末我們持有 3.03 億美元的現金與有價證券，以及由 ACO 實體持有、未列入資產負債表的 4,700 萬美元現金。

Year-end cash position is still expected to be at least $125 million. Last, we executed a reverse stock split at the end of the quarter. Additional details can be found on our investor website. Moving to guidance. We are revising our full year 2026 guide to reflect the strength of the first quarter results, including better than expected revenue associated with higher estimated risk scores for the year and the first quarter performance in ACO REACH. In addition, as previously mentioned, it also includes a new full risk contract signed in Q1 2026 in an existing market with a new payer.

我們仍預期年底現金部位至少為 1.25 億美元。最後，我們在季末執行了反向股票分割（reverse stock split）。更多細節可在我們的投資人網站查閱。接著談指引。我們正在修訂 2026 全年指引，以反映第一季結果的強勁表現，包括與全年較高的估計風險分數相關、優於預期的營收，以及第一季 ACO REACH 的表現。此外，如先前所述，修訂內容也納入我們在 2026 年第一季於既有市場與新付款方簽署的一份新全風險合約。

Our confidence remains rooted in the same key tenets we have previously outlined, including operating execution across clinical and quality programs, improved data visibility, and forecasting capabilities related to the enhanced data pipeline, payer contracting improvements, which emphasize profitability for both medical margin and cash flow, and a conservative cost trend assumption supported by factors previously mentioned.

我們的信心仍然根植於先前所闡述的相同關鍵原則，包括在臨床與品質計畫上的營運執行力、透過強化後的資料管線提升資料可視性與預測能力、以同時強調醫療毛利與現金流獲利性的付款方合約改善，以及在前述因素支持下採取保守的成本趨勢假設。

Utilizing the midpoint of guidance ranges provided within our earnings release, we now expect revenue of approximately $5.7 billion, medical margin of approximately $375 million in 2026, and Adjusted EBITDA of approximately $25 million. As I indicated, while the second half of 2025 saw favorable claims development, we continue to be prudent in our reserving and are maintaining our full year net cost trend outlook of 7%.

採用我們在財報新聞稿中所提供指引區間的中位數，我們目前預期2026年營收約為57億美元、醫療毛利約為3.75億美元，且調整後EBITDA約為2,500萬美元。如我所指出，儘管2025年下半年理賠發展有利，我們在準備金提列上仍持審慎態度，並維持全年淨成本趨勢展望為7%。

Focusing on the second quarter and utilizing the midpoint of guidance ranges, we expect revenue of $1.45 billion, medical margin of $123 million, and adjusted EBITDA of $20 million. I will close by saying that we are very pleased with our first quarter’s performance, including delivering strong positive adjusted EBITDA. The enhanced data and reserving models improving our visibility to claims and revenue trends. We have executed on our strategic transformation and continue to drive improved performance across all aspects of the business. As Ron mentioned, we also remain optimistic about our runway for continued improvement beyond 2026 based on the continued execution across our initiatives and the final 2027 rate notice.

聚焦第二季並採用指引區間的中位數，我們預期營收為14.5億美元、醫療毛利為1.23億美元，且調整後EBITDA為2,000萬美元。最後我想說，我們對第一季的表現非常滿意，包括交出強勁的正向調整後EBITDA。強化後的資料與準備金模型正在提升我們對理賠與營收趨勢的可視性。我們已執行策略轉型，並持續推動業務各面向的績效改善。如Ron所提及，基於我們各項計畫的持續落實以及最終的2027年費率通知，我們對2026年之後持續改善的發展空間也仍然樂觀。

With respect to the final rate notice for 2027, we believe our starting point across our markets is in line with the 5.33% effective growth rate CMS noted. With additional opportunities based on our BOI quality and contracting efforts. Based on our model and review across the business, we believe we have minimal exposure to unlinked chart reviews.

就2027年的最終費率通知而言，我們認為在各市場的起點與CMS所提到的5.33%有效成長率一致，並且基於我們在BOI品質與合約簽訂方面的努力，仍有額外機會。根據我們的模型與對全公司業務的檢視，我們認為我們對未連結的病歷圖表審查（unlinked chart reviews）的曝險很小。

With respect to the 1.12% normalization factor, I will remind everyone that we have been able to more than offset the v28 hurdle over the past couple of years. Further supporting our potential will be continued discipline around payer contracting, implementation of programs to lower overall medical costs, and further driving operating efficiencies. The team will remain focused on minimizing risk related to Part D, emphasizing our quality initiatives, and balancing payer priorities with our own profitability.

就1.12%的常態化因子而言，我要提醒大家，過去幾年我們已能夠超額抵銷v28門檻。進一步支撐我們潛力的，將是對付款方合約的持續紀律、推動降低整體醫療成本的計畫，以及進一步提升營運效率。團隊將持續專注於將Part D相關風險降至最低、強調我們的品質倡議，並在付款方優先事項與我們自身獲利能力之間取得平衡。

And last, we believe CMS continues to demonstrate their support for full risk value-based care models focused on clinical and quality programs that drive improved outcomes, reduce costs, and enhance member satisfaction. Therefore, we remain optimistic about the potential for agilon.

最後，我們認為CMS持續展現其對全風險、以價值為基礎照護模式的支持，該模式聚焦於能帶來更佳結果、降低成本並提升會員滿意度的臨床與品質計畫。因此，我們仍對agilon的潛力保持樂觀。

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

那麼，接線員，我們進入本次電話會議的問答環節。

(Operator Instructions) Jailendra Singh, Truist Securities.

（接線員指示）Jailendra Singh，Truist Securities。

Thank you. Thanks for taking my questions. I want to ask about the ACO REACH EBITDA, kind of nice number there, $26.5 million. You guys are maintaining the guidance for full year is $25 million to $30 million now for the full year. Why are you guys not expecting any further contribution for that business for the rest of the year?

謝謝。感謝讓我提問。我想問一下ACO REACH的EBITDA，這個數字挺不錯的，2,650萬美元。你們目前維持全年指引為2,500萬到3,000萬美元。為什麼你們不預期該業務在今年剩餘時間會有更多貢獻？

Yeah. Thanks, Jailendra. The real -- the $5 million benefit that we saw, we just really increased that in the guide for the year for the REACH program. The $5 million benefit that we saw in the quarter was really related to 2025 performance, and it was associated with the suspect skin substitutes and the urinary catheters.

是的。謝謝你，Jailendra。我們看到的那500萬美元效益，基本上我們已把它提高並納入今年REACH計畫的全年指引中。該季度看到的500萬美元效益主要與2025年的表現相關，並且與疑似皮膚替代物（suspect skin substitutes）以及泌尿導管（urinary catheters）有關。

And so CMS, you know, decided to back those out of the cost for 2025, so we got a pick up there. And so that’s really what you’re seeing. It’s a little early in the year for us to think about, you know, I would say, REACH performance and adjusting that at this point in time, right?

因此CMS決定把這些從2025年的成本中剔除，所以我們在那裡有一筆回收（pick up）。所以你看到的就是這個。對我們來說，今年才剛開始，現在就去評估、我會說，REACH的表現並在此時點調整，還有點太早，對吧？

Okay. And then my follow-up, you guys talked about AI helping you to capture some more efficiencies in the provider operational workflow and admin stuff there. The efficiencies you are seeing, the gains you’re seeing right now, should we think of those, like, incremental to the OpEx benefit of $35 million you guys have talked about for 2026? Or is that already reflected in your guidance? Just trying to understand the opportunity there.

好的。那我的追問是，你們談到AI正在幫助你們在提供者端的營運工作流程與行政作業上捕捉更多效率。你們目前看到的效率、看到的改善，應該視為你們先前談到2026年3,500萬美元OpEx效益的增量嗎？還是已經反映在你們的指引裡？我只是想了解那裡的機會。

Yeah. Two things, I would say. I would bifurcate the AI programs. One is OpEx efficiencies. The other one would probably impact more of, I would say, the above the line, right? So more of medical cost and revenue. We mentioned the AI-driven risk stratification. I mean, that’s really looking at medical costs. We use AI in our suspecting algorithms as well, that’s on the revenue side.

是的。我會說有兩件事。我會把AI計畫分成兩類：一類是OpEx效率；另一類可能更多影響到、我會說，損益表上方（above the line），也就是醫療成本與營收。我們提到AI驅動的風險分層（risk stratification），那主要是在看醫療成本。我們也在疑似判別（suspecting）演算法中使用AI，那是在營收端。

I guess, what I would say is, probably limited early impact on the OpEx line, more significant on both the revenue and medical cost line. As you know, we operate in an environment where you’re working on things today, but the value shows up much, much later in the healthcare environment, right?

我想我會說的是，對OpEx項目在早期的影響可能有限，但對營收與醫療成本兩條線的影響會更顯著。如你所知，我們所處的環境是，你今天做的事情，但其價值會在醫療照護環境中更晚才顯現，對吧？

Yeah. Okay. Thanks a lot.

好的。非常感謝。

Matthew Shea, Needham.

Matthew Shea，Needham。

Hey, thanks for taking the questions. Nice to hear about the scaling clinical programs. I guess, maybe just want to put some finer points around those. I think at a conference a couple months ago, you guys had talked about that by the end of Q2. You had expected to get 50% to 70% plus of markets live on dementia and COPD pathways. Is that still the right way to think about the rollout?

嗨，謝謝讓我提問。很高興聽到臨床計畫正在擴大規模。我想也許想把一些細節釐清一下。我記得在幾個月前的一場會議上，你們提到到第二季末，預期有50%到70%以上的市場會上線失智症與COPD路徑。這仍然是看待推廣進度的正確方式嗎？

And then on the financial side, could you remind us how long it takes to generate outcomes from these programs? Like, does scaling COPD and dementia add benefit to 2026 profitability, or should we look at that as more of a 2027 benefit?

另外在財務面，能否提醒我們這些計畫要多久才能產生成果？例如，擴大COPD與失智症是否會對2026年的獲利帶來助益，還是應該把它視為更偏向2027年的助益？

Yeah, I would say yes on the COPD and dementia rollout. And yes, again, on your second question of would it add value to 2026. However, you know, it has to show up in the claims, and obviously, you know, that takes time, right? But I would say yes.

是的，我會說COPD與失智症的推廣是的。至於你的第二個問題，是否會對2026年帶來價值，我也會說是。不過，你知道，它必須反映在理賠上，而顯然那需要時間，對吧？但我會說是的。

And scaling, if you think about we initiated the heart failure program a year ago, it’s our most mature program, and we are obviously seeing the benefit of that today. I think in the prepared remarks, you heard a lot of statistics about how it’s really improving the lives of our members.

至於擴大規模，如果你想想我們一年前啟動的心衰竭計畫，那是我們最成熟的計畫，而我們顯然今天已經看到它帶來的效益。我想在事先準備的發言中，你也聽到很多統計數據，說明它確實正在改善我們會員的生活。

And so we have seen the outcomes of that. And I think we’re pretty excited about rolling out the other programs and continuing to focus on other clinical programs as we think about member care going forward.

因此我們已看到其成果。我想我們對推廣其他計畫感到相當興奮，並且在展望未來的會員照護時，會持續聚焦於其他臨床計畫。

Yeah, probably the only point I would make is how our physicians feel about being actively engaged in these clinical pathways. They see this as really part of the reason they went to medical school, which is to help improve the quality of people’s lives.

是的，我可能唯一想補充的一點是，我們的醫師對於能夠積極參與這些臨床路徑的感受。他們認為這正是他們去念醫學院的原因之一，也就是幫助提升人們的生活品質。

And the ability to earlier identify these conditions, to get people on the right therapies, not only avoids perhaps unnecessary hospitalization, but most importantly, improves the lives of the patients. And they really feel very positive about that.

而能夠更早識別這些病況、讓人們接受正確的治療，不僅可能避免不必要的住院，更重要的是改善病患的生活。他們對此真的感到非常正向。

Okay, great. Appreciate that color. Then maybe to follow up on that point about, you know, provider engagement and working with them. A couple months ago, you guys had been vocal about maybe some governance changes, and that at a physician group level, you were being more aggressive in terms of how you manage networks and sort of going market by market and tightening up that governance.

好的，很好。感謝這些補充。那也許接著追問你剛才提到的提供者參與以及與他們合作的部分。幾個月前，你們曾明確提到可能會有一些治理（governance）變更，而且在醫師團體層級，你們在管理網絡方面會更積極，並且按市場逐一推進、收緊治理。

Would love to just have you guys maybe unpack that a little bit. What ultimately are you doing or implementing? And any way to think about, you know, what sort of inning we’re in with that tightening of the governance and when we might start to see some results from that? Thanks.

很希望你們能再多拆解一下。你們最終在做或在導入什麼？另外，從收緊治理的進度來看，我們目前大概處於哪個階段？以及我們可能何時開始看到一些成果？謝謝。

Thank you, Matthew. I think the focus we've had is really working with the payers and basically saying to our payers that we're not going to pay them for the privilege of doing business with them. That our physicians are doing a great job of improving quality, which is reflected in the SARS ratings that we've often talked about.

謝謝你，Matthew。我想我們的重點其實是與付款方合作，並基本上對付款方表示，我們不會為了與他們做生意的「特權」而付錢。我們的醫師在提升品質方面做得非常好，這也反映在我們經常談到的SARS評等中。

Our focus has really been working collaboratively with the physicians to articulate to the pair community the value that we can create for them, the value we can create for their patients. So it really hasn't been about the governance of the groups themselves. It's about how we work together to participate and actively develop the kind of contractual negotiating results we've seen this year.

我們的重點其實一直是與醫師協同合作，向支付方社群清楚闡述我們能為他們創造的價值，以及我們能為其病患創造的價值。因此，這真的不是關於各團體本身的治理問題，而是關於我們如何共同合作、參與並積極推動我們今年所看到的那種合約談判成果。

George Hill, Deutsche Bank.

George Hill，德意志銀行。

Yeah. Good morning, guys. Just, Jeff, I was wondering if you would talk about your conversations with your ACO REACH clients, customers right now about how they’re thinking about the REACH program for next year. Like, are you expecting to see the same level of participation? Do you guys expect that your economics are gonna look the same? Given the contribution that ACO REACH has made to the business, it’d be interesting to hear how those conversations are going or standing going forward.

是的。各位早安。Jeff，我想請你談談你們目前與 ACO REACH 客戶／客戶群的對話，關於他們如何看待明年的 REACH 計畫。比如說，你們是否預期會看到相同程度的參與？你們是否預期你們的經濟效益會看起來一樣？鑑於 ACO REACH 對業務的貢獻，想聽聽這些對話目前進展如何，以及未來的狀況。

Yeah. Yeah. I mean, obviously, the details of the lead program just came out, so we’re in the process of, I would say, analyzing all that information and really determining, you know, which path is best from either a lead or MSSP program. I think the good news for us is that we’ve participated in MSSP and obviously the REACH program and have been very successful.

是的。是的。我是說，很明顯，LEAD 計畫的細節才剛公布，所以我們正在進行中——我會說——分析所有資訊，並真正判斷，從 LEAD 或 MSSP 計畫來看，哪一條路徑最好。我想對我們而言的好消息是，我們參與過 MSSP，當然也參與過 REACH 計畫，而且都非常成功。

And so I guess, as we think about it, we think we can be successful in both programs moving forward, and they will be positive contributors to our financial performance in 2027 and beyond. So it’s a little early, but we’re certainly having conversations and we’re running all the calculations to figure out which path is best to go down.

所以我想，當我們思考這件事時，我們認為未來在兩個計畫中都能成功，而且它們將在 2027 年及之後對我們的財務表現帶來正面貢獻。現在還稍早，但我們確實正在對話，也在跑所有的試算，來找出哪一條路徑最適合。

And Jeff, if I can have a quick follow-up, I guess, just as you think about kind of the improvement in the guidance in fiscal 2026, just from talking to some of the plans, is do you feel like the results in fiscal 2026 are something that can be built on for 2027? What I’m worrying about is to what degree do you think the business faces a reset as you go into contracting for 2027 and bids for 2027, you know, membership moves for 2027. Just be interested in how you’re thinking about sustainability. Thanks.

Jeff，如果我可以快速追問一下：當你們看待 2026 財年的指引上修時，從與一些保險計畫的交流來看，你是否覺得 2026 財年的結果可以作為 2027 年的基礎？我擔心的是，當你們進入 2027 年的合約談判、2027 年的投標，以及 2027 年的會員移轉時，業務在多大程度上會面臨一次重置。想聽聽你對可持續性的看法。謝謝。

Yeah, no, I would certainly say it’s a foundation that can be built on. I mean, that’s what we’ve been focused on over the last 18 months, is really driving towards profitability. We will take that same lens as we think about contract negotiations, in -- for 2027, which we are in active discussions at this point in time for all the reasons that Ron just previously mentioned. So I do think it’s a solid foundation for us to build off of.

是的，不，我當然會說這是一個可以延伸建構的基礎。我的意思是，這就是我們過去 18 個月一直專注的方向——真正推動走向獲利。我們在思考 2027 年的合約談判時也會用同樣的視角；就如 Ron 剛才提到的各種原因，我們目前也正在積極討論中。所以我確實認為這是我們可以在其上持續建構的穩固基礎。

Appreciate the color.

感謝補充說明。

Stephen Baxter, Wells Fargo.

Stephen Baxter，富國銀行。

Hi. Thanks. I just wanted to make sure that, you know, we understand all the sources of medical margin upside in the quarter versus your guidance. I think you sized the full year expected benefit from the higher risk scores at the 1% level. I think that on a quarterly basis is something like $14 million or $15 million of, you know, additional medical margin.

嗨，謝謝。我只是想確認一下，我們是否理解本季醫療毛利（medical margin）相較於你們指引的所有上行來源。我認為你們把風險分數較高帶來的全年預期效益估在 1% 的水準。我想以季度來看，大概是 1,400 萬或 1,500 萬美元左右的額外醫療毛利。

When we look at the balance of the peak, which I think was closer to $35 million, again, trying to make sure we have all the pieces there. I guess, you had a benefit from PYD. You’re also saying you’re booking cost trends to guidance levels versus kind of modeling any kind of improvement.

當我們看其餘的差異，我認為更接近 3,500 萬美元——同樣地，想確保我們把所有組成要素都拼齊。我想你們有來自 PYD 的效益。你們也提到，你們是按指引水準入帳成本趨勢，而不是在模型中假設任何改善。

Yeah, first maybe we can clarify that, and then I have a question as a follow-up. Thank you.

是的，首先也許我們可以先釐清這點，然後我有一個追問。謝謝。

Yeah. Yeah. Maybe, maybe I’ll start with just for Q1 bridging you to maybe the guide, the guide, mid for a medical margin perspective, so that the variance is roughly $26 million compared to the guide mid, and there’s a couple of things in there. You’re right. The risk adjustment update, think of that as $50 million for the full year. Obviously, we would get half of that. And so there’s a piece that’s associated with the risk adjustment update.

是的。是的。也許我先從第一季把你們銜接到指引——從醫療毛利角度看，指引中位數來說，差異大約是 2,600 萬美元，裡面有幾個因素。你說得對，風險調整更新（risk adjustment update）——把它想成全年 5,000 萬美元。很明顯我們會拿到其中一半。所以其中有一部分是與風險調整更新相關。

And then we mentioned the new contract. So the new contract, although it has, I would say we’ve modeled it as break-even margin for the year, obviously Q1, if you lay out the seasonality of our business, there would be margin on that contract in the first quarter. So those are the two things that are impacting medical margin in Q1 as you think about the midpoint of the guidance we previously provided.

然後我們也提到新合約。這個新合約，雖然我會說我們在模型中把它視為全年損益兩平的毛利，但很明顯第一季如果考量我們業務的季節性，該合約在第一季會有毛利。因此，當你以我們先前提供的指引中位數來思考時，影響第一季醫療毛利的就是這兩件事。

Got it. And then, just in terms of the, you know, the 2027 payer contracting objectives, I’d love to just hear a little bit more of an expansion of, like, what are the things that have sort of been fully accomplished in terms of what you were able to do for 2026? Like, I’m thinking like it sounds like Part D risk is something you’ve made a lot of progress on, but you know, maybe things like percentage of premium are more of an opportunity prospectively. I guess, how would you kind of characterize the opportunity set on payer contracting versus, you know, what you’ve been able to do so far? Thanks.

了解。那接著，就 2027 年支付方合約的目標而言，我很想再多聽一些延伸說明：你們在 2026 年合約上已經完成了哪些事項？例如聽起來 Part D 風險是你們已經取得很大進展的部分，但像是保費百分比（percent of premium）可能在未來仍有機會。我想問的是，你會如何描述支付方合約的機會集合，相較於你們目前已經做到的成果？謝謝。

Yeah, certainly. I, you know, I don’t think our perspective has changed as far as the items that we are seeking. You’re right, percent of premium is obviously one of the ones at the top of the list. Continued reduction of Part D exposure, we were very successful over the last couple of years. This year, you know, less than 15% exposure on Part D. Would certainly like to see that go down even more. But we have, you know, reduced the magnitude of the risk to where it’s manageable. But certainly, that is on the list.

是的，當然。我想，就我們所追求的項目而言，我不認為我們的觀點有改變。你說得對，保費百分比顯然是清單最上方的項目之一。持續降低 Part D 的曝險，我們在過去幾年非常成功。今年 Part D 的曝險不到 15%。我們當然希望能再更低一些。但我們已經把風險的幅度降到可管理的程度。不過，這確實仍在清單上。

The other thing is, you know, risk corridors or carving out things that are outside of our control, like supplemental benefits.All of those same levers that we were talking about a year ago are the same things that we’re focused on for 2027. Again, I think it’s just early in our contracting cycle. We’re having a very productive conversations with the payers. They’re very supportive of our model. And so you know, we’ll have to play that out as the year goes on.

另外一點是，風險走廊（risk corridors），或把一些我們無法控制的事項切割出去（carve-out），例如補充福利（supplemental benefits）。我們一年前談到的那些相同槓桿，仍然是我們在 2027 年所聚焦的事情。再次強調，我認為目前仍在合約週期的早期階段。我們與支付方的對話非常有成效。他們也非常支持我們的模式。所以，接下來就要看今年進展如何。

Daniel Grossle, Citigroup.

Daniel Grossle，花旗集團。

Hey, this is Luis on for Daniel. You said last quarter that there was $15 million of new geographic entry expenses. I know some of those are for current providers, but you also said that some would be, some of that guidance is embedded for new possible investments for additional growth. Can you provide an update on that if possible? Thanks.

嗨，我是 Luis，代 Daniel 提問。你們上季提到有 1,500 萬美元的新地理區域進入費用。我知道其中一些是給現有提供者的，但你們也說過，指引中有一部分是為了可能的新投資、以支持額外成長而預留的。若可以的話，能否提供最新進度？謝謝。

Yeah. Yeah. I think you may be the geographic entry that was in the guide maybe for the full year, I think that’s what you’re talking about. I would say those costs are just generally in line with what we expected in the first quarter. Nothing really out of the ordinary there.

是的。是的。我想你指的是指引裡、可能是全年層級的新地理區域進入——我想你說的是這個。我會說，第一季這些成本大致符合我們的預期，沒有什麼特別異常。

Got it, understood. One more follow-up from me is, are you able to break out the 7.4% cost trend embedded in guidance? Is there any particular categories that are expected to drive much of that? What would give you comfort to revise that down moving forward? Thank you.

了解，明白。我再追問一個：你們能否拆解一下指引中內含的 7.4% 成本趨勢？是否有任何特定類別預期會驅動其中的大部分？未來若要把它往下修，什麼情況會讓你們更有信心？謝謝。

Say that again? That first part you kind of cut out there.

你再說一次？你前面那一段有點斷掉了。

Sorry. Are you able to break out the 7.4% cost trend embedded in guidance? Like, are there any particular categories expected to drive, like, much of that?

抱歉。你們能否拆解一下指引中內含的 7.4% 成本趨勢？例如，有沒有任何特定類別預期會驅動其中的大部分？

Yeah, you know, I would say, the 7.4% was, just to clarify, that’s what we recorded in the first quarter. For the full year, our guidance is 7%, net. You know, we have limited paid claims visibility as we sit here today in the first quarter.

是的，你知道，我會說，7.4%——只是澄清一下——那是我們在第一季所記錄的數字。就全年而言，我們的指引是淨額7%。你知道，以我們目前在第一季所處的時間點來看，我們對已支付理賠的可視性有限。

What we do have, I would say, continues the theme of Part B, you know -- Part B escalated, Part B costs, and inpatient costs. That’s where we continue to see the cost escalation. That’s been a common theme for over the last year. So, I would say, consistent. But again, we’re sitting on limited data here for the first quarter.

我們目前掌握到的資訊，我會說，仍延續了Part B的主題，你知道——Part B上升、Part B成本，以及住院成本。這就是我們持續看到成本上升的地方。這在過去一年多來一直是共同的主題。所以，我會說，是一致的。但再說一次，我們在第一季這裡掌握的數據有限。

Understood. Thank you.

了解。謝謝。

Amir Farahani, Evercore.

Amir Farahani，Evercore。

Thanks, guys. You previously discussed roughly 50 bps of tailwind from improved payer bids. I guess, how’s that tracking year to date? Also, with the 2027 bidding season around the corner, would love to hear, you know, what you guys are hearing from your payer partners in terms of benefit design, premiums, et cetera. You know, would appreciate any view of how that’s, you know, translating to potential impact for next year.

謝謝，各位。你們先前提到，因付款方投標改善帶來約50個基點的順風。我想問，年初至今的追蹤情況如何？另外，隨著2027年投標季即將到來，也很想聽聽你們從付款方合作夥伴那邊聽到的訊息，例如福利設計、保費等等。也希望你們能分享任何觀點，說明這些因素如何轉化為對明年的潛在影響。

Yeah, maybe I’ll do the payer part. The messages that we’re hearing in their communications is continuing to have a very strong focus on margin improvement. We would expect that their bids, their product positioning, everything is about restoring themselves to a -- what they view as a reasonable level of margin, which we think is good for us.

是的，也許我先談付款方的部分。我們在他們的溝通中聽到的訊息是，仍然非常聚焦於改善利潤率。我們預期他們的投標、產品定位等一切，都是為了讓他們回到——他們認為合理的利潤率水準，而我們認為這對我們是有利的。

Yeah, the second piece you talked about was the benefit of the payer contracting. You know, I think the number we quoted in the, excuse me, in the initial guide was roughly $127 million for the full year. When we talked about that on the guide, that was done. Those contracts were executed. So that benefit is absolutely flowing through in the first quarter.

是的，你提到的第二部分是付款方簽約帶來的效益。你知道，我想我們在最初的指引中引用的數字是全年約1.27億美元。當我們在指引中談到這點時，那已經完成了；那些合約都已簽署。因此，這項效益在第一季確實已經反映出來。

Okay. No, that’s helpful. Thank you so much. In terms of the -- maybe one follow-up question, the group MA mix, maybe if you can give an update in terms of where that stands today. You know, we’ve heard from several payers, they have, you know, flagged that there is recovery in the MA margin, the group business in 2026. I guess, are we seeing structurally better economics in your books, and is that upside captured in the guide? Thank you so much.

好的。不，這很有幫助。非常感謝。就——也許再追問一個問題，關於團體MA組合（mix），能否更新一下目前的狀況？你知道，我們從幾家付款方那邊聽到，他們已經指出MA利潤率在2026年的團體業務會出現復甦。我想問，我們是否在你們帳上看到結構性更好的經濟性？而這個上行是否已包含在指引中？非常感謝。

Yeah. I guess what I’d say, our group mix roughly hasn’t changed from last year. Very consistent. Obviously, when we think about negotiations with payer contracts, it’s all members. You know, the number that we quoted in our initial guide would be inclusive of that.

是的。我想我會說，我們的團體組合大致上與去年相比沒有改變，非常一致。顯然，當我們考慮與付款方合約的談判時，涵蓋的是所有會員。你知道，我們在最初指引中引用的數字會包含這部分。

Jack Slevin, Jefferies.

Jack Slevin，Jefferies。

Hey, good afternoon. Congrats on the quarter, thanks for taking the questions. Maybe to start, just to clean up a little bit of what I heard, as far as that upside in the quarter maybe piggybacking on Stephen’s comment or question, just to be super clear, there was no PYD that you recognized in the first quarter. Is that the way to understand it?

嗨，下午好。恭喜本季表現，謝謝回答問題。也許先釐清一下我聽到的內容，關於本季的上行，可能承接Stephen的評論或問題，為了非常清楚地確認，你們在第一季沒有認列任何PYD。這樣理解對嗎？

And maybe to add on that, just I -- you know, heard about the favorable development. Would love to hear a little bit about what that may have looked like on that development that you saw in the second half of 2025. You know, was it just not a continuation of some of the outlier cases you had at the end of 3Q? Any incremental color would be really helpful. Thanks.

另外再補充一下，我——你知道，聽到有利發展（favorable development）。很想多了解一些你們在2025年下半年看到的那個發展大概是什麼樣子。你知道，是不是只是你們在第三季末一些離群個案沒有延續？任何額外的說明都會很有幫助。謝謝。

Yeah. Certainly. So the prior year development, that’s a number that you can find in the filing, in the 10-Q, in the medical cost roll forward. It’s roughly $12 million for the quarter related to 2025 dates of service. And you are correct, effectively there was really no flow-through.

是的，當然。關於前一年發展（prior year development），這個數字你可以在申報文件、10-Q裡的醫療成本滾動表（medical cost roll forward）中找到。本季大約是1,200萬美元，與2025年的服務日期（dates of service）相關。而你說得沒錯，基本上確實沒有什麼流入（flow-through）。

Because, you know, during the quarter we added additional reserves to Part D. As you know, we have limited information on Part D costs, and we had 30% of our members have that risk in 2025. And so we just took the opportunity to bolster those reserves, because we really don’t get final reconciliation until the third

因為，你知道，在本季我們對Part D增加了額外準備金。如你所知，我們對Part D成本的資訊有限，而且在2025年有30%的會員承擔了那項風險。因此我們就把握機會強化那些準備金，因為我們要到第三季才會拿到最終對帳（final reconciliation）。

So you are correct that there was really no benefit from the prior year development. Remember Part D is in revenue for us. You had a good news from last year in the medical expense line, and that was offset by a reduction in revenue, which really represents the Part D.

所以你說得對，前一年發展確實沒有帶來什麼效益。請記得，對我們而言Part D是在營收裡。你在醫療費用項下看到去年帶來的好消息，但那被營收的減少所抵銷，而那其實就代表Part D。

Okay. Super helpful. Appreciate that. Then just as a follow-up on some of the 2027 commentary. You know, Jeff, I think you had said on the last quarter that even with sort of looking at the advance notice, considering what you guys have been able to do on burden of illness, you guys felt like you could possibly expand margins or feel confident about expanding margins in 2027.

好的，非常有幫助，謝謝。那再追問一下關於2027年的一些評論。你知道，Jeff，我想你在上季提到，即使看了advance notice，考量你們在疾病負擔（burden of illness）方面能做到的事情，你們覺得在2027年可能可以擴大利潤率，或對擴大利潤率有信心。

I guess, you know, obviously the numbers have changed here and gotten more positive. Have anything else, you know, has anything else really changed if we think about where you were a few months ago as far as, you know, confidence for 2027 or how you’re thinking about that equation on the course out of the business?

我想問，你知道，顯然這裡的數字已經改變、變得更正面了。若回想幾個月前你們對2027年的信心，或你們如何看待業務發展路徑中的那個方程式，有沒有其他事情真的改變了？

Yeah, I mean, I would say the only thing that I would point to that changed is obviously our performance this quarter with respect to the risk adjustment, right? I would say now we have more confidence on a going forward basis.

是的，我的意思是，我會說唯一我會指出的變化，顯然是我們本季在風險調整（risk adjustment）方面的表現，對吧？我會說，現在我們對未來的持續表現更有信心。

You know, this year, for example, we said we were going to outperform the final year of v28. Now, we have more confidence that it’s going to be even higher than that. So I guess that gives us more confidence going forward in 2027 and beyond that we can offset, for example, the risk normalization, the normalization factor of 1.12%. Again, we’ve commented that in the prepared remarks that we don’t believe we have any material exposure to sources of diagnosis, given the design of our model being closely aligned with the primary care physicians.

你知道，例如今年我們說我們會優於v28的最後一年。現在，我們更有信心它會比那個還要更高。所以我想，這讓我們對2027年及之後更有信心，例如我們可以抵銷風險常態化（risk normalization）、1.12%的常態化因子（normalization factor）。再說一次，我們在事先準備的講稿中也提到，基於我們模型的設計與基層照護醫師（primary care physicians）高度一致，我們認為在診斷來源（sources of diagnosis）方面沒有任何重大曝險。

And so as we think about the growth rate for 2027, we’re really zeroing in on that 5.33%.

因此，當我們思考2027年的成長率時，我們會更聚焦在5.33%這個數字上。

Really helpful. Appreciate it, and congrats again on the quarter.

非常有幫助。謝謝，也再次恭喜本季表現。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Thanks. Appreciate all the commentary here. On the new risk contract with the new payer, I guess what was attractive about that contract? Look, I get it’s in an existing market. Are those generally members maybe you had before but switched to this payer’s plans, or is this a new member cohort? Are you able to provide what the pickup in the guidance was from this contract?

謝謝。很感謝這裡所有的評論。關於與新付款方簽訂的新風險合約，我想問這份合約的吸引力在哪裡？你看，我理解它是在既有市場。這些通常是你們以前可能有、但後來轉到這家付款方方案的會員嗎？還是一個新的會員群？你們能否說明這份合約對指引的上調貢獻是多少？

If you already said it, I’m sorry, just a lot of numbers flying around.

如果你們已經說過了我很抱歉，只是數字太多了。

Yeah, yeah, no, certainly. It’s in a market with an existing physician group. You know, I think from our perspective it is a new payer contract, so it’s a new contract with a payer.

是的，是的，當然。它是在一個已有醫師團體的市場。你知道，我想從我們的角度來看，這是一份新的付款方合約，所以是與一個付款方的新合約。

As we think about that, and I just mentioned earlier that we modeled that at roughly -- it’s roughly $200 million in revenue. We’ve modeled it at roughly break even margin for the year. I think for us it’s really an opportunity for a multi-year improvement in margin, and we think we can deliver that. I mean, it’s not uncommon for us to have year zero, conservatively modeled at, you know, break even margin.

當我們思考這件事——我剛才也提到——我們把它建模為大約……營收大約2億美元。我們把它建模為全年大致打平的利潤率。我想對我們而言，這真的是一個多年期改善利潤率的機會，而我們認為我們能做到。我的意思是，對我們來說，將第零年（year zero）保守地建模為——你知道——打平利潤率，並不罕見。

Got it. Thank you very much.

了解了。非常感謝。

Craig Jones, Bank of America.

Craig Jones，美國銀行。

Great. Thank you. So you mentioned, you know, pretty much no impact from the unlinked chart reviews, that we’re gonna see in 2027. It seems like CMS is pretty gumbo on, you know, continuing to kind of level the playing field.

很好。謝謝。所以你提到，基本上我們在 2027 年會看到的未連結病歷審查（unlinked chart reviews）幾乎沒有影響。看起來 CMS 對於持續讓競爭環境更公平，態度相當堅定。

So as you look forward, you know, maybe 2028 or even further out there, you know, what about what kind of impact would you see from linked chart reviews and maybe health risk assessments and, you know, is there any other kind of low-hanging fruit you see that, you know, CMS could go after? Thank you.

那麼往前看，可能到 2028 年甚至更久之後，連結病歷審查（linked chart reviews）以及可能的健康風險評估（health risk assessments）會帶來什麼樣的影響？另外，你是否看到其他 CMS 可能會著手的「低垂果實」（low-hanging fruit）？謝謝。

Well, look, I think that we feel good about where we are for the reason that we have 100% chart review. Physicians see every patient. Physicians, the charts are audited very carefully. Doesn’t mean we won’t have some issues, but it means that we’re much more rigorous than we think some of the other plans have been in terms of how they have coded historically.

嗯，你看，我認為我們對目前的狀況感到放心，原因是我們做到 100% 的病歷審查。醫師會看診每一位病人。醫師的病歷也會被非常仔細地稽核。這不代表我們不會遇到一些問題，但這表示相較於我們認為其他一些計畫在過去的編碼方式，我們的嚴謹程度高得多。

I think that we can expect CMS will continue to try to spend the taxpayer’s dollar wisely, and our focus on making certain it’s linked to real care that’s delivered to real patients, we think is the best thing we can do.

我認為我們可以預期 CMS 會持續嘗試更明智地使用納稅人的資金；而我們的重點是確保它與實際提供給真實病人的照護相連結，我們認為這是我們能做的最好的事情。

Michael Ha, Baird.

Michael Ha，Baird。

Thank you. Regarding the REACH model, I guess as you run your calculations to determine which path to go down, how are you contemplating the eventual, that AI inferred risk adjustment model that’s being phased into the REACH program? How much visibility do you actually have into how this AI model might impact risk adjustment?

謝謝。關於 REACH 模式，我想在你們進行計算以決定要走哪一條路時，你們如何看待最終會逐步導入 REACH 計畫的 AI 推論風險調整模型（AI inferred risk adjustment model）？你們實際上對這個 AI 模型可能如何影響風險調整，有多少能見度？

Yeah, Michael, there’s not a lot of details on that right now, right? So I think it’s hard to obviously model in something where there’s really no details about how that’s going to work. And we'll just have to play that out as we give visibility to whatever that model is.

是的，Michael，目前關於那個的細節不多，對吧？所以我認為在幾乎沒有細節說明它將如何運作的情況下，顯然很難把它納入模型。我們只能在該模型逐步明朗、我們獲得更多能見度時，再視情況推進。

Got it. Thank you. I think last quarter, you mentioned the opportunity to possibly more than double payer incentive contributions in 2026, which I think was $25 million for '25. Your '26 guide conservatively assumed the same, which presented, I think, an area of upside. I was wondering how is that tracking so far through 2026? How much of that path from $25 million to potentially north of $50 million might you already have visibility into?

了解，謝謝。我記得上季你提到，2026 年保險支付方激勵金貢獻（payer incentive contributions）可能有機會增加到超過兩倍；我想 2025 年是 2,500 萬美元。你們對 2026 年的指引保守地假設維持相同水準，這看起來是一個上行空間。我想請問，到目前為止在 2026 年的進展如何？從 2,500 萬美元到可能超過 5,000 萬美元的這條路徑，你們現在已經能看到多少？

And yeah, just would love to understand, like, what it takes to get from $25 million to possibly double that this year. Thank you.

另外也很想了解，例如，要從 2,500 萬美元提升到今年可能翻倍，大概需要哪些條件？謝謝。

Yeah. I guess what I’d say, you’re correct that the opportunity has doubled. I think that just shows the importance of quality across the board, specifically for payers. And so the opportunity for us to earn additional dollars is there.

好的。我想我會說，你說得沒錯，這個機會確實翻倍了。我認為這也顯示出全面品質的重要性，特別是對支付方而言。因此，我們確實有機會賺取額外的收入。

What we said as part of the guide is we have a similar level of performance in '26 guide assuming we performed at the same level of '25. I mean, it’s super early, right? We don’t really have any data on that yet, so we’re just gonna have to wait until time goes on throughout the year. But we feel pretty confident that we are delivering superior quality to our payer partners and our members.

我們在指引中所說的是：在 2026 年的指引裡，我們假設表現水準與 2025 年相同。我的意思是，現在還非常早，對吧？我們其實還沒有任何相關數據，所以只能隨著年度進行、時間推移再觀察。但我們對於自己能為支付方合作夥伴與會員提供更優異的品質，感到相當有信心。

Ryan Daniels, William Blair.

Ryan Daniels，William Blair。

Yeah, guys. Thanks for taking the question. I’ll keep it to just one. Given the operational improvements you’re seeing, the clinical pathways, the better data feeds, when does the company consider going back on the offensive a bit, kind of growing the member base, maybe going out and, you know, reinvigorating the new partner pipeline, especially as there’s a clear demand from payers to continue to expand these partnerships? Thanks.

是的，各位，謝謝讓我提問。我只問一題。鑑於你們看到的營運改善、臨床路徑、以及更好的資料串流，公司何時會考慮稍微回到更積極的策略，例如擴大會員基礎、重新活絡新的合作夥伴管線？尤其在支付方明確有需求、希望持續擴大這些合作關係的情況下。謝謝。

I think one thing that sometimes gets missed is the fact that our partners are deeply embedded in these communities. They’ve been there for years. They have large commercial panels. And every month, people turn 65 and enter Medicare Advantage.

我認為有一點有時會被忽略：我們的合作夥伴深深扎根在這些社區。他們在那裡已經很多年了。他們有很大的商業保險病人群（commercial panels）。而且每個月都有人滿 65 歲並加入 Medicare Advantage。

There is some degree of embedded growth. It’s nowhere near like opening a new market, but it means that you don’t suffer attrition typically as a result of not expanding in a meaningful way. Also, some of the groups do in fact add new physicians. They bring them in. I would say the focus right now is on in-market growth, in-market execution. The time will come when we will turn our attention to other things, but that time’s not here yet.

因此存在某種程度的內生性成長。這遠不如開拓新市場那樣，但這意味著通常不會因為沒有以有意義的方式擴張而出現客戶流失。此外，有些團體確實會新增醫師、把他們納入。我會說目前的重點是在既有市場內的成長、既有市場內的執行。未來會有一天我們會把注意力轉向其他事情，但現在還不是時候。

We have reached the end of the Q&A session. I will now turn the call back to Ron Williams for closing remarks.

問答環節到此結束。我現在把電話會議交回 Ron Williams 作結語。

Yeah. I want to thank everyone who joined us this evening. Since stepping in as Executive Chairman eight months ago, I’ve really worked very closely with the leadership team. We’ve been highly focused on increasing the sense of urgency, heightened the focus on the key priorities that have focused on really driving improved performance for our members, for our primary care partners, and for payers.

好的。我要感謝今晚加入我們的每一位。自從八個月前我接任執行董事長以來，我一直與領導團隊非常密切地合作。我們高度聚焦於提升緊迫感，並加強對關鍵優先事項的專注，真正推動我們在會員、基層醫療合作夥伴以及支付方方面的績效改善。

And I think that while we believe that the environment remains dynamic, we are confident that the actions we have taken will deepen the existing strengths of our partnership model. We think it’s a very unique model because of the proximity to the physician. It gives us an ability to make certain that the suspects and things that we determine are resulting in real clinical interventions, and we think that is extremely important to patients and clearly is important to CMS.

我認為，雖然我們相信外部環境仍然多變，但我們有信心，我們採取的行動將會深化我們合作夥伴模式既有的優勢。我們認為這是一個非常獨特的模式，因為它與醫師的距離非常近。這讓我們有能力確保我們所懷疑的事項、以及我們判定的問題，能夠轉化為真正的臨床介入；我們認為這對病人極其重要，且顯然也對 CMS 很重要。

I want to close really by welcoming Tim O’Rourke, our new CEO. I am thrilled to have Tim join us today. He brings the right balance of understanding the payer, understanding the provider, and understanding the importance that primary care physicians bring to our unique delivery model. I want to close by thanking Tim for joining us, and I have to say he did extensive due diligence, which was most impressive, on making a decision that we feel very good about having him part of our team. Our employees have really worked very hard to get us where we are, and I want to give a special thank you to everyone in agilon who’s helped us achieve the results we are reporting today. Thank you, all.

最後我想歡迎我們的新任 CEO Tim O’Rourke。我非常高興 Tim 今天加入我們。他在理解支付方、理解提供者（provider），以及理解基層照護醫師在我們獨特的交付模式中所扮演的重要性方面，帶來了恰到好處的平衡。最後也要感謝 Tim 加入我們；我必須說，他在做出這個決定前做了非常深入的盡職調查，令人印象深刻，我們也非常高興他成為我們團隊的一員。我們的員工真的非常努力，才讓我們走到今天這一步；我也要特別感謝 agilon 的每一位同仁，協助我們達成今天所報告的成果。謝謝大家。

This concludes today's call. Thank you for attending. You may now disconnect.

今天的電話會議到此結束。感謝各位參與。您現在可以掛線。