agilon health, inc. (AGL): Business Model Canvas [Dec-2025 Updated]

You're digging into a company that's making a clear pivot: shifting focus from just growing bigger to actually making better margins, and that changes how you look at their whole structure. I've mapped out the Business Model Canvas for agilon health, showing exactly how they turn their network of over 3,000 primary care physicians into a profitable engine, especially as they manage roughly 503,000 Medicare Advantage members this year toward a projected $5.82 billion revenue midpoint. It's a model built on full-risk capitation, designed to keep PCPs independent while driving down costs-they are even targeting $30 million in operating expense savings for 2026-so let's see the nine blocks that make this machine run.

agilon health, inc. (AGL) - Canvas Business Model: Key Partnerships

You're looking at the core relationships that allow agilon health, inc. (AGL) to execute its value-based care model. These aren't just vendor agreements; these are deep, long-term contracts that shift financial risk and align incentives across the care continuum.

Independent Primary Care Physician (PCP) groups for long-term contracts

The foundation of agilon health, inc. (AGL)'s model is its physician network. These partnerships are structured as long-term agreements, enabling PCPs to maintain their independence while transitioning to full-risk arrangements. The scale of this network is critical for achieving the necessary patient volume and data aggregation.

• agilon health, inc. (AGL) provides access to a peer network of 2,200+ primary care physicians (PCPs).
• Prior to 2025, partnerships with groups like Premier Health expanded the committed PCP base to more than 2,700 PCPs.
• In 2023, the Accountable Care Organizations (ACOs) participating in the ACO REACH model included 1,500 primary care physicians.

Major Health Plans and Payers for full-risk capitation agreements

The financial engine runs on full-risk capitation agreements with major health plans, primarily for Medicare Advantage members. These contracts are the source of the Per Member Per Month (PMPM) revenue that agilon health, inc. (AGL) manages.

• agilon health, inc. (AGL) partners with scaled medical groups that average 3 to 5 payers per market.
• The company relies on its relationships with a number of key payors to operate its business.
• The agreements with payors are noted as having limited terms, making renewal a key operational focus.

Health systems and multi-specialty physician practices

agilon health, inc. (AGL) partners with established physician groups and health systems to accelerate their transition to the Total Care Model. These are often large, community-based organizations looking for a partner to manage the complexity of full-risk value-based care.

• More than 30 physician groups and health systems were in long-term partnerships as of May 2024, transitioning their Medicare patients to full-risk models.
• Partnerships include major groups like Graves Gilbert Clinic in Kentucky and Springfield Clinic in Illinois.
• Premier Health, one of Ohio's largest private, nonprofit, comprehensive health care systems, entered a long-term partnership to accelerate its transition to the full-risk model.

Strategic technology vendors for data and analytics support

While specific vendor names aren't detailed in the partnership context, the reliance on technology for performance management is clear. Investment in the platform is a competitive advantage, driving automation and clinical outcomes.

• Investment in technology is cited as a key competitive advantage, driving improved automation, efficiency, quality, and clinical outcomes.
• A new financial data pipeline was implemented to enhance revenue and claims information management.
• Enhanced data platform insights informed a projected lower risk adjustment for 2025, representing 72% of membership as of Q1 2025.

Centers for Medicare & Medicaid Services (CMS) for ACO REACH

The ACO REACH model is a direct partnership with CMS, representing a critical, full-risk component of the business. The structure of these agreements dictates specific governance and performance metrics.

Here's a look at the scale and performance within the ACO REACH program as of mid-2025:

Metric	Value/Amount (as of mid-2025)	Source Context
Total ACO REACH Model Beneficiaries	116,000 (as of June 30, 2025)	Platform Membership
ACO REACH Gross Savings (2023 Performance Year)	$150 million	2023 Performance
ACO REACH Gross Savings Rate (2023 Performance Year)	13%	2023 Performance
ACO REACH Medical Margin	Over $100 PMPM	Financial Target
ACO REACH Adjusted EBITDA (Q2 2025)	Positive $10 million	Quarterly Financials
ACO REACH Agreement Initial Term End Date	December 31, 2026	Contractual Detail

The company plans to expand its participation in ACO REACH and MSSP, noting that current penetration is only 20%. The ACO REACH governing body requires 75% control by participating providers or their representatives.

Finance: review Q3 2025 cash flow projections against the $327 million in cash and cash equivalents reported on June 30, 2025.

agilon health, inc. (AGL) - Canvas Business Model: Key Activities

You're looking at the core engine of agilon health, inc. (AGL) as of late 2025, focusing on what they actually do day-to-day to make their value-based care model work. It's all about execution on the ground with physicians and data.

Managing and optimizing full-risk value-based care contracts

The central activity is managing contracts where agilon health, inc. (AGL) takes on the full financial accountability-that's 100% upside/downside risk-for the total cost and quality of care for their Medicare Advantage (MA) and ACO REACH populations. This requires constant optimization, especially given the current rate environment. A key part of this optimization in 2025 was actively managing downside risk exposure. They reduced their Part D risk exposure from two-thirds of members in 2024 to less than 30% of membership in 2025. This shift is crucial for stabilizing the financial performance of these contracts.

Developing and deploying the proprietary 'agilon platform'

The platform development is centered on data visibility to drive better financial and clinical decisions. They deployed an enhanced data pipeline in Q1 2025, which, by the end of Q2 2025, covered 72% of their total membership. This moves them away from receiving summarized PDF statements to getting member-level cost detail. This technology underpins their ability to manage risk accurately.

Physician onboarding, training, and clinical program execution

This activity supports the network of physicians delivering the care. As of March 31, 2025, the total members on the agilon health, inc. (AGL) platform stood at 605,000, which included 491,000 Medicare Advantage members. The newest physician partners (the Class of 2025) are being brought onto the model using a measured approach, described as a glide path before moving to full risk. For context on training scale, in 2024, the goal was to have 90% of new physicians in mature markets trained in the first half of that year.

Population health management and patient risk stratification

Leveraging the platform, the focus is on proactively managing patient health, especially for complex cases. They are bolstering programs for high-risk populations, such as heart failure and dementia. The ultimate goal of this clinical execution is reflected in quality scores; the company is targeting 75% of members in 4+ Star plans for Performance Year 2027, building on a consolidated star average of 4.2 achieved previously. The enhanced data visibility helps improve risk score accuracy and cost prediction.

Cost discipline and operating expense reduction, targeting $30 million savings in 2026

Given the financial headwinds faced in 2025, cost discipline is a major Key Activity. agilon health, inc. (AGL) has explicitly stated a target to reduce operating expenses by $30 million for the year 2026. This is being achieved by leveraging their scaled infrastructure and technology investments to drive operating efficiency. For example, platform support costs were 2.8% of revenue in Q1 2024, against a target of 3% for that year, showing early progress in expense management.

Here's a quick look at some of the scale and financial context for these activities as of mid-to-late 2025:

Metric Category	Specific Metric	Latest Reported/Targeted Number
Membership Scale (Q1 2025)	Total Members on Platform (End of Q1 2025)	605,000
Platform Deployment (Mid-2025)	Member Data in Financial Pipeline (End of Q2 2025)	72%
Risk Management (2025)	Part D Risk Exposure (as % of Membership)	<30%
Financial Target (2026)	Targeted Operating Expense Reduction	$30 million
Quality Goal (PY2027)	Target % of Members in 4+ Star Plans	75%

The focus on data detail is a clear operational shift; moving from one-page PDF summaries to getting member-level cost detail is the definition of enhancing the platform's core function.

The execution of clinical programs is tied directly to the quality outcomes, which then feed back into the contract economics. For instance, the ACO REACH program in 2023 achieved $150 million in gross savings, with cost trends 300 basis points below the Medicare benchmark.

Finance: draft 13-week cash view by Friday.

agilon health, inc. (AGL) - Canvas Business Model: Key Resources

You're looking at the core assets agilon health, inc. (AGL) relies on to execute its value-based care model. These aren't just abstract concepts; they are concrete numbers and systems that underpin their financial and clinical operations as of late 2025.

The proprietary 'agilon platform' is central, supporting a total member base of 618,000 as of September 30, 2025. This platform is where the data integration, clinical program deployment, and financial management all happen for their partners. The scale of the physician network is a major asset, with partnerships enabling care from a network that includes over 3,000 primary care physicians, serving seniors across numerous communities.

A significant differentiator is the enhanced data pipeline. Through this investment, agilon health now has timely direct payer data feeds covering approximately 80% of its members. This visibility is key to managing risk effectively, especially as they navigate the transition to full-risk arrangements. Speaking of risk, the company maintains the financial capital necessary to assume full-risk capitation for medical costs, as evidenced by their balance sheet. As of September 30, 2025, agilon health, inc. reported $311 million in cash and cash equivalents and marketable securities against total debt of only $35 million.

The clinical side is supported by established programs and protocols. These aren't just documents; they drive measurable results. For instance, one of their clinical programs helped reduce new inpatient heart failure diagnosis rates from 18% in 2024 to 5% in 2025 across their Medicare Advantage population. Also, more than 90 percent of surveyed providers believe the programs delivered through the agilon network enabled them to provide better care.

Here's a quick look at the scale of the platform's reach and some key financial backing as of mid-to-late 2025:

Key Resource Metric	Reported Figure (Late 2025)	Date/Context
Total Members Live on Platform	618,000	September 30, 2025
Medicare Advantage Members	503,000	September 30, 2025
ACO REACH Model Beneficiaries	115,000	September 30, 2025
Cash & Marketable Securities	$311 million	September 30, 2025
Total Debt	$35 million	September 30, 2025

The platform's capabilities are built around several integrated functions that support the physician partners in managing total patient health:

• Data integration across payor, EMR, labs, and pharmacies.
• Deployment of actionable clinical playbooks based on shared insights.
• Enabling physician partners to rapidly flip to a global risk model.
• Connecting multiple payors, patients, and physicians into a single experience.

The Class of 2025 new partners are entering on a 'glidepath approach to full risk,' meaning the financial capital is deployed strategically over time, not all at once, which is a prudent way to manage the assumption of medical cost responsibility.

agilon health, inc. (AGL) - Canvas Business Model: Value Propositions

Enables physicians to transition to a profitable, value-based Total Care Model

• PCPs supported by agilon health's full-risk VBC model saw an average of 8 more new Traditional Medicare patients annually in 2023 compared to fee-for-service peers.
• This represents an approximate 35% relative increase in new Traditional Medicare patient volume.
• PCPs shifting to VBC kept their practices open to new Traditional Medicare patients for 0.7 more months per year on average.
• The company's full-year 2025 Medical Margin guidance is between $275 million and $325 million.
• The company is targeting cash flow breakeven by 2027.

Provides capital and technology for physicians to maintain independence

• agilon health provides technology, people, capital, process, and access to a peer network.
• The peer network included over 3,000 primary care doctors as of May 2024.
• In 2024, the Network reinvested over $250 million into local primary care within the communities served.
• The platform offers comprehensive capabilities in data analytics, care coordination, and risk management.

Improves patient outcomes, like reducing new inpatient heart failure diagnoses to 5% in 2025

Here's the quick math on that specific outcome:

Metric	2024 Value	2025 Value
New Inpatient Heart Failure Diagnoses Rate	18%	5%
Heart Failure 30-Day Readmit Rate (with integrated solutions)	National Average ~20%	Below 5%

Also, in markets with virtual pharmacy solutions active, approximately 50% of heart failure with reduced ejection fraction patients are on guideline-directed medication therapy, compared to national averages below 20%.

Offers payers a partner to manage the total cost of care for senior populations

• As of June 30, 2025, agilon health supported 614,000 total members on its platform.
• Of those members, 498,000 were Medicare Advantage members.
• The company projects full-year 2025 revenue between $5.85 billion and $6.025 billion.
• The company is focused on enhancing financial and clinical data visibility and partnership performance.

Higher physician satisfaction by shifting focus from volume to patient health

• The VBC model incentivizes PCPs to spend more time with patients, shifting away from fee-for-service volume rewards.
• Benefits of clinical and operating programs include improved physician onboarding and quality performance.
• The model allows physician partners to focus on the total health of their patients.

Finance: draft updated 2027 cash flow breakeven sensitivity analysis by next Tuesday.

agilon health, inc. (AGL) - Canvas Business Model: Customer Relationships

You're looking at how agilon health, inc. (AGL) builds and maintains its core relationships with physician groups-it's not a transactional setup; it's deep and long-term. The entire model hinges on a long-term, high-touch partnership model with physician groups, designed to help them transition from the old fee-for-service way to a value-based Total Care Model, letting them keep their independence. This is the main draw for their customers.

The commitment is evident in the scale of the network. As of the second quarter of 2025, agilon health, inc. (AGL) had a total of 614,000 members on its platform, which included 498,000 Medicare Advantage (MA) members. This network is built on partnerships with physician groups, and as of May 2024, the Physician Network included over 3,000 primary care physicians across more than 30 groups and health systems in long-term partnerships. These partners typically work with an average of 3 to 5 payers in their local market. That's a lot of coordination.

The relationship is supported by dedicated local market teams supporting physician practice transformation. These teams are crucial for onboarding and execution. The company made a conscious decision to grow meaningfully in 2023 and 2024, which required significant investment in platform capabilities and OpEx to bring on new members and enter new markets. This investment is designed to pay off by improving physician performance, which in turn attracts more doctors to join the network. For example, PCPs supported by agilon health, inc. (AGL)'s VBC model saw an approximate 35% relative increase in new Traditional Medicare (TM) patient volume, or about eight more new TM patients per year, compared to a non-VBC cohort. Plus, they kept their practices open to new TM patients for 0.7 more months per year on average.

The integrated technology platform for continuous data sharing and support is what makes the high-touch model scalable. This platform provides comprehensive capabilities in data analytics, care coordination, and risk management. The enhanced data visibility is key; for instance, in 2025, the platform informed a reduction in risk adjustment revenue of $48 million year-to-date, representing 72% of their membership, because it provided better insights into risk coding. This data-driven approach allows for a singular view of the patient at the point of care, helping physicians manage complex needs like medication adjustments or closing care gaps.

Proactive patient outreach and care coordination services are central to the Total Care Model. The goal is to shift from ad hoc care when someone gets sick to much better continuity of care. This focus on proactive management yields measurable results; agilon health, inc. (AGL) has reported a 20% to 30% reduction in ER and inpatient utilization compared to local benchmarks. In the ACO REACH program specifically, utilization was outperforming the reference fee-for-service population by over 300 basis points as of late 2023, showing the impact of managed care.

Finally, the relationship is cemented by financial and clinical alignment through shared savings incentives. The model rewards quality and cost reduction, not volume. Anchor physician groups receive a portion of the Risk-Bearing Entity's savings from successfully improving care quality and reducing costs. This alignment is quantified in performance metrics. For instance, the Medicare Advantage program achieved quality scores of 4.25 stars or better, which resulted in a 5% bonus. Furthermore, the medical margin in the ACO REACH program was reported at over $100 PMPM, with a long-term goal of $150 to $200 PMPM in mature markets. This financial structure is working at the market level, too; as of late 2024, 87% of markets (21 of 24) were adjusted EBITDA positive at the market level, meaning the Medical Margin generated was covering the costs of operating that market. The company's reiterated 2025 EBITDA guidance uplift of $50 million was specifically comprised of $25 million from quality incentives and $25 million from clinical cost savings.

Here's a quick look at some key relationship metrics as of mid-2025:

Metric Category	Specific Data Point	Value / Amount
Partnership Scale (Q2 2025 End)	Total Members on Platform	614,000
Partnership Scale (Q2 2025 End)	Medicare Advantage (MA) Membership	498,000
Partnership Scale (May 2024 Announcement)	Total Primary Care Doctors in Network	Over 3,000
Technology Impact (YTD 2025)	Risk Adjustment Revenue Reduction Informed by Platform	$48 million
Clinical Impact (VBC vs FFS)	Relative Increase in New TM Patient Volume	35%
Financial Alignment (Quality)	MA Program Quality Score for Bonus Eligibility	4.25 stars or better
Financial Alignment (Margin)	ACO REACH Medical Margin (Reported)	Over $100 PMPM
Market Viability	Markets Covering Operating Costs via Medical Margin	87% (21 of 24)

The demand for this partnership remains strong, as evidenced by the fact that even in a transition year like 2025, physician groups are still looking to join the platform to avoid acquisition by health systems or insurance company affiliates.

Finance: draft 13-week cash view by Friday.

agilon health, inc. (AGL) - Canvas Business Model: Channels

You're looking at how agilon health, inc. (AGL) gets its value proposition-enabling value-based care-out to the market and its key partners. The channels here are less about selling a widget and more about forging deep, long-term, full-risk relationships with physician groups.

Direct sales and business development to target leading physician groups

The primary channel for growth is direct engagement with established, community-based physician groups and health systems. This is a high-touch, relationship-driven sales process focused on convincing leaders to transition to the Total Care Model.

The scale of this channel is reflected in the network size and membership figures as of mid-2025. As of June 30, 2025, the total members on the agilon platform reached 614,000. This membership base is the direct result of successful business development efforts. For instance, the 'Class of 2025' was anticipated to bring in approximately 20,000 new Medicare Advantage members, often starting with a care coordination fee before transitioning to full risk.

Here's a snapshot of the scale achieved through these partnership channels:

Metric	Value as of Late 2025 Data Point	Context/Date of Data
Total Members on Platform	614,000	June 30, 2025
Medicare Advantage Members	498,000	June 30, 2025
ACO REACH Model Beneficiaries	116,000	June 30, 2025
Physician Groups/Health Systems in Partnership	More than 30	As of May 2024 announcement
Total Primary Care Physicians in Network	Over 3,000	As of May 2024 announcement

Peer-to-peer physician referrals within the agilon network

Once a group is partnered, the network itself becomes a powerful channel for organic growth. Satisfied partners act as advocates, which is crucial in the physician community where trust is paramount. This word-of-mouth growth is highly efficient.

The engagement level within the existing network supports this channel. Agilon health reported that its physician partners maintain high engagement, with net promoter scores reported in the 70s and 80s. Furthermore, the network reinvested $250+ million into local primary care in 2024, demonstrating tangible benefits that fuel referrals. The platform also provides access to a peer network of over 2,200+ primary care physicians.

This channel is about demonstrating success:

• Peer network access: Over 2,200+ PCPs.
• Partner satisfaction: NPS scores in the 70s and 80s.
• Local reinvestment: $250+ million in 2024.

Local market presence and community-based physician practices

The model is inherently local, focusing on community-based physician practices. The direct sales channel establishes a footprint in specific geographic areas, which then builds density. As of May 2024, the network spanned over 30+ communities.

The company has been strategic about its physical and operational presence. For example, new partnerships in 2024 meant agilon entered the state of Illinois for the first time and expanded in Kentucky, Minnesota, and North Carolina. Geographic entry costs for 2025 were estimated to be between $35-40 million, reflecting a measured growth strategy to align performance in the current environment, rather than an aggressive, broad expansion.

Investor relations and public communications for capital markets access

For capital markets access, the channel is formal, regulated communication. This involves regular disclosures to maintain liquidity and investor confidence. You see this activity scheduled throughout the year.

Key communication events in 2025 included:

• First Quarter 2025 Financial Results release on May 6, 2025.
• Second Quarter 2025 Results release on August 5, 2025.
• Third Quarter 2025 Earnings Presentation available in November 2025.

Financial performance communicated through these channels in 2025 provides the data points for market assessment. For instance, Q2 2025 total revenues were $1.4 billion, and the company reported a net loss of $104 million for that quarter. The company has a stated goal to reach cash flow breakeven by 2027.

agilon health, inc. (AGL) - Canvas Business Model: Customer Segments

You're looking at who agilon health, inc. (AGL) is actually serving right now, which is key to understanding their revenue engine. It's not just one group; it's a focused ecosystem centered on seniors under value-based care contracts.

Independent Primary Care Physician (PCP) groups focused on senior care

These physician groups are the core partners. agilon health, inc. empowers them to shift from the old fee-for-service way of doing things to a Total Care Model, which means they get paid based on keeping patients healthy, not just treating them when they're sick. As of December 31, 2024, the network was built around 29 anchor physician groups operating across 30 geographies. The platform supports a network that includes over 2,200+ primary care physicians.

The customer here is the physician group itself, which is looking for:

• Capital and technology support.
• A path to full-risk value-based care.
• Maintenance of physician independence.

Senior patients enrolled in Medicare Advantage (MA) plans, totaling 503,000 members in Q3 2025

This is the largest patient population driving the core business. These are seniors who have chosen a Medicare Advantage plan that partners with agilon health, inc.'s physician groups. The focus is on managing the total cost and quality of care for this specific group. You need to know the scale here, so for the third quarter of 2025, the number of MA members is stated as 503,000.

Beneficiaries in the ACO REACH model, totaling 115,000 members in Q3 2025

This segment represents Traditional Medicare beneficiaries managed under the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model. This is a high-risk track where the physician partners share in the savings or losses for the total cost of care. For Q3 2025, the number of beneficiaries in this model is stated as 115,000.

To give you a sense of the scale as of the middle of the year, here's a quick look at the membership snapshot from the second quarter:

Metric	Count as of June 30, 2025
Total Members on Platform	614,000
Medicare Advantage Members	498,000
ACO REACH Model Beneficiaries	116,000

Large, multi-specialty physician practices in diverse U.S. communities

While the primary focus is on senior care through PCPs, the network also includes other practice types. The agilon health, inc. Physician Network is comprised of independent primary care physician practices, multi-specialty practices, practice associations, hospital physician groups, and hospital systems. This diversity helps them serve the total health needs of their attributed Medicare patients across various settings.

The key customer characteristics agilon health, inc. targets across these segments include:

• Physician groups committed to value-based care principles.
• Medicare-eligible seniors needing coordinated, high-quality care.
• Practices operating in the 30+ geographies where agilon health, inc. has established its platform.

Finance: draft 13-week cash view by Friday.

agilon health, inc. (AGL) - Canvas Business Model: Cost Structure

You're looking at the cost structure for agilon health, inc. (AGL) as of late 2025. This isn't just a list of expenses; it's where the money goes to support their physician partners and manage the risk in their Medicare-centric model. Honestly, the biggest driver of cost variability is the actual care delivery.

Medical costs paid to specialists and hospitals for member care (largest cost)

The direct cost of care is best seen through the Medical Margin, which is revenue minus medical costs. When this number is negative, it means the cost of care exceeded the revenue generated for that period. For the third quarter of 2025, the medical margin was a loss of $57 million. agilon health, inc. (AGL) is actively managing this trend, as evidenced by the reinstated full-year 2025 guidance midpoint projecting a medical margin of $5 million, a significant swing from the Q3 result. This implies better cost control or risk adjustment realization is expected in the final quarter.

• Q3 2025 Medical Margin: negative $57 million
• Q3 2024 Medical Margin: negative $58 million
• FY 2025 Projected Medical Margin (Midpoint): $5 million
• FY 2025 Projected Medical Margin (Range): negative $5 million to $15 million

Technology platform development and maintenance expenses

The platform is key for data analytics and care coordination. While a specific technology expense line item isn't isolated in the latest reports, cost discipline efforts are clear. They are building a more streamlined organization, and this includes technology infrastructure improvements, like the enhanced data pipeline that went live in Q1 2025, covering approximately 80% of their members with more timely direct payer data feeds.

Operating expenses for corporate and local market support teams

These are the general overhead and administrative costs to run the business and support the physician groups. The company is actively working to reduce this spend. Management has specifically targeted an estimated $30 million reduction in operating expenses for the 2026 fiscal year. The overall profitability challenge is reflected in the Adjusted EBITDA loss for the third quarter of 2025, which was $91 million.

Here's a quick look at the profitability picture for Q3 2025 versus the full-year 2025 guidance:

Metric	Q3 2025 Actual	FY 2025 Guidance (Midpoint)
Revenue	$1.44 billion	$5.82 billion
Medical Margin	negative $57 million	$5 million
Adjusted EBITDA	negative $91 million	negative $258 million

Physician partner payments, including shared savings distributions

Payments to partners are embedded in the model, often tied to performance and shared savings. The performance of the Accountable Care Organization (ACO) model entities is a key component. For fiscal year 2025, the expected Adjusted EBITDA contribution from these ACO model entities is projected to be between $40 million to $45 million.

High initial geography entry costs, which they are now streamlining

Exiting certain markets has created a direct, measurable cost impact in the current period. The company absorbed a negative financial impact of $20 million in the third quarter of 2025 specifically due to these exited markets. For the full year 2025, the expected negative impact from these exited markets is estimated to be $60 million. They are definitely moving to a more streamlined structure now.

• Negative impact from exited markets in Q3 2025: $20 million
• Full Year 2025 expected impact from exited markets: $60 million

Finance: draft 13-week cash view by Friday.

agilon health, inc. (AGL) - Canvas Business Model: Revenue Streams

You're looking at how agilon health, inc. (AGL) brings in money, which is all about managing risk and population health for seniors. The core of the revenue model centers on taking on financial risk from payers, primarily through Medicare Advantage (MA) contracts.

The primary revenue driver is Capitation revenue, which is the Per Member Per Month (PMPM) payment received from Health Plans/Payers for managing the full-risk MA members. This is the foundation of the value-based enablement platform. As of the second quarter of 2025, agilon health, inc. served 498,000 Medicare Advantage members. The full-year 2025 membership guidance projects MA membership in the range of 503,000 to 506,000.

The company also generates revenue through its participation in the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model beneficiaries. This stream is structured around shared savings. For the full fiscal year 2025, this ACO REACH model is expected to contribute between $35 million to $40 million to Adjusted EBITDA. For context on recent performance, the ACO REACH Adjusted EBITDA was $18 million in the third quarter of 2025.

The overall financial expectation for the year reflects the combined performance of these streams. Full-year 2025 revenue is projected at a midpoint of $5.82 billion. The guidance range for the full year is $5.81 billion to $5.83 billion.

Another component involves Care coordination fees for new members who are on a glidepath toward full risk arrangements. This represents revenue generated while transitioning partners onto the most comprehensive, full-risk contracts. The company is actively working on optimizing its platform and clinical programs to enhance performance in these arrangements.

Here's a look at the membership and revenue context as of late 2025:

Metric	Latest Reported Figure (Q3 2025)	Full Year 2025 Guidance (Midpoint/Range)
Total Revenue	$1.44 billion (Q3 2025)	$5.82 billion (Midpoint)
Medicare Advantage Membership	Not explicitly stated for Q3 2025	503,000 to 506,000
ACO Model Beneficiaries	Not explicitly stated for Q3 2025	113,000 to 115,000
ACO REACH Adjusted EBITDA Contribution	$18 million (Q3 2025)	$35 million to $40 million (FY 2025)

The revenue streams are heavily reliant on the underlying membership base, which is managed through long-term partnerships and global capitation arrangements. The company has also focused on operating cost reductions, specifically noting a reduction of operating costs by $30 million.

You can see the revenue composition is tied to the transition of physician groups onto the platform, which involves several stages of financial engagement:

• Full-Risk Capitation: The most mature revenue stream from MA members.
• Glidepath Fees: Initial fees for care coordination services for newer partners.
• Shared Savings: Performance-based revenue from the ACO REACH model.

The company is using an enhanced data pipeline, live in the first quarter of 2025, to improve forecasting and reduce volatility in revenue recognition, which impacts risk adjustment components of capitation. Finance: draft 13-week cash view by Friday.