All right, good afternoon. Next up, pleased to have, my name's Justin Lake. I cover Healthc are Services here at Wolfe. Pleased to have the management team from Agilon, the company's CEO, Steve Sell, CFO, Jeff Schwaneke. Before we get into the fireside portion of this chat, the company has a few slides with some interesting information they want to share with us, so I'll turn it over to Steve. Yeah, thanks, Justin. It's great to be back. What we wanted to do today is just take about five, six minutes and maybe give a little bit different view on our business from a partnership performance perspective and put in context some of the actions and decisions we've recently made. If you go to the next slide, I think the first key takeaway is, at a macro level, the reason we started the company to provide primary care physicians with a different business model that rewards them for being in value and moves them away from fee-for-service is even stronger today. There's a couple of structural factors that really drive that. One is their practice has a growing number of seniors in it. Those seniors are bringing an increasing health care burden and complexity into that practice. And the number of primary care doctors that are there to take care of them is decreasing because primary care doctors are burning out. If you go to the next slide, that structural demand and kind of the success we had in the early days of the company has really led to our growth in the last couple of years. We made a conscious decision to grow pretty meaningfully. And what you can see is in 2023 and 2024, we've shared this data before, but we have more than doubled the number of members within our partnership. So you've got almost 300,000 members that have come on the platform in 2023 and 2024. Now, that's created some near-term challenges, but also some long-term opportunity. If you just kind of go with the facts, one is, while the company is eight years old, the average vintage of our membership base is right around three years. That stayed relatively flat over the past few years because of that recent growth. The second key point is that we have had to invest meaningfully from an OPEX perspective and in terms of platform capabilities to bring on these members, to enter a lot of new markets, and to bring on a lot of payers, many of whom are in risk for the first time. When you look at our performance overall, you are seeing the class of 2023 and 2024 have not yet pulled through because they're very early within their life cycle. I'll give you a view on that. That return on investment is not yet there. We believe this is really a function of timing, and as the spread corrects in this business, you're going to see that benefit. If you go to the next slide, this is a new view. We have not shown this view before. Typically, we provide a cohort view based on when a partner comes on the platform and what their performance looks like across time, and so what we've tried to do after our Q3 call, when we announced the exit of two partnerships, we had a number of questions around, can you talk about the performance of your partners overall, and so we've tried to give you a view in which we stratify the performance of these partners. We all know that in the last couple of years, the macro environment, as we've seen incredible growth, has been challenging. Utilization has been up. CMS rates have been muted. We've had the implementation of V28, and a big impact has been pretty aggressive payer bidding that has affected the economics within our Medicare Advantage book. Even with that, one of the things we tried to highlight in our Q3 call is that ex, the two markets that we're exiting from at the end of this year, 100% of our markets are medical margin positive. That means the revenue less the medical expense within that market is positive, and 87% of them, or 21 of 24, are adjusted EBITDA positive at the market level, meaning they are covering the costs of operating that market based on the medical margin that they're generating within that. You can see that we've got 19% of our members and 29% of our partnerships sitting in that high level. Those markets are running over $100 PMPM, even in this environment. We've got 31% of our membership and 33% of our partnerships that are running at a mid-level. That's north of $50 PMPM. And then we have three partnerships that we talked about on our call that we put in that low bucket. Most of those are out of that class of 2023 that has just come on the platform and is sitting here in year two. They're medical margin positive, but they are not covering the costs at the local level and therefore not able to contribute to the overall, corporate earnings. Notably, our year one markets that you see on the right, which is the largest class that we've had to date, that class is performing at the high level that we would expect, at the highest level we would expect within year one. Typically, we expect $30-$60 PMPM. This group is performing at the high end of that. And so there are some learnings, Justin, that maybe we can get into as we talk about this in the Q&A. But I thought dimensioning this way really gives people a sense of, even in the challenging market, our MA economics are pulling through and we are able to generate distributions to our partners. If you go to the next slide, the reason we're able to deliver these results is really two things. One, our ability to manage cost trend relative to the benchmark. And two, deliver 4+ Stars performance. On the left, you see the ACO REACH results that were released just after our Q3 call. They embargo it. We knew about this but couldn't talk about it on the call. And so this was released. What you see is that Agilon is generating a 13% gross savings rate. That means we beat the national trend by roughly 300 basis points in 2023, and just like our hard performers in MA, we're running $104 PMPM in that year of 2023. On the right, we have our Stars performance, very important issue to our MA payers today, just released within the last month and a half, and what you can see is all of our year 2+ markets are north of four Stars, and most of them are north of four and a quarter Stars, which is very important to our partners given the increasing benchmarks that are seen out there today within the MA program. And so finally, when you talk about the actions that we're taking, if you go to the next slide, we are clearly aware that not every partnership is performing the way we want it to. And so we've decided to take a couple of actions. First, as I mentioned, we're exiting two of those unprofitable partnerships. We've done this mutually with our partners, to come to that agreement. And then secondly, and this is a key theme, we are really rationalizing the payer footprint that we have. There's a couple of things we're trying to do with them, substantially reduce the amount of things that we can't control. Part D risk is a major area for us, and we announced that we were going to be taking that from just under 70% of our members to just under 50% of our members with Part D risk in 2025. And then second, in both new and existing markets, we will rationalize that footprint. And we shared on our Q3 call, we will actually reduce the number of payer contracts that we have by 10%. And so maybe Jeff can talk briefly about cash, and then we can go to Q&A. Yeah, next slide. Last slide here. Just a quick update on cash flow. This is the same information we presented at the end of the third quarter, just in a graphical form. So we expect to end the year at $365 million in cash. That includes $35 million of ACO REACH cash, burn $110 million, and end the year at $255 million, at the end of 2025 on our way to profitability and break-even cash flow by 2027. We are pulling some cash flow levers, obviously. As Steve mentioned, the partnership exits are meaningful from a cash flow perspective. We have tighter working capital management and our payer contract negotiations. Just to put a finer point on the contract negotiations, a lot, but not all of our payers pay us in advance of our margin expectations. And so we think there's some opportunity there, as well as the percentage that they pay us is also different. So we think there's opportunity to improve the cash flow from that perspective. I'll hand it to you, Justin. Great. Let's go in reverse order, Jeff, since you're talking about cash levers. You know, if you walk us through, for instance, the exits, did you give a number there in terms of how much EBITDA accretion there is just from, or cash accretion, cash flow accretion there is just from exiting those markets? Yeah, we haven't given a number. You can see the magnitude on the slide from a med margin perspective. Not a small bar. Right. Right. From the med margins perspective. The reason why we haven't given numbers. We're not done with all of that work. So, you know, if you recall at the end of Q3, we kind of gave a range of potential membership loss and a range of revenue loss. So we're not quite finalized, but when we are complete, we'll update you on that. Okay. And, you know, any thoughts on, like, is there a target for working capital that you're, that you think you can get to within that, within that flat? Yeah, I think this is less about what I call a target, more specific around certain receivables we have on the books that we can go collect, and so I just think there's an opportunity to pull some things forward in the working capital, but it's really specific, discrete things. Right. Maybe just then to take a step back and try not to pin you down on specifics. But if you think about, I'm going to get to cash flow, you know, break even in 2027, how much of that is, you know, for lack of a better term, working capital based, like, I'm going to collect a little bit earlier versus, you know, where does your EBITDA need to be to get to that in 2027? Yeah, I guess what I would say is the numbers on here do not reflect, for example, tighter working capital management or payer contract negotiations. Those would be incremental levers that we can pull to improve this outlook that you see on the slide. But obviously, our adjusted EBITDA has to be positive, right, to cover CapEx and growth investment. Okay. So that is a pure number. That's before any of these other levers. Yeah. Got it. Got it. And, you know, the other thing you hear from everybody in the industry right now is cost cutting, right? Layoffs, et cetera. You know, to your point, you've made a lot of investments to grow. I want to talk about that in a second. But like, is there a cost cutting program that you've kind of outlined for 2025 that you can share with us? So we invested meaningfully in OPEX as we doubled the company in 2023 and 2024. I think where we sit today, we do not feel the need to increase that OPEX. And just based on the fact, as we exit out of that, our largest investment sits at the market level, Justin. And so that naturally adjusts as we move out of that. Similarly, we see an opportunity to get far more efficiencies from the technology investments that we've made. We acquired a software platform that allows us to integrate, which reduces the manual nature of our work. And we've centralized functions that have pulled some of the work out of the markets around things like chart reviews and others that we see opportunities around. So those are the big areas. We've been at about 3% of revenue from a cost perspective and seen kind of efficiency each year. Even with the exits, we think we can maintain that number. You know, so let's go to growth, right? One of the things that's going to control your earnings, right, trajectory is how much you grow, right? Just given the, you know, the J-c urve there. Yep. You know, I'm embarrassed to say, you know, I've been so focused on medical costs. I can't remember what you had told us for 2025 membership growth. Yeah. Can you give us some color there? And then, you know, this is usually kind of coming into the time where you're talking about the class of 2026. Yep. Right? Are you, you know, pumping the brakes? Are you slamming on the brakes? Like, what's going on in terms of how you're thinking about growth? Yeah, well, I think the headline is we're trying to be very smart about the way we grow. There's three ways we grow, Justin. So one is in the existing footprint that we've built. Each year, members turn age 65, their PCP is in our partnership and they choose Medicare Advantage. Right. The second that we've seen pretty significantly is other primary care doctors in those communities end up joining our partnerships and our platform. Now, those first two this year, when you back out the effect of our exits, have grown 8.9%. Same geo. Right. So that's almost double what the national average has been. That is a very efficient way for us to grow. That's volume. You put unit on that, you're probably talking about a double-digit, low double-digit growth that you're able to do before you would even talk about adding new partner. The classes is where these new partners come in. Sure. For the class of 2025, we announced a set of partners that will bring 45,000 seniors on the platform. But to put that in perspective, that compares to 140,000 that were in the class of 2024. And so we're trying to be very smart about how much volume we bring on, making sure we get that right partner archetype, the biggest thing being the payer construct. Right. One of the reasons we believe the class of 2024 is off to a good start at the high end of the range that we would normally expect is, with the exception of one partner, all of them are in existing state footprints. You've got existing payer contracts. You've got the data exchange worked out back and forth on that member-level revenue and cost information that's so important for us to see. And you've got an existing team and clinical program. So that for us seems like a smart way to grow on a go-forward basis. And that's how we're thinking about it. And that leads to more cash efficiency because one of our burns is in our entry costs, our geographic entry costs that we pay out each year. That could be $50, $60 million a year. As you reduce that class of partners coming in, it reduces that burn as well. Got it. So if we're thinking out to 2026 and 2025, you're adding 45,000 members, probably thinking about something between there and, you know, kind of flat. Yeah. I mean, I think. 2026 to be bigger than 2025? It's too early to say right now. I think that we're going to be very strong within the first two categories that I talked about in terms of same store. I think we'll be very measured about bringing on the right types of partners. One of the things, Justin, that we're doing is for those partners we're bringing on the class of 2025, we're going to be using much more a no-downside care management fee glide path in that year one. Right. So that we can get all of the data connectivity worked out and underwrite it in the correct way as we move into year two. So I think it'll be measured probably more in the size of the class of 2025, but also even the economics that we'll look at, depending upon the environment, maybe more in that glide path as well. Got it. That's helpful. I appreciate it. Maybe we can shift, you know, one of the things I think not just for Agilon, but we're thinking about, you know, holistically with the value-based care business, which is obviously, you know, struggling across the board, right? A bunch of your peers have declared bankruptcy recently even, right? You know, the issue, right? We all know it's medical cost trend and the underwriting that's happened. A lot of it is outside of your control in terms of the underwriting, like you said, that's happened at the managed care side, right? That the plans have suffered from as well, but, you know, you guys have an even bigger struggle to some extent. So, you know, we're seeing that pullback for 2025. You know, we've published plenty on that, right? You're seeing that the plans have cut benefits and that's going to help you. But, you know, beyond the medical cost and the stuff you can't control, you know, the contracts, right? You know, it helped us to understand, you know, not just for Agilon, but for everybody, how were these contracts two or three years ago, you know, how are they evolving now? And what are the key differences between, you know, the positive payer contracts? Like, what's the structure that's positive versus the structure you're trying to get away from? Yeah, no, it's a great question. So in the early days of the company, as we grew, we really not just expanded our number of partners and members, we dramatically expanded the number of payer contracts. I mean, we've got over 100 payer contracts in 2024, which is a mixture of national and regionals. The key elements to your question of the most successful contracts are those where we really see a payer commitment to value-based care, is sort of how we frame it for them. That means a couple of things. One, we get rewarded on the items that we can control and do really well, like we showed you in those REACH results. So Part C medical trend and Stars performance. And so we are seeing more and more incremental percentage of premium incentives tied to driving that Stars performance at four and a quarter is kind of the new four Stars. Yeah. That's very meaningful for us. And then we're seeing a greater percentage of premium around that Part C component. The second thing is really limiting the non-controllable items. In that category, we put Part D as in dog, supplemental benefits, in particular. And so, as I shared, we've got just under 70% of our members with Part D exposure in 2024. We're taking that to under 50%. We've actually got the majority of our payers that have carved out Part D in 2024. It's a subset of a few that have larger Part D membership that we're working with right now to take that down. So one or two contracts kind of meaningfully moves that number. And so that is a very significant part of that. And we're seeing progress on that. And that's a major focus for us. You talked about the bids on supplemental benefits. That's been on our list. As I look at 2025, I don't see as much exposure there just based on the reductions that people have made around those things, and then perhaps the most critical one is this really data transparency and availability around that member-level revenue and cost information, how they're bidding and having a chance to review that before we basically take the underwriting risk on that bid, and then census data that really allows Jeff and the team on a two-day lag versus a two-month lag to really understand what's happening in that inpatient setting. Right. I think the progress that we've been able to make around our medical cost reserving and forecasting is really tied to that, and in some cases, we'll walk away or, as we just announced, we're delaying one partner because with some regional payers, we couldn't get that data transparency and availability. Right. So what is the pushback from these, you know, from the payers that are, you know, the two big payers that won't, you know, move Part D out, right? The stuff that you really can't control, especially the, you know, even outside of Part D, the dollar cards, how are you supposed to manage that? So why are, you know, why are they forcing you to, you know, take risk on stuff like that? We made a lot of progress on the dollar cards. Those have shrunk pretty dramatically in terms of how those are structured and where we're at. On the Part D piece, some people will say philosophically they want the group in because the PCPs are writing some of those prescriptions. Sure. And our comment back is operationally, if you can't pull it out, we'll put a financial corridor around it so that Jeff can really forecast within a range what that performance is going to look like. You'll get the benefit of the PCP managing it, referring to the specialists that affect all of that. And so that, that's sort of the back and forth. But Justin, it is at the top of our priority list in terms of working with them. And we're seeing that. And that's what's led to some of these partners or payers that we're exiting with where we can't come to an agreement around that. The economics aren't looking good. And we've just decided to shrink our footprint for 2025. And Jeff, have you been able to kind of, you know, for the folks, you know, there's a lot of changes happening in Part D, right? On the standalone side, you've, the government's kind of taken a lot of the risk out with this demo, but not so much on the Medicare Advantage side. A ton of questions on, you know, whether that's exposure for everybody next year. Have you been able to kind of, you know, put a corridor almost in your contracts to say, you know, we're not willing to underwrite this at a loss? No, I mean, that goes to Steve's point. I mean, I think that's what Steve's saying is, right now we're in the negotiations of either carving it out or putting some type of corridor. But, you know, we're, you know, right now we're saying looking into next year, we think maybe that's 50% or more than 50% of our members that will have that. The other 50% we'll have risk there. Got it. And that's so, okay, to be clear, so it's the 50% are either completely removed or you have a corridor. So. 50% you have exposure to fully like you always have. I think that's what we're comfortable saying right now. What we said is we'll update in January because we're kind of back and forth with quite a few people on that. So we said we'd get it to 50% or better in terms of not having exposure. Got it. And, you know, talk to us about, you know, the ACO REACH has been a, you know, a real, you know, bright spot for the company, right? Not everybody's winning in that, in that space. You guys have done really well. What's the contribution to earnings right now? And give us a little bit of color in terms of why you think that's so differentiated. Yeah, it's roughly $38 million for the year. I think it was in our guide, our last guide. So, you know, really good program, meaningful contribution as Steve showed on the slide today. Our performance has been great in that program, beating the benchmark last year by over 300 basis points. So, you know, happy with our performance there. Anything, Steve? Well, I mean, so the medical margin for 2023, $104 PMPM kind of lines up well with those high performers in MA. And, you know, we're able to do it well at scale. And I think it'll be interesting to see with the new administration. They've been really supportive of full risk programs in the Medicare Fee-for-Service Program. And so what the future looks like around that, I think we're cautiously optimistic. You know, one of the things we're all looking potentially to help for 2026 is the higher trend in Medicare Advantage maybe running through fee-for-service as well. We get that into Medicare Advantage rates. You know, one of the, you know, potential canaries in the coal mine, so to speak, could be ACO REACH numbers and fee-for-service, right? Maybe you could give us an update on like where did CMS, you know, they tell you, here's what we think is 2024 trend is at the beginning of the year, right? Because you're measured against that. Yeah. And then they give you updates every couple of months. Yeah. Maybe you could tell us where they started the year and where it is now? So the full- year trend for 2023 landed at 6.13, roughly. 6.13. The update, we get it every month. The update through October? I'm not sure October, maybe a month earlier. September, October is 7.4%. And so it's a higher trend in 2024 than in 2023 in that national benchmark that you get measured against in the ACO REACH program. I think your point is, is that an indicator? Right. What could happen from an MA rate perspective? Absolutely. From your lips to God's ears. Yeah. That'd be great. That 6.13% even sounds like 2023 restated higher, right? Because I don't think that was the assumption on 2023 trend was that high in the fee-for-service numbers that they gave us in the rate notice. But I'll check that. Certainly the 7.4% is materially higher than what they had in the 2024. I know it failed through the end of 2023. I can't remember, but. Got it. So the, you know, as you think about, you know, the risk, the ability of the company to kind of, to your point, Jeff, like you're trying to tighten up the communication, right, on the medical cost side. One of the things that I think a lot of us were surprised by is the risk score restatement, right? That's just something that typically, you know, you feel like is typical blocking and tackling. You guys have so much control of that, right? Because you're the kind of starting point for a lot of that. How does that get, you know, let's say so offline from what you had expected for something going all the way back to 2023? Like, can you walk us through like how, you know, how that, you know, I guess filters through from you to the plan to CMS and back? Yeah, I mean, I think it's historically been an area of strength. It's restated favorably every year. 2023 was really the exception to that. I think we made a number of investments in 2023 to really improve our risk score performance. And we did improve it, but not to the level that we had expected. That included things like, you know, dramatically increasing our chart reviews, increasing our access to clinical data, increased scheduling. The other thing I talked about in our growth is we brought on a lot of new payers as well. And so as we look at it, elevated expectations came in at 1.5% net lift, but that was below what we had expected. And I think Jeff and I look at it and say there's opportunities for us to be better at every level from the top of the funnel all the way through what we submit. And then this data visibility back on that member-level revenue that we talked about. And we had leakage at each step along the way and some different performances in different markets. So that is one that we have tightened down. I think the first thing we're doing is we're saying we're going to be much more cautious in terms of how we forecast it on a go forward basis. But I would agree with you. I think this is a pure execution opportunity for us to be better on it. And that's what we're focused on. Okay. Maybe we'll just end with a question on V28, right? Certainly there was a lot of debate on how that was going to impact various payers. And I think it's been, you know, pretty variable payer to payer. How has that, you know, impacted your business versus, you know, what you expected? And how are you thinking about your ability to kind of work through that in 2025 and 2026 as it finishes getting implemented? Yeah, yeah. I think it was right in line with our expectations around 2%-2.5%. So V28, the impact was in line. And as I think as Steve mentioned, even in 2024, you know, we're seeing a net lift in our risk scores of 1.5%. That's after the impact of V28. So as we think about 2025, I think we're going to be prudent around, you know, what we forecast there given our historical lift percentages. So, you know, what I would say is based on our net lift this year, I would say it's manageable. Got it. So you're expecting to be able to offset this and like do something similar in that 1.5% range in 2025, 2026? Yeah. Sitting here today, you know, that's, I'd say we're consistent with what we've experienced in the past. I'd say that's a good starting point. That's great. Steve, Jeff, I really appreciate your time being here with us today. Appreciate everyone joining us. Thanks again. Thank you. Thank you, Justin. It's great seeing you, bud. Thanks for being here. How's Robbie treating you? Yeah, it's great. You know, it's not the greatest timing just because a lot of these companies are doing, you know, investor days and stuff. So, but there's no good time for these conferences, right? Everybody's doing.