Good morning. My name is Lisa Gill, and I'm the Healthcare Services Analyst with JPMorgan. It is with great pleasure this morning that we have agilon health with us. With us, we have Steve Sell, CEO. Steve and I will have a fireside breakout question session after his presentation. With that, Steve.
All right. Great. Thanks, Lisa. Good morning, everyone. It's great to be here, have a full room and everybody in person. Feels like maybe we're getting back to normal. This morning, I'm really excited to give you some context on the power of our business model, on the impact that we're having in these communities, and you're gonna see it in terms of incredible growth, in terms of primary care physicians joining onto our platform, and the impact we're able to drive from a margin perspective. I'm gonna talk to you critically about how we're able to do that across a diverse set of 17 markets in 2022, in 25 markets in 2023, and then I'll close with an updated guide. We issued a Form 8-K this morning to talk you through that.
Starting with context, primary care physicians need a new business model, and we fundamentally believe they are the key to restructuring healthcare at the local level. The current fee-for-service system is broken, and it's delivering a healthcare experience that is fragmented, it's uncoordinated, and for primary care physicians, it's unsustainably economic. The challenges of that system are getting worse every day. 10,000 people a day are turning age 65, pressuring the local systems. While key constituents like CMS and health plans believe that primary care is the key to the solution, we are facing a woeful shortage of primary care physicians. We've created a solution which we call the agilon Total Care Model. It allows primary care doctors to practice medicine the way they were trained, spend the most time with the most complex patients.
It changes the payment model and aligns their incentives in which they take the total care responsibility for their senior patients. It provides them with a holistic view across their senior patients, which they've never seen before, insights on the opportunities for improvements in terms of cost, quality, and experience, and a single experience that they have not had before. As we work with our primary care partners to transform healthcare at the local level, we have a simple flywheel that I'll walk you through. We enter geographies that are typically 100% fee-for-service, We enter into a long-term exclusive joint venture. Primary care doctors join our platform through their group. As we create a budget-based model working across all payers in the community, we invest extensively in terms of care delivery resources.
Think social workers, pharmacists, care managers that are in the primary care office, as well as nurses embedded in high volume intersections in local healthcare like ERs and hospital floors. We are able to provide them with insights that allows that care team to be decked against those opportunities, and that delivers better patient outcomes, which I'll show you from a cost, quality, and experience perspective. That creates new physician economics and new practice economics as we take the same patients, the same doctors, and the same dollars, and we're able to take out waste. That gets this flywheel turning. As the results are better, as the economics are better, more doctors join, both in existing geographies and in new geographies. Today, our flywheel is turning pretty quickly. We've more than doubled our markets from 21 to 23. We're in 25 markets in 12 states.
We have 500,000 senior patients on the platform as of this year. We are now working with 1% of the primary care doctors across the country, we've invested or reinvested over $400 million into local primary care since 2018. Patients are winning as well. Our stars performance, which I'll show you, is top-notch. For all of our year 2-plus markets, we are able to get them to a critical threshold, which is above four stars. The market macro tailwinds are at our back. CMS by 2030 wants all senior patients to be in a total care relationship with their PCPs, MA has become the de facto insurance model of choice for seniors.
We lay all of this across a very strong economic model that has subscription economics laid across a long-term partnership with physicians that have long-term sticky relationships with their patients. All of this is supported by a capital-efficient acquisition model. We measure the impact and progress of our model in two important ways: our growth in markets and members, and our growth in margin. The scale we have reached, which I show you on this page, of 500,000 senior patients growing at a compound annual growth rate of 50% is remarkable. Not only has our TAM grown as we enter these additional markets, but we are capturing a larger share of it. Today, we are announcing that in 2023, we will add a record 130,000 new senior patients to our platform.
This is a step up of 54% from the 84,000 that we added in 2022. At the same time, we are inflecting a large margin ramp each year. It demonstrates our ability to add members on the platform in large numbers, while we are also able to mature our cohorts across that period of time. In 2022, we stepped up both medical margin and adjusted EBITDA substantially. Today, we are providing 2023 adjusted EBITDA guidance of $75 to 90 million. Another meaningful step up in profitability. To understand this phenomenon, how an annual EBITDA ramp of +$40 million in 2022, +$70 to 80 million in 2023 gets created, you need to get underneath the composite view and understand how members mature across time.
This cohort migration of members across time is one of the true powers in the financial model of agilon health. Our ability to create long-term member subscription economics that appreciate over time is super important for our physicians, for the communities, and it gets that flywheel turning faster and faster. In 2022, I talked to you about stepping up adjusted EBITDA, $40 to 45 million. What drove that? 90% of that came from our year two-plus markets, as we're able to deploy programs, have a meaningful impact in terms of medical expense reduction as members mature over time. Our year one partner markets had 84,000 members. That's a very substantial number. They really had a de minimis contribution to our adjusted EBITDA ramp in 2022.
Given what I just told you about 23, imagine as those 84,000 members migrate from $51 in 2022 to a meaningful step up in 2023. At our Investor Day, we will give you the full view on these cohorts and how this stairstep works from year one to year five markets. Here, we're giving you this aggregated year two-plus partner view to get the sense. Finally, there's platform support leverage. We have an incredibly capital-efficient model. We've been able to reduce platform support costs in 2022 from 7% to 5%. In 2023, you will see another significant improvement. The next chunk of this presentation really talks about how we're able to do this, how we're able to do it across a diverse set of 17 markets, 2022.
It'll be 25 markets, as I said, this year. What I'll tell you is it's not an accident. We have a consistent and structured process. We have a data insight model that points out the opportunities. We have a consistent set of operational processes that run on a daily cadence in these offices with our partners. Who are the patients that need to be seen? Who are the patients to follow up? What should social work be doing around that? We have an expanded care team model that is far greater than our partners had in the fee-for-service world. Not only do they have extensive resources within that primary care office, but they do have folks embedded in ERs. They do have nurses embedded at hospital floors.
We do have referral teams that make sure that when a primary care physician makes a referral, that patient gets to the best qualified specialist available for them. This view here, I think reflects one of the greatest powers of agilon. I also think it shows to you how we're different. This is a market view. There is variability in fee-for-service healthcare. This market view reflects that. That is true in 70%, 80%, 90% of the markets in the country. Here, we show you primary care physician performance, arrayed around really the tenets of what you need to do to be successful in value-based care. It's access, it's quality, and it's reducing utilization. What you see here is that there is significant variability in this market based on the fact that it's been uncoordinated, it's been fragmented.
These primary care doctors are in a group together, yet you can see how varied their performance is. The first thing that we do when we come in is we aggregate all of this data and give them this view, is that they can see just how different their performance is against each other, but also against what is best in class Medicare performance. Medicare is a national program. The secrets in terms of what you need to do from access and quality and utilization are not hard to understand, these doctors have never been able to see that, because it's been so fragmented for them. Look at our results. In year 1, we had wide variability. We've been able to narrow that extensively through this structured and consistent process.
By year 3 in this market, from an access perspective, almost every primary care physician is where they need to be, in this case, in terms of Annual Wellness Visits for greater than 90% of their population. From a quality perspective, this is looking at diabetic patients and blood glucose control. You also see incredible improvement in the narrowing and variability with most of the primary care physicians there. From a utilization perspective, you see a 20% reduction in admits per thousand, really driven by the bottom quartile. We provide incredible data to these physicians. The ability to have a significant improvement in the bottom quartile of those physicians raises the boat overall for this market and is really meaningful. The outcomes that we're able to drive in this market, we're driving in all of our markets. This is incredibly valuable to payers.
They are not able to drive these sort of results. We share this with payers through our joint operating committees. They have a fragmented fee-for-service network that's out there. The ability to have a partner like agilon working with our groups driving these outcomes are meaningful for them. It's super important for these communities. It's obviously great for patients. It's great for physicians. Other physicians see this, and they choose to join agilon's partners. This is our network view. This is looking at 17 markets. On the left, we're showing you where did we start from a quality perspective when we brought these partners on board.
The takeaway is that we have the ability with that structured process to drive every single market above that critical four-star threshold, which for people who are not inside healthcare, that is where CMS has said, "We will pay a 5% bonus for reaching that threshold." That comes from the structured process. That same structured process allows us to show a significant reduction in terms of admissions, readmissions, and time in the ER against a composite view of a local benchmark. There is a benchmark in every county in the country. Medicare is a local program. That's how you get paid. That's how you get benchmarked. It is very easy to see where you started and the ability to drive that over time.
One of the final things I'll highlight in terms of how we do this is you need to do a very good job, an exceptional job, taking care of the most complex patients. They drive the majority of challenges from a cost perspective, from a quality perspective. Here we are showing you some research that we'll be publishing next week in a white paper, which we're very proud of. It shows our ability to manage diabetic patients, which are roughly 25% of the senior population, at levels that are really exceptional against the Stars benchmarks which are out there. More importantly, the improvement that we show on here relative to the Medicare Advantage average nationally. We are 2 to 3 x better in terms of the rate of improvement based on this structured approach which we've taken.
You look at the patient outcomes from a controlled group. We're controlling roughly 90% of the diabetic patients within versus the uncontrolled group, and you can see a significant difference of 74 admits per thousand between them and roughly $135 per member per month. Managing complex patients makes a real difference in this business. We are doing a very good job at that. Where does that leave us? Our flywheel is turning very fast. Primary care physicians are choosing to join us. They are joining us in new states. We've added 4 for 2023, and they're joining us in existing states. The ramp of 600 primary care physicians in the last year is significant. As we look out to 2024, we see another meaningful step-up coming our way.
One analogy that I would leave you with is I think what we are creating in now 12 states is a value-based care infrastructure, which is not just available to our partners, it's available to any physician that wants to make the move to value-based care. The insight model, the payment model, the incentive model, the resource model that I talked about makes it easy for physicians to make the choice to join these partnerships and move into value-based care and bring the patients with them. That's a key part of our model. We're working with existing capacity, existing doctors that have their patients. They're moving from the fee-for-service world into value-based care. You can see certain states that are relatively new for us in which it's incredible acceleration. Michigan is an example. We've been there 18 months.
We have doubled the number of primary care physicians in Michigan from 150 to 300, and we've more than doubled the number of members in that market. We are also, as we are working on the class of 2024 and even the class of 2025, finding groups that maybe weren't ready to be early adopters a few years ago, but now see that infrastructure set up. They see the outcomes for peer groups, large groups that are making the choice to come over, and we are gonna run them in large implementations so that they can come on our platform and be successful. Let me close. Our platform is being successful. Our flywheel is turning rapidly.
Just to reaffirm what we put out in the Form 8-K this morning, we're reaffirming our 2022 guidance, which has that meaningful step up of $40 to 45 million year-over-year. We are providing the preliminary 2023 outlook of $75 to 90 million in terms of adjusted EBITDA. Notably, this only has $5 to 10 million coming from Direct Contracting. What it says is our MA business and that flywheel is really driving outsized year-over-year improvement and impact. We are raising our ending Medicare Advantage membership to greater than 400,000 dollars in 2023, that's up from 390,000 that we had previously. It has this record class that I talked about. In Direct Contracting and REACH, I know we're gonna talk about this, we'll be at 80,000 to 85,000 members.
We actually made the conscious choice with a couple of our partners to have a longer implementation cycle, bring them on into some Direct Contracting entities in 2024, so they can really hit the ground running and get the benefit of all the programs I talked about. Finally, the class of 24 is really looking very good for us. It will not only be strong in terms of new markets, but as I mentioned, in our existing geographies, we are seeing some very large groups that will most likely be coming on board. With that, Lisa, you can go to questions.
Yeah, great. Join me. First off, Steve, thank you so much for all the detail today. I'm sure that it probably seems incredibly clear to you, sitting in your seat, your competitive advantage, but, you know, one of the big questions we get is, how do we think about all of these different physician enablement companies? What makes agilon different than peers? As we have more companies in the marketplace, like, what's the real differentiator? Are you going up against competitors trying to recruit physicians in markets, or is it still so new that that's not the case?
No, I appreciate it. You know, I think it's a great time to be a primary care doctor. I think we're all in a very good space, is the way I would start by answering that. When you look at this supply and demand, limited supply of primary care doctors, complex patients aging, the demand for really leveraging those PCPs is great. I think what is fundamentally different is if you think about that slide I showed about that market, we're doing this at a scale, and we're saying we are gonna use the primary care physician as the key to restructuring care delivery in that community.
Right.
I don't know anyone else that's doing it. That leads us to. We need to work with the existing docs that are in that community. We're entering into the exclusive joint venture partnership, which is fairly distinct. That's really allowed us to create a culture with our doctors, taking a long-term view. We have a national network which is growing. New doctors constantly tell us that when they get a chance to meet with our existing partners, that is really a game changer for them. They're finding people that are like-minded. They're really able to change that. I think our platform then supports that. The ability to provide that view. Our partners have never seen that before.
Right.
Amazingly.
Right.
It's so fragmented, right? They're getting it from different payers.
Right.
We're focused on how do we reduce that variability, which I think people don't necessarily even really take that on and didn't necessarily believe that those types of results were possible.
I find it fascinating, and this has always been the way that you've looked at the market, is to go after the less known Medicare Advantage markets. Seniors are everywhere, right? A lot of people think of, I'm gonna go to Arizona, I'm gonna go to Southern Florida, and that's not where you are. You're going to different parts of the country where you're teaching the doctor about you know, being a at-risk primary care physician. Does that limit your opportunities for those kinds of markets or?
No. I mean, Like, there's 80%, 90% of the markets in the country look like the picture that I showed. Southern California, I mean, I was in Southern California for a long time. Southern Florida, Arizona, I mean, those are markets that made the move into value-based care a long time. That infrastructure that I talked about is set up there. The ability to be first to go to these markets, to find this big partner, to set up that infrastructure, to get that flywheel going and getting other partners to join, we love that model.
The 12 states that we're in has increased our total addressable market of members in those states from 5 million to 7.5 million. There is a lot of runway, and what we're seeing is more and more doctors joining, more patients coming on the platform, which is how you're getting that 50% compound growth rate year-over-year.
If I think about the growth in MA lives that you talked about today and you put in the Form 8-K, is that coming from the Like, we just had open enrollment, right? For all the health plans, is it that you have certain relationships with certain health plans, and that's where the members came from? Is it that some doctors had more members than you anticipated? Like, how do I think about where that membership came from?
Well, it's, I mean, I would say the flywheel is working in our new markets.
Okay.
Right? That's a meaningful part of it. It's working with in our existing geographies. We have that double digits in geography growth every year. What payers love about our model is that we typically are growing 1.5. If we're in a 4% growth market, we might be growing six or seven. If we're in a 15% growth market, we could be in the low twenties. The other thing that payers love is that we have incredible retention our base, and so people are staying with them. They're really getting the benefit of the benefits that have been offered by the health plan that are there. I think that growth is coming from a variety of places. I think we've had another very strong AEP, but we really want it to be strong across all of our payers, because that's important for the success of our model.
You have 4 new partnerships for 2024. They have a longer implementation cycle compared to maybe some of the others in the past. Maybe walk us through some of the key steps in the typical implementation, and specific to 2024, can you talk about, you know, using that extra implementation time to prepare to go live? Are they gonna be that much better off when we think about what first year economics traditionally look like?
Well, the incremental impact of extra months is really important in terms of how they start. I think I would back up and say, why do we have a longer implementation cycle? We have a longer implementation cycle because we have a shorter sales cycle. It used to be 1 year. Now it's, you know, 4, 5, 6 months. We have a 4- or 5-person biz dev team that's driving this.
Right
which is pretty extraordinary when you look at the growth, and it's really by leveraging the network, which is there. That's a key part of really driving the overall cycle, which is there. The implementation, when you walk through it, is we go in, we create the payment structure across multiple payers. We aggregate the data so we can provide that view. We bring on the local team and those care team resources that we talked about.
Right.
Most importantly, we make sure that we get the primary care or primary care doctors to get their patients in on a much higher rate.
Right.
That access slide that I showed getting people up to that 90% threshold or 80% in that year 0 is super impactful.
Okay.
It gives you that baseline. The more time you have, the better information you have, the more you're able to get patients in for that, the more you're able to install clinical programs, things like taking care of complex renal patients end of life care, that maybe you wouldn't have been able to normally get in what we call our year zero.
Okay.
That, that all affects the, the benefits that you get from that. It's, it's a... Well, I guess the last thing I would say is that our partners are very savvy. They understand the benefit of a longer implementation cycle.
They're not anxious to kinda get on the platform.
Well, I think how you start is super important.
Right.
I think you know, if you have a longer implementation cycle, you can probably narrow some of that variability in a year one market. That market we showed you is probably like a seven or eight-month implementation cycle.
Right.
It was back in the earlier days. We could have some that could have 14.
Okay.
That could help you with that view overall.
No, that's helpful. You know, a big focus in the MA space over the last couple of years has been supplemental benefits. Although plan design benefits, you know, agilon is responsible for managing all the costs, right?
Right.
How does the company evaluate the benefit offering for its members to make sure you're maximizing utilization of benefits that can drive better outcomes? Is this something that's been beneficial to agilon to have these better benefits with MA?
Yeah. Well, I think so. I think the payers would tell you that our shop and compare program that we run seniors through so they make a good choice given their health condition, and matching that the benefits available to them is best in class. We actually have the seniors come to a briefing.
Right.
Now that we're back in person and virtual as well. At the end, they get an overview, they've met with their doctor, and then they walk through the health plan, so they make a really smart choice. Once we set up, we wanna make sure that we're taking advantage of that of those benefits. An example I would give you is Humana just featured us in their value-based care program for having created a program that focuses on physical activity for seniors.
It was a 12-video series, and they have a benefit that if people do certain things, they can get a benefit, $60 or 70. We ran that for them. The primary care doctors narrated the entire thing. They walked through. The primary care doctors guided their senior patients to go and take advantage of that. That helps keep people healthier.
Right.
Humana wants people to do that, and the uptake on that benefit from the agilon partners is dramatically greater than what they see anywhere else.
That's gonna help the outcomes longer term for the member.
It's gonna help.
For you.
It's gonna help everybody.
Right? If we think about the flywheel, yep.
It's good for the patient, good for the doctor. That's the idea, is to have that alignment.
You did mention ACO REACH, and we did say we were gonna talk about it today.
Yeah, we did.
you know, it's modestly profitable in 2022, right?
Right.
Originally, I think that Tim had talked about 0 to $29 million, us and the rest of the street just kind of goes right to that middle of $15 million. Today, you talked about $5 to 10 million of profitability for ACO Reach. Do I have those numbers right?
About $10 million for the guide for 2023.
2023.
The number year to date for ACO REACH in 2022 through Q3, we haven't reported Q4 obviously $6 million. What we're saying for next year.
Sure.
Is on roughly the same membership base. It's gonna be $5 to 10 million against a total guide of $75 to 90 million.
Which means it's very small. I think.
It's 10, l ess than 10%.
I think any of us in the room, because it's below the line, right? It looks like it's a bigger part of your overall EBITDA than it actually is, or your EBIT, just because of the way that it falls below the line, right?
Yeah, but.
again, like when we think about this in total-.
Contribution coming from MA.
Right.
It then sits on top of t he platform support process flows through then. Think about what I talked about. In a $40 to 45 million step-up in adjusted EBITDA in 2022, 90% of that.
It's gonna come from MA.
Came from MA.
Yep.
Year two-plus markets. Direct Contracting is modestly profitable. Strategically, we love it. It allows that flywheel to turn faster. There's greater concentration in the office.
Right.
You can execute even better when you have all the senior patients that are in it, and 10 of our 17 markets in 2022, we had just that. It is a step down from MA in terms of profitability, which is what we've guided to.
Right. As we think about that program going forward and the changes that they've made around that program for ACO REACH, I mean, is this just a stepping stone where you say to the physician, "Okay, we're gonna teach you to take risk, and here's a lower risk way to move towards capitation?" Or?
For Reach?
No. When you think about REACH, right?
Yeah.
These are fee-for-service.
Right.
Are these physicians that are coming into the program, and they've got some fee-for-service patients, and then they have some capitated? Or are they starting here with the non-capitated and learning around, you know, managing those patients in a better way?
you know, a typical physician has 30, 35%-
Yep.
Of their practice are seniors. The balance are commercial.
Right.
The senior number grows every year, which is part of the pressure.
Right.
That doctors are facing. Call it roughly half of that is MA, half of that is fee-for-service. It can be proportionate, a little bit different. In 10 of our 17 markets, we have all of those members, that 30%-35%. In a global capitated relationship, which allows that flywheel, it has them managing the budget, allows those care team resources to be decked against it. They get the benefits of that. Reach to us gives us scale. It gives us greater consistency within the office.
Right.
it's the same path as MA. We don't do REACH without MA-.
MA. Okay.
Side by side.
Okay.
Every year, there's a migration. You know, at 6 people turn 65, a lot of them choose MA. Each year, folks that are in fee-for-service choose over, whether they're in REACH or not, we don't see a really different vehicle. It's not like it's a greater growth vehicle.
Okay.
If they've been in REACH when they come into MA, they're gonna start in a much better place.
Okay. That makes a lot more sense.
Yeah.
When I think about that. You know, on the last earnings call, there were some questions around how to think about RADV, which is coming February first. What that means for providers. You know, the question is, will there be some clawback for the MA plans, and what does that mean for the provider community? What are your thoughts on that? Contractually, what could potentially happen between yourselves and the Medicare Advantage Plans?
Yeah. I mean, I think the headline for Agilon is we don't think RADV is really a significant risk for us. It's for a few reasons. One is we have a.
Right.
Risk adjustment process.
Right.
I think we do it the right way. It's peer-reviewed. We add codes, and we delete codes.
Right.
Right? We're doing both of those things, and our overall risk adjustment score is just above 1. If you're a new person, that's kind of an indicator there. 2 is, we are responsible for the codes that we submit, not beyond that. If there's an extrapolation.
Right. Right, right. Yep. Got it.
Which I think is what you're asking about, that's between CMS and the payer.
Right.
I ran a payer for 20 years. What I can tell you is running a diverse network of folks, when I had to reconcile something like that, the last thing I would do was I would try and extract that from a partner that's delivering the type of results-
Right.
That I just talked about. There's contractual protections, but you can argue and fight that all day long. I've been doing this long enough to understand that. The bigger piece is the relationship power t hat we have within that. These payers wanna do a lot more with us. They want us to go to other markets.
That doesn't seem like a smart approach to that. The third thing I would say is the RADV period right now is, like, 2011 to 2015. Our first partner went live in 2018.
2018. It doesn't get impacted. Right.
It's like years down. We mean 5 years.
Right.
When we're talking here. We can talk about where that's at, but it's, it is gonna take a while for that to play through.
I've heard arguments that, to your point around the extrapolation, that as a provider, you'd say, "Sure, go ahead and audit all of my risk scores. And you'll see, like, we have the documentation.
We're accountable-
Right.
To what we submitted, which is the right way to do that.
Do you feel that, you know, I know it's only been a few years since 2018, but do you feel that there's been any changes around, like, the risk scoring between 2018 and today?
Not for us. I mean, if that's what you're asking.
Yeah.
I mean, I think the way we're running our process has always been built around this physician peer review process.
Right.
We talked about sort of where the composite is. No, I don't. You know, I think there probably will be changes in terms of how the scoring gets done, how the weighting gets done. I don't think that's.
Super served with the judgment, right? Yeah.
I don't think that's necessarily a bad thing overall. I mean, I think that, you know, if and when something like that happens, I actually think we're a big win.
Yeah.
I think the way we do it is the way plans want it to be done. I think we're driving our results based on managing costs the way that I showed. so.
When we were at your Analyst Day last March, you announced the agreement with MaineHealth. Wh ich was really differentiated, right? MaineHealth, which is a hospital system. Can you, maybe just talk about, one, how that's gone, and two, you know, does that open up incremental opportunities with others?
Well, I think, you know, as we talk about our TAM broadening the types of partners that are interested in the partnership that we've got has brought sort of primary care only m ulti-specialty, IPA-like networks, and now we've got our first health system. That's an important opportunity for us. We do have, so we've talked about multiple health systems that are interested. Andy Mueller is the CEO at MaineHealth, has been out talking and pretty public about why he did this. I think health systems, they need a primary care strategy. They have a set of employed docs. They also have IPA docs. They have to figure out how to leverage that. They need a Medicare strategy.
Right.
'Cause Medicare, just as it's challenging for the primary care physician, is challenging for a lot of these health systems. When you listen to Andy, who's a primary care doctor, he sounds like a lot of our other partners that are out there.
Right.
Our partnership is actually with the MaineHealth Medical Group, just as we work with any medical groups. We have to execute the same things with them that we do with any partner which is out there. I would tell you that it's gone incredibly well. Well, we went live January first. We're off to a good start, and I think it's a bellwether for other health systems that are interested.
If I remember correctly, I mean, the last several years, so many physicians were bought by hospital systems, right? Creates another incremental opportunity to work with those physician groups within the hospital systems.
Yes. I think that's an opportunity and a risk for that system. They're trying to figure out how they handle that and the opportunity to take these primary care doctors with their attributed patients into the Total Care Model to get that outcome benefit, get some of the economic benefit. It can really sort of change the overall equation for primary care and for the Medicare base.
We only have a minute left, and I like to leave my presentations with when we're sitting here a year from now, what do you think investors will appreciate about agilon that they don't today? 'Cause I think, you know, we really like the story. We think that this is an incredible opportunity, but the market hasn't necessarily agreed with that. What do you think it'll take over the next 12 months to really get investors to have a different view?
Well, I think the results that we put up helps people understand. I think understanding the power in this flywheel and the cohort maturation.
Yeah.
Even in the discussions we had this morning with some investors, given that this presentation was out at the beginning of the day, people really started to sort of understand the power of these classes as they move. How do you have a model that delivers today, but the out year performance opportunity is just so significant? I think this infrastructure point that I made about kind of flipping a market to value-based care and the opportunity of that end market TAM for other physicians and members to join is pretty significant. I think people are starting to slowly understand what we're doing is really different. This variability point about going into a market at scale with 25%, 30%, 45% of the adult primary care capacity and taking out the variability on cost, quality, and access is super powerful.
Great. Well, we're out of time. Thank you so much. Thank you, Steve. This was great.
Thanks, Lisa.
Thanks.