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    Bright Health Group Reports First Quarter 2023 Results

    5/9/23 6:45:00 AM ET
    $BHG
    Medical Specialities
    Health Care
    Get the next $BHG alert in real time by email
    • Q1'23 Revenue from Continuing Business of $756.3 million, up 23% year over year on strong growth in Consumer Care external value-based consumers served
    • Q1'23 Net Loss from Continuing Business of $94.8 million, Adjusted EBITDA Loss of $35.1 million
    • Consumer Care segment generated positive Operating Income in Q1'23
    • Q1'23 California MCR was 89.0% excluding prior period Medical Costs, consistent with seasonal expectations
    • Maintaining expectation for 2023 consolidated Adjusted EBITDA profitability†

    Bright Health Group, Inc. ("Bright Health" or the "Company") (NYSE:BHG), the technology enabled, value-driven healthcare company serving aging and underserved consumers with unmet clinical needs, today reported financial results for its first quarter ended March 31, 2023.

    "Bright Health had a strong start to the year in the First Quarter. The Consumer Care segment generated positive Operating Income, and the Medical Cost Ratio in our Medicare Advantage business was in-line with our expectations after adjusting for prior period costs and given normal seasonality patterns," said Mike Mikan, President and CEO of Bright Health. "Our Consumer Care business continued to add value-based care consumers in the First Quarter, and along with strength in our REACH ACO business, we believe that the segment is positioned well for long-term profitable growth."

    Key Metrics

     

    As of March 31,

     

    2023

     

    2022

    Consumer and Patient Metrics

     

     

     

    Bright HealthCare Consumers

    123,000

     

    120,000

    Consumer Care Value-Based Consumers

    373,000

     

    530,000

     

    Three Months Ended

    ($ in thousands)

    March 31

     

     

    2023

     

     

     

    2022

     

    Financial Metrics

     

     

     

    Revenue

    $

    756,341

     

     

    $

    613,263

     

    Medical Cost Ratio - Bright HealthCare1

     

    95.0

    %

     

     

    96.7

    %

    Net Loss from Continuing Operations

    $

    (94,792

    )

     

    $

    (163,514

    )

    Adjusted EBITDA (non-GAAP)

    $

    (35,053

    )

     

    $

    (59,089

    )

     

    1 Bright HealthCare Medical Cost Ratio includes $27.5 million in prior period medical costs (608bps) in the three months ended March 31, 2023, and $2.1 million in prior period medical costs (49bps) in the three months ended March 31, 2022.

     

    See the table at the end of this release for additional information and a reconciliation of the non-GAAP measures used in the table above.

    Financial Outlook

    For full year 2023, Bright Health is providing the following guidance and commentary:

    Bright Health's 2023 Revenue and Adjusted EBITDA profitability expectations are unchanged, while Adjusted Operating Cost Ratio now forecast for the high end of the prior range.

    • Bright Health's Enterprise Revenue is expected to be between $2.9 billion and $3.1 billion
    • On a segment basis, Bright HealthCare Revenue is expected to be greater than $1.8 billion, while Consumer Care Revenue is expected to be between $1.1 billion and $1.3 billion
    • Enterprise Adjusted Operating Cost Ratio is expected to be approximately 14%†
    • Bright Health expects to be Adjusted EBITDA profitable in 2023†

    † Reconciliations of projected Adjusted EBITDA and projected Adjusted Operating Cost Ratio to the most directly comparable GAAP financial measures are not provided because the Company is unable to provide such reconciliations without unreasonable effort. The inability to provide a reconciliation is due to the uncertainty and inherent difficulty predicting the occurrence, the financial impact and the periods in which the non-GAAP adjustments may be recognized. With respect to Adjusted EBITDA, these GAAP measures may include the impact of such items as interest expense, income tax expense, depreciation and amortization, impairment of goodwill or intangible assets, transaction costs, share-based compensation expense, changes in the fair value of equity securities, changes in the fair value of contingent consideration, contract termination costs, restructuring costs; and the tax effect of all such items. Historically, the Company has excluded these items from non-GAAP financial measures. With respect to Adjusted Operating Cost Ratio, these GAAP measures may include the impact of such items as stock-based compensation, changes in the fair value of contingent consideration, contract termination costs, and depreciation and amortization. The Company currently expects to continue to exclude these items in future disclosures of non-GAAP financial measures and may also exclude other items that may arise (collectively, "non-GAAP adjustments"). The decisions and events that typically lead to the recognition of non-GAAP adjustments, such as a decision to exit part of the business, are inherently unpredictable as to if or when they may occur. For the same reasons, the Company is unable to address the probable significance of the unavailable information, which could be material to future results.

    Earnings Conference Call

    As previously announced, Bright Health Group will discuss the Company's results, strategy, and outlook on a conference call with investors at 8:00 a.m. Eastern Time today. Bright Health Group will host a live webcast of this conference call which can be accessed from the Investor Relations page of the company's website (investors.brighthealthgroup.com). Following the call, a webcast replay will be available on the same site. This earnings release and the Form 8-K filed May 9, 2023 can be accessed on the Investor Relations page of the Company's website. We routinely post important information on our website, including corporate and investor presentations and financial information. We intend to use our website as a means of disclosing material, non-public information and for complying with our disclosure obligations under Regulation FD. Such disclosures will be included in the Investor Relations section of our website. Accordingly, investors should monitor this portion of our website, in addition to following our press releases, U.S. Securities and Exchange Commission ("SEC") filings and public conference calls and webcasts.

    About Bright Health Group

    Bright Health Group is a technology enabled, value-driven healthcare company that organizes and operates networks of affiliate care providers to be successful at managing population risk. We focus on serving aging and underserved consumers that have unmet clinical needs through our Fully Aligned Care Model in Florida, Texas and California, some of the largest markets in healthcare where 26% of the U.S. aging population call home. We believe everyone should have access to personal, affordable, and high-quality healthcare. Our mission is to Make healthcare right. Together. For more information, visit www.brighthealthgroup.com.

    Forward-Looking Statements

    Statements made in this release that are not statements of historical fact, including statements about our beliefs and expectations, are forward-looking statements and should be evaluated as such. Forward-looking statements include information concerning possible or assumed future results of operations, including descriptions of our business plan and strategies. These statements often include words such as "anticipate," "expect," "plan," "believe," "intend," "project," "forecast," "estimates," "projections," "outlook," "ensure," and other similar expressions. These forward-looking statements include any statements regarding our plans and expectations with respect to Bright Health Group, Inc. Such forward-looking statements are subject to various risks, uncertainties and assumptions. Accordingly, there are or will be important factors that could cause actual outcomes or results to differ materially from those indicated in these statements. Factors that might materially affect such forward-looking statements include: our ability to continue as a going concern; our ability to comply with the terms of our credit facility, including financial covenants, both during and after any waiver period, and/or obtain any additional waivers of any terms of our credit facility to the extent required; our ability to sell our Medicare Advantage business in California on acceptable terms, including our ability to receive the proceeds thereof in a manner that would alleviate our current financial position; our ability to quickly and efficiently wind down our IFP businesses and MA businesses outside of California; potential disruptions to our business due to our corporate restructuring and resulting headcount reduction; our ability to accurately estimate and effectively manage the costs relating to changes in our businesses offerings and models; a delay or inability to withdraw regulated capital from our subsidiaries; a lack of acceptance or slow adoption of our business model; our ability to retain existing consumers and expand consumer enrollment; our and our Care Partner's abilities to obtain and accurately assess, code, and report risk adjustment factor scores; our ability to contract with care providers and arrange for the provision of quality care; our ability to accurately estimate our medical expenses, effectively manage our costs and claims liabilities or appropriately price our products and charge premiums; our ability to obtain claims information timely and accurately; the impact of the ongoing COVID-19 pandemic on our business and results of operations; the risks associated with our reliance on third-party providers to operate our business; the impact of modifications or changes to the U.S. health insurance markets; our ability to manage the growth of our business; our ability to operate, update or implement our technology platform and other information technology systems; our ability to retain key executives; our ability to successfully pursue acquisitions and integrate acquired businesses; the occurrence of severe weather events, catastrophic health events, natural or man-made disasters, and social and political conditions or civil unrest; our ability to prevent and contain data security incidents and the impact of data security incidents on our members, patients, employees and financial results; our ability to comply with requirements to maintain effective internal controls; our ability to adapt to the new risks associated with our expansion into ACO REACH; and the other factors set forth under the heading "Risk Factors" in the Company's reports on Form 10-K, Form 10-Q, and Form 8-K (including all amendments to those reports) and our other filings with the SEC. Except as required by law, we undertake no obligation to update publicly any forward-looking statements for any reason after the date of this release to conform these statements to actual results or changes in our expectations.

    Bright Health Group, Inc. and Subsidiaries

    Consolidated Balance Sheets

    (in thousands, except share and per share data)

    (Unaudited)

     

     

    March 31,

    2023

     

    December 31,

    2022

    Assets

    ​

    ​

    ​

    Current assets:

    ​

    ​

    ​

    Cash and cash equivalents

    $

    382,506

     

     

    $

    466,325

     

    Short-term investments

     

    12,112

     

     

     

    13,206

     

    Accounts receivable, net of allowance of $6,513 and $6,098, respectively

     

    125,241

     

     

     

    73,605

     

    ACO REACH performance year receivable

     

    882,884

     

     

     

    99,181

     

    Current assets of discontinued operations

     

    2,225,739

     

     

     

    2,783,474

     

    Prepaids and other current assets

     

    142,932

     

     

     

    134,843

     

    Total current assets

     

    3,771,414

     

    ​

     

    3,570,634

     

    Other assets:

    ​

    ​

    ​

    Long-term investments

     

    3,816

     

     

     

    5,401

     

    Property, equipment and capitalized software, net

     

    40,747

     

     

     

    42,596

     

    Goodwill

     

    760,078

     

     

     

    760,078

     

    Intangible assets, net

     

    242,286

     

     

     

    249,083

     

    Other non-current assets

     

    29,664

     

     

     

    37,260

     

    Total other assets

     

    1,076,591

     

    ​

     

    1,094,418

     

    Total assets

     

    4,848,005

     

    ​

     

    4,665,052

     

    Liabilities, Redeemable Noncontrolling Interest, Redeemable Preferred Stock and Shareholders' Equity (Deficit)

     

     

     

    Current liabilities:

     

     

     

    Medical costs payable

    $

    458,465

     

    ​

    $

    411,753

     

    Accounts payable

     

    33,638

     

    ​

     

    67,854

     

    Unearned revenue

     

    139,416

     

    ​

     

    242

     

    ACO REACH performance year obligation

     

    719,420

     

     

     

    —

     

    Short-term borrowings

     

    303,947

     

     

     

    303,947

     

    Current liabilities of discontinued operations

     

    2,225,739

     

     

     

    2,783,474

     

    Other current liabilities

     

    131,256

     

    ​

     

    121,424

     

    Total current liabilities

     

    4,011,881

     

    ​

     

    3,688,694

     

    Other liabilities

     

    32,191

     

    ​

     

    36,673

     

    Total liabilities

     

    4,044,072

     

    ​

     

    3,725,367

     

     

    ​

    ​

    ​

    Redeemable noncontrolling interests

     

    223,503

     

    ​

     

    219,758

     

    Redeemable Series A preferred stock, $0.0001 par value; 750,000 shares authorized in 2023 and 2022; 750,000 shares issued and outstanding in 2023 and 2022

     

    747,481

     

    ​

     

    747,481

     

    Redeemable Series B preferred stock, $0.0001 par value; 175,000 shares authorized in 2023 and 2022; 175,000 shares issued and outstanding in 2023 and 2022

     

    172,936

     

    ​

     

    172,936

     

    Shareholders' equity (deficit):

     

     

    ​

    Common stock, $0.0001 par value; 3,000,000,000 shares authorized in 2023 and 2022; 636,142,597 and 630,271,508 shares issued and outstanding in 2023 and 2022, respectively

     

    63

     

    ​

     

    63

     

    Additional paid-in capital

     

    3,005,592

     

    ​

     

    2,972,271

     

    Accumulated deficit

     

    (3,331,406

    )

    ​

     

    (3,156,395

    )

    Accumulated other comprehensive loss

     

    (2,236

    )

    ​

     

    (4,429

    )

    Treasury Stock, at cost, 2,522,148 shares at March 31, 2023, and December 31, 2022, respectively

     

    (12,000

    )

    ​

     

    (12,000

    )

    Total shareholders' equity (deficit)

     

    (339,987

    )

    ​

     

    (200,490

    )

    Total liabilities, redeemable noncontrolling interests, redeemable preferred stock and shareholders' equity (deficit)

    $

    4,848,005

     

    ​

    $

    4,665,052

     

    Bright Health Group, Inc. and Subsidiaries

    Consolidated Statements of Income (Loss)

    (in thousands, except share and per share data)

    (Unaudited)

     

    ​

    Three Months Ended March 31,

    ​

     

    2023

     

    ​

     

    2022

     

    Revenue:

    ​

     

    ​

    Premium revenue

    $

    502,918

     

     

    $

    458,962

     

    ACO REACH revenue

     

    239,807

     

     

     

    182,797

     

    Service revenue

     

    13,570

     

     

     

    12,392

     

    Investment income (loss)

     

    46

     

     

     

    (40,888

    )

    Total revenue

     

    756,341

     

     

     

    613,263

     

    Operating expenses:

    ​

     

    ​

    Medical costs

     

    688,515

     

     

     

    594,248

     

    Operating costs

     

    140,324

     

     

     

    159,117

     

    Restructuring charges

     

    3,357

     

     

     

    6,864

     

    Depreciation and amortization

     

    9,891

     

     

     

    12,897

     

    Total operating expenses

     

    842,087

     

     

     

    773,126

     

    Operating loss

     

    (85,746

    )

     

     

    (159,863

    )

    Interest expense

     

    7,787

     

     

     

    1,193

     

    Other income

     

    —

     

     

     

    (784

    )

    Loss from continuing operations before income taxes

     

    (93,533

    )

     

     

    (160,272

    )

    Income tax expense

     

    1,259

     

     

     

    3,242

     

    Net loss from continuing operations

     

    (94,792

    )

     

     

    (163,514

    )

    Loss from discontinued operations, net of tax

     

    (74,669

    )

     

     

    (17,115

    )

    Net Loss

     

    (169,461

    )

     

     

    (180,629

    )

    Net earnings from continuing operations attributable to noncontrolling interests

     

    (5,550

    )

     

     

    (14,605

    )

    Series A preferred stock dividend accrued

     

    (9,714

    )

     

     

    (8,938

    )

    Series B preferred stock dividend accrued

     

    (2,180

    )

     

     

    —

     

    Net loss attributable to Bright Health Group, Inc. common shareholders

    $

    (186,905

    )

     

    $

    (204,172

    )

     

     

     

     

    Basic and diluted loss per share attributable to Bright Health Group, Inc. common shareholders

     

     

     

    Continuing operations

    $

    (0.18

    )

     

    $

    (0.30

    )

    Discontinued operations

     

    (0.12

    )

     

     

    (0.02

    )

    Basic and diluted loss per share

     

    (0.30

    )

     

     

    (0.32

    )

     

     

     

     

    Basic and diluted weighted-average common shares outstanding

     

    631,534

     

     

     

    628,765

     

    Bright Health Group, Inc. and Subsidiaries

    Consolidated Statements of Cash Flows

    (in thousands)

    (Unaudited)

     

    ​

    Three Months Ended March 31,

    ​

     

    2023

     

     

     

    2022

     

    Cash flows from operating activities:

    ​

    ​

    ​

    Net loss

    $

    (169,461

    )

    ​

    $

    (180,629

    )

    Adjustments to reconcile net loss to net cash provided by operating activities:

     

     

     

    Depreciation and amortization

     

    9,891

     

    ​

     

    13,041

     

    Impairment of intangible assets

     

    —

     

     

     

    6,720

     

    Share-based compensation

     

    33,320

     

    ​

     

    32,921

     

    Deferred income taxes

     

    436

     

    ​

     

    717

     

    Unrealized loss on equity securities

     

    —

     

     

     

    40,968

     

    Other, net

     

    (2,807

    )

    ​

     

    2,378

     

    Changes in assets and liabilities, net of acquired assets and liabilities:

     

    ​

     

    Accounts receivable

     

    (43,409

    )

    ​

     

    (29,221

    )

    ACO REACH performance year receivable

     

    (783,703

    )

     

     

    (638,641

    )

    Other assets

     

    22,448

     

    ​

     

    (22,270

    )

    Medical cost payable

     

    (423,459

    )

    ​

     

    337,180

     

    Risk adjustment payable

     

    4,153

     

    ​

     

    354,276

     

    Accounts payable and other liabilities

     

    (119,416

    )

    ​

     

    52,182

     

    Unearned revenue

     

    137,563

     

    ​

     

    (18,402

    )

    ACO REACH performance year obligation

     

    719,420

     

     

     

    533,537

     

    Net cash (used in) provided by operating activities

     

    (615,024

    )

    ​

     

    484,757

     

    Cash flows from investing activities:

     

     

     

    Purchases of investments

     

    (2,880

    )

    ​

     

    (782,091

    )

    Proceeds from sales, paydown, and maturities of investments

     

    690,161

     

    ​

     

    154,765

     

    Purchases of property and equipment

     

    (1,863

    )

    ​

     

    (5,491

    )

    Business divestitures, net of cash disposed of

     

    1,370

     

     

     

    Business acquisitions, net of cash acquired

     

    —

     

    ​

     

    (310

    )

    Net cash provided by (used in) investing activities

     

    686,788

     

    ​

     

    (633,127

    )

    Cash flows from financing activities:

    ​

    ​

    ​

    Net proceeds from short-term borrowings

     

    —

     

     

     

    (155,000

    )

    Proceeds from issuance of preferred stock

     

    —

     

    ​

     

    747,481

     

    Proceeds from issuance of common stock

     

    1

     

    ​

     

    257

     

    Distributions to noncontrolling interest holders

     

    (1,805

    )

     

     

    —

     

    Net cash (used in) provided by financing activities

     

    (1,804

    )

    ​

     

    592,738

     

    Net increase in cash and cash equivalents

     

    69,960

     

    ​

     

    444,368

     

    Cash and cash equivalents – beginning of year

     

    1,932,290

     

    ​

     

    1,061,179

     

    Cash and cash equivalents – end of period

    $

    2,002,250

     

    ​

    $

    1,505,547

     

    Supplemental disclosures of cash flow information:

    ​

    ​

     

    Changes in unrealized loss on available-for-sale securities in OCI

    $

    2,193

     

    ​

    $

    (26,340

    )

    Cash paid for interest

     

    7,157

     

    ​

     

    1,168

     

    Bright Health Group, Inc. and Subsidiaries

    Segment Information

    (in thousands)

    (Unaudited)

     

    Bright HealthCare

     

     

     

    ($ in thousands)

    Three Months Ended

    March 31,

    Statement of income (loss) and operating data:

     

    2023

     

     

     

    2022

     

     

     

     

     

    Revenue:

     

     

     

    Premium revenue

    $

    453,370

     

     

    $

    430,313

     

    Investment income (loss)

     

    46

     

     

     

    80

     

    Total revenue

     

    453,416

     

     

     

    430,393

     

    Operating expenses

     

     

     

    Medical costs

     

    430,928

     

     

     

    416,200

     

    Operating costs

     

    49,453

     

     

     

    41,117

     

    Depreciation and amortization

     

    4,408

     

     

     

    4,459

     

    Total operating expenses

     

    484,789

     

     

     

    461,776

     

    Operating loss

    $

    (31,373

    )

     

    $

    (31,383

    )

    Medical Cost Ratio (MCR)(1)

     

    95.0

    %

     

     

    96.7

    %

     

    (1) Bright HealthCare medical cost ratio includes $27.5 million in prior period medical costs (608bps) in the three months ended March 31, 2023, and $2.1 million in prior period medical costs (49bps) in the three months ended March 31, 2022.

    Consumer Care

     

     

     

    ($ in thousands)

    Three Months Ended

    March 31,

    Statement of income (loss) and operating data:

    2023

     

     

    2022

     

     

     

     

     

    Revenue:

     

     

     

    Premium revenue

    $

    49,548

     

    $

    28,649

     

    Affiliated revenue

     

    —

     

     

    368,053

     

    ACO REACH revenue

     

    239,807

     

     

    182,797

     

    Service revenue

     

    13,570

     

     

    12,392

     

    Investment income (loss)

     

    —

     

     

    (40,968

    )

    Total revenue

     

    302,925

     

     

    550,923

     

    Operating expenses

     

     

     

    Medical costs

     

    257,587

     

     

    566,694

     

    Operating costs

     

    37,814

     

     

    47,281

     

    Depreciation and amortization

     

    3,132

     

     

    7,002

     

    Total operating expenses

     

    298,533

     

     

    620,977

     

    Operating income (loss)

    $

    4,392

     

    $

    (70,054

    )

    Bright Health Group, Inc. and Subsidiaries

    Historical Financials

    Recast Income Statement(1)

    (in thousands)

     

    ($ in thousands)

     

     

    Three Months Ended

    Consolidated Statements of Income (loss) and operating data:

    March 31,

     

    June 30,

     

    September 30,

     

    December 31,

     

    2022

     

     

     

    2022

     

     

     

    2022

     

     

     

    2022

     

    Revenue:

     

     

     

     

     

     

     

    Premium revenue

    $

    458,962

     

     

    $

    437,234

     

     

    $

    423,995

     

     

    $

    444,758

     

    ACO REACH revenue

     

    182,797

     

     

     

    137,205

     

     

     

    145,433

     

     

     

    188,652

     

    Service revenue

     

    12,392

     

     

     

    12,811

     

     

     

    12,079

     

     

     

    10,731

     

    Investment income (loss)

     

    (40,888

    )

     

     

    (16,213

    )

     

     

    4,882

     

     

     

    (2,800

    )

    Total revenue

     

    613,263

     

     

     

    571,037

     

     

     

    586,389

     

     

     

    641,341

     

    Operating costs

     

     

     

     

     

     

     

    Medical costs

     

    594,248

     

     

     

    507,322

     

     

     

    506,235

     

     

     

    598,438

     

    Operating costs

     

    159,117

     

     

     

    140,650

     

     

     

    146,532

     

     

     

    185,731

     

    Restructuring charges

     

    6,864

     

     

     

    2,791

     

     

     

    1,215

     

     

     

    20,869

     

    Goodwill impairment

     

    —

     

     

     

    —

     

     

     

    70,017

     

     

     

    1,208

     

    Intangibles impairment

     

    —

     

     

     

    —

     

     

     

    42,611

     

     

     

    —

     

    Depreciation and amortization

     

    12,897

     

     

     

    13,227

     

     

     

    13,904

     

     

     

    10,402

     

    Total operating costs

     

    773,126

     

     

     

    663,990

     

     

     

    780,514

     

     

     

    816,648

     

    Operating loss

     

    (159,863

    )

     

     

    (92,953

    )

     

     

    (194,125

    )

     

     

    (175,307

    )

    Interest expense

     

    1,193

     

     

     

    337

     

     

     

    4,905

     

     

     

    6,386

     

    Other income

     

    (784

    )

     

     

    2

     

     

     

    (2

    )

     

     

    —

     

    Loss from continuing operations before income taxes

     

    (160,272

    )

     

     

    (93,292

    )

     

     

    (199,028

    )

     

     

    (181,693

    )

    Income tax expense (benefit)

     

    3,242

     

     

     

    2,904

     

     

     

    1,762

     

     

     

    (4,228

    )

    Net loss from continuing operations

     

    (163,514

    )

     

     

    (96,196

    )

     

     

    (200,790

    )

     

     

    (177,465

    )

    Loss from discontinued operations, net of tax

     

    (17,115

    )

     

     

    (155,134

    )

     

     

    (69,339

    )

     

     

    (480,327

    )

    Net loss

     

    (180,629

    )

     

     

    (251,330

    )

     

     

    (270,129

    )

     

     

    (657,792

    )

    Net earnings from continuing operations attributable to noncontrolling interests

     

    (14,605

    )

     

     

    (23,336

    )

     

     

    (46,711

    )

     

     

    (11,012

    )

    Series A preferred stock dividend accrued

     

    (8,938

    )

     

     

    (9,461

    )

     

     

    (9,684

    )

     

     

    (9,806

    )

    Series B preferred stock dividend accrued

     

    —

     

     

     

    —

     

     

     

    —

     

     

     

    (1,798

    )

    Net loss attributable to Bright Health

    Group, Inc. common shareholders

    $

    (204,172

    )

     

    $

    (284,127

    )

     

    $

    (326,524

    )

     

    $

    (680,408

    )

    Operating Cost Ratio

     

    25.9

    %

     

     

    24.6

    %

     

     

    25.0

    %

     

     

    29.0

    %

     

    (1)The 2022 quarterly Statements of Income (Loss) have been recast to reflect the move of the IFP business to discontinued operations as well as to correct the accounting for gross versus net revenue recognition conclusion from certain value-based care arrangements and an error identified in the data to account for our risk adjustment factor.

    Bright Health Group, Inc. and Subsidiaries

    Historical Financials

    Recast Segment Information (1)

    (in thousands)

    (Unaudited)

     

    Bright HealthCare

    Recast 2022 Segment Information

    ($ in thousands)

     

     

     

     

     

     

    Three Months Ended

     

    March 31,

     

    June 30,

     

    September 30,

     

    December 31,

    Statement of income (loss) and operating data:

     

    2022

     

     

     

    2022

     

     

     

    2022

     

     

     

    2022

     

     

     

     

     

     

     

     

     

    Revenue:

     

     

     

     

     

     

     

    Premium revenue

    $

    430,313

     

     

    $

    419,594

     

     

    $

    390,989

     

     

    $

    411,149

     

    Investment income (loss)

     

    80

     

     

     

    (29

    )

     

     

    36

     

     

     

    323

     

    Total revenue

     

    430,393

     

     

     

    419,565

     

     

     

    391,025

     

     

     

    411,472

     

    Operating expenses

     

     

     

     

     

     

     

    Medical costs

     

    416,200

     

     

     

    378,801

     

     

     

    355,347

     

     

     

    400,586

     

    Operating costs

     

    41,117

     

     

     

    43,513

     

     

     

    43,291

     

     

     

    59,715

     

    Goodwill impairment

     

    —

     

     

     

    —

     

     

     

    70,017

     

     

     

    —

     

    Depreciation and amortization

     

    4,459

     

     

     

    4,416

     

     

     

    4,416

     

     

     

    4,411

     

    Total operating expenses

     

    461,776

     

     

     

    426,730

     

     

     

    473,071

     

     

     

    464,712

     

    Operating loss

    $

    (31,383

    )

     

    $

    (7,165

    )

     

    $

    (82,046

    )

     

    $

    (53,240

    )

    Medical Cost Ratio (MCR)

     

    96.7

    %

     

     

    90.3

    %

     

     

    90.9

    %

     

     

    97.4

    %

    Consumer Care

    Recast 2022 Segment Information

    ($ in thousands)

     

     

     

     

     

     

     

     

    Three Months Ended

     

    March 31,

     

    June 30,

     

    September 30,

     

    December 31,

    Statement of income (loss) and operating data:

     

    2022

     

     

     

    2022

     

     

     

    2022

     

     

     

    2022

     

     

     

     

     

     

     

     

     

    Revenue:

     

     

     

     

     

     

     

    Premium revenue

    $

    28,649

     

     

    $

    17,640

     

     

    $

    33,006

     

     

    $

    33,609

     

    Affiliated revenue

     

    368,053

     

     

     

    203,965

     

     

     

    250,594

     

     

     

    206,421

     

    ACO REACH revenue

     

    182,797

     

     

     

    137,205

     

     

     

    145,433

     

     

     

    188,652

     

    Service revenue

     

    12,392

     

     

     

    12,811

     

     

     

    12,079

     

     

     

    10,731

     

    Investment income (loss)

     

    (40,968

    )

     

     

    (16,184

    )

     

     

    4,846

     

     

     

    (3,123

    )

    Total revenue

     

    550,923

     

     

     

    355,437

     

     

     

    445,958

     

     

     

    436,290

     

    Operating expenses

     

     

     

     

     

     

     

    Medical costs

     

    566,694

     

     

     

    326,532

     

     

     

    403,069

     

     

     

    548,283

     

    Operating costs

     

    47,281

     

     

     

    40,320

     

     

     

    46,302

     

     

     

    57,799

     

    Goodwill impairment

     

    —

     

     

     

    —

     

     

     

    —

     

     

     

    1,208

     

    Intangible assets impairment

     

    —

     

     

     

    —

     

     

     

    42,611

     

     

     

    —

     

    Depreciation and amortization

     

    7,002

     

     

     

    7,195

     

     

     

    6,375

     

     

     

    3,680

     

    Total operating expenses

     

    620,977

     

     

     

    374,047

     

     

     

    498,357

     

     

     

    610,970

     

    Operating loss

    $

    (70,054

    )

     

    $

    (18,610

    )

     

    $

    (52,399

    )

     

    $

    (174,680

    )

     

    (1)The 2022 segment financials have been recast to reflect the move of the IFP business to discontinued operations as well as to correct the accounting for gross versus net revenue recognition conclusion from certain value-based care arrangements and an error identified in the data to account for our risk adjustment factor.

    Non-GAAP Financial Measures

    We use the non-GAAP financial measures Adjusted EBITDA and Adjusted Operating Cost Ratio. We define Adjusted EBITDA as Net Loss excluding loss from discontinued operations, Interest Expense, Income Taxes, Depreciation and Amortization, adjusted for the impact of impairment of goodwill or intangible assets, acquisition and financing-related transaction costs, share-based compensation, changes in the fair value of contingent consideration, changes in the fair value of equity securities, contract termination and other exit costs and restructuring costs. We define Adjusted Operating Cost Ratio as Operating Cost Ration excluding share-based compensation. These non-GAAP measures have been presented in this quarterly Earnings Release as supplemental measures of financial performance that are not required by or presented in accordance with GAAP because we believe they assist management and investors in comparing our operating performance across reporting periods on a consistent basis by excluding and including items that we do not believe are indicative of our core operating performance. Management believes these measures are useful to investors in highlighting trends in our operating performance, while other measures can differ significantly depending on long-term strategic decisions regarding capital structure, the tax jurisdictions in which we operate and capital investments. Management uses Adjusted EBITDA and Adjusted Operating Cost Ratio to supplement GAAP measures of performance in the evaluation of the effectiveness of our business strategies, to make budgeting decisions, to establish discretionary annual incentive compensation and to compare our performance against that of other peer companies using similar measures. Management supplements GAAP results with non-GAAP financial measures to provide a more complete understanding of the factors and trends affecting the business than GAAP results alone.

    Adjusted EBITDA is not a recognized term under GAAP and should not be considered as an alternative to Net Income (Loss) as a measure of financial performance or any other performance measure derived in accordance with GAAP. Additionally, Adjusted EBITDA is not intended to be a measure of free cash flow available for management's discretionary use as it does not consider certain cash requirements such as interest payments, tax payments and debt service requirements. The presentation of Adjusted EBITDA has limitations as an analytical tool and should not be considered in isolation or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentation of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company.

    Adjusted Operating Cost Ratio is not a recognized term under GAAP and should not be considered as an alternative to Operating Cost Ratio as a measure of financial performance or any other performance measure derived in accordance with GAAP. The presentation of Adjusted Operating Cost Ratio has limitations as an analytical tool and should not be considered in isolation or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentation of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company.

    The following table provides a reconciliation of net loss to Adjusted EBITDA for the periods presented:

     

    Three Months Ended

    March 31,

    ($ in thousands)

     

    2023

     

     

     

    2022

     

    Net loss

    $

    (169,461

    )

     

    $

    (180,629

    )

    Loss from discontinued operations (a)

     

    74,669

     

     

     

    17,115

     

    EBITDA adjustments from continuing operations:

     

     

     

    Interest expense

     

    7,787

     

     

     

    1,193

     

    Income tax expense (benefit)

     

    1,259

     

     

     

    3,242

     

    Depreciation and amortization

     

    9,891

     

     

     

    12,897

     

    Transaction costs (b)

     

    1,849

     

     

     

    852

     

    Share-based compensation expense (c)

     

    33,320

     

     

     

    32,921

     

    Change in fair value of equity securities

     

    —

     

     

     

    40,968

     

    Change in fair value of contingent consideration (d)

     

    (1,827

    )

     

     

    —

     

    Termination and other exit costs (e)

     

    4,157

     

     

     

    5,488

     

    Restructuring costs (f)

     

    3,303

     

     

     

    6,864

     

    EBITDA adjustments from continuing operations

    $

    59,739

     

     

    $

    104,425

     

    Adjusted EBITDA

    $

    (35,053

    )

     

    $

    (59,089

    )

    (a)

    Beginning in the fourth quarter of 2022, Adjusted EBITDA excludes the impact of discontinued operations. The comparable period in 2022 has been recast to exclude these impacts. Represents losses associated with the Commercial business segment that we exited at the end of 2022.

    (b)

    Transaction costs include accounting, tax, valuation, consulting, legal and investment banking fees directly relating to financing initiatives. These costs can vary from period to period and impact comparability, and we do not believe such transaction costs reflect the ongoing performance of our business.

    (c)

    Represents non-cash compensation expense related to stock option and restricted stock unit award grants, which can vary from period to period based on a number of factors, including the timing, quantity and grant date fair value of the awards.

    (d)

    Represents the non-cash change in fair value of contingent consideration from business combinations, which is remeasured at fair value each reporting period.

    (e)

    Represents amounts paid for early termination of existing vendor contracts and, beginning in 2023, includes the impact of our MA legacy operations that we exited at the end of 2022. The adjustment in the comparable period in 2022 has been recast to include these impacts.

    (f)

    Restructuring costs represent severance costs as part of a workforce reduction and impairment of certain long-lived assets relating to our decision to exit the Commercial business for the 2023 plan year.

    The following table provides a reconciliation of Adjusted Operating Cost Ratio for the periods presented:

     

    Three Months Ended

    March 31,

    ($ in thousands)

    2023

     

    2022

    Operating Cost Ratio

    18.6%

     

    25.9%

    Impact of Share-based compensation expense

    (4.4)%

     

    (5.4)%

    Adjusted Operating Cost Ratio

    14.1%

     

    20.6%

     

    View source version on businesswire.com: https://www.businesswire.com/news/home/20230509005350/en/

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    • Bright Health Group Appoints Jay Matushak as Chief Financial Officer

      Cathy Smith to Step Down to Pursue New Opportunity, Effective May 12, 2023 Bright Health Group, Inc. ("Bright Health" or the "Company") (NYSE:BHG), the technology enabled, value-driven healthcare company serving aging and underserved consumers with unmet clinical needs, today announced that it has appointed Jay Matushak as the Company's next Chief Financial Officer, effective May 12, 2023. Mr. Matushak will succeed Cathy Smith, who is stepping down to pursue another opportunity. Mr. Matushak, a seasoned finance and operational executive with deep expertise in the healthcare business, joined Bright Health in 2021. He currently serves as Senior Vice President of Finance and is responsible

      5/3/23 5:00:00 PM ET
      $BHG
      Medical Specialities
      Health Care
    • Bright Health Group Announces Retirement of General Counsel Keith Nelsen

      Jeff Craig, lead counsel for the Company's NeueHealth business, named General Counsel and Corporate Secretary Bright Health Group, Inc. ("Bright Health" or "The Company") (NYSE:BHG), the first technology-enabled, Fully Aligned system of care built for healthcare's consumer retail market, today announced that Keith Nelsen will retire as General Counsel and Corporate Secretary. Jeff Craig, lead counsel for the Company's NeueHealth business, will be promoted to the role of General Counsel and Corporate Secretary effective March 18, 2022. Nelsen will stay on as a senior advisor with the Company until June 30, 2022, to ensure a smooth transition. "Keith has been a key leader for many of our mi

      3/15/22 4:35:00 PM ET
      $BHG
      Medical Specialities
      Health Care
    • Bright Health Group Names Leading Healthcare Expert to Board

      Matthew Manders to Join as Independent Director Bright Health Group, Inc. ("Bright Health") (NYSE:BHG), the first technology-enabled, Fully Aligned system of care built for healthcare's consumer retail market, today announced that leading healthcare expert Matt Manders will join the company's Board as an independent director, effective March 1. Manders brings a wealth of diverse healthcare experience, focus on operational excellence, and expertise in consumer-driven healthcare. Most recently, he served as president of Cigna Corporation's Government and Solutions organization, part of a 30-plus-year career with the company. In this role, Manders led and managed Cigna's U.S. Government busi

      3/1/22 8:10:00 AM ET
      $BHG
      Medical Specialities
      Health Care