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    CareMax Reports Fourth Quarter and Full Year 2023 Results

    3/18/24 6:55:00 AM ET
    $CMAX
    Hospital/Nursing Management
    Health Care
    Get the next $CMAX alert in real time by email
    • Met 2023 Guidance for Medicare Advantage Membership and Total Revenue
    • Year-end 2023 Medicare Advantage Membership of 111,500, up 19% year-over-year
    • Full Year 2023 Total Revenue of $751.1 million, up 19% year-over-year
    • Exploring Strategic Options to Maximize Value of Certain Assets and Generate Further Liquidity

    CareMax, Inc. (NASDAQ:CMAX, CMAXW))) ("CareMax" or the "Company"), a leading technology-enabled value-based care delivery system, today announced financial results for the fourth quarter and full year ended December 31, 2023.

    "In the fourth quarter, we began taking major steps with the goal of solidifying the long-term viability of our business," said Carlos de Solo, Chief Executive Officer. "We have made difficult but necessary decisions to de-emphasize certain longer duration investments, such as de novo centers, and to refocus efforts on driving medical margin within our core centers and management services organization while implementing cost saving initiatives across the organization. Our lenders have also granted us limited waivers of certain financial covenants in our credit facility in the short term to help provide us with flexibility as we explore strategic options across our lines of business to maximize the value of certain assets. In short, we are taking the actions we believe are necessary to reposition CareMax for future success."

    Mr. de Solo continued, "What has not changed is our commitment to clinical excellence. Having achieved a 5-Star quality rating across our centers for the third consecutive year, CareMax remains at the forefront of enabling physicians to succeed under value-based care. We thank our team members for their dedication to our mission and for upholding the high standards of care our organization was founded upon."

    Fourth Quarter 2023 Results

    • Total membership of 270,000, up 4% year-over-year.
    • Medicare Advantage membership of 111,500, up 19% year-over-year.
    • Total revenue was $151.8 million, down 8% year-over-year.
    • Net loss was $465.8 million, including $369.2 million of non-cash goodwill impairment, compared to net income of $10.4 million for the fourth quarter of 2022, which included a $76.3 million non-cash gain on remeasurement of contingent earnout liabilities and a $20.1 million non-cash income tax benefit, partially offset by a $70.0 million non-cash goodwill impairment.
    • Adjusted EBITDA was ($71.8) million, compared to $4.5 million for the fourth quarter of 2022.1
    • Platform Contribution was ($55.6) million, compared to $25.6 million for the fourth quarter of 2022.1
    • Medical Expense Ratio was 122.7%, compared to 69.5% for the fourth quarter of 2022, primarily due to the impacts of prior period developments and a provision for adverse deviation.
    • De novo pre-opening costs and post-opening losses for the fourth quarter of 2023 were $5.9 million.2

    Full Year 2023 Results

    • Total revenue was $751.1 million, up 19% year-over-year.
    • Medical Expense Ratio was 91.5%, compared to 72.7% for the year ended December 31, 2022.
    • Net loss was $683.3 million, including $547.2 million of non-cash goodwill impairment, compared to net loss of $37.8 million for the year ended December 31, 2022, which included a $76.3 million non-cash gain on remeasurement of contingent earnout liabilities and a $19.5 million non-cash income tax benefit, partially offset by a $70.0 million non-cash goodwill impairment.
    • Adjusted EBITDA was ($63.1) million for the year ended December 31, 2023 and $19.1 million for the year ended December 31, 2022.1
    • Platform Contribution was $18.8 million, compared to $85.1 for the year ended December 31, 2022.1

    Forward-Looking Commentary for Full Year 2024

    CareMax is in the process of exploring strategic options across its business to maximize the value of certain of its assets and help generate further liquidity. While management believes that these efforts will result in financial benefits to the Company, the exact impacts of the outcomes of these processes on the Company's financial performance are uncertain. Accordingly, the Company is not providing a 2024 financial outlook at this time.

    1 Adjusted EBITDA and Platform Contribution are non-GAAP financial metrics. A reconciliation of non-GAAP metrics to the most directly comparable GAAP financial measures is included in the appendix to this earnings release. Beginning with the three months ended June 30, 2023, the Company has updated its calculation of Adjusted EBITDA on a retrospective basis to no longer add back certain compensation costs for stay-on bonuses and duplicative salaries previously included within the Business Combination integration costs adjustment.

    2 De novo pre-opening costs represent (1) incremental payroll costs from employees specifically associated with the operational, contractual, physical, or regulatory infrastructure for de novo centers, prior to their opening; (2) legal costs directly associated with the de novo centers, incurred prior to their opening, which includes services such as execution of leases, health plan contracts and other agreements; (3) other expenses related to diligence, design, permitting, and other "soft costs" at new sites; and (4) rent and facility expenses prior to center opening. De novo post-opening losses include center-level operating losses recognized at a de novo center until the center breaks even, which consist of revenue, external provider costs and cost of care allocated to the de novo center.

    Conference Call Details

    Management will host a conference call at 8:30 AM ET today to discuss the results. The conference call can be accessed by dialing (888) 330-2508 for U.S. participants, or (240) 789-2735 for international participants, and referencing conference ID 7874605. A live audio webcast will also be available on the "Events & Presentations" section of CareMax's investor relations website at ir.caremax.com. Following the live call, a replay will be available on the Company's website.

    About CareMax

    Founded in 2011, CareMax is a value-based care delivery system that utilizes a proprietary technology-enabled platform and multi-specialty, whole person health model to deliver comprehensive, preventative and coordinated care for its members. With over 200,000 Medicare Value-Based Care Members across 10 states, and fully integrated, Five-Star Quality rated health and wellness centers, CareMax is redefining healthcare across the country by reducing costs, improving overall outcomes and promoting health equity for seniors. Learn more at www.caremax.com.

    Forward-Looking Statements

    This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended. These forward-looking statements include statements regarding our future growth, strategy and financial performance. Words such as "anticipate," "believe," "budget," "contemplate," "continue," "could," "envision," "estimate," "expect," "guidance," "indicate," "intend," "may," "might," "plan," "possibly," "potential," "predict," "probably," "pro forma," "project," "seek," "should," "target," or "will," or the negative or other variations thereof, and similar words or phrases or comparable terminology, are intended to identify forward-looking statements. These forward-looking statements reflect the Company's expectations, plans or forecasts of future events and views as of the date of this press release. These forward-looking statements are not guarantees of future performance, conditions or results, and involve a number of known and unknown risks, uncertainties, assumptions and other important factors, many of which are outside the Company's control, that could cause actual results or outcomes to differ materially from those discussed in the forward-looking statements.

    Important risks and uncertainties that could cause the Company's actual results and financial condition to differ materially from those indicated in forward-looking statements include, among others, the Company's net losses, level of indebtedness and significant cash used in operating activities have raised substantial doubt regarding its ability to continue as a going concern; the Company's future capital requirements and sources and uses of cash, including funds to satisfy its liquidity needs and the Company's ability to comply with the covenants under the agreements governing its indebtedness; the Company's ability to successfully execute its strategy, which may include divesting certain assets or businesses; the Company's ability to successfully implement cost-saving measures or achieve expected benefits under its plans to optimize performance of the MSO network and its centers; the impact of restrictions on the Company's current and future operations contained in certain of its agreements; risks relating to lease termination, lease expense escalators, lease extensions, special charges and the Company's inability to comply with provisions of its lease agreements; the Company's ability to integrate acquired businesses and realize expected benefits of any such transactions; the Company's ability to attract new patients; changes in market or industry conditions, regulatory environment, competitive conditions, and receptivity to the Company's services; changes in laws and regulations applicable to the Company's business, in particular with respect to Medicare Advantage and Medicaid; the Company's ability to maintain its relationships with health plans and other key payers; any delay, modification or cancellation of government contracts; the impact of COVID-19 or any variant thereof or any other pandemic or epidemic on the Company's business and results of operation; insolvency, credit problems or other financial difficulties that could confront the Company's counterparties in strategic acquisitions, investments and other collaborations could expose the Company to significant financial risk and significantly impact the Company's ability to expand its overall profitability; the Company's ability to address the material weakness in its internal control over financial reporting; the Company's ability to recruit and retain qualified team members and independent physicians; risks related to future acquisitions; the Company's ability to develop and maintain proper and effective internal control over financial reporting and the impact of any prior period developments. For a detailed discussion of the risk factors that could affect the Company's actual results, please refer to the risk factors identified in the Company's reports filed with the SEC. All information provided in this press release is as of the date hereof, and the Company undertakes no duty to update or revise this information unless required by law, and forward-looking statements should not be relied upon as representing the Company's assessments as of any date subsequent to the date of this press release.

    Use of Non-GAAP Financial Information

    Certain financial information and data contained in this press release is unaudited and does not conform to Regulation S-X. Accordingly, such information and data may not be included in, may be adjusted in, or may be presented differently in, any periodic filing, information or proxy statement, or prospectus or registration statement to be filed by the Company with the SEC. Some of the financial information and data contained in this press release, such as Adjusted EBITDA and Platform Contribution and margin thereof have not been prepared in accordance with United States generally accepted accounting principles ("GAAP"). These non-GAAP measures of financial results are not GAAP measures of our financial results or liquidity and should not be considered as an alternative to net income (loss) as a measure of financial results, cash flows from operating activities as a measure of liquidity, or any other performance measure derived in accordance with GAAP. The Company believes these non-GAAP measures of financial results provide useful information to management and investors regarding certain financial and business trends relating to the Company's financial condition and results of operations. The Company's management uses these non-GAAP measures for trend analyses and for budgeting and planning purposes.

    The Company believes that the use of these non-GAAP financial measures provides an additional tool for investors to use in evaluating projected operating results and trends in and in comparing the Company's financial measures with other similar companies, many of which present similar non-GAAP financial measures to investors. Management does not consider these non-GAAP measures in isolation or as an alternative to financial measures determined in accordance with GAAP. The principal limitation of these non-GAAP financial measures is that they exclude significant expenses and income that are required by GAAP to be recorded in the Company's financial statements. In addition, they are subject to inherent limitations as they reflect the exercise of judgments by management about which expenses and income are excluded or included in determining these non-GAAP financial measures. For this reason, these non-GAAP measures may not be comparable to other companies' similarly labeled non-GAAP financial measures. In order to compensate for these limitations, management presents non-GAAP financial measures in connection with GAAP results.

    A reconciliation for Adjusted EBITDA and Platform Contribution to the most directly comparable GAAP financial measures is included below.

    CAREMAX, INC.

    CONSOLIDATED BALANCE SHEETS

    (in thousands, except share and per share data)

    (Unaudited)

     

     

     

    December 31,

    2023

     

     

    December 31,

    2022

     

    ASSETS

     

     

     

     

     

     

     

     

     

     

     

     

     

    Current Assets

     

     

     

     

     

     

    Cash and cash equivalents

     

    $

    65,528

     

     

    $

    41,626

     

    Accounts receivable, net

     

     

    114,754

     

     

     

    151,743

     

    Other current assets

     

     

    3,066

     

     

     

    3,968

     

    Total Current Assets

     

     

    183,348

     

     

     

    197,336

     

     

     

     

     

     

     

     

    Property and equipment, net

     

     

    47,918

     

     

     

    21,006

     

    Operating lease right-of-use assets

     

     

    109,215

     

     

     

    108,937

     

    Goodwill, net

     

     

    156,841

     

     

     

    700,643

     

    Intangible assets, net

     

     

    101,243

     

     

     

    123,585

     

    Deferred debt issuance costs

     

     

    —

     

     

     

    1,685

     

    Other assets

     

     

    24,737

     

     

     

    17,550

     

    Total Assets

     

    $

    623,301

     

     

    $

    1,170,743

     

     

     

     

     

     

     

     

    LIABILITIES AND STOCKHOLDERS' EQUITY

     

     

     

     

     

     

     

     

     

     

     

     

     

    Current Liabilities

     

     

     

     

     

     

    Accounts payable

     

    $

    6,275

     

     

    $

    7,687

     

    Accrued expenses

     

     

    16,224

     

     

     

    16,854

     

    Risk settlement liabilities

     

     

    42,602

     

     

     

    14,171

     

    Related party liabilities

     

     

    190

     

     

     

    1,777

     

    Related party debt, net

     

     

    —

     

     

     

    30,277

     

    Current portion of third-party debt, net

     

     

    364,380

     

     

     

    253

     

    Current portion of operating lease liabilities

     

     

    8,975

     

     

     

    5,512

     

    Other current liabilities

     

     

    165

     

     

     

    790

     

    Total Current Liabilities

     

     

    438,812

     

     

     

    77,322

     

    Derivative warrant liabilities

     

     

    22

     

     

     

    3,974

     

    Long-term debt, net

     

     

    21,443

     

     

     

    230,725

     

    Long-term operating lease liabilities

     

     

    97,136

     

     

     

    96,539

     

    Contingent earnout liability

     

     

    —

     

     

     

    134,561

     

    Other liabilities

     

     

    4,443

     

     

     

    8,075

     

    Total Liabilities

     

     

    561,856

     

     

     

    551,196

     

    COMMITMENTS AND CONTINGENCIES

     

     

     

     

     

     

    STOCKHOLDERS' EQUITY

     

     

     

     

     

     

    Preferred stock (1,000,000 shares authorized; one share issued and outstanding as of December 31, 2023 and December 31, 2022)

     

     

    —

     

     

     

    —

     

    Class A common stock ($0.0001 par value; 8,333,333 shares authorized; 3,744,732 and 3,711,086 shares issued and outstanding as of December 31, 2023 and December 31, 2022, respectively) 1

     

     

    11

     

     

     

    11

     

    Additional paid-in-capital

     

     

    782,371

     

     

     

    657,126

     

    Accumulated deficit

     

     

    (720,938

    )

     

     

    (37,590

    )

    Total Stockholders' Equity

     

     

    61,444

     

     

     

    619,547

     

     

     

     

     

     

     

     

    Total Liabilities and Stockholders' Equity

     

    $

    623,301

     

     

    $

    1,170,743

     

     

     

     

     

     

     

     

    1 Share amounts have been restated to reflect the 1-for-30 reverse stock split that the Company completed on January 31, 2024.

     

    CAREMAX, INC.

    CONSOLIDATED STATEMENTS OF OPERATIONS

    (in thousands, except share and per share data)

    (Unaudited)

     

     

    Three Months Ended December 31,

     

     

    Years Ended December 31,

     

     

    2023

     

     

    2022

     

     

    2023

     

     

    2022

     

    Revenue

     

     

     

     

     

     

     

     

     

     

    Medicare risk-based revenue

    $

    108,650

     

     

    $

    113,041

     

     

    $

    519,834

     

     

    $

    486,718

     

    Medicaid risk-based revenue

     

    26,263

     

     

     

    36,620

     

     

     

    105,893

     

     

     

    96,534

     

    Government value-based care revenue

     

    7,425

     

     

     

    6,389

     

     

     

    67,708

     

     

     

    6,389

     

    Other revenue

     

    9,497

     

     

     

    8,213

     

     

     

    57,667

     

     

     

    41,492

     

    Total revenue

     

    151,835

     

     

     

    164,263

     

     

     

    751,102

     

     

     

    631,132

     

     

     

     

     

     

     

     

     

     

     

     

     

    Operating expenses

     

     

     

     

     

     

     

     

     

     

     

    External provider costs

     

    165,522

     

     

     

    104,078

     

     

     

    572,329

     

     

     

    424,182

     

    Cost of care

     

    42,226

     

     

     

    38,723

     

     

     

    164,872

     

     

     

    126,648

     

    Sales and marketing

     

    3,681

     

     

     

    3,806

     

     

     

    14,274

     

     

     

    11,761

     

    Corporate, general and administrative

     

    16,662

     

     

     

    17,096

     

     

     

    80,684

     

     

     

    75,824

     

    Depreciation and amortization

     

    7,550

     

     

     

    7,180

     

     

     

    27,787

     

     

     

    21,719

     

    Goodwill impairment

     

    369,200

     

     

     

    70,000

     

     

     

    547,200

     

     

     

    70,000

     

    Acquisition related costs

     

    —

     

     

     

    9,616

     

     

     

    108

     

     

     

    13,165

     

    Total operating expenses

     

    604,841

     

     

     

    250,498

     

     

     

    1,407,254

     

     

     

    743,297

     

    Operating loss

     

    (453,006

    )

     

     

    (86,235

    )

     

     

    (656,152

    )

     

     

    (112,165

    )

    Nonoperating income (expense)

     

     

     

     

     

     

     

     

     

     

     

    Interest expense

     

    (16,526

    )

     

     

    (8,743

    )

     

     

    (54,434

    )

     

     

    (20,455

    )

    Change in fair value of derivative warrant liabilities

     

    961

     

     

     

    7,877

     

     

     

    3,952

     

     

     

    4,401

     

    Gain on remeasurement of contingent earnout liabilities

     

    —

     

     

     

    76,295

     

     

     

    19,916

     

     

     

    76,295

     

    Loss on extinguishment of debt

     

    —

     

     

     

    —

     

     

     

    —

     

     

     

    (6,172

    )

    Other income, net

     

    1,410

     

     

     

    1,168

     

     

     

    2,507

     

     

     

    759

     

     

     

    (14,155

    )

     

     

    76,597

     

     

     

    (28,059

    )

     

     

    54,828

     

    Loss before income tax

     

    (467,162

    )

     

     

    (9,640

    )

     

     

    (684,211

    )

     

     

    (57,337

    )

    Income tax benefit

     

    (1,395

    )

     

     

    (20,074

    )

     

     

    (863

    )

     

     

    (19,542

    )

    Net (loss) income

    $

    (465,766

    )

     

    $

    10,434

     

     

    $

    (683,348

    )

     

    $

    (37,796

    )

     

     

     

     

     

     

     

     

     

     

     

     

    Weighted-average basic shares outstanding 1

     

    3,740,304

     

     

     

    3,362,890

     

     

     

    3,727,725

     

     

     

    3,026,644

     

    Net (loss) income per share

     

     

     

     

     

     

     

     

     

     

     

    Basic

    $

    (124.53

    )

     

    $

    3.10

     

     

    $

    (183.31

    )

     

    $

    (12.49

    )

     

    1 Share amounts have been restated to reflect the 1-for-30 reverse stock split that the Company completed on January 31, 2024.

    CAREMAX, INC.

    CONSOLIDATED STATEMENTS OF CASH FLOWS

    (in thousands)

    (Unaudited)

     

     

     

    Years Ended December 31,

     

     

     

    2023

     

     

    2022

     

    CASH FLOWS FROM OPERATING ACTIVITIES

     

     

     

     

     

     

    Net loss

     

    $

    (683,348

    )

     

    $

    (37,796

    )

    Adjustments to reconcile net loss to cash and cash equivalents:

     

     

     

     

     

     

    Depreciation and amortization expense

     

     

    27,787

     

     

     

    21,719

     

    Amortization of debt issuance costs and discounts

     

     

    8,314

     

     

     

    2,382

     

    Stock-based compensation expense

     

     

    10,599

     

     

     

    10,271

     

    Income tax benefit

     

     

    (863

    )

     

     

    (19,542

    )

    Change in fair value of derivative warrant liabilities

     

     

    (3,952

    )

     

     

    (4,401

    )

    Gain on remeasurement of contingent earnout liabilities

     

     

    (19,916

    )

     

     

    (76,295

    )

    Loss on extinguishment of debt

     

     

    —

     

     

     

    6,172

     

    Payment-in-kind interest expense

     

     

    12,064

     

     

     

    5,277

     

    Non-cash finance lease expense

     

     

    419

     

     

     

    —

     

    Provision for credit losses

     

     

    (1,588

    )

     

     

    1,243

     

    Goodwill impairment

     

     

    547,200

     

     

     

    70,000

     

    Amortization of right-of-use assets

     

     

    11,527

     

     

     

    —

     

    Other non-cash, net

     

     

    1,488

     

     

     

    853

     

    Changes in operating assets and liabilities:

     

     

     

     

     

     

    Accounts receivable

     

     

    25,941

     

     

     

    (66,561

    )

    Other current assets

     

     

    902

     

     

     

    2,505

     

    Risk settlement liabilities

     

     

    32,560

     

     

     

    6,775

     

    Other assets

     

     

    (6,501

    )

     

     

    (3,127

    )

    Operating lease liabilities

     

     

    (5,897

    )

     

     

    4,386

     

    Accounts payable

     

     

    413

     

     

     

    1,730

     

    Accrued expenses

     

     

    (2,601

    )

     

     

    4,722

     

    Related party liabilities

     

     

    (1,069

    )

     

     

    —

     

    Other liabilities

     

     

    (393

    )

     

     

    1,470

     

    Net cash used in operating activities

     

     

    (46,913

    )

     

     

    (68,216

    )

     

     

     

     

     

     

     

    CASH FLOWS FROM INVESTING ACTIVITIES

     

     

     

     

     

     

    Purchase of property and equipment

     

     

    (14,611

    )

     

     

    (7,450

    )

    Return of cash held in escrow

     

     

    —

     

     

     

    785

     

    Acquisition of businesses, net of cash acquired

     

     

    —

     

     

     

    (55,837

    )

    Net cash used in investing activities

     

     

    (14,611

    )

     

     

    (62,502

    )

     

     

     

     

     

     

     

    CASH FLOWS FROM FINANCING ACTIVITIES

     

     

     

     

     

     

    Proceeds from borrowings

     

     

    122,000

     

     

     

    229,241

     

    Proceeds from related party borrowings

     

     

    —

     

     

     

    29,876

     

    Principal payments of related party debt

     

     

    (35,510

    )

     

     

    (121,977

    )

    Principal payments of third-party debt

     

     

    (253

    )

     

     

    —

     

    Payments of debt issuance costs

     

     

    (810

    )

     

     

    (7,272

    )

    Collateral for letters of credit

     

     

    —

     

     

     

    (5,439

    )

    Net cash provided by financing activities

     

     

    85,427

     

     

     

    124,428

     

     

     

     

     

     

     

     

    NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS

     

     

    23,903

     

     

     

    (6,290

    )

    Cash and cash equivalents - beginning of period

     

     

    41,626

     

     

     

    47,917

     

    CASH AND CASH EQUIVALENTS - END OF PERIOD

     

    $

    65,528

     

     

    $

    41,626

     

    Non-GAAP Financial Summary

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    (Unaudited)

    Three Months Ended 

    (in thousands)

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

    Medicare risk-based revenue

    $

    91,277

     

    $

    107,747

     

    $

    143,664

     

    $

    122,267

     

    $

    113,041

     

    $

    121,593

     

    $

    155,486

     

    $

    134,105

     

    $

    108,650

    Medicaid risk-based revenue

     

    20,160

     

     

    20,165

     

     

    19,896

     

     

    19,852

     

     

    36,620

     

     

    25,626

     

     

    30,054

     

     

    23,950

     

     

    26,263

     

    Government value-based care revenue

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    6,389

     

     

    10,010

     

     

    22,206

     

     

    28,067

     

     

    7,425

     

    Other revenue

     

    6,869

     

     

    9,008

     

     

    8,719

     

     

    15,551

     

     

    8,213

     

     

    15,754

     

     

    16,694

     

     

    15,721

     

     

    9,497

     

    Total revenue

     

    118,306

     

     

    136,920

     

     

    172,279

     

     

    157,670

     

     

    164,263

     

     

    172,983

     

     

    224,440

     

     

    201,843

     

     

    151,835

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    External provider costs

     

    79,724

     

     

    92,856

     

     

    120,348

     

     

    106,900

     

     

    104,078

     

     

    110,673

     

     

    156,995

     

     

    139,139

     

     

    165,522

    Cost of care

     

    22,606

     

     

    26,854

     

     

    30,293

     

     

    30,150

     

     

    34,581

     

     

    37,627

     

     

    38,865

     

     

    41,599

     

     

    41,915

     

    Platform contribution

     

    15,977

     

     

    17,210

     

     

    21,638

     

     

    20,620

     

     

    25,604

     

     

    24,683

     

     

    28,580

     

     

    21,106

     

     

    (55,602

    )

    Platform contribution margin (%)

     

    13.5

    %

     

    12.6

    %

     

    12.6

    %

     

    13.1

    %

     

    15.6

    %

     

    14.3

    %

     

    12.7

    %

     

    10.5

    %

     

    (36.6

    %)

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Sales and marketing

     

    2,615

     

    3,301

     

     

    2,299

     

     

    2,355

     

     

    3,806

     

     

    3,765

     

     

    3,381

     

     

    3,501

     

     

    3,627

    Corporate, general and administrative

     

    11,228

     

     

    10,873

     

     

    12,165

     

     

    13,877

     

     

    17,263

     

     

    21,329

     

     

    18,158

     

     

    15,527

     

     

    12,531

     

    Adjusted operating expenses

     

    13,843

     

     

    14,174

     

     

    14,464

     

     

    16,232

     

     

    21,069

     

     

    25,094

     

     

    21,539

     

     

    19,028

     

     

    16,158

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Adjusted EBITDA

    $

    2,134

    $

    3,035

     

    $

    7,175

     

    $

    4,388

     

    $

    4,535

     

    $

    (411

    )

    $

    7,042

     

    $

    2,077

     

    $

    (71,759

    )

    Reconciliation to Adjusted EBITDA

    Three Months Ended 

     

    (in thousands)

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

     

    Net loss

    $

    (3,553

    )

    $

    (16,797

    )

    $

    (9,381

    )

    $

    (22,053

    )

    $

    10,434

     

    $

    (82,082

    )

    $

    (32,376

    )

    $

    (103,123

    )

    $

    (465,766

    )

    Interest expense

     

    1,905

     

     

    1,728

     

     

    3,896

     

     

    6,088

     

     

    8,743

     

     

    10,711

     

     

    13,197

     

     

    14,000

     

     

    16,526

     

    Depreciation and amortization

     

    6,089

     

     

    5,062

     

     

    4,903

     

     

    4,573

     

     

    7,180

     

     

    6,576

     

     

    6,828

     

     

    6,833

     

     

    7,550

     

    Remeasurement of warrant and contingent earnout liabilities

     

    (8,734

    )

     

    3,536

     

     

    (7,391

    )

     

    7,331

     

     

    (84,171

    )

     

    (37,242

    )

     

    15,786

     

     

    (1,450

    )

     

    (961

    )

    Goodwill impairment

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    70,000

     

     

    98,000

     

     

    —

     

     

    80,000

     

     

    369,200

     

    Stock-based compensation

     

    375

     

     

    1,087

     

     

    2,788

     

     

    3,611

     

     

    2,786

     

     

    2,298

     

     

    2,464

     

     

    3,243

     

     

    2,595

     

    Loss on extinguishment of debt

     

    7

     

     

    —

     

     

    6,172

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

    Business Combination integration costs (1)

     

    2,277

     

     

    4,379

     

     

    1,887

     

     

    2,586

     

     

    163

     

     

    716

     

     

    686

     

     

    483

     

     

    833

     

    Acquisition and integration related costs (2)

     

    2,325

     

     

    3,429

     

     

    4,074

     

     

    2,118

     

     

    10,632

     

     

    622

     

     

    815

     

     

    652

     

     

    1,069

     

    DeSpac costs

     

    742

     

     

    9

     

     

    10

     

     

    11

     

     

    10

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

    Other (3)

     

    543

     

     

    421

     

     

    46

     

     

    (58

    )

     

    (1,168

    )

     

    (187

    )

     

    (535

    )

     

    1,263

     

     

    (1,409

    )

    Income tax provision (benefit)

     

    159

     

     

    181

     

     

    171

     

     

    181

     

     

    (20,074

    )

     

    177

     

     

    177

     

     

    177

     

     

    (1,395

    )

    Adjusted EBITDA

    $

    2,134

     

    $

    3,035

     

    $

    7,175

     

    $

    4,388

     

    $

    4,535

     

    $

    (411

    )

    $

    7,042

     

    $

    2,077

     

    $

    (71,759

    )

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Memo:

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    De novo pre-opening costs

    $

    806

     

    $

    973

     

    $

    506

     

    $

    2,426

     

    $

    3,205

     

    $

    1,975

     

    $

    1,560

     

    $

    1,880

     

    $

    1,323

     

    De novo post-opening losses

     

    489

     

     

    1,119

     

     

    993

     

     

    1,533

     

     

    2,274

     

     

    3,885

     

     

    4,228

     

     

    3,906

     

     

    4,558

     

    (1)

     

    Represents initial costs to set up public company processes, incremental vendor expenses identified as temporary or duplicative and expected to be rationalized in the short term, and legal and professional expenses outside of the ordinary course of business, which are being incurred as part of the Company's efforts as it integrates the two privately held companies that were combined in the Business Combination. Significant components of Business Combination integration costs were as follows:

     

    Three Months Ended

     

    (in thousands)

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

     

    Consulting and legal fees (a)

    $

    1,639

     

    $

    3,190

     

    $

    887

     

    $

    725

     

    $

    257

     

    $

    282

     

    $

    237

     

    $

    69

     

    $

    451

     

    Severance costs

     

    949

     

     

    25

     

     

    252

     

     

    1,080

     

     

    167

     

     

    11

     

     

    13

     

     

    —

     

     

    —

     

    Other (b)

     

    (311

    )

     

    1,164

     

     

    748

     

     

    782

     

     

    (261

    )

     

    423

     

     

    436

     

     

    414

     

     

    382

     

     

    $

    2,277

     

    $

    4,379

     

    $

    1,887

     

    $

    2,586

     

    $

    163

     

    $

    716

     

    $

    686

     

    $

    483

     

    $

    833

     

    (a) Represents consulting and legal costs directly associated with efforts related to integration of the two privately held companies that were combined in the Business Combination.

    (b) Represents primarily vendor expenses identified as temporary or duplicative and/or expenses outside the ordinary course of business and not necessary to run the Company's business.

    (2)

     

    Includes all costs recognized in acquisition related costs in our condensed consolidated statements of operations and incremental payroll compensation expense for employees directly associated with services to achieve synergies related to closed transactions. Significant components of acquisition and integration related costs were as follows:

    Three Months Ended

     

    (in thousands)

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

     

    Advisor and other professional fees (a)

    $

    1,183

     

    $

    1,622

     

    $

    2,359

     

    $

    1,219

     

    $

    9,877

     

    $

    (258

    )

    $

    (34

    )

    $

    94

     

    $

    352

     

    Compensation costs (b)

     

    1,142

     

     

    1,808

     

     

    1,715

     

     

    899

     

     

    755

     

     

    880

     

     

    849

     

     

    558

     

     

    717

     

     

    $

    2,325

     

    $

    3,429

     

    $

    4,074

     

    $

    2,118

     

    $

    10,632

     

    $

    622

     

    $

    815

     

    $

    652

     

    $

    1,069

     

    (a) Includes payments to our third-party transaction advisory firm associated with transaction contracts, including the Steward transaction that closed in November 2022. Also, costs include legal and accounting fees directly associated with contemplated or closed transactions.

    (b) Includes incremental payroll compensation expense for employees directly associated with services to achieve synergies related to closed transactions.

    (3)

     

    Components of other were as follows:

     

    Three Months Ended

     

    (in thousands)

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

     

    Other income

    $

    —

     

    $

    —

     

    $

    —

     

    $

    —

     

    $

    (1,000

    )

    $

    —

     

    $

    —

     

    $

    —

     

    $

    (874

    )

    Tax-related costs

     

    95

     

     

    265

     

     

    69

     

     

    (178

    )

     

    46

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

    Legal settlement

     

    229

     

     

    —

     

     

    (43

    )

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

    Interest income

     

    —

     

     

    —

     

     

    —

     

     

    (12

    )

     

    (201

    )

     

    (253

    )

     

    (602

    )

     

    (433

    )

     

    (560

    )

    Severance costs

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    —

     

     

    1,639

     

     

    —

     

    Other

     

    219

     

     

    156

     

     

    19

     

     

    133

     

     

    (13

    )

     

    66

     

     

    67

     

     

    58

     

     

    25

     

     

    $

    543

     

    $

    421

     

    $

    46

     

    $

    (58

    )

    $

    (1,168

    )

    $

    (187

    )

    $

    (535

    )

    $

    1,263

     

    $

    (1,409

    )

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Non-GAAP Operating Metrics

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

     

    Centers

     

    45

     

     

    48

     

     

    48

     

     

    51

     

     

    62

     

     

    62

     

     

    62

     

     

    62

     

     

    56

     

    Markets

     

    4

     

     

    6

     

     

    6

     

     

    7

     

     

    7

     

     

    7

     

     

    7

     

     

    7

     

     

    7

     

    Patients (MCREM)*

     

    50,100

     

     

    50,600

     

     

    54,000

     

     

    57,400

     

     

    221,500

     

     

    225,100

     

     

    226,500

     

     

    228,700

     

     

    229,300

     

    Patients in value-based care arrangements (MCREM)

     

    79.3

    %

     

    79.8

    %

     

    81.0

    %

     

    78.2

    %

     

    97.6

    %

     

    99.0

    %

     

    99.4

    %

     

    98.8

    %

     

    98.8

    %

    Platform Contribution ($, millions)

    $

    16.0

     

    $

    17.2

     

    $

    21.6

     

    $

    20.6

     

    $

    25.6

     

    $

    24.7

     

    $

    28.6

     

    $

    21.1

     

    $

    (55.6

    )

    * MCREM defined as Medicare Equivalent Members, which assumes the level of support received by a Medicare patient is equivalent to that received by three Medicaid or Commercial patients.

     

     

    Reconciliation to Platform Contribution

    (in millions)

    Dec 31,

    2021

     

    Mar 31,

    2022

     

    Jun 30,

    2022

     

    Sep 30,

    2022

     

    Dec 31,

    2022

     

    Mar 31,

    2023

     

    Jun 30,

    2023

     

    Sep 30,

    2023

     

    Dec 31,

    2023

     

    Gross profit (a)

    $

    9.6

     

    $

    11.2

     

    $

    15.4

     

    $

    14.8

     

    $

    17.2

     

    $

    17.1

     

    $

    20.4

     

    $

    12.0

     

    $

    (63.5

    )

    Depreciation and amortization

     

    6.1

     

     

    5.1

     

     

    4.9

     

     

    4.6

     

     

    7.2

     

     

    6.6

     

     

    6.8

     

     

    6.8

     

     

    7.6

     

    Stock-based compensation

     

    0.1

     

     

    0.4

     

     

    1.3

     

     

    1.2

     

     

    1.2

     

     

    1.0

     

     

    1.3

     

     

    1.2

     

     

    0.1

     

    Other adjustments (b)

     

    0.2

     

     

    0.5

     

     

    0.1

     

     

    0.1

     

     

    —

     

     

    —

     

     

    —

     

     

    1.0

     

     

    0.2

     

    Platform Contribution

    $

    16.0

     

    $

    17.2

     

    $

    21.6

     

    $

    20.6

     

    $

    25.6

     

    $

    24.7

     

    $

    28.6

     

    $

    21.1

     

    $

    (55.6

    )

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    (a) Gross profit reflects the reclassification of stock-based compensation expense previously included in corporate, general and administrative expenses, which decreased gross profit by $0.1 million during the three months ended December 31, 2021, $0.4 million during the three months ended March 31, 2022, $1.3 million during the three months ended June 30, 2022, $1.2 million during the three months ended September 30, 2022, and $1.2 million during the three months ended December 31, 2022.

     

    (b) Other adjustments include incremental costs related to post-Business Combination integration initiatives and other one-time center-level costs. Other adjustments reflected during the three months ended March 31, 2022, include $0.3 million of costs for a pilot project regarding outsourcing. During the three months ended September 30, 2023 and December 31, 2023, other adjustments include $1.0 million and $0.2 million, respectively, of severance costs related to center staff.

     

    Calculation of the Medical Expense Ratio

     

    Three Months Ended December 31,

     

    Years Ended December 31,

     

    (in thousands, except ratio)

    2023

     

     

    2022

     

    2023

     

     

    2022

    External provider costs

    $

    165,522

     

     

    $

    104,078

     

    $

    572,329

     

     

    $

    424,182

    Medicare and Medicaid risk-based revenue

     

    134,913

     

     

     

    149,661

     

     

    625,727

     

     

    583,252

     

    Medical Expense Ratio

     

    122.7

    %

     

     

    69.5

    %

     

    91.5

    %

     

     

    72.7

    %

     

    View source version on businesswire.com: https://www.businesswire.com/news/home/20240318654271/en/

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