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    P3 Health Partners Announces Second Quarter 2024 Results

    8/7/24 4:05:00 PM ET
    $PIII
    Medical/Nursing Services
    Health Care
    Get the next $PIII alert in real time by email

    Management to Host Conference Call and Webcast August 7, 2024 at 4:30 PM ET

    P3 Health Partners Inc. ("P3" or the "Company") (NASDAQ:PIII), a patient-centered and physician-led population health management company, today announced its financial results for the second quarter ended June 30, 2024.

    "In the second quarter, we experienced continued growth in our top line while simultaneously enhancing our balance sheet through a successful capital raise," said Aric Coffman, CEO of P3. "Building on P3's key strengths, I have identified several initiatives during my first 90 days as CEO that will further enhance our capabilities and help achieve sustainable profitability."

    Second Quarter 2024 Financial Results

    • Total revenue was $379.2 million, an increase of 15% compared to $329.1 million in the second quarter of the prior year
    • Capitated revenue was $374.3 million, an increase of 15% compared to $325.6 million in the second quarter of the prior year
    • Gross profit was $14.0 million, as compared to $26.8 million in the prior year. Gross profit PMPM was $36, compared to $86 PMPM in the prior year
    • Medical margin1 was $41.1 million compared to $50.5 million in the prior year. Medical margin PMPM1 was $107, compared to a medical margin PMPM of $161 in the prior year
    • Net loss was $28.8 million compared to a net loss of $27.6 million in the second quarter of the prior year. Net loss PMPM was $75 compared to a net loss PMPM of $88 in the prior year
    • Adjusted EBITDA loss1 was $8.8 million compared to Adjusted EBITDA of $0.2 million in the second quarter of the prior year. Adjusted EBITDA loss PMPM1 was $23, compared to Adjusted EBITDA PMPM of $1 in the second quarter of the prior year

    Fiscal 2024 Guidance

     

     

     

    Year Ended

    December 31, 2024

     

     

    Low

    High

    At-Risk Members(2)

     

     

    125,000

     

     

    135,000

     

    Total Revenues (in millions)

     

    $

    1,450

     

    $

    1,550

     

    Medical Margin(1)(3) (in millions)

     

    $

    230

     

    $

    250

     

    Medical Margin(3) PMPM

     

    $

    165

     

    $

    175

     

    Adjusted EBITDA(3) (in millions)

     

    $

    20

     

    $

    40

     

    (1) Adjusted EBITDA, Adjusted EBITDA per member, per month ("PMPM"), medical margin, and medical margin PMPM are non-GAAP financial measures. For reconciliations of these measures to the most directly comparable GAAP measures, if applicable, and more information regarding the Company's use of non-GAAP financial measures, please see the section titled "Non-GAAP Financial Measures."
     
    (2) See "Key Performance Metrics" for additional information on how the Company defines "at-risk members."
     
    (3) The Company is not able to provide a quantitative reconciliation of guidance for Adjusted EBITDA (loss), medical margin and medical margin PMPM to net income (loss), gross profit and gross profit PMPM the most directly comparable GAAP measures, respectively, and has not provided forward-looking guidance for net income (loss), gross profit (loss) or gross profit (loss) PMPM because of the uncertainty around certain items that may impact net income (loss), gross profit (loss) or gross profit (loss) PMPM that are not within our control or cannot be reasonably predicted without unreasonable effort. For more information regarding the non-GAAP financial measures discussed in this press release, please see "Non-GAAP Financial Measures" below.

    The foregoing 2024 outlook statements represent management's current estimate as of the date of this release. Actual results may differ materially depending on a number of factors. Investors are urged to read the "Cautionary Note Regarding Forward-Looking Statements" included in this release. Management does not assume any obligation to update these estimates.

    Management to Host Conference Call and Webcast on August 7, 2024 at 4:30 PM ET

    Title & Webcast

     

    P3 Health Second Quarter Earnings Conference Call

    Date & Time

     

    August 7, 2024, 4:30pm Eastern Time

    Conference Call Details

     

    Toll-Free 1-833-316-0546 (US)

    International 1-412-317-0692

    Ask to be joined into the P3 Health Partners call

    The conference call will also be webcast live in the "Events & Presentations" section of the Investor page of the P3 website (ir.p3hp.org). The Company's press release will be available at ir.p3hp.org website in advance of the conference call. An archived recording of the webcast will be available at ir.p3hp.org for a period of 90 days following the conference call.

    About P3 Health Partners (NASDAQ:PIII):

    P3 Health Partners Inc. is a leading population health management company committed to transforming healthcare by improving the lives of both patients and providers. Founded and led by physicians, P3 has an expansive network of more than 2,900 affiliated primary care providers across the country. Our local teams of health care professionals manage the care of thousands of patients in 27 counties across five states. P3 supports primary care providers with value-based care coordination and administrative services that improve patient outcomes and lower costs. Through partnerships with these local providers, the P3 care team creates an enhanced patient experience by navigating, coordinating, and integrating the patient's care within the healthcare system. For more information, visit www.p3hp.org and follow us on LinkedIn and Facebook.

    Non-GAAP Financial Measures

    In addition to the financial results prepared in accordance with accounting principles generally accepted in the U.S. ("GAAP"), this press release contains certain non-GAAP financial measures as defined by the SEC rules, including Adjusted EBITDA and Adjusted EBITDA PMPM, medical margin, and medical margin PMPM. EBITDA is defined as GAAP net income (loss) before (i) interest, (ii) income taxes and (iii) depreciation and amortization. Adjusted EBITDA is defined as EBITDA, further adjusted to exclude the effect of certain supplemental adjustments, such as (i) mark-to-market warrant gain/loss, (ii) premium deficiency reserves, (iii) equity-based compensation expense and (iv) certain other items that we believe are not indicative of our core operating performances. Adjusted EBITDA PMPM is defined as Adjusted EBITDA divided by the number of at-risk Medicare members each month divided by the number of months in the period. We believe these non-GAAP financial measures provide an additional tool for investors to use in evaluating ongoing operating results and trends and in comparing our financial measures with other similar companies. Medical margin represents the amount earned from capitated revenue after medical claims expenses are deducted and medical margin PMPM is defined as medical margin divided by the number of Medicare members each month divided by the number of months in the period.

    Medical claims expenses represent costs incurred for medical services provided to our members. As our platform grows and matures over time, we expect medical margin to increase in absolute dollars; however, medical margin PMPM may vary as the percentage of new members brought onto our platform fluctuates. New membership added to the platform is typically dilutive to medical margin PMPM. We do not consider these non-GAAP measures in isolation or as an alternative to financial measures determined in accordance with GAAP. These non-GAAP financial measures are subject to inherent limitations as they reflect the exercise of judgments by management about which expense and income are excluded or included in determining these non-GAAP financial measures. In addition, other companies may calculate non-GAAP financial measures differently or may use other measures to evaluate their performance, all of which could reduce the usefulness of our non-GAAP financial measures as tools for comparison. The tables at the end of this press release present a reconciliation of Adjusted EBITDA to net income (loss) and Adjusted EBITDA PMPM to net income (loss) PMPM, medical margin to gross profit, and medical margin PMPM to gross profit PMPM, which are the most directly comparable financial measures calculated in accordance with GAAP.

    Key Performance Metrics

    In addition to our GAAP and non-GAAP financial information, the Company also monitors "at-risk members" to help us evaluate our business, identify trends affecting our business, formulate business plans and make strategic decisions. At-risk membership represents the approximate number of Medicare members for whom we receive a fixed percentage of premium under capitation arrangements as of the end of a particular period.

    Cautionary Note Regarding Forward-Looking Statements

    This press release contains forward-looking statements within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. We intend such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933, as amended, Section 21E of the Securities Exchange Act of 1934, as amended. 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 address various matters, including the Company's future expected growth strategy and operating performance; outlook as to total revenue, at-risk membership, medical margin, medical margin PMPM, and Adjusted EBITDA for the full year 2024; and our ability to enhance our capabilities and achieve sustainable profitability, all of which reflect the Company's expectations based upon currently available information and data. Because such statements are based on expectations as to future financial and operating results and are not statements of fact, actual results may differ materially from those projected or estimated and you are cautioned not to place undue reliance on these forward-looking statements. 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 our actual results and financial condition to differ materially from those indicated in forward-looking statements include, among others, our ability to continue as a going concern; our potential need to raise additional capital to fund our existing operations or develop and commercialize new services or expand our operations; our ability to achieve or maintain profitability; our ability to maintain compliance with our debt covenants in the future, or obtain required waivers from our lenders if future operating performance were to fall below current projections, and if there are material changes to management's assumptions, we could be required to recognize non-cash charges to operating earnings for goodwill and/or other intangible asset impairment; our ability to identify and develop successful new geographies, physician partners, payors and patients; changes in market or industry conditions, regulatory environment, competitive conditions, and receptivity to our services; our ability to fund our growth and expand our operations; changes in laws and regulations applicable to our business; our ability to maintain our relationships with health plans and other key payors; our ability to establish and maintain effective internal controls and the impact of the material weaknesses we have identified; our ability to maintain the listing of our securities on The Nasdaq Stock Market, LLC; increased labor costs; our ability to recruit and retain qualified team members and independent physicians; and the factors described under Part I, Item 1A. "Risk Factors" and Part II, Item 7. "Management's Discussion and Analysis of Financial Condition and Results of Operations" in our Annual Report on Form 10-K for the year ended December 31, 2023, filed with the SEC on March 28, 2024, and in our subsequent filings with the SEC.

    All information in this press release is as of the date hereof, and we undertake no duty to update or revise this information unless required by law. You are cautioned not to place undue reliance on any forward-looking statements contained in this press release.

    P3 HEALTH PARTNERS INC. and SUBSIDIARIES

    CONDENSED CONSOLIDATED BALANCE SHEETS

    (in thousands, except per share amounts)

    (unaudited)

     

     

    June 30, 2024

     

    December 31, 2023

    ASSETS

     

     

     

    CURRENT ASSETS:

     

     

     

    Cash

    $

    73,086

     

     

    $

    36,320

     

    Restricted cash

     

    5,116

     

     

     

    4,614

     

    Health plan receivable, net of allowance for credit losses of $150

     

    153,259

     

     

     

    118,497

     

    Clinic fees, insurance and other receivable

     

    2,165

     

     

     

    2,973

     

    Prepaid expenses and other current assets

     

    8,478

     

     

     

    3,613

     

    TOTAL CURRENT ASSETS

     

    242,104

     

     

     

    166,017

     

    Property and equipment, net

     

    7,537

     

     

     

    8,686

     

    Intangible assets, net

     

    624,673

     

     

     

    666,733

     

    Other long-term assets

     

    18,445

     

     

     

    19,531

     

    TOTAL ASSETS (1)

    $

    892,759

     

     

    $

    860,967

     

    LIABILITIES, MEZZANINE EQUITY, AND STOCKHOLDERS' EQUITY

     

     

     

    CURRENT LIABILITIES:

     

     

     

    Accounts payable

    $

    7,989

     

     

    $

    8,663

     

    Accrued expenses and other current liabilities

     

    39,900

     

     

     

    36,884

     

    Accrued payroll

     

    3,744

     

     

     

    3,506

     

    Health plan settlements payable

     

    22,851

     

     

     

    34,992

     

    Claims payable

     

    233,761

     

     

     

    178,009

     

    Premium deficiency reserve

     

    11,273

     

     

     

    13,670

     

    Accrued interest

     

    31,905

     

     

     

    23,648

     

    Short-term debt

     

    831

     

     

     

    —

     

    TOTAL CURRENT LIABILITIES

     

    352,254

     

     

     

    299,372

     

    Operating lease liability

     

    12,192

     

     

     

    13,622

     

    Warrant liabilities

     

    25,455

     

     

     

    1,085

     

    Contingent consideration

     

    4,907

     

     

     

    4,907

     

    Long-term debt, net

     

    133,124

     

     

     

    108,319

     

    TOTAL LIABILITIES (1)

     

    527,932

     

     

     

    427,305

     

    COMMITMENTS AND CONTINGENCIES

     

     

     

    MEZZANINE EQUITY:

     

     

     

    Redeemable non-controlling interest

     

    197,987

     

     

     

    291,532

     

    STOCKHOLDERS' EQUITY:

     

     

     

    Class A common stock, $0.0001 par value; 800,000 shares authorized; 161,762 and 116,588 shares issued and outstanding as of June 30, 2024 and December 31, 2023, respectively

     

    16

     

     

     

    12

     

    Class V common stock, $0.0001 par value; 205,000 shares authorized; 195,957 and 196,569 shares issued and outstanding as of June 30, 2024 and December 31, 2023, respectively

     

    20

     

     

     

    20

     

    Additional paid in capital

     

    564,868

     

     

     

    509,442

     

    Accumulated deficit

     

    (398,064

    )

     

     

    (367,344

    )

    TOTAL STOCKHOLDERS' EQUITY

     

    166,840

     

     

     

    142,130

     

    TOTAL LIABILITIES, MEZZANINE EQUITY, AND STOCKHOLDERS' EQUITY

    $

    892,759

     

     

    $

    860,967

     

    ____________________

    (1)

    The Company's condensed consolidated balance sheets include the assets and liabilities of its consolidated variable interest entities ("VIEs"). As discussed in Note 13 "Variable Interest Entities," P3 LLC is itself a VIE. P3 LLC represents substantially all the assets and liabilities of the Company. As a result, the language and amounts below refer only to VIEs held at the P3 LLC level. The condensed consolidated balance sheets include total assets that can be used only to settle obligations of P3 LLC's consolidated VIEs totaling $11.1 million and $8.6 million as of June 30, 2024 and December 31, 2023, respectively, and total liabilities of P3 LLC's consolidated VIEs for which creditors do not have recourse to the general credit of the Company totaled $14.3 million and $13.6 million as of June 30, 2024 and December 31, 2023, respectively. These VIE assets and liabilities do not include $47.0 million and $44.2 million of net amounts due to affiliates as of June 30, 2024 and December 31, 2023, respectively, as these are eliminated in consolidation and not presented within the condensed consolidated balance sheets.

    P3 HEALTH PARTNERS INC. and SUBSIDIARIES

    CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

    (in thousands, except per share amounts)

    (unaudited)

     

     

    Three Months Ended June 30,

     

    Six Months Ended June 30,

     

    2024

     

    2023

     

    2024

     

    2023

    OPERATING REVENUE:

     

     

     

     

     

     

     

    Capitated revenue

    $

    374,306

     

     

    $

    325,616

     

     

    $

    758,440

     

     

    $

    624,320

     

    Other patient service revenue

     

    4,851

     

     

     

    3,470

     

     

     

    9,205

     

     

     

    6,843

     

    TOTAL OPERATING REVENUE

     

    379,157

     

     

     

    329,086

     

     

     

    767,645

     

     

     

    631,163

     

    OPERATING EXPENSE:

     

     

     

     

     

     

     

    Medical expense

     

    365,171

     

     

     

    302,271

     

     

     

    747,228

     

     

     

    587,841

     

    Premium deficiency reserve

     

    (3,397

    )

     

     

    (2,012

    )

     

     

    (2,397

    )

     

     

    3,128

     

    Corporate, general and administrative expense

     

    26,610

     

     

     

    27,223

     

     

     

    54,011

     

     

     

    64,866

     

    Sales and marketing expense

     

    414

     

     

     

    857

     

     

     

    736

     

     

     

    1,858

     

    Depreciation and amortization

     

    21,693

     

     

     

    21,780

     

     

     

    43,232

     

     

     

    43,320

     

    TOTAL OPERATING EXPENSE

     

    410,491

     

     

     

    350,119

     

     

     

    842,810

     

     

     

    701,013

     

    OPERATING LOSS

     

    (31,334

    )

     

     

    (21,033

    )

     

     

    (75,165

    )

     

     

    (69,850

    )

    OTHER INCOME (EXPENSE):

     

     

     

     

     

     

     

    Interest expense, net

     

    (5,436

    )

     

     

    (3,851

    )

     

     

    (9,692

    )

     

     

    (7,937

    )

    Mark-to-market of stock warrants

     

    8,673

     

     

     

    (1,731

    )

     

     

    8,889

     

     

     

    (1,082

    )

    Other

     

    291

     

     

     

    (741

    )

     

     

    628

     

     

     

    (645

    )

    TOTAL OTHER EXPENSE

     

    3,528

     

     

     

    (6,323

    )

     

     

    (175

    )

     

     

    (9,664

    )

    LOSS BEFORE INCOME TAXES

     

    (27,806

    )

     

     

    (27,356

    )

     

     

    (75,340

    )

     

     

    (79,514

    )

    PROVISION FOR INCOME TAXES

     

    (968

    )

     

     

    (226

    )

     

     

    (3,040

    )

     

     

    (516

    )

    NET LOSS

     

    (28,774

    )

     

     

    (27,582

    )

     

     

    (78,380

    )

     

     

    (80,030

    )

    LESS: NET LOSS ATTRIBUTABLE TO REDEEMABLE NON-CONTROLLING INTEREST

     

    (16,754

    )

     

     

    (17,766

    )

     

     

    (47,660

    )

     

     

    (61,015

    )

    NET LOSS ATTRIBUTABLE TO CONTROLLING INTEREST

    $

    (12,020

    )

     

    $

    (9,816

    )

     

    $

    (30,720

    )

     

    $

    (19,015

    )

     

     

     

     

     

     

     

     

    NET LOSS PER SHARE (Note 9):

     

     

     

     

     

     

     

    Basic

    $

    (0.09

    )

     

    $

    (0.09

    )

     

    $

    (0.24

    )

     

    $

    (0.25

    )

    Diluted

    $

    (0.15

    )

     

    $

    (0.09

    )

     

    $

    (0.30

    )

     

    $

    (0.29

    )

     

     

     

     

     

     

     

     

    WEIGHTED AVERAGE COMMON SHARES OUTSTANDING (Note 9):

     

     

     

     

     

     

     

    Basic

     

    136,601

     

     

     

    107,454

     

     

     

    127,806

     

     

     

    74,699

     

    Diluted

     

    141,083

     

     

     

    107,454

     

     

     

    130,047

     

     

     

    276,028

     

    P3 HEALTH PARTNERS INC. and SUBSIDIARIES

    CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

    (in thousands)

    (unaudited)

     

     

    Six Months Ended June 30,

     

    2024

     

    2023

    CASH FLOWS FROM OPERATING ACTIVITIES:

     

     

     

    Net loss

    $

    (78,380

    )

     

    $

    (80,030

    )

    Adjustments to reconcile net loss to net cash used in operating activities:

     

     

     

    Depreciation and amortization

     

    43,232

     

     

     

    43,320

     

    Equity-based compensation

     

    3,073

     

     

     

    2,008

     

    Amortization of original issue discount and debt issuance costs

     

    (91

    )

     

     

    340

     

    Accretion of contingent consideration

     

    —

     

     

     

    113

     

    Mark-to-market adjustment of stock warrants

     

    (8,889

    )

     

     

    1,082

     

    Premium deficiency reserve

     

    (2,397

    )

     

     

    3,128

     

    Changes in operating assets and liabilities:

     

     

     

    Health plan receivable

     

    (34,762

    )

     

     

    (30,540

    )

    Clinic fees, insurance, and other receivable

     

    775

     

     

     

    5,563

     

    Prepaid expenses and other current assets

     

    (4,865

    )

     

     

    139

     

    Other long-term assets

     

    60

     

     

     

    (1,289

    )

    Accounts payable, accrued expenses, and other current liabilities

     

    30

     

     

     

    1,924

     

    Accrued payroll

     

    238

     

     

     

    (3,086

    )

    Health plan settlements payable

     

    (12,141

    )

     

     

    (6,730

    )

    Claims payable

     

    55,752

     

     

     

    7,321

     

    Accrued interest

     

    8,257

     

     

     

    4,625

     

    Operating lease liability

     

    (164

    )

     

     

    (452

    )

    Net cash used in operating activities

     

    (30,272

    )

     

     

    (52,564

    )

    CASH FLOWS FROM INVESTING ACTIVITIES:

     

     

     

    Purchases of property and equipment

     

    —

     

     

     

    (1,652

    )

    Net cash used in investing activities

     

    —

     

     

     

    (1,652

    )

    CASH FLOWS FROM FINANCING ACTIVITIES:

     

     

     

    Proceeds from long-term debt, net of original issue discount

     

    25,000

     

     

     

    14,102

     

    Payment of debt issuance costs

     

    —

     

     

     

    (173

    )

    Proceeds from private placement offering, net of offering costs paid

     

    42,234

     

     

     

    87,329

     

    Proceeds from at-the-market sales, net of offering costs paid

     

    33

     

     

     

    —

     

    Deferred offering costs paid

     

    (455

    )

     

     

    —

     

    Payment of tax withholdings upon settlement of restricted stock unit awards

     

    (103

    )

     

     

    —

     

    Repayment of short-term and long-term debt

     

    (1,040

    )

     

     

    —

     

    Proceeds from short-term debt

     

    1,871

     

     

     

    —

     

    Net cash provided by financing activities

     

    67,540

     

     

     

    101,258

     

    Net change in cash and restricted cash

     

    37,268

     

     

     

    47,042

     

    Cash and restricted cash, beginning of period

     

    40,934

     

     

     

    18,457

     

    Cash and restricted cash, end of period

    $

    78,202

     

     

    $

    65,499

     

    RECONCILIATION OF NET LOSS TO ADJUSTED EBITDA (LOSS)

    (in thousands, except PMPM)

    (unaudited)

     

     

    Three Months Ended

     

    Six Months Ended June 30,

    June 30, 2024

     

    June 30, 2023

     

    March 31, 2024

     

    2024

     

    2023

    Net loss

    $

    (28,774

    )

     

    $

    (27,582

    )

     

    $

    (49,606

    )

     

    $

    (78,380

    )

     

    $

    (80,030

    )

    Interest expense, net

     

    5,436

     

     

     

    3,851

     

     

     

    4,256

     

     

     

    9,692

     

     

     

    7,937

     

    Depreciation and amortization

     

    21,693

     

     

     

    21,780

     

     

     

    21,539

     

     

     

    43,232

     

     

     

    43,320

     

    Provision for income taxes

     

    968

     

     

     

    226

     

     

     

    2,072

     

     

     

    3,040

     

     

     

    516

     

    Mark-to-market of stock warrants

     

    (8,673

    )

     

     

    1,731

     

     

     

    (216

    )

     

     

    (8,889

    )

     

     

    1,082

     

    Premium deficiency reserve

     

    (3,397

    )

     

     

    (2,012

    )

     

     

    1,000

     

     

     

    (2,397

    )

     

     

    3,128

     

    Equity-based compensation

     

    1,624

     

     

     

    1,031

     

     

     

    1,449

     

     

     

    3,073

     

     

     

    2,008

     

    Other(1)

     

    2,276

     

     

     

    1,192

     

     

     

    (264

    )

     

     

    2,012

     

     

     

    3,053

     

    Transaction and other related costs(2)

     

    —

     

     

     

    —

     

     

     

    —

     

     

     

    —

     

     

     

    70

     

    Adjusted EBITDA (loss)

    $

    (8,847

    )

     

    $

    217

     

     

    $

    (19,770

    )

     

    $

    (28,617

    )

     

    $

    (18,916

    )

    Adjusted EBITDA (loss) PMPM

    $

    (23

    )

     

    $

    1

     

     

    $

    (52

    )

     

    $

    (38

    )

     

    $

    (31

    )

    _____________________________________________

    (1)

    Other during the three and six months ended June 30, 2024 consisted of (i) interest income offset by (ii) severance and related expense in connection with our chief executive officer transition, and (iii) valuation allowance on our notes receivable. Other during the three and six months ended June 30, 2023 consisted of (i) interest income offset by (ii) cybersecurity incident loss, (iii) restructuring and other charges, including severance and benefits paid to employees pursuant to workforce reduction plans, (iv) the disposition of our Pahrump operations, (v) expenses for third-party consultants to assist us with the development, implementation, and documentation of new and enhanced internal controls and processes for compliance with Sarbanes-Oxley Section 404(b) with respect to the six months ended June 30, 2023, (vi) a legal settlement outside of the ordinary course of business with respect to the six months ended June 30, 2023, and (vii) valuation allowance on our notes receivable.

    (2)

    Transaction and other related costs during the six months ended June 30, 2023 consisted of legal fees incurred related to acquisition-related litigation.

    MEDICAL MARGIN

    (in thousands, except PMPM)

    (unaudited)

     

     

    Three Months Ended

     

    Six Months Ended June 30,

     

    June 30, 2024

     

    June 30, 2023

     

    March 31, 2024

     

    2024

     

    2023

    Capitated revenue

    $

    374,306

     

     

    $

    325,616

     

     

    $

    384,134

     

     

    $

    758,440

     

     

    $

    624,320

     

    Less: medical claims expense

     

    (333,217

    )

     

     

    (275,121

    )

     

     

    (347,582

    )

     

     

    (680,799

    )

     

     

    (534,579

    )

    Medical margin

    $

    41,089

     

     

    $

    50,495

     

     

    $

    36,552

     

     

    $

    77,641

     

     

    $

    89,741

     

    Medical margin PMPM

    $

    107

     

     

    $

    161

     

     

    $

    96

     

     

    $

    102

     

     

    $

    145

     

    RECONCILIATION OF GROSS PROFIT TO MEDICAL MARGIN

    (in thousands)

    (unaudited)

     

     

    Three Months Ended

     

    Six Months Ended June 30,

    June 30, 2024

     

    June 30, 2023

     

    March 31, 2024

     

    2024

     

    2023

    Gross profit

    $

    13,986

     

     

    $

    26,815

     

     

    $

    6,431

     

     

    $

    20,417

     

     

    $

    43,322

     

    Other patient service revenue

     

    (4,851

    )

     

     

    (3,470

    )

     

     

    (4,354

    )

     

     

    (9,205

    )

     

     

    (6,843

    )

    Other medical expense

     

    31,954

     

     

     

    27,150

     

     

     

    34,475

     

     

     

    66,429

     

     

     

    53,262

     

    Medical margin

    $

    41,089

     

     

    $

    50,495

     

     

    $

    36,552

     

     

    $

    77,641

     

     

    $

    89,741

     

    RECONCILIATION OF TOTAL OPERATING EXPENSE TO ADJUSTED OPERATING EXPENSE

    (in thousands)

    (unaudited)

     

     

    Three Months Ended June 30,

     

    Six Months Ended June 30,

    2024

     

    2023

     

    2024

     

    2023

    Total operating expense

    $

    410,491

     

     

    $

    350,119

     

     

    $

    842,810

     

     

    $

    701,013

     

    Medical expense

     

    (365,171

    )

     

     

    (302,271

    )

     

     

    (747,228

    )

     

     

    (587,841

    )

    Depreciation and amortization

     

    (21,693

    )

     

     

    (21,780

    )

     

     

    (43,232

    )

     

     

    (43,320

    )

    Premium deficiency reserve

     

    3,397

     

     

     

    2,012

     

     

     

    2,397

     

     

     

    (3,128

    )

    Equity-based compensation

     

    (1,624

    )

     

     

    (1,031

    )

     

     

    (3,073

    )

     

     

    (2,008

    )

    Other

     

    (2,541

    )

     

     

    (446

    )

     

     

    (2,593

    )

     

     

    (2,397

    )

    Transaction and other related costs

     

    —

     

     

     

    —

     

     

     

    —

     

     

     

    (70

    )

    Adjusted operating expense

    $

    22,859

     

     

    $

    26,603

     

     

    $

    49,081

     

     

    $

    62,249

     

     

    View source version on businesswire.com: https://www.businesswire.com/news/home/20240807864847/en/

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