Total Revenue

+4.6%

Total Revenue grew from approximately $440.83 million in Q4 2023 to $460.97 million in Q4 2024. This modest rise reflects continued growth in core revenue streams (such as FFS and capitation arrangements) seen in previous periods, though the increase is more subdued compared to earlier dramatic improvements. " " "

Operating Income

+270%

Operating Income jumped from $1.42 million in Q4 2023 to $5.25 million in Q4 2024. This significant improvement is driven by robust revenue performance combined with tighter expense controls and efficiencies that were being built in the prior period, suggesting a continued focus on improving margin performance. " "

Net Income

More than doubled (+131%)

Net Income increased from $2.32 million in Q4 2023 to $5.37 million in Q4 2024. This more than doubling is attributable to the substantial improvement in operating income along with likely benefits from reduced non-cash expenses and improved cost management, echoing trends observed in previous quarters. " "

Net Cash Provided by Operating Activities

+16.7%

Net Cash Provided by Operating Activities grew from approximately $64.10 million in Q4 2023 to $74.80 million in Q4 2024. This increase reflects better conversion of earnings into cash and improved working capital management, building on the operational improvements and cash flow efficiencies noted in earlier periods. " " "

Cash and Cash Equivalents

+26% (approx.)

Cash and Cash Equivalents increased from $389.51 million in Q4 2023 to $491.15 million in Q4 2024, demonstrating a significant strengthening of liquidity. This change is likely due to the combined effects of higher operating cash flow and disciplined capital management, following a trend of improved cash metrics in previous reporting periods. " "

Adjusted EBITDA Growth

Annual

Targeting “20% or greater” " " " (FY 2024)

Expected to grow “approximately 19%” at midpoint " " " " " " " " (FY 2025)

lowered

Free Cash Flow Conversion

Annual

Expecting approximately “90%” conversion " (FY 2024)

Expected to convert “at least 80%” of adjusted EBITDA " " " " " " " " (FY 2025)

lowered

Attributed Lives

Annual

“Expected to exceed the high end of their initial range” " (FY 2024)

“Expected to grow approximately 7.5% year-over-year, with a range of 1.3–1.4 million lives (up to 11.5% at the high end)” " " " " " " " " (FY 2025)

no prior guidance

Implemented Providers

Annual

no prior guidance

“Increase of 9.6% year-over-year to reach 5,250” " " " " " " " "

no prior guidance

Care Margin Growth

Annual

no prior guidance

“Expected to grow approximately 8.9% at the midpoint” " " " " " " " "

no prior guidance

EBITDA Margin Expansion

Annual

no prior guidance

“Expected to expand by approximately 200 basis points year-over-year” " " " " " " " "

no prior guidance

Capital Expenditures

Annual

no prior guidance

“Expected to remain de minimis” " " " " " " " "

no prior guidance

Effective Tax Rate

Annual

no prior guidance

“Assumed to be in the range of 26% to 28%” " " " " " " " "

no prior guidance

New Market Entry Costs

Annual

no prior guidance

“Assumes no new market entries or business development activity” " " " " " " " "

no prior guidance

Financial Performance and EBITDA Growth

Consistently highlighted in Q1 through Q3 with steady increases in adjusted EBITDA and robust practice collections " " " "

Q4 reported strong performance with practice collections up 4.7% YoY and EBITDA up 44% YoY, with full‐year figures surpassing prior quarters " "

Consistent positive performance with improved EBITDA growth and robust financial metrics. " " "

Free Cash Flow Generation and Conversion Rates

Q1–Q3 discussions noted conversion rates around 80–90% with strong historical performance " " " "

Q4 reported a record $109.3 million free cash flow at 121% conversion, while forward guidance indicates a reduction to 80% due to NOL depletion " " " "

Historically strong free cash flow conversion now faces forward-looking caution because of depleting NOLs. " " " "

Strong Cash Position and Capital Deployment Strategy

Q1 through Q3 emphasized strong cash balances (ranging from $351M to $473M), no debt, and a disciplined approach to market expansion and business development " " "

Q4 showcased an even stronger cash position at $491M and a well-articulated strategy to deploy capital for entering new states and potentially returning capital to shareholders " " " "

Steady financial strength with disciplined capital deployment, building on a consistently strong balance sheet. " " "

Market Expansion and Provider Growth

Discussions in Q1–Q3 focused on significant provider growth and market expansion, including new state entries and strong implemented provider trends " " "

Q4 confirmed robust provider growth (11.2% YoY) with guidance for further expansion and continued focus on growing the provider network " " "

Steady and robust expansion efforts with strategic market entries and provider additions continuing. " "

Value-Based Care Programs and Shared Savings (MSSP)

Q1–Q3 detailed strong MSSP performance, diversified value‐based contracts, and effective shared savings generation with conservative accruals " " "

Q4 reiterated strong MSSP performance with prudent shared savings assumptions and continued diversification amid some utilization headwinds " "

Sustained performance in value‐based care with cautious forward guidance, maintaining diversification as a hedge. " " "

Medicare Advantage Headwinds and Rate Changes

Q1–Q3 discussions acknowledged ongoing MA challenges, risk-sharing adjustments, and cautious risk acceptance with renegotiations noted in earlier calls " " "

Q4 emphasized continued headwinds in MA, including renegotiated contracts and caution in ramping up capitation due to rate changes and utilization pressures " " "

Consistent challenges in the MA space managed by strategic restructuring and cautious risk management. " " "

Operating Challenges: Fee-for-Service Collections and Elevated Utilization

Q1–Q3 noted steady fee-for-service growth tempered by some challenges from elevated utilization trends, with variability managed across markets " " " "

Q4 reported solid fee-for-service collections (4.7% YoY growth) while acknowledging persistent elevated utilization trends affecting shared savings, especially in MA " " "

Stable operational performance amid continued elevated utilization; guidance remains cautious but positive. " " "

Emerging Impact of Depleting NOL Carryforwards and Cash Tax Burdens

Not mentioned in Q1, Q2, and Q3 discussions [–]

Q4 introduced discussion on nearing the end of NOL carryforwards, leading to higher cash tax burdens and a future reduction in free cash flow conversion rates " " "

A new issue emerging in Q4 that could negatively impact free cash flow conversion in future periods. " " "

Benchmark Rebasing Effects on MSSP Performance

Q1 mentioned CMS updates and favorable MSSP benchmarks; Q3 provided detailed discussion on rebasing impact with diversified ACO strategies; Q2 did not include this topic " " "

Q4 discussed benchmark rebasing effects in detail, with guidance incorporating the impacts of five-year rebasing, without changing overall strategy "

A consistently monitored topic, now receiving detailed guidance integration in Q4 with no fundamental change in approach. " "

Rising Stock-Based Compensation Expenses

Q1 and Q2 detailed rising compensation expenses due to timing differences (with Q1 having a full-year effect) " "

Q4 did not discuss stock-based compensation, indicating a reduced emphasis compared to earlier periods [–]

Reduced focus on stock-based comp in Q4 suggests stabilization or less emphasis relative to prior periods. " "

Attribution Dynamics: Provider Growth vs. Attributed Lives

Q1 discussions explained attribution variations impacted by acquisitions, exits, and mix differences; Q2 and Q3 reiterated close ties between provider growth and attributed lives " " " "

Q4 provided nuanced insights showing attributed lives growth lagging provider growth for 2025, with detailed mix explanations " "

Consistent discussion with refined nuances in Q4 highlighting a deceleration in attributed lives growth relative to provider additions. " "