‹ agilon health
Ch 1 · Revenue Went Down on Purpose
Chapter 1 · Growth
Revenue down 7%, net income up 4x.
agilon left bad markets and bad contracts on purpose. The result: less revenue, much better economics.
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✦ The bottom line
Q1 2026 revenue was $1.42 billion — down 7% from a year earlier. Membership dropped from 605K to 536K. But every profit line went the right way: gross profit +28%, medical margin +16%, net income +$37M, adjusted EBITDA +162%.
↓ the brief below
✦ Teach me
What 'value-based care' actually means
Traditional medicine works fee for service: a doctor gets paid for each test, visit, or procedure. Value-based care flips it. Insurers pay agilon a fixed amount per Medicare Advantage patient per year (called capitation). If the patient's actual healthcare costs are less than that, agilon keeps the difference. If costs are more, agilon eats the loss. The model rewards keeping people healthy — and punishes underwriting badly.
Wall Street calls this
Capitation / risk-bearing primary care
In 2024-25 healthcare costs blew through agilon's estimates, and the model swung from profitable to deeply loss-making. The turnaround is about *which contracts* agilon will and won't take.
The top line · latest quarter
$1.42
B
Q1 2026 revenue of $1.42B, down 7% from $1.53B — reflecting deliberate exits from unprofitable markets and payor contracts.
Source · 8-K · Item 2.02 — Q1 2026 results · Q1 2026 · Filed May 6, 2026
The why the revenue went down is the whole growth story. agilon walked away from contracts and markets that didn't work. The result is fewer members — but the members agilon kept are the right ones, and the contract economics are improving.
The other top line · medical margin
$149
M
Medical margin — what's left after paying for members' care — was $149M, up 16% YoY despite the smaller member base. That's per-member economics improving fast.
Source · 8-K · Item 2.02 — Q1 2026 results · Q1 2026 · Filed May 6, 2026
Watch
Right direction on every profit metric — but revenue decline tells you the turnaround is real and painful.
You just finished
Chapter 1 · GROWTH
Revenue Went Down on Purpose
you now read: money coming in (revenue)
Up next
Then
Chapter 3 · MOAT
Owning the Physician Relationship
Chapter 4 · MANAGEMENT
New CEO at the Inflection
Chapter 5 · BEHIND THE NUMBERS
The Story Behind the Numbers
Chapter 6 · RISK
The Underwriting Risk