Sentiment Analysis of the earnings transcript to help figure out if there are any bullish or bearish sentiments that could be gathered from it. We're doing ML and AI based analysis on the earnings call to get some more insights.
Please consider a small donation if you think this website provides you with relevant information
| Statement |
|---|
| In conclusion, we believe our clinically-centric shared risk model supported by our AVA technology insights will thrive in the current MA environment |
| Fourth quarter inpatient admissions per thousand ran 7% better year-over-year, a trend which persisted into January |
| We generated strong membership growth, demonstrated control over our medical utilization, outperformed the market in Stars and made investments to position us for even greater success in 2024 |
| Our ability to take action on insights through direct data feeds from near real-time pharmacy, lab, admission, discharge, transfer and authorization data is a significant competitive advantage in controlling our MBR and achieving excellent Stars results |
| That's going to be a very good year |
| I'm not going to comment on that but I feel very, very good about the tailwinds |
| It's just a competitive advantage in this environment |
| Taken together, our model is advantaged by enhanced visibility through AVA and control of member care provided by our employee clinical teams |
| All of that is really poised for 2025 to be a really, really good year that I think |
| Our ability to manage risk, drive higher quality clinical outcomes and produce medical cost savings translates into more value for our members |
| This enables Alignment to grow membership above market rates at an attractive margin profile |
| As we contemplate our 2024 guidance, we are proud to share that our model continues to differentiate Alignment in the marketplace |
| The utilization and MLR we have outside of California is really, really good |
| We expect that our member growth will outpace the industry and we will gain market share by focusing on quality clinical outcomes, excellent member engagement and high-value benefits for our members |
| So, I think it's going to be a good thing for us |
| We also leveraged our strong Stars rating relative to our competitors to take share in the market with 82% of our AEP sales coming from planned switchers |
| More specifically to our January experience, we saw very solid, I'd say, sales progress and pretty significant retention improvement again |
| But as we sit here through February, we're very pleased with our early results and traction and making sure we get the right members engaged in our clinical programs |
| And so both from a growth and margin standpoint, we're very optimistic about our 2025 positioning |
| The improvement in member retention will also contribute to strong returning member MBR |
| I think you heard John mention a bit on the growth side of things that we're going to benefit in 2025 as our competitors fall on average below a 4-Star payment |
| I think for the foreseeable future, we do not plan to take downside risk on the ACO REACH program but rather we'll look to continue to support our provider partners with our existing license, we still have remaining and really focus our efforts on Medicare Advantage, where we see an enormous growth opportunity and margin improvement opportunities starting heading into 2025 |
| I think when you take that and add on the V28 risk adjustment headwinds and the broader utilization headwinds that you've heard from across the industry, we feel very good about our ability to sustain above market growth and achieve something in excess of 20% for 2025 |
| I think heading into 2025, our position is going to get even stronger |
| And again, our competitive position of Stars is improving |
| At the same time, to your point on the margin side of things, I think that growth affords us continued SG&A economies of scale heading into 2025 |
| Beyond MBR, the entirety of our adjusted EBITDA margin expansion is driven by an improving SG&A ratio year-over-year |
| I think from a utilization standpoint, to your comment, I think we feel pretty good about what we're seeing on the inpatient side thus far |
| Looking ahead to 2025 and beyond, we are confident about our continued ability to drive above-market growth and profitability improvements |
| We see growth tailwinds from widening Stars advantages and our conservative position on risk adjustment |
| Statement |
|---|
| Lastly, our adjusted EBITDA was negative $35 million |
| Lastly, our adjusted EBITDA was negative $20 million |
| More recently, during the fourth quarter, we saw a 7% year-over-year decline in inpatient volume |
| Subsequent to the release of our January 8-K, we saw $2 million of adverse development in our ACO REACH line of business related to fourth quarter days of service |
| Part D is also much less profitable in the first half of the year as compared to the second half, particularly in the first quarter |
| Utilization trends for the full year and fourth quarter 2023 showed year-over-year declines |
| And I think that a lot of the noise around reimbursement is somewhat a function of people's Star ratings going down |
| And unless you have the tools that we have, it is very difficult to kind of get the kind of outcomes that we'd be able to achieve in Stars in particular |
| The interesting thing is we think that by doing it in California, we think it's the hardest thing anywhere in the country |
| I think also V28, the impact of V28 is affecting everybody but it's affecting us less |
| Adjusted EBITDA was a loss of $35 million, consistent with our comments from our January 8, 8-K |
| Does that -- it seems like because the half is not really capitated and driven by AVA it's going to outperform, does that create any pressure in your relationship with the physicians? Like is that to their detriment if others aren't |
| This trend continued to persist into January 2024 |
| And it's affecting us less because we knew heading into the year that some kind of reimbursement risk is going to be something we had to deal with |
| And you put that in the context of some others that have been more aggressive on risk adjustment that are going to go down, in some cases, 20% |
| And some organizations, if you go down from 4.5 to 3.5 Stars, that's close to a 10% hit to reimbursement |
| Jessica Tassan And then I guess I just -- I was hoping to understand when you described 82% of AEP adds coming from member switching despite the fact that supplemental benefits are only up or value is only up modestly year-over-year |
| We're just going to get hit less in our particular markets because of the way we manage risk adjustment |
Please consider a small donation if you think this website provides you with relevant information