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Variable Interest Entities
 3 Months Ended
Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Variable Interest Entities
NOTE 14. Variable Interest Entities
Consolidated Variable Interest Entities
agilon health, inc.’s consolidated assets and liabilities as of March 31, 2024 and December 31, 2023 include certain assets of VIEs that can only be used to settle the liabilities of the related VIE. The VIE creditors do not have recourse to agilon health, inc.
agilon health, inc.’s consolidated assets and liabilities include VIE assets and liabilities as follows (in thousands):
 March 31,
2024		December 31,
2023
Assets
Cash and cash equivalents$59,680 $62,154 
Restricted cash equivalents6,842 6,757 
Receivables, net1,569,319 940,618 
Prepaid expenses and other current assets, net21,926 21,907 
Property and equipment, net1,636 1,754 
Intangible assets, net46,578 25,561 
Other assets, net6,144 6,334 
Liabilities
Medical claims and related payables1,266,651 737,724 
Accounts payable and accrued expenses219,407 188,671 
Other liabilities5,062 4,184 
Risk-bearing Entities. At March 31, 2024, the Company operates 34 wholly-owned risk-bearing entities (“RBEs”) for the purpose of entering into risk-bearing contracts with payors. Each RBE’s equity at risk is considered insufficient to finance its activities without additional support, and, therefore, each RBE is considered a VIE. The Company consolidates the RBEs as it has determined that it is the primary beneficiary because it has: (i) the ability to control the activities that most significantly impact the RBEs’ economic performance; and (ii) the obligation to absorb losses or right to receive benefits that could potentially be significant to the RBEs. Specifically, the Company has the unilateral ability and authority, through the RBE governance and management agreements, to make significant decisions about strategic and operating activities of the RBEs, including negotiating and entering into risk-bearing contracts with payors, and approving the RBEs’ annual operating budgets. The Company also has the obligation to fund losses of the RBEs and the right to receive a significant percentage of any financial surplus generated by the RBEs. The assets of the RBEs primarily consist of cash and cash equivalents, receivables, net, intangible assets, net, and other assets. Its obligations primarily consist of medical claims and related payables as well as operating expenses of the RBEs (accounts payable and accrued expenses), including incentive compensation obligations to the Company’s physician partners. On February 18, 2021, the Company executed the Credit Facility, which is guaranteed by certain of the Company’s VIEs. Assets generated by the RBEs (primarily from medical services revenues) may be used, in certain limited circumstances, to settle the Company’s contractual debt obligations.
Unconsolidated Variable Interest Entities
As of March 31, 2024, the Company had 11 equity method investees that were deemed to be VIEs. The Company has determined that the activities that most significantly impact the performance of these VIEs consist of the allocation of resources to and other decisions related to clinical activities and provider contracting decisions. Because the Company does not have the ability to control these activities due to another party’s control of the VIEs’ board of directors, the Company has determined that it is not the primary beneficiary of and therefore does not consolidate these VIEs. The Company provided support to assist its CMS ACO Models investments in obtaining surety bonds related to risk-bearing capital contributions to CMS. As of March 31, 2024 and December 31, 2023, the ACOs had $103.0 million and $38.5 million outstanding surety bonds. The Company's maximum loss exposure as a result of the Company’s involvement with the VIEs cannot be quantified as the Company has the obligation to provide ongoing operational support to the unconsolidated VIEs, as needed.
Equity Method Investments
The following table summarizes the Company’s equity method investees (in thousands):
 March 31,
2024		December 31,
2023
Equity method investments - Other(1)
$9,477 $9,148 
Equity method investments - CMS ACO Models(1)
44,195 35,605 
Equity method liabilities - CMS ACO Models(2)
(2,284)(1,199)
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(1)Included in Other assets, net in the condensed consolidated balance sheets.
(2)Included in Other liabilities in the condensed consolidated balance sheets.
The Company is a partner in 10 wholly-owned CMS ACO Models entities in collaboration with 15 of its physician group partners operating in 13 geographies. The combined summarized operating results of the Company’s CMS ACO Models entities are as follows (in thousands):
 Three Months Ended
March 31,
 20242023
Medical services revenue$440,160 $280,529 
Medical services expense(398,792)(257,477)
Other medical expenses(1)
(25,405)(15,744)
Income (loss) from operations9,532 2,001 
Net income (loss)(2)
5,631 1,334 
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(1)For the three months ended March 31, 2024 and 2023, includes physician incentive expenses of $16.7 million and $9.7 million, respectively.
(2)Included in Income (loss) from equity method investments in the condensed consolidated statements of operations.
The combined summarized balance sheet of the Company’s CMS ACO Models entities are as follows (in thousands):
 March 31,
2024		December 31,
2023
Current assets$294,399 $174,967 
Noncurrent assets3,341 3,341 
Total assets297,740 178,308 
Current and total liabilities255,829 142,027