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Variable Interest Entities
 12 Months Ended
Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Variable Interest Entities
NOTE 18. Variable Interest Entities
Consolidated Variable Interest Entities
agilon health, inc.’s consolidated assets and liabilities as of December 31, 2024 and 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):
December 31,
20242023
Assets
Cash and cash equivalents$78,650 $62,154 
Restricted cash equivalents5,627 6,757 
Receivables, net1,015,753 940,618 
Prepaid expenses and other current assets, net17,725 21,907 
Property and equipment, net1,255 1,754 
Intangible assets, net49,406 25,561 
Other assets, net4,790 6,334 
Liabilities
Medical claims and related payables931,664 737,724 
Accounts payable and accrued expenses199,432 188,671 
Other liabilities2,270 4,184 
Risk-bearing Entities. At December 31, 2024, the Company operates 33 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, net; 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 December 31, 2024, the Company had 12 equity method investments (liabilities), including 10 wholly-owned CMS ACO Models entities discussed below, 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. During 2023, 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 December 31, 2024, the CMS ACO Models investments had $65.2 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):
December 31,
20242023
Equity method investments - Other(1)
$9,365 $9,148 
Equity method investments - CMS ACO Models(1)
52,391 35,605 
Equity method liabilities - CMS ACO Models(2)
(12,290)(1,199)
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(1)Included in Other assets, net in the consolidated balance sheets.
(2)Included in Other liabilities in the consolidated balance sheets.
The Company is a partner in ten wholly-owned CMS ACOs in collaboration with 15 of its physician group partners operating in 13 geographies as of December 31, 2024. The combined summarized operating results of the Company’s CMS ACO Models investments, which are recognized as equity income (loss), are as follows (in thousands):
Year Ended December 31,
202420232022
Medical services revenue$1,814,618 $1,160,978 $1,071,302 
Medical services expense(1,667,806)(1,024,468)(991,565)
Other medical expenses(1)
(89,788)(96,154)(52,041)
Income (loss) from operations22,687 22,500 14,294 
Net income (loss)(2)
15,050 16,336 10,556 
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(1)The years ended December 31, 2024, 2023, and 2022, include physician compensation expenses of $58.4 million, $53.7 million, and $27.1 million, respectively. The year ended December 31, 2023, includes $15.2 million of physician compensation expenses to reduce the physician partners’ compensation percentage in current and future years in exchange for the Company’s common stock. The Company recognized such liability in accounts payable and accrued expenses as of December 31, 2023. The common stock shares were issued in February 2024.
(2)Included in Income (loss) from equity method investments in the consolidated statement of operations. The years ended December 31, 2024, 2023, and 2022, includes operating and administrative expenses for services provided by the Company of $14.9 million, $2.9 million, and $2.8 million, respectively.

The combined summarized balance sheet of the Company’s CMS ACO Models investments are as follows (in thousands):
December 31,
20242023
Current assets$444,963 $174,967 
Noncurrent assets1,894 3,341 
Total assets446,857 178,308 
Current and total liabilities406,756 142,027