Healthcare · Profile from Healthcare Research Companion
agilon health, inc.
The private-equity-built platform that promised to turn established independent physician groups into full-risk Medicare Advantage businesses without buying them. agilon signed 20-year joint ventures with community physician groups, took global capitation contracts from insurers on their behalf and split the "medical margin". It went public in 2021 as one of the most valuable companies in value-based care. From 2023 it became the clearest public example of what happens when a company holds the insurance risk but not the care: medical costs rose, CMS cut risk scores, guidance was cut and then withdrawn, the CEO left, and the shares fell by more than 95% before a 1-for-25 reverse split and a 2026 turnaround attempt.
At a glance
- Founded
- Formation announced October 4, 2016, Long Beach, California, by Clayton, Dubilier & Rice (CD&R) from MSO and technology businesses in California and Hawaii
- Founders
- Ronald A. Williams (former Aetna chairman and CEO; CD&R operating advisor), with CD&R partner Ravi Sachdev; physician leaders from the acquired businesses
- Headquarters
- Company releases use both Austin, Texas and Westerville, Ohio (originally Long Beach, California)
- Ownership / structure
- Public company, NYSE: AGL (IPO April 2021). CD&R remained the largest holder (~24% as of March 2025, reported). 1-for-25 reverse stock split effective March 30, 2026
- Leadership (2026)
- Tim O'Rourke, CEO (from May 7, 2026; ex-Humana, Centene, Ascension Complete); Ronald A. Williams, Chairman (Executive Chairman August 2025–May 2026). Steven Sell was CEO June 2020–August 2025
- Segment
- Provider enablement / management services organisation (MSO) taking full-risk Medicare Advantage contracts with partner physician groups; ACO REACH participant in traditional Medicare
- Payer and patient
- Medicare Advantage plans (Humana, UnitedHealthcare, Aetna, Elevance and regional plans) pay a percentage of premium; CMS pays shared savings through ACO REACH; patients are seniors of partner primary-care groups
- Scale
- ~511,000 MA members and ~114,000 ACO beneficiaries at end-2025 (reported); ~549,000 total members at June 30, 2026 (437,000 MA, 112,000 ACO); partner groups in 30+ markets across 14 states by 2023 (reported)
- Financials
- Revenue $1.22bn (2020) → $6.06bn (2024) → $5.93bn (2025); medical margin $205m (2024) → −$57m (2025); net loss ~$391m (2025); 2026 guidance raised to ~$5.8bn revenue and ~$485m medical margin at midpoint (August 2026)
- Capital / market cap
- IPO raised ~$1.23bn gross at $23/share (April 2021); closing high $43.25 (June 2021, pre-split); fell below $1 in August 2025; market value in the hundreds of millions by 2026 (verify)
9 strategic moves analysed
Each one gets a full strategy file in the companion: context, the decision, the financing, what happened, and the lesson.
2016
CDR Formation California Hawaii MSO
Founding (private-equity build by acquisition)
2018
Physician Partnership Model Austin and Akron
Launch / business model (long-term physician joint ventures with global capitation)
2020
California Medicaid Exit and New CEO
Divestiture (three sales) and CEO appointment
2021
NYSE IPO
IPO (New York Stock Exchange, ticker AGL)
2022
Direct Contracting and ACO REACH
Partnership / entry into a CMS Innovation Center risk model
2023
Rapid Partner Expansion and Hawaii Sale
Expansion (new partner "classes") and divestiture (MDX Hawaii)
2024
Cost Trend Shock and Guidance Cuts
Failure / guidance reset (repeated cuts) and start of retrenchment
2025
Market Exits and CEO Departure
Restructuring (market and payer exits, cost cuts) and leadership change
2026
Reverse Split and Turnaround
Restructuring (reverse stock split), leadership change and operating turnaround