ASTRANA HEALTH, INC. Apollo Medical Holdings
November 2023
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Forward-looking Statements
This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward- looking statements include any statements about the Company's business, financial condition, operating results, plans, objectives, expectations and intentions, expansion plans, estimates of our total addressable market, integration of acquired companies and any projections of earnings, revenue, EBITDA, Adjusted EBITDA or other financial items, such as the Company's projected capitation and future liquidity, and may be identified by the use of forward-looking terms such as "anticipate," "could," "can," "may," "might," "potential," "predict," "should," "estimate," "expect," "project," "believe," "plan," "envision," "intend," "continue," "target," "seek," "will," "would," and the negative of such terms, other variations on such terms or other similar or comparable words, phrases or terminology. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company's reports to the U.S. Securities and Exchange Commission (the "SEC"), including without limitation the risk factors discussed in the Company's Annual Report on Form 10-K/A for the year ended December 31, 2022, and subsequent Quarterly Reports on Form 10-Q.
Because the factors referred to above could cause actual results or outcomes to differ materially from those expressed or implied in any forward-looking statements, you should not place undue reliance on any such forward-looking statements. Any forward-looking statements speak only as of the date of this presentation and, unless legally required, the Company does not undertake any obligation to update any forward-looking statement, as a result of new information, future events or otherwise.
Use of Non-GAAP Financial Measures
This presentation contains the non-GAAP financial measures EBITDA and Adjusted EBITDA, of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles ("GAAP") is net income. These measures are not in accordance with, or alternatives to, GAAP, and may be calculated differently from other non-GAAP financial measures used by other companies. The Company uses Adjusted EBITDA as a supplemental performance measure of our operations, for financial and operational decision-making, and as a supplemental means of evaluating period-to-period comparisons on a consistent basis. Adjusted EBITDA is calculated as earnings before interest, taxes, depreciation, and amortization, excluding income or loss from equity method investments, non-recurring transactions, stock-based compensation, and APC excluded assets costs. Beginning in the third quarter ended September 30, 2022, the Company has revised the calculation for Adjusted EBITDA to exclude provider bonus payments and losses from recently acquired IPAs, which it believes to be more reflective of its business.
The Company believes the presentation of these non-GAAP financial measures provides investors with relevant and useful information, as it allows investors to evaluate the operating performance of the business activities without having to account for differences recognized because of non-core or non-recurring financial information. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures,
investors are provided with a more meaningful understanding of the Company's ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the Company uses as a basis
for evaluating operational performance, allocating resources, and planning and forecasting future periods. Non-GAAP financial measures are not intended to be considered in isolation, or as a substitute for, GAAP financial measures. Other companies may calculate both EBITDA and Adjusted EBITDA differently, limiting the usefulness of these measures for comparative purposes. To the extent this Presentation contains historical or future non-GAAP financial measures, the Company has provided corresponding GAAP financial measures for comparative purposes. The reconciliation between certain GAAP and non-GAAP measures is provided in the Appendix.
The Company has not provided a quantitative reconciliation of applicable non-GAAP measure, such as adjusted EBITDA margin targets to the most comparable GAAP measure, such as net income on a forward-looking basis within this presentation because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to line items that cannot be calculated. These items, which could materially affect the computation of forward-looking GAAP net income, are inherently uncertain and depend on various factors, some of which are outside of the Company's control.
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ApolloMed at-a-glance
ApolloMed is a healthcare platform that organizes and enables providers to drive accessible, high-quality, and high-value care for all patients through a provider-centric,technology-empowered approach
The three segments of our proven business model are:
Care Partners:
Affiliated and employed provider network, empowered to take risk across all health plan lines of business to deliver integrated care
Care Delivery:
Flexible footprint of owned primary care and multi-specialty clinics with employed providers who deliver personalized care
Care Enablement:
Comprehensive technology and solutions platform, powering all providers to deliver the best possible care to all patients in their communities
A PLATFORM WITH…
SCALE
~900k | 10k+ |
Providers in | |
Total value-based lives | |
ApolloMed network1 | |
20+ | 30+ |
Payer partners | Markets |
DEMONSTRABLE CLINICAL OUTCOMES | |
49% | 46% |
Lower hospital admissions | Lower ER visits per k vs. |
per k vs. benchmark2 | benchmark2 |
FINANCIAL STRENGTH | |
$1.3B | $141M |
TTM revenue | TTM Adj. EBITDA |
Note: TTM ended September 30, 2023. For more information, see "Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" slides for more information | ||
1 | Includes contracted and employed providers in our provider network, across all specialties, and including both Consolidated and Managed providers | 3 |
2 | ApolloMed figures based on analysis of Jan-Sept 2023 internal data from all consolidated IPAs (Medicare Advantage) |
The ApolloMed model
Improves access to care
- We successfully serve our communities by building broad networks of affiliated Primary and Specialist providers and supplementing them with our employed providers
- Our flexible model meets all patients across all care settings
Powers high-quality outcomes
- Our provider-centric,purpose-built solutions drive consistency in care and superior clinical outcomes
- High-qualitycare keeps our patients healthier and happier, improving overall quality of life
Drives high-value care
- We engage patients in preventive care and coordinate high-valuecare to reduce unnecessary medical spend
- With 35+ years of experience, we have built a model that drives savings and sustainable, profitable unit economics
10,000+ | 49% | ~1,500bps |
Employed and affiliated providers1 | Lower hospital admissions per k vs. benchmark2 | Decrease in MCR from 2019-YTD Q3 20233 |
In the communities we serve, our expansive network of providers delivers high-quality and high-value coordinated care to patients, with
seamless and flexible access
1 Includes contracted and employed providers in our provider network, across all specialties, and including both Consolidated and Managed providers
2 | ApolloMed figures based on analysis of Jan-Sept 2023 internal data from all consolidated IPAs (Medicare Advantage) | 4 |
3 | MCR, or Medical Cost Ratio, calculated as Cost of services, excluding depreciation and amortization, divided by Total Revenue; based on ApolloMed's Core SoCal market, comprised of ~236k members in |
2019 and ~319k members as of 09/30/2023
The ApolloMed model transforms the status quo into a highly coordinated, high- value, accessible healthcare ecosystem
Status Quo
- Insufficient / costly access to quality care
- Poor provider and patient satisfaction
- Limited technology and coordinated care
The ApolloMed Model
+ ~20 Others
Affiliate providers
Care Delivery
Risk-bearing organization (Care Partners)
Care Enablement
TECHNOLOGY SUITE | CLINICAL AND COORDINATED | PAYER AND ADMINISTRATIVE | ||
SOLUTIONS | CARE SOLUTIONS | SOLUTIONS | ||
- We organize and partner with providers to create risk-bearing organizations in our Care Partners
("CP") segment - Our CP entities contract with payers, entering value-based care
("VBC") arrangements - Through our Care Enablement platform, we provide comprehensive technology and support solutions to providers
- We constantly analyze our networks and build/acquire centers in our Care Delivery business to enhance access and care
Through our flexible approach, we plan to continue organizing and empowering providers across the U.S., accelerating towards a future
where all Americans have access to high-quality,high-value, and accessible healthcare
5
Our flexible model optimizes delivery of accessible, high-quality,high-value care
Affiliate providers
Care Delivery
Risk-bearing organization (Care Partners)
+ ~20 Others
Care Partners
Affiliate Providers | |
Primary Care | Ancillary Services |
Multi-Specialty | Outpatient Clinics |
Care Delivery | |
Primary Care | Ancillary Services |
Multi-Specialty | Outpatient Clinics |
Care Enablement
Third-Party | TECHNOLOGY SUITE SOLUTIONS | |||
Clients | ||||
Ops | VBE1 Suite & | Point of | Analytics & | |
Automation | Data Lake | Care Tools | Reporting |
- Value-BasedEnablement
- Utilization Management
CLINICAL & COORDINATED CARE SOLUTIONS
Quality | Clinical | Remote Patient | UM2 & Care |
Programs | Monitoring | Management | |
PAYER AND ADMINISTRATIVE SOLUTIONS
Provider | Contracting & | Revenue | Prior |
Relations | Credentialing | Cycle | Authorization |
6
Care Partners: High-performing network of aligned provider partners
+ ~20 Others
Care Partners
Affiliate Providers | Care Delivery | ||
Primary Care | Ancillary Services | Primary Care | Ancillary Services |
- Acts as a "single payer" for our network of providers, enabling VBC arrangements (i.e., full-risk contracts)
- Serves all patients, including Medicare FFS, Medicare Advantage, Medicaid, Commercial and Exchange
- Enables continuity of care in ApolloMed's ecosystem across age, stage of life, or life circumstance
- Empowers providers, with support from our ApolloMed Care Teams, Care Enablement technology, and operations platform
- Meets providers where they are; enables independent providers to remain independent while succeeding in value-based care
Multi-Specialty Outpatient ClinicsMulti-Specialty Outpatient Clinics
Care Enablement | 6,200+ | 575k+ | ~90% | 10-20% | ||
Affiliated | Members in VBC | ApolloMed's | Long-term EBITDA | |||
TECHNOLOGY SUITE | CLINICAL AND COORDINATED | PAYER AND | Providers1 | Contracts | Revenue Mix2 | Margin Target |
ADMINISTRATIVE | ||||||
SOLUTIONS | CARE SOLUTIONS | |||||
SOLUTIONS | ||||||
Note: See "Use of Non-GAAP Financial Measures" slide for more information | ||
1 | Includes contracted and employed providers in our provider network, across all specialties, and including only Consolidated providers | 7 |
2 | As of the TTM period ending September 30, 2023; ApolloMed standalone data (does not pro forma for CFC acquisition) |
Care Delivery: Extensive, high-quality network of employed providers
+ ~20 Others
Care Partners
Affiliate Providers | Care Delivery | ||
Primary Care | Ancillary Services | Primary Care | Ancillary Services |
- Primary care, multispecialty care, imaging, and laboratory clinics with 61 locations across 3 states to enhance access to care for patients
- We analyze our Care Partners networks by specialty and geography, and build / acquire practices and provider groups to fulfill network gaps in access, and ensure patients have high-quality access to care
- Ability to build out clinics tailor-made for specific markets help us scale as we enter de novo into new markets
- Provides ApolloMed with a de-risked growth avenue, as we can acquire high-performing Care Partners or Care Enablement clients
Multi-Specialty Outpatient ClinicsMulti-SpecialtyOutpatient Clinics
Care Enablement | 61 | >700k | ~5% | 10-20% | |
Locations | Unique Patients | ApolloMed's | Long-term EBITDA | ||
TECHNOLOGY SUITE | CLINICAL AND COORDINATED | PAYER AND | Seen Annually | Revenue Mix1 | Margin Target |
ADMINISTRATIVE | |||||
SOLUTIONS | CARE SOLUTIONS | ||||
SOLUTIONS | |||||
Note: See "Use of Non-GAAP Financial Measures" slide for more information | |
1 As of the TTM period ending September 30, 2023; ApolloMed standalone data (does not pro forma for CFC acquisition) | 8 |
Care Enablement: End-to-end integrated clinical, operational, financial, and administrative platform
+ ~20 Others
Care Partners | Care Partners Care Delivery |
Affiliate Providers | Care Delivery | ||
Primary Care | Ancillary Services | Primary Care | Ancillary Services |
- Our technology and support platform enhances delivery of high- quality and high-value care to our patients
- Our Care Enablement tools are leveraged across our Care Partners and Care Delivery lines of business
- Our Care Enablement solutions are also used by 3rd party providers outside of our ecosystem
- Our platform is underpinned by 35+ years of real-world data, driving superior clinical and financial outcomes
Multi-Specialty Outpatient ClinicsMulti-Specialty Outpatient Clinics
Care Enablement | 10,000+ | ~900k | ~5% | 20-30% | ||
Providers in | Members in VBC | ApolloMed's | Long-term EBITDA | |||
TECHNOLOGY SUITE | CLINICAL AND COORDINATED | PAYER AND | ApolloMed | Contracts | Revenue Mix2 | Margin Target |
Network1 | ||||||
ADMINISTRATIVE | ||||||
SOLUTIONS | CARE SOLUTIONS | |||||
SOLUTIONS | ||||||
Note: See "Use of Non-GAAP Financial Measures" slide for more information | ||
1 | Includes contracted and employed providers in our provider network, across all specialties, and including both Consolidated and Managed providers | 9 |
2 | As of the TTM period ending September 30, 2023; ApolloMed standalone data (does not pro forma for CFC acquisition) |
Our proprietary & purpose-built technology platform leverages 35+ years of real-world clinical data to drive scalable and repeatable results
Provider Empowerment
and Engagement
- All-in-onepoint-of-care tool for both providers and practices
- Check member eligibility
- Submit & receive auto-approval for prior authorizations
- View & act on quality and risk adjustment gaps
- Collaborate with Care Teams1
- View longitudinal patient records, SDOH2, and population health data
90%+
Members with active PCP3
Care Management & Patient
Outcomes
- Intelligent patient population risk stratification
- Focused and purposeful member Care Management Plans to ensure evidence-based solutions and responses
- 250 full-time employees on our Care Team2, improving delivery of care and patient outcomes
~100%
Member satisfaction rate4
Population Health and Analytics
- NCQA-certifiedHEDIS® engine drives actionable insights for providers, closing gaps in care
- Composable "Command Center" dashboard highlights trends5 and opportunities to improve access and quality for patients
- Care access analytics highlights provider network opportunities
~60%
Gaps in care closed
through portal6
Operating Leverage
- Scalable platform yields meaningful operating leverage
- 65% prior authorizations are automatically approved, driving increased access for patients
- Ability to demonstrably improve operating leverage for third- party Care Enablement clients
94%
Claims adjudicated
automatically
Note: All images presented are for illustrative purposes only
- ApolloMed's Care Team includes MDs, NPs, PAs, RNs, LVNs, etc.
- SODH = Social Determinants of Health
- Indicates percentage of members attributed to a Primary Care providers that actively uses Provider Empowerment and Engagement tools.
- Member satisfaction rate, based on members engaged by ApolloMed's Outpatient Care Management Team in 2023
- Trends are customizable by specialty, by region, with trends in prior authorization counts, utilization, costs, among other trends
- ~60% of total possible gaps in care identified YTD as of 9/30/2023 were closed through our portal
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Disclaimer
Apollo Medical Holdings Inc. published this content on 01 December 2023 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 01 December 2023 14:47:36 UTC.
