Alignment Healthcare : J.P. Morgan 2025 Presentation

Published: 2025-01-13 09:36:04 ET ALHC

A NEW ERA OF AGING

Medicare

Advantage

Done Right

© 2025 Alignment Healthcare USA, LLC. All Rights Reserved. Alignment Healthcare is a registered trademark with the U.S. Patent and Trademark Office.

Breakout 2024 Execution Creates Foundation to Scale in 2025 & Beyond

2024

Scale and Momentum

2025

Steady Growth & Margin Expansion

Notes:

1. Based on full-year 2024 guidance midpoint provided as of Oct. 29, 20243

2. Adjusted SG&A divided by revenue excluding ACO REACH. Adjusted SG&A defined as adjusted gross profit minus adjusted EBITDA

Founded through Personal Experience

& Built through Lessons Learned

Personal Experience

Lessons Learned in Healthcare

FHP International

Vertical Integration, One of

the First MA Contracts

Provider Partnerships,

1 million MA Seniors

Core Systems, Technology and

Supply Chain Operations

Chronic Care Management

4

A Differentiated Approach to Medicare Advantage

Alignment Principles of Success in Medicare Advantage: Transparency, Visibility, Control, Durability

Approach MA as a care management business: not an

Daily clinical meetings, joint operating sessions with providers,

emphasis on clinical gap closures, care delivery though home-

actuarial pricing business

based health and senior advocacy.

Commitment to clinical excellence: investing in

~4% of medical expenses for at-risk members invested in

employed clinical resources to provide more care

employed clinical model, including >400 employed clinical

to high-risk seniors

staff comprising ~25% of full-time employees.

Managing risk and caring for seniors is our core

competency: preference to assume financial risk

64% of members in at-risk contracts.

and upside instead of globally capping

Actionable data to empower clinical decisions: Operate

AVA technology: 200+ unique data sources, 250+ dashboards,

with daily visibility into key utilization & clinical metrics

40+ workflow and engagement applications, 200+ AI models.

Business model designed to scale: capital-efficienthome

Not dependent on owned brick and mortar clinics. Empower,

and virtual care model focuses on 20% of members that

instead of compete with, existing community doctors. Allows

represent 80% of institutional costs

for capital-efficient replicability.

5

This is How We Win: The Virtuous Cycle - Doing Well by Doing Good

High Quality and Low Cost Create Durable Competitive Advantages

5

Y

R

E

V

I

L

E

N

D

O

I

E

T

N

C

E

I

V

T

R

E

R

S

E

&

S

U

S

T

A

I

N

A

B

L

E

G

R

O

W

T

H

1

ACTIONA

B

L

E

D

A

T

A

2

,

Y

T T

I

S

L

O

A

U

C

H

Q

W

I

G

L

O

H

• Alignment Virtual Application (AVA): Purpose-built

technology platform

• Real time member data to support health plan

operations

• Actionable insights enables timely medical intervention

by our Care Anywhere clinical teams

• Care Anywhere (CAW): Employed clinical teams who act

on AVA medical insights

• Engage with our highest-risk seniors to improve

member health

• Agile teams deployed at the home and virtually

C

S

O

I

4

M

T

P

F

E

E

TI

E

3

TIVE B

• Curated Products tailored to fit senior lifestyles

6

We Control Costs by Providing More Care

AVA stratifies members into risk categories; Care Anywhere teams proactively target interventions for chronic, high-risk members (1)

AVA | Member Risk Stratification

Care Anywhere Team

74%

5%

26% 95%

Proactive Outreach | 24/7 access |

Enhanced Care Coordination

MEMBERSHIP

INSTITUTIONAL

MEMBERSHIP INSTITUTIONAL

COSTS

COSTS

CHRONIC

HEALTHY

PR

E-CHRON

IC

HEALTHY

Physician Advanced

Medical

UTILIZER

Practice Clinician

Assistant

74%

7%

7%

12%

MEMBERSHIP

MEMBERSHIP

MEMBERSHIP

MEMBERSHIP

Social Worker

Behavioral

5%

19%

1%

74%

Health Coach

INSTITUTIONAL

INSTITUTIONAL

INSTITUTIONAL

INSTITUTIONAL

CLAIMS

CLAIMS

CLAIMS

CLAIMS

Average Member Primary Care Physician (PCP) Visits

Estimated Care Anywhere Member

Per Year: ~5 (2)

Touches Per Year: ~24 (3)

Notes:

1. Based on at-risk members

2. Based on encounter data7

3. Based on Care Anywhere eligible & enrolled members with an "Extreme" risk score. Estimated number of visits per year includes members who had an initial CAW visit plus estimates including program-based follow-up activities and engagement (telephonic and virtual).

Alignment Delivers Industry-Leading Results

Quality

>80 Care Anywhere NPS

98% of Members in

1.9% Auth. Denial Rate3: Providing Care

4.9 Google Rating1

4+ Star Rated Plans2

& Preventing Fraud, Waste, Abuse

Retention

Sales

47% Lower Voluntary

30% 5-Year

>80% of Gross Sales

Turnover vs Industry Avg.4

Membership CAGR5

Through Plan Switchers

Clinical Consistency & Replicability 6

153 Inpatient Admissions / K

150-165 Admission / K

CA Admissions / K: 152

39% better than MFFS

over past 7 years

Ex-CA Admissions / K: 148

Notes:

8

1.

Google Rating based on Alignment Health Corporate HQ rating; composite of more than 7,000 ratings as of Dec. 2024

4. Voluntary disenrollment based on CY23 CMS Stars reporting for H3815 and national avg.

2.

Plan membership as of Dec. 2024

5.

Growth CAGR based on the midpoint of 2024 year-end membership guidance provided as of October 29, 2024

3.

Based on full-year 2023 authorization data. Includes full and partial authorization denials

6.

Medicare FFS data represents 2019 Medicare FFS; ALHC data represents YTD 3Q 2024 At-Risk member utilization metrics

Case Study: Virtuous Cycle in Action

1

Medical Outcomes

2

3

Product Investment

Membership Growth

MBR (%) and Inpatient Admissions per Thousand

Average Rebate Value ($ pmpm)

Average Medicare Advantage Enrollment

95%

220

$300

3,000

90%

200

$250

2,500

85%

180

80%

160

$200

2,000

75%

140

$150

1,500

70%

120

$100

1,000

65%

100

60%

80

$50

500

2018

2019

2020

2021

2022

2023

MBR (%)

Inpatient APK

$0

0

2018

2019

2020

2021

2022

2023

2024

2018

2019

2020

2021

2022

2023

9

Our Model Enables Us to Manage Costs while Growing Quickly

YTD 3Q24 YoY Change in MBR (%) vs Change in Membership (%)

Better

Change in YTD Q3 MBR (%)

YoY

-30%

7.0%

Peer 6

Peer 1

6.0%

5.0%

4.0%

Peer 5

Alignment

3.0%

Peer 4

Healthcare

2.0%

Peer 3

1.0%

0.0%

-20%

-10%

0%

10%

20%

30%

40%

50%

60%

70%

-1.0%

Peer 2

-2.0%

-3.0%

YoY Change in Q3 MA Membership (%)

Better

10

Notes:

1. Alignment MBR reflects adj. MBR excluding ACO REACH. MBR metrics for peers represent the most comparable reported measure to an individual MA MBR. YoY membership comparisons exclude the impact of acquired membership.

Disclaimer

Alignment Healthcare Inc. published this content on January 13, 2025, and is solely responsible for the information contained herein. Distributed by Public, unedited and unaltered, on January 13, 2025 at 14:35:05.044.