AGL · agilon health

The thesis

agilon health has turned profitable on its medical book two quarters running, and it roughly doubled its full-year adjusted EBITDA (earnings before interest, taxes, depreciation and amortization) guidance on 4 November 2026. That gives the shares a modest edge over the S&P 500 for the next three months. The case is settled by whether 2027 can hold these margins without the one-time true-ups that helped 2026. The 17 November 2026 investor event gives the first look, and the fourth-quarter report gives the first 2027 numbers.

The 4 November 2026 results release reported Q3 2026 revenue of $1.52 billion, up 6% year over year. Net income was $35 million, against a net loss of $110 million a year earlier. Adjusted EBITDA was $64 million, against negative $91 million. The medical services expense ratio, which is medical costs as a share of revenue, was 88.5% against 104.0%.

Full-year guidance moved up on every line. Adjusted EBITDA guidance is now $145–$155 million, up from $75–$95 million. Revenue guidance is $5.870–$5.890 billion, up from $5.775–$5.860 billion. The expense ratio guide is 90.3%–90.5%, down from 91.4%–91.9%.

At the 12 November 2026 close of $110.30, the shares sit 17.1% below the 52-week intraday high of $133.04 set on 17 July 2026. The market has priced in the 2026 recovery but not a confident 2027. Targets keep rising. StoneX kept a Buy rating and raised its target to $145 on 11 November 2026, according to Benzinga. The rating is Medium because the guidance raise is a real change in earnings power, while the one-time items and a weaker 2027 contracting tailwind remain open.

Bullish and bearish views on agilon health, inc.

The bull case on agilon health, inc. (AGL), in brief: guidance rose by about $70 million. The bear case: part of the beat is one-time.

Bull case

• Guidance rose by about $70 million. Full-year adjusted EBITDA guidance went to $145–$155 million from $75–$95 million, per the 4 November 2026 results release.
• Cost ratio fell 15.5 points. The Q3 2026 medical services expense ratio was 88.5%, against 104.0% a year earlier, per the same release.
• Three firms raised targets in a week. StoneX raised its target to $145 on 11 November 2026 (Benzinga). Deutsche Bank kept Buy and raised to $139 from $116 on 6 November 2026. Evercore ISI kept In-Line and raised to $105 from $95 on 5 November 2026.
• The ACO book is set to grow. Management expects accountable care organization (ACO) membership to grow 40% to 50% in 2027, to about 160,000, according to TipRanks' 8 November 2026 summary of the earnings call. ACO membership was 112,000 on 30 September 2026.
• Cash is building. Cash, cash equivalents and marketable securities were $312 million at 30 September 2026, against total debt of $32 million, per the Q3 release. Earnings Whispers reported on 4 November 2026 that management raised its year-end cash floor to at least $175 million from $125 million.
• Medicare Advantage stopped shrinking sequentially. Medicare Advantage members were 454,000 at 30 September 2026, up from 426,000 in Q1 and 437,000 in Q2, per Earnings Whispers' 4 November 2026 recap.

Bear case

• Part of the beat is one-time. Earnings Whispers counted $14 million of prior-year development, a $23 million year-to-date risk-adjustment true-up, $12 million of first-half cost-trend favorability and $7 million of prior-year ACO contribution in its 4 November 2026 recap.
• The 2027 contracting tailwind shrinks. Payor contracting added $127 million in 2026, and about 80% of contracts have already been repriced, so management expects a smaller benefit in 2027, per Earnings Whispers on 4 November 2026.
• Q4 implies a loss. The raised guide, after $187 million of adjusted EBITDA in the first nine months, implies a Q4 2026 adjusted EBITDA loss of roughly $32–$42 million, per Earnings Whispers' 4 November 2026 calculation.
• Cost trend is rising. Management put first-half 2026 cost trend in the low-6% range and Q3 in the low-7% range, per TipRanks' 8 November 2026 call summary.
• Receivables are swelling. Receivables rose to $1.02 billion at 30 September 2026 from $674 million at the 2025 year-end, per Earnings Whispers, while year-to-date operating cash flow was only $16 million.

Price setup

The shares closed at $110.30 on 12 November 2026, down from $114.81 on 11 November 2026. Every close from 5 November to 12 November 2026 fell between $110.30 and $114.02 or $114.81, so the post-report gain has held for six sessions.

In adjusted daily closes, the 50-day moving average is $90.24 and the 200-day moving average is $68.67, both as of 12 November 2026. The price sits well above both. The shares are up 13.8% over three months, from a $96.90 close on 14 August 2026.

The 52-week intraday high is $133.04, set on 17 July 2026. The last close is 17.1% below it. A return toward that high would need the 2027 picture to confirm that 2026 margins are repeatable.

SEC Form 4 filings show no open-market insider sales into the rally. The most recent, filed 18 August 2026, records 17 shares withheld for tax by the chief accounting officer.

Catalysts ahead

• 17 November 2026: Virtual investor event, "Driving Performance At Scale: The agilon Framework", 2:00 PM ET. Management covers clinical strategy, technology and quality with a live Q&A; any 2027 membership or margin detail shows whether 2026 margins can hold without one-time true-ups.
• 31 December 2026: Final performance year of the CMS ACO REACH model ends. About 112,000 ACO members move into successor programs; the 2027 target of about 160,000 ACO members depends on that transition.
• ~25 February 2027 (est.): Q4 and full-year 2026 results with first 2027 guidance. Tests delivery of the $145–$155 million adjusted EBITDA guidance and the $175 million year-end cash floor, and sets the 2027 earnings baseline.

What would change the view

A daily close below $90, just under the 50-day moving average, which would erase the re-rating that followed the 4 November 2026 report. A cut to the $145–$155 million 2026 adjusted EBITDA guidance, or year-end 2026 cash below the $175 million floor, would also break the case.

The risks this note tracks, each with what would confirm it:

• 2026 margins depend on one-time prior-period development and risk-adjustment true-ups that do not recur in 2027. Confirmed by: a 2027 outlook at the 17 November 2026 event or in Q4 guidance implying adjusted EBITDA well below the 2026 range of $145–$155 million.
• Medical cost trend keeps rising from the low-6% range of the first half of 2026. Confirmed by: Q4 2026 cost trend reported above the low-7% range of Q3, or a full-year expense ratio above 90.5%.
• Medicare Advantage membership contracts faster than ACO growth offsets it. Confirmed by: 2027 guidance showing Medicare Advantage members below 454,000 with ACO membership short of the 40%–50% growth target.
• Profits stay on paper as receivables build and cash conversion lags. Confirmed by: year-end 2026 cash below the $175 million floor, or receivables rising further from $1.02 billion at the Q4 report.
• The ACO REACH to successor-program transition disrupts 2027 ACO contracting. Confirmed by: company disclosure that fewer than about 160,000 ACO members are contracted for 2027.

What it trades with

agilon health trades mainly on its own medical-cost results. On 5 November 2026, Benzinga reported the Nasdaq down more than 3% in a session in which the shares closed at $113.77 after the results. Beyond company results, the shares move with Medicare Advantage cost-trend read-throughs from large insurers and with Centers for Medicare & Medicaid Services (CMS) rate notices and model changes. The shift of ACO members from the ACO REACH model to successor programs at the end of 2026 is a policy exposure that the broad market does not share.