Weekly Health Tech Reads | 5/11/25

👋 Hey all! Kevin here. Welcome to this edition of my free weekly newsletter, where I discuss the key healthcare innovation news from the past week.

This week was the one week each quarter where most public health tech companies decide to report earnings. I highlighted six of the more interesting earnings calls below — agilon, Evolent, Clover, Hims, Oscar, and Privia. There were some major stock swings among those companies, both for better (Oscar & Hims) and worse (agilon and Evolent). And then to cap off the week, Omada decided to drop its S-1 on Friday afternoon. More below.

Happy Sunday!
- Kevin

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Q1 EARNINGS

A Rundown of Key Health Tech Earnings Reports

Here’s a rundown of key earnings reports this week with a few thoughts from the various calls:

Oscar Health (release, transcript)
▲ 31% for the week 

• Oscar posted a good quarter as it generated $275 million of net income on the quarter and reaffirmed guidance for the year. The standout of the quarter was Oscar’s improvement in SG&A, which came in at 15.8%, a 2.6% improvement year-over-year. This performance was driven by a few factors: fixed cost leverage (40% of the improvement), lower broker taxes and fees (45% of the improvement), and variable cost efficiency (15% of the improvement). These improvements will help Oscar drive significant margin expansion in 2025 and beyond, which I’d imagine had a lot to do with the stock jump this week.

• An analyst asked about the impact of CVS exiting the ACA market, and Oscar noted it’ll be an opportunity come 1/1/2026 for Oscar as there is significant overlap with CVS’s membership, and noted CVS has a pricing issue that Oscar expects it could avoid.

• This was an interesting comment from Oscar on the potential pricing challenge the ACA may have in 2026: “We may have a pricing issue as we get into the 2026 market versus where we've been, which is at or below CPI, largely because there's a high single-digit impact of both integrity regulations and enhanced premium credits that will be the basis before we apply trend going forward. So that could be a major change. It would have an impact. We believe that now that we sit at 8% uninsured that we could get back into double digits if that should happen. But we're watching all of that happen in front of us.”

• The ICHRA conversation during the call was not particularly tangible. After being asked by an analyst about progress in ICHRA, Oscar talked vaguely about there being increased momentum around ICHRA. But Oscar also seemed to note that some regulatory changes are needed to really drive momentum, because there is always resistance that comes up.
  

Hims & Hers (release, shareholder letter, transcript)
▲ 20% for the week 

• Hims shared a new long term growth target — by 2030 it expects to generate $6.5 billion in revenue and $1.3 billion in adjusted EBITDA. That’d be impressive growth and margin expansion over its 2024 numbers, which were $1.5 billion of revenue and $177 million of adjusted EBITDA. As part of achieving that long term target, Hims articulated five key growth pillars moving forward:

  1. Personalized solutions. Hims plans to move from hundreds to thousands of treatments, powered by data from labs and wearable devices.

  2. Expansion into “emotionally resonant specialties”, including low testosterone and menopause support this year. Longevity, sleep and preventative care are all big long term areas for Hims.

  3. Convenient precision care. Not much was shared specifically on this.

  4. Partnerships to become a best-in-class curator of services. I don’t think it was explicitly stated, but presumably this referred to the Novo partnership given some of the other comments on that relationship (see more below).

  5. Global expansion. Hims pointed to early UK traction as evidence here.

• Hims discussed a rather large pivot in its sexual health category, shifting away from an “on-demand” product towards a daily product that is integrated with other offerings. 40% of sexual health subscribers are using a daily product currently, which as doubled year-over-year and is driving a 10% retention improvement in year 1 for a member. Hims expects volatility in the sexual health product as it makes this transition, but believes that it will drive more durable growth mid-to-long term.

• The Novo Nordisk partnership came up repeatedly, with Hims referring to it as a “pivotal milestone” that will serve as a blueprint for future partnerships to expand reach and relevance for Hims. Hims expects future collaborations like this across pharma, diagnostics companies, and provider organizations. It doesn’t necessarily seem like Hims and Novo are philosophically aligned from the call — particularly in terms of “personalized” doses versus commercial doses — but rather Hims now has enough members that it feels like it has the negotiating power to bring organizations like Novo to the table.

• Marketing spend dropped to 39% of revenue for the quarter, a 8% year-over-year improvement, even with a 1-minute Super Bowl ad. Hims noted it is seeing more subscribers join the platform through organic and low-cost channels.

• Hims was asked it it will ever take insurance at some point in time. The response from Hims CEO: “No, I have very, very low interest in figuring out how to integrate insurance.” He makes a pretty compelling argument here IMO, suggesting that many patients coming to Hims are insured but are choosing to pay cash because nobody is getting the benefit of insurance.

agilon health (release, slides, transcript)
▼ 31% for the week

• agilon membership fell year-over-year from 523,000 members in Q1 2024 to 491,000 in Q1 2025. Medical cost trend remained elevated in Q1, as agilon expected. agilon’s year 2+ markets saw trend of 5.5% in Q1 versus 6.7% in Q1 2024. agilon expects trend to run 1.5% lower in 2025 because of payor bids and the two-midnight rule.

• agilon has 50% of its membership up for renewal on January 1st, 2026, and it will continue to push payors on reducing agilon’s exposure to Part D risk. agilon has had one small payor agree to reduce this risk. Analysts asked a number of questions about agilon returning to growth in 2026 and what that looks like. agilon noted the intent to move into risk contracts as quickly as possible, but it is too early for them to know if they’re going to take a glide path approach again in 2026.

• agilon hinted toward the end of the call that oncology is going to be a big area of focus for it moving forward, and it sees a large opportunity for its PCPs to work with community oncologists.

• Listening to the earnings call, I don’t fully understand what drove the stock down 30%+ this week. Yes, declining membership isn’t good, but it actually seems like for the first time in a while agilon is back to executing as anticipated. There will be a number of questions agilon faces going forward as it attempts to get back to growth in the future, but I’m not sure I see the 30% stock decline.

Privia Health Group (release, slides, transcript)
▲ 8% for the week 

• Privia is raising its guidance to target the mid-to-high end of the previous range it provided investors on the heels of a strong quarter and the acquisition of IMS in Arizona.

• Privia spent a good deal of time on the call discussing the acquisition of IMS, which it announced in April as its anchor practice in Arizona. Privia purchased IMS, which has 70 providers and ~28,000 VBC patients, for $95 million. Interestingly it appears that IMS has previously used another provider enablement platform, which presumably Privia will replace.

• Privia continued its cautious tone towards VBC contracts, sharing that it does not expect to enter into fully capitated contracts with payors. It will do so only if it feels it is getting compensated for taking that risk, but otherwise it prefers to enter shared risk arrangements with payors.

Clover (release, transcript)
▲ 5% for the week (was up 12% after earnings)

• Clover had a strong Q1, leading it to raise EBITDA guidance and reiterate membership and revenue guidance for the year. It seems like Clover is sitting in a good position for 2026 as it continues to hit its stride as an MA plan. Clover will achieve quality bonus payments associated with hitting 4-stars, while also benefitting from the final rate increase, and further maturation of its membership base.

• Clover noted that the majority of its MA growth has occurred in New Jersey, where it has a strong penetration of Clover Assistant (which makes sense given its roots as a provider-sponsored health plan in NJ). This prompted some interesting questions from analysts, curious about how much Clover continue to grow in NJ now that it has 20%+ market share. Clover still feels it can grow there before being saturated in the market. I think Clover’s ability to consistently perform outside of New Jersey will be one of the key questions to watch for Clover moving forward.

• The update on Counterpart Health, Clover’s attempt to sell the Clover Assitant to third parties, was underwhelming. In the opening remarks, Clover noted the pipeline is growing and that Clover is hiring implementation resources to ensure successful onboarding for their partners. Longtime readers will recall the implementation issues that +Oscar had when embarking on a similar endeavor, so its an odd comment to see from Clover. When asked for more detail on when to expect it to start contributing financially to the organization, Clover noted they’ll be talking more about that as the quarter progresses.

Evolent Health (release, transcript)
▼ 15% for the week

• Evolent noted it is seeing oncology trend coming in “modestly lower” than the 12% it had expected, driven by it successfully guiding oncologists towards high quality, low cost care options. While it did not adjust EBITDA outlook for FY 2025, it did note that the current outlook assumes a 12% trend, and given the Q1 trend it seems like there is room for outperformance.

• 85% of Evolent’s savings in oncology is from non-UM efforts, including peer-to-peer consults, provider quality incentives, and practice transformation. 15% of savings is driven by UM, and it expects that will be a much smaller % in the near term. Evolent plans to add patient navigation capabilities as a third leg to drive incremental savings of 10% - 20%, noting that this is Part A savings versus Part B savings, where Evolent has traditionally focused.

Other Health Tech Earnings Calls:

• Astrana (release, transcript) ▼ 8% for the week

• GoodRx (release, transcript) ▼ 7% for the week

• Health Catalyst (release, transcript) ▲ 1% for the week 

• NeueHealth (release, transcript) ▼ 1% for the week

• Talkspace (release, transcript) ▼ 5% for the week

DIGITAL HEALTH S-1

Omada Health files its S-1, publicly starting IPO process

Long-time digital health darling Omada Health publicly filed its S-1 late on Friday afternoon, joining Hinge Health as the second digital health company having filed an S-1 in the past few months.

Since launching in 2011, Omada has grown to serve 2,000+ customers and 679,000 members enrolled in its programs as of March 31, 2025. Omada grew revenue 38% in 2024, generating ~$170 million of revenue across its four key products: prevention / weight health, diabetes, hypertension, and MSK. Omada sells primarily through channel partners, with partners representing 90% of its customers. The chart below demonstrates the breakdown of Omada’s 20 million lives that currently have access to it as a covered benefit, heavily weighted towards commercial self-insured lives:

Cigna plays a significant role in the story here as a key growth partner for Omada, with partners that appear to be Cigna Healthcare and Express Scripts representing the two largest revenue channels for Omada, accounting for just over 50% of Omada’s revenue the past few years. In 2024 Omada received $89.9 million in payments from its MSA with Evernorth, which represented 53% of its $169.8 million in revenue that year. Omada also made payments back to Cigna of $17.2 million in 2024. Cigna Ventures is also one of the five largest shareholders in Omada, owning ~7% of the company.

Omada has raised $500+ million over the life of the business, last raising $192 million in early 2022 at a valuation over $1 billion. At that time, Omada reported that it had 1,700 customers and 550,000 members. That would imply a CAGR of 5.5% for customers and 7.2% for members over the past three years. Omada must have changed how it defines members along the way, because in the S-1 Omada reports having had only 299,000 members at the end of 2022:

Omada refers to itself at one point in the document as an “anti-point solution”, pointing to the fact that 31% of its customers use more than one Omada solution as proof of this. While the S-1 notes this number has doubled over the past three years, you can also see in the 2022 funding announcement that Omada reported that 32% of its new deals in 2021 were multi-product contracts. This multi-product growth seems like one of the key pieces of Omada’s growth story, so it will be worth keeping an eye on how it grows that time.

One of the more interesting strategic points of the S-1 is how heavily Omada emphasizes the human component of its care model, describing its combination of people and technology, termed “Compassionate Intelligence,” as a key competitive advantage. At one point, Omada noted that many digital health solutions have failed in part because of under-estimating human relationships. Omada spent a good deal of time in the S-1 describing its care team and how its technology platform supports those care teams in providing a personalized experience. Compare that to the recent Hinge Health S-1, for example, and you can see the difference in narratives — Hinge’s S-1 was very much about automating care delivery, while Omada’s is much more about enabling its care teams.

It’s going to be worth to watch how the public markets react to both Omada and Hinge, along with whichever other digital health companies file an S-1 in the coming weeks. They make for very good comparable companies for potential investors. Reading both S-1s, its hard to envision public equity investors getting overly that excited about the opportunity selling digital health tools to employers, particularly given some of the challenges other public companies have had in that market over the past several years.

Take Omada’s S-1 as a good example of this — you have a best-in-class company that by all accounts has invested heavily in doing things right (i.e. see the amount of clinical evidence it has generated). Yet if you’re an investor, you have to grapple with the fact that it has taken $500+ million in capital to grow this business to $170 million of annual revenue over 14 years, and the business is still running at a negative 25% operating margin in 2024. All of this while having a huge revenue concentration risk via its relationship with Cigna. It just seems like a tough business to continue successfully driving scale in over time.

All that said, I imagine that everyone working in digital health — founders, employees, investors, and interested observers alike — will be watching and hoping that these IPOs go out successfully.

Strategy and Transformation Manager at SCAN Health Plan, a not-for-profit Medicare Advantage health plan. Learn more.
$106k - $170k | Long Beach, CA

Founding Engineer at Legion Health, a AI-native operations layer for psychiatric care. Learn more.
$120k - $180k | San Francisco

Chief Brand & Divisional Marketing at Providence, a large not-for-profit health system. Learn more.
$280k - $350k | Renton, WA

Sr. Director of Data and Analytics at Visana, a virtual women’s health clinic. Learn more.
$NA | Remote

Product Manager 3 - MyBSWHealth Membership Experience at Baylor Scott & White Health, a large not-for-profit health system. Learn more.
$87k - $151k | Remote

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