Cano Health Announces Financial Results for the First Quarter 2022
05/09/2022 - 06:30 AM
Maintains Full Year Guidance
MIAMI , May 9, 2022 /PRNewswire/ -- Cano Health, Inc. ("Cano Health" or the "Company") (NYSE: CANO), a leading value-based primary care provider and population health company, today announced financial results for the first quarter ended March 31, 2022 .
First Quarter Financial Results
Total membership of 269,333, including 160,306 Medicare capitated members, an increase of 130% and 112%, respectively year-over-year Total revenue of $704.3 million , an increase of 156% year-over-year Net loss of $0.1 million , benefiting from a $27.2 million fair value adjustment of warrant liabilities Adjusted EBITDA1 of $45.0 million , compared to $17.5 million in the first quarter of 2021, an increase of 157% year-over-year As of May 6, 2022 , the Company had approximately 208 million shares of Class A common stock and 277 million shares of Class B common stock issued and outstanding. Total share count for the purposes of calculating market capitalization was approximately 484 million.
"Cano Health's first quarter results reflect the continued growth of our operations and strength of our business model," said Dr. Marlow Hernandez , Chairman and Chief Executive Officer of Cano Health. "Fueled by a significant increase in Medicare members, we have more than doubled our total membership over the past year, firmly establishing us as one of the nation's largest value-based primary care providers. To meet the growing demand for our services, we continue to add capacity in key markets and build scale and density. While rapidly expanding our business, our population health platform, combined with our differentiated growth strategy, is driving sustainable and profitable growth."
Direct Contracting Entity (DCE) Program Update DCE membership at the end of the quarter was 41,201, an increase from 7,651 at the end of 2021. First quarter membership reflects updated 2022 roster reconciliations provided by the Centers for Medicare and Medicaid Services (CMS).
Total medical cost ratio (MCR)2 in the first quarter was 79.5%, reflecting the impact of DCE membership, which had an MCR of approximately 96.0%. Excluding the impact of DCE, total MCR in the first quarter was approximately 74.0%, which is below the 74.6% reported in the first quarter of 2021, prior to the start of the DCE program. The Company expects total MCR in the second half of 2022 to be significantly lower than Total MCR in the first half of 2022.
Guidance The Company is maintaining its guidance for full year 2022 provided on March 14, 2022 . The outlook for full year 2022 is as follows:
Membership in the range of 290,000 to 295,000 Total revenue in the range of $2.8 billion to $2.9 billion Total medical cost ratio (MCR) in the range of 76.0% to 76.5% Adjusted EBITDA in the range of $230 million to $240 million The Company added seven medical centers in the quarter, bringing total owned medical centers to 137, including 31 centers outside of Florida ; the Company expects to operate 184-189 owned medical centers by the end of 2022 The Company has not reconciled its expectations as to non-GAAP measures in future periods to their most directly comparable GAAP measure because certain costs and expenses are outside of its control or cannot be reasonably predicted. Accordingly, reconciliation is not available without unreasonable effort, although it is important to note that these factors could be material to the Company's results computed in accordance with GAAP.
Conference Call Information Cano Health will host a conference call today at 8:30 AM ET to review the Company's business and financial results for the quarter ended March 31, 2022 .
To access the live call and webcast, please dial (844) 684-0650 for U.S. participants, or +1 (343) 761-2594 for international participants, and reference the Cano Health First Quarter 2022 Earnings Conference Call and Conference ID 6284596. The conference call will also be webcast live in the "Events & Presentations" section of the Investor page of the Cano Health website.
A replay will be available in the "Events & Presentations" section of the Cano Health website for on-demand listening shortly after the completion of the call and will be available for 30 days.
Forward Looking Statements This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements relate to future events and involve known and unknown risks, uncertainties and other factors which are, in some cases, beyond our control and could materially affect actual results, performance or achievements. Such forward-looking statement include, without limitation, our anticipated results of operations, including our financial guidance for the 2022 fiscal year, our business strategies, our projected costs, prospects and plans, and other aspects of our operations or operating results. These forward-looking statements generally can be identified by phrases such as "will," "expects," "anticipates," "foresees," "forecasts," "estimates" or other words or phrases of similar import. It is uncertain whether any of the events anticipated by the forward-looking statements will transpire or occur, or if any of them do, what impact they will have on our results of operations and financial condition. Important risks and uncertainties that could cause our actual results and financial condition to differ materially from those indicated in forward-looking statements include, among others, changes in market or industry conditions, regulatory environment, competitive conditions, and receptivity to our services; adverse effects on the Company's business as a result of the restatement of our previously issued financial statements; our ability to realize expected results with respect to patient membership, total revenue and earnings; our ability to enter into new markets and continue our growth; our ability to integrate our acquisitions and achieve desired synergies; our ability to maintain our relationships with health plans and other key payors; the impact of COVID-19 on our business and results of operations; our future capital requirements and sources and uses of cash, including funds to satisfy our liquidity needs; and our ability to recruit and retain qualified team members and independent physicians. For a detailed discussion of the risks and uncertainties that could cause our actual results to differ materially from those expressed or implied by the forward-looking statements, please refer to our filings with the Securities and Exchange Commission (the "SEC"). All information provided in this press release is as of the date hereof, and we undertake no duty to update or revise this information unless required by law.
Non-GAAP Financial Measures This press release contains certain non-GAAP financial measures as defined by the SEC rules. EBITDA and Adjusted EBITDA have not been prepared in accordance with United States generally accepted accounting principles ("GAAP"). EBITDA is defined as net income (loss) before interest, income taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA, adjusted to add back the effect of certain expenses, such as stock-based compensation expense, de novo losses (consisting of costs associated with the ramp up of new medical centers and losses incurred for the twelve months after the opening of a new facility), acquisition transaction costs (consisting of transaction costs and corporate development payroll costs), fair value adjustments in contingent consideration, restructuring and other charges, loss on extinguishment of debt, and changes in fair value of warrant liabilities. We believe these non-GAAP financial measures provide an additional tool for investors to use in evaluating ongoing operating results and trends and in comparing our financial measures with other similar companies. We do not consider these non-GAAP measures in isolation or as an alternative to financial measures determined in accordance with GAAP. These non-GAAP financial measures are subject to inherent limitations as they reflect the exercise of judgments by management about which expense, income and other items are excluded or included in determining these non-GAAP financial measures. In addition, other companies may calculate non-GAAP financial measures differently or may use other measures to evaluate their performance, all of which could reduce the usefulness of our non-GAAP financial measures as tools for comparison. A reconciliation of those measures to their most directly comparable GAAP measures is available under the heading "Reconciliation of Non-GAAP Measures." About Cano Health Cano Health (NYSE: CANO) is a high-touch, technology-powered healthcare company delivering personalized, value-based primary care to nearly 270,000 members. With its headquarters in Miami, Florida , Cano Health is transforming healthcare by delivering primary care that measurably improves the health, wellness, and quality of life of its patients and the communities it serves. Founded in 2009, Cano Health has more than 4,000 employees, and operates primary care medical centers and supports affiliated providers in nine states and Puerto Rico . For more information, visit canohealth.com or investors.canohealth.com .
Investor Relations Contact: Derek Fiebig Cano Health, Inc. (786) 206-1930derek.fiebig@canohealth.com
Media Relations Contact: Georgi Morales Pipkin Cano Health, Inc. (786) 206-3322georgi.pipkin@canohealth.com
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
UNAUDITED
Three Months Ended
March 31,
(in thousands, except share and per share data)
2022
2021
Revenue:
Capitated revenue
$ 674,351
$ 261,357
Fee-for-service and other revenue
29,986
13,245
Total revenue
704,337
274,602
Operating expenses:
Third-party medical costs
535,779
195,046
Direct patient expense
60,677
34,237
Selling, general and administrative expenses
96,587
35,009
Depreciation and amortization expense
19,036
5,846
Transaction costs and other
8,375
8,954
Change in fair value of contingent consideration
(4,661)
285
Total operating expenses
715,793
279,377
Loss from operations
(11,456)
(4,775)
Other income and expense:
Interest expense
(13,284)
(10,626)
Interest income
1
1
Loss on extinguishment of debt
(1,428)
—
Change in fair value of warrant liabilities
27,162
—
Total other income (expense)
12,451
(10,625)
Net income (loss) before income tax expense
995
(15,400)
Income tax expense
1,080
714
Net loss
$ (85)
$ (16,114)
Net loss attributable to non-controlling interests
(745)
—
Net income attributable to Class A common stockholders
$ 660
$ —
Net income per share attributable to Class A common stockholders, basic
$ —
N/A
Net loss per share attributable to Class A common stockholders, diluted
$ —
N/A
Weighted-average shares used in computation of earnings per share:
Basic
191,410,221
N/A
Diluted
468,132,925
N/A
CONDENSED CONSOLIDATED BALANCE SHEETS
UNAUDITED
As of,
(in thousands)
March 31, 2022
December 31, 2021
Assets
Current assets:
Cash, cash equivalents and restricted cash
$ 113,052
$ 163,170
Accounts receivable, net of unpaid service provider costs
191,724
133,433
Prepaid expenses and other current assets
18,859
20,632
Total current assets
323,635
317,235
Property and equipment, net
95,595
85,261
Operating lease right of use assets
152,180
132,173
Goodwill
772,704
769,667
Payor relationships, net
569,086
576,648
Other intangibles, net
241,963
248,973
Other assets
16,602
13,582
Total assets
2,171,765
2,143,539
Liabilities and stockholders' equity
Current liabilities:
Current portion of notes payable
6,444
6,493
Current portion of finance lease liabilities
1,448
1,295
Current portion of contingent consideration
3,062
3,123
Accounts payable and accrued expenses
93,368
80,829
Current portions due to sellers
1,480
17,357
Current portion operating lease liabilities
18,383
15,275
Other current liabilities
34,472
36,664
Total current liabilities
158,657
161,036
Notes payable, net of current portion and debt issuance costs
915,738
915,266
Long term portion of operating lease liabilities
141,477
122,935
Warrants liabilities
52,982
80,144
Long term portion of finance lease liabilities
2,738
2,181
Contingent consideration
30,700
35,300
Other liabilities
31,696
28,109
Total liabilities
1,333,988
1,344,971
Stockholders' Equity
Shares of Class A common stock
20
18
Shares of Class B common stock
28
30
Additional paid-in capital
464,262
397,443
Accumulated deficit
(78,100)
(78,760)
Total Stockholders' Equity before non-controlling interests
386,210
318,731
Non-controlling interests
451,567
479,837
Total Stockholders' Equity
837,777
798,568
Total Liabilities and Stockholders' Equity
$ 2,171,765
$ 2,143,539
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
UNAUDITED
Three Months Ended March 31,
(in thousands)
2022
2021
Cash Flows from Operating Activities:
Net loss
$ (85)
$ (16,114)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization expense
19,036
5,846
Change in fair value of contingent consideration
(4,661)
285
Change in fair value of warrant liabilities
(27,162)
—
Loss on extinguishment of debt
1,428
—
Amortization of debt issuance costs
748
2,170
Non-cash lease expense
1,705
—
Equity-based compensation
13,816
71
Changes in operating assets and liabilities:
Accounts receivable, net
(58,291)
(6,929)
Other assets
(3,060)
(882)
Prepaid expenses and other current assets
1,773
(6,537)
Interest accrued due to seller
97
536
Accounts payable and accrued expenses
10,010
5,973
Other liabilities
7,443
893
Net cash used in operating activities
(37,203)
(14,688)
Cash Flows from Investing Activities:
Purchase of property and equipment
(7,776)
(2,645)
Acquisitions of subsidiaries including non-compete intangibles, net of cash acquired
(3,495)
(898)
Payments to sellers
(2,186)
(6,155)
Other
—
(1)
Net cash used in investing activities
(13,457)
(9,699)
Cash Flows from Financing Activities:
Capitalized transaction costs related to merger
—
(2,414)
Payments of long-term debt
(1,611)
(1,200)
Debt issuance costs
(87)
—
Proceeds from insurance financing arrangements
2,529
1,702
Payments of principal on insurance financing arrangements
(690)
(567)
Repayments of equipment loans
(129)
(76)
Repayments of capital lease obligations
(340)
(263)
Employee stock purchase plan contributions
870
—
Net cash provided by (used in) financing activities
542
(2,818)
Net decrease in cash, cash equivalents and restricted cash
(50,118)
(27,205)
Cash, cash equivalents and restricted cash at beginning of year
163,170
33,807
Cash, cash equivalents and restricted cash at end of period
$ 113,052
$ 6,602
Reconciliation of Non-GAAP
Adjusted EBITDA
UNAUDITED
Three Months Ended March 31,
(in thousands)
2022
2021
Net loss
$ (85)
$ (16,114)
Interest income
(1)
(1)
Interest expense
13,284
10,626
Income tax expense
1,080
714
Depreciation and amortization expense
19,036
5,846
EBITDA
$ 33,314
$
$ 1,071
Stock-based compensation
13,816
71
De novo losses (1)
15,816
5,839
Acquisition transaction costs (2)
9,871
9,818
Restructuring and other
2,585
411
Change in fair value of contingent consideration
(4,661)
285
Loss on extinguishment of debt
1,428
—
Change in fair value of warrant liabilities
(27,162)
—
Adjusted EBITDA
$ 45,007
$
$ 17,495
(1)
De novo losses include those costs associated with the ramp up of new facilities and that are not expected to be incurred past the first 12 months after opening. These costs collectively are higher than comparable expenses incurred once such a facility has been open and generating revenue and would not have been incurred unless a new facility was being opened.
(2)
Acquisition transaction costs included $1.0 million and $0.9 million of corporate development payroll costs for the three months ended March 31, 2022 and 2021, respectively. Corporate development payroll costs include those expenses directly related to the additional staff needed to support our increased acquisition activity.
Key Metrics
Three Months Ended March 31,
2022
2021
% Change
Members:
Medicare Advantage
119,105
75,488
57.8%
Medicare DCE
41,201
—
—%
Total Medicare
160,306
75,488
112.4 %
Medicaid
67,982
21,801
211.8%
ACA
41,045
19,606
109.3%
Total members
269,333
116,895
130.4%
Member months:
Medicare Advantage
354,415
224,830
57.6 %
Medicare DCE
125,089
—
—%
Total Medicare
479,504
224,830
57.6 %
Medicaid
202,197
62,908
221.4%
ACA
121,911
56,037
117.6%
Total member months
803,612
343,775
133.8%
Per Member Per Month ("PMPM"):
Medicare Advantage
$ 1,249
$ 979
27.6%
Medicare DCE
$ 1,379
$ —
—%
Total Medicare
$ 1,283
$ 979
27.6%
Medicaid
$ 257
$ 615
(58.2)%
ACA
$ 58
$ 44
31.8%
Total PMPM
$ 839
$ 760
10.4%
Owned medical centers
137
72
1 Adjusted EBITDA is a non-GAAP financial measure. A reconciliation of this non-GAAP financial measure to its most directly comparable GAAP financial measure is provided in the Reconciliation of Non-GAAP Adjusted EBITDA table included in this press release. An explanation of this measure and how it is calculated is also included under the heading "Non-GAAP Financial Measures."
2 Medical cost ratio (MCR) is calculated as third-party medical expense divided by capitated revenue.
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SOURCE Cano Health, Inc.