Alignment Healthcare (NASDAQ:ALHC) Q2 2026 Earnings Call

0:00 Good afternoon, and welcome to Alignment Healthcare Second Quarter twenty twenty six Earnings Conference Call and Webcast. All participants will be in a listen only mode. After today's presentation, there will be an opportunity to ask questions. To ask the question during the session, you will need to press 11 on your telephone. You would then hear an automated message advising your hand is raised. To withdraw your question, please press 11 again. We ask that you limit yourself to one question only. Note that this event is being recorded. Leading today's call are John Kayo, Chairman and CEO and Jim Head, Chief Financial Officer. Before we begin, we would like to remind you that certain statements made during this call will be forward looking statements as defined by the Private Securities Litigation Reform Act.

0:54 These forward looking statements are subject to various risks and uncertainties and reflect our current expectations based on our beliefs, assumptions and information currently

1:04 available to us. Descriptions of some of the factors that could cause actual results to differ materially from these forward looking statements are discussed in more detail in our filings with the SEC, including the Risk Factors sections of our Annual Report on Form 10 ks for the fiscal year ended 12/31/2025. Although we believe our expectations are reasonable, we undertake no obligation to revise any statements to reflect changes that occur after this call. In addition, please note that the company will be discussing certain non GAAP financial measures that they believe are important in evaluating performance. Details on the relationship between these non GAAP measures to the most comparable GAAP measures a reconciliation of historical non GAAP financial measures can be found in the press release that is posted on the company's website and our Form 10 Q for the fiscal quarter ended 06/30/2026.

2:05 I would now like to hand the conference over to John Kayo, Executive Chairman and CEO. Sir, you may begin. Hello, and thank you for joining us on our second quarter earnings conference call. For second quarter twenty twenty six, health plan membership of 294,100 represented year over year membership growth of approximately 31%. This drove total revenue of 1,300,000,000, which increased 32% year over year. Adjusted gross profit of 183,000,000 represented an adjusted MVR of 86.3%, which improved by 40 basis points year over year. Meanwhile, adjusted SG and A of $115,000,000 improved as a percentage of revenue by 20 basis points year over year to 8.6%.

3:00 Taken together, Q2 adjusted EBITDA of $68,000,000 produced an adjusted EBITDA margin of 5.1% and represents 60 basis points of margin expansion year over year. This quarter marks our lowest MBR as a public company and culminated in first half adjusted EBITDA of $106,000,000 putting us well on track to achieve our full year guidance of $154,000,000 at the midpoint. Importantly, we accomplished this while continuing to invest in our business. Our year to date performance reflects our unique ability to balance both growth and margin objectives by actively managing our members through our care anywhere clinical teams.

3:46 With six months of experience into the year, we have strong visibility into the acuity profile of our members and remain focused on engaging our polychronic population who are most at risk.

4:00 Strong second quarter performance is supported by the deployment of the newest version of our AIVA AI powered stratification model. This advancement improved our ability to predict which members are going to be hospitalized. Our model now accurately and dynamically predicts the ten percent of members who account for nearly seventy percent of hospital admissions over the next thirty days. Innovation such as this and the deployment of our disease state registries support the proactive engagement activities of our Care Anywhere teams. While we continue to demonstrate strong year over year improvement across each of our key financial indicators, an even greater opportunity remains ahead of us.

4:45 Given our rapid growth in recent years, approximately 50% of our members are still in a year one or year two cohort. This results in significant embedded earnings potential within our existing membership, which we expect to realize as we engage members through our clinical programs over time. When we first shared the embedded gross profit potential within our membership in early twenty twenty five, we indicated a total opportunity of approximately 600,000,000 of adjusted gross profit. Today, the midpoint of our 2026 full year guidance already indicates expectations for 640,000,000 of adjusted gross profit. Meanwhile, the embedded gross profit potential of today's membership has grown to approximately 880,000,000.

5:34 This positions us well to deliver further earnings growth from the existing members we serve today, while future membership growth further expands our embedded earnings potential. Equally important are the investments we have made in our core systems, cross functional workflows and talent, each of which are strengthening the durability and scalability of our MA platform. These investments are translating into better clinical outcomes, reinforcing the confidence we have in our operations and highlighting a core principle of our business, creating alignment among providers, members, and shareholders, which enables us to do well by doing good. While we invest thoughtfully for the future, our near term SG and A leverage demonstrates the efficiency of our operating model and improving unit economics.

6:27 First half adjusted SG and A as a percentage of revenue of 8.7% improved 40 basis points year over year and more than 300 basis points over the past three years. All of this was achieved while making investments like implementing a more scalable human resources platform, clinical EHR capabilities, and enhanced claims processing systems. Looking ahead, we continue to see opportunities to invest in the second half of the year to drive further operating leverage in the future through automation of back office processes and greater economies of scale. As we capture these efficiencies, we expect to reinvest a portion of our savings in areas with tangible, measurable returns.

7:14 This includes new market expansions, branding initiatives, and deepening our AI capabilities. Beyond its potential to unlock efficiencies in our cost structure, AI represents a meaningful opportunity to further enhance our care model and support providers. Most importantly, our approach to AI is grounded in decades of clinical expertise

7:37 and reinforces our commitment to high quality care. This is further supported by a governance framework to ensure responsible use, human accountability, and equitable treatment of our members. In closing, our strategy of balancing rapid growth, disciplined margin expansion and continuous investment to scale our operations remain unchanged and continues to underpin our story.

8:02 We achieved this by putting seniors first and supporting our providers. Our second quarter results underscore the strength of our model. As we move forward, we will maintain our disciplined approach to strike the right balance between growth and profitability. With that, I'll turn the call over to Jim to further discuss our financial results and outlook. Jim? Thanks, John. I'll dive into our second quarter results. For the quarter ended June 2026, health plan membership of 294,100 increased 31% year over year, supported by strong new member additions and high retention amongst our existing members. This drove revenue of $1,300,000,000 in the quarter, representing 32% growth year over year.

8:49 Second quarter adjusted gross profit of $183,000,000 represented an adjusted MBR of 86.3%, which reflects an improvement of approximately 40 basis points year over year. Adjusted MVR, excluding the final suite pickup related to our new members, was 86.7 percent, which was favorable to the midpoint of our guidance range. Overall medical cost trends continue to track closely to our expectations. Consistent with typical seasonal patterns in our outlook for the year, inpatient admissions per thousand declined sequentially, and core medical utilization was in line with our assumptions. Meanwhile, Part D and supplemental benefits expense ran modestly favorable to our expectations year to date.

9:35 We believe each of these factors are supportive of our full year guidance. Turning to operating expenses. Our adjusted SG and A was $115,000,000 an increase of 29% year over year. Adjusted SG and A as a percentage of revenue was 8.6%, which improved 20 basis points year over year and outperformed the midpoint of our implied guidance range by 40 basis points, even as we continue to invest in our automation and scalability initiatives, as John highlighted earlier.

10:07 Finally, second quarter adjusted EBITDA of $68,000,000 grew by 48% year over year and produced an adjusted EBITDA margin of 5.1%, which represents approximately 60 basis points of margin expansion year over year. In addition, first half adjusted EBITDA of $106,000,000 represents an increase of 60% versus the prior year. Moving on to cash flow and the balance sheet. We generated $111,000,000 in operating cash flow during the first half of the year, and our liquidity profile remains strong. We concluded the quarter with $7.00 $2,000,000 in cash, cash equivalents and short term investments. Lastly, our funded leverage ratio at the end of Q2 improved to 2.2 times our trailing twelve months EBITDA.

10:58 Moving to our guidance. For the full year 2026, we expect health plan membership to be between 298,301 members revenue to be in the range of $5,200,000,000 to 5,230,000,000 adjusted gross profit to be between $630,000,006 $50,000,000 and adjusted EBITDA to be in the range of 145,000,000 to 163,000,000

11:28 For the third quarter, we expect health plan membership to be between two hundred and ninety five thousand five hundred and two hundred and ninety seven thousand five hundred members, revenue to be in the range of 1.30 to 1,320,000,000, adjusted gross profit to be between 148,000,000 and $158,000,000 and adjusted EBITDA to be in the range of 20,000,000 to $30,000,000

11:54 With respect to our full year guidance, we are increasing our membership growth expectations given continued strength of our sales execution. In conjunction with the increase in our membership outlook, we are also raising our full year revenue guidance to approximately $5,200,000,000 at the midpoint, which reflects 32% growth year over year.

12:17 Turning to our profitability metrics, we are raising the low end of our adjusted gross profit range by $10,000,000 and increasing the low end of our adjusted EBITDA guidance range by 7,000,000 to reflect increased confidence in our full year objectives following a strong first half of the year.

12:36 Spending a moment on seasonality, the midpoint of our full year guidance and year to date results indicate that we expect approximately 30% of our full year adjusted EBITDA to be generated in the second half. This compares to approximately 40% of full year EBITDA in the second half of the prior year. The change in our seasonality expectation is partially driven by a flatter slope to our Part D MBR, along with investments we are making in our clinical operations during the third quarter.

13:06 Meanwhile, we continue to take a prudent approach to our utilization assumptions across each of our major cost categories for the remaining six months of the year. As we move into the back half of the year, given our strong performance, we will continue to make further investments in clinical innovation, AI, and talent. In the third quarter, we anticipate additional investments in Care Anywhere and an earlier ramp of our clinical hiring in preparation for new market growth and expansion, which will result in a seasonally higher MBR when compared to the prior year.

13:40 Likewise, we expect a greater portion of our full year SG and A expenses to be incurred in the third quarter compared to prior years due to the timing of our investments. In closing, we are very pleased with our performance throughout the first half of the year, which reflects our continued disciplined focus on our care model and our members and consistent execution against our operating plans. The progress we are making on the transformational progress we have discussed today further strengthens our competitive advantages long term. This reinforces our confidence in our ability to deliver continued growth and capture the substantial opportunity ahead for Alignment. With that, let's open the call to questions. Operator? Thank

14:29 Our Our first question comes from the line of Ryan Daniels with William Blair. Your line is open.

14:49 Yes, guys. Thanks so much for taking the questions. Appreciate it. Wanted to dive a little bit deeper into the Q3 guide. I think that's probably the focus of investors heading out of the print. Can you go into a little bit more detail about just the timing of some of the investments you're making? And any more color digging deeper to what some of those investments are, how transitory and then what benefits you see in the back half of the year, maybe more importantly into 'twenty seven and 'twenty eight? Thanks. Sure. I think the

15:20 probably there's two dimensions to this Q3 guide. It's kind of the seasonality aspect and then the investment aspect. So inside that seasonality, we'll dive into the investments. But sequentially, we're going to see a little bit of an uptick in our MBR, and that is from investments. It's a little bit year over year new member mix and it's Part D. So think about those three components

15:47 that are driving that. But as it pertains to the investments, we're just continuing to find areas to invest in the business and John and the team's been pretty consistent about this throughout the last couple of years in terms of putting ourselves in a position to really take advantage of the opportunity in front of us. So more specifically in the investments, we're going to make it in two different areas. One's going hit the MBR, and that's in our clinical operations. Care anywhere, preparing for new market growth and some other investments we're making there. And the other part is going to be in SG and A as we continue to push forward, get ready for market launches in 2027 and put ourselves in a position to get some returns in '27 on these projects.

16:32 So think about automation, AI, things of that nature. They're not insignificant and we think they're really good return and set us up for the long term. It could be in the second half an additional double digit million across clinical and SG and A categories with the weighting of some of that being a little bit higher in Q3.

16:53 Okay, but this is all very deliberate and it's inside the financial commitments we're making for 2026. So to kind of step back for a moment, we had a grade 25, we're signing up for '26 and delivering against a very good first half as you know and still managing to invest in the business to put us in a good position for the future because we really feel it's there's a lot of opportunity in front of us, but it will impact the second half of the year in terms of our MBR and our SG and A, but we're still going to deliver on our commitment.

17:30 Great, super helpful Colin, thank you. Thank you. Please stand by for our next question. Our next question comes from the line of Michael with Baird. Your line is open. Hi. Thank you. Multi part question. First, I'm backing into roughly $6,000,000 fleet benefit. Is that right? And if so, any reason why it's smaller than last year even though your book is larger this year? Second, I noticed in 10 Q, you had, I think, about $6,500,000 of unfavorable prior year development this quarter. I was wondering if you could elaborate on the timing and nature of those costs. And then last,

18:10 just the underlying 2Q MLR excluding both those items,

18:13 I'm getting roughly around 86.2% is that about right? And any comments on like monthly cadence throughout second quarter when it comes to QM? Thank you. Let's do the three parts. The first one was the sweep. This is Michael, you're referring to the newbie final sweep for 2025. As you're aware, we take a prudent approach on that in the sense that we do not have visibility on that sweep, And so we tend to take a cautious approach and just book to the MMR until we see it. And the thing that can impact that beyond just the number of members, Michael, is the mix. I think one of the bigger impacts is V28 as the second year of V28 rolled into our 2025 dates of service and then just risk sharing agreements around it.

19:03 So you're absolutely right it was a smaller number than last year and I guess you could call it on a per member basis it was smaller. I think one of the bigger drivers there was V28 and so is it you you mentioned 6,000,000 that's circa pretty close to what it means we talked about 40 basis points on the call in terms of impact. So that's point number one. The second thing is prior period reserve. So just to kind of put in context, know we are always looking at our reserve positions and that's in all states of service.

19:40 Year to date we're favorable about 2,000,000 on prior year in total and we feel good about where we're at. Inside Q2 we had a very solid quarter as I just mentioned, and within that strong beat we chose to bolster our reserves by about $6,000,000. Okay, and this is we looked at the development of the claims in 2025, and you know we're always looking at that and saying can we take a position and increase our reserves, and we looked at the quarter and said this is a good time, know this makes sense,

20:16 and so we feel pretty good about our reserve positioning you know year to date. And then the last one, just want to make sure, I think you had the third part. Yeah, if you were to exclude the unfavorable development and the sweep benefit, am I thinking about underlying core 2Q MLR at about 86.2? Yeah, I haven't done the math,

20:40 Michael, but if you add back the prior period and then subtract out 40 basis points, I mean, it's a dollar and percentage, but I think it's probably net around the same level on MBR. Okay. Thank you. Thank you. Our next question comes from the line of Justin Lake with Wolfe Research. Your line is open.

21:06 Thanks. Can you talk a little bit about the Q3 seasonality in terms of Part D and why it's different? And then also in

21:16 terms of the new member mix and why that's driving a difference there? Thanks. Yeah and so just Justin sounds like you're asking to amplify on those three components or two of the three components. So the Part D is just a little different versus last year. It's a flatter slope between the first half and the second half and that's just kind of the behavior in the second year post IRA and the behavior of our experience. And then the new member mix year over year we just have more acuity in the new member mix which is adding a little bit more to the MBR across the board. And so if you compare it to Q2 last year it's a little bit heavier, but that investment that we talk about is a big piece of that, the investments in the clinical infrastructure.

22:08 Thank you. Please stand by for our next question. Next question comes from the line of Matthew Gillmor with KeyBanc. Your line is open. Thanks for the question. Jim, I wanted to see if you'd be willing to share the 80 ks metric for the quarter or just year to date. And then more broadly for John, I was curious if you'd offer any perspective on just twenty twenty seven bids. I know you may be limited on what you may say in terms of how your approach, but just be curious in terms of the perspective you'd offer and how you think the industry will approach twenty twenty seven bidding. Thanks. Matt, thanks for that.

22:45 So as we mentioned on the call, 80 ks did improve sequentially and I'll be more specific, it was in the mid-150s and in line with our expectations, you know, given our membership mix and how we're tracking this year, so pretty much in line. I would say Matt that on an ongoing disclosure perspective, I think we're going to move away from digitally disclosing it every quarter. And I'll give you the rationale. While it's really important internally how we manage the business, our clinical operations at center, externally it seems to create a little bit of noise and I think it doesn't necessarily affect the overall health of our operation. So Q1 last quarter was a perfect example of like talking about 80 ks and kind of creating probably more static than signal.

23:35 But having said that, we'll find a balance because we want to continue to provide the right context around our performance and the trends going forward. So I know you're mindful of this and we'll be respectful of it but it's just I don't know if we're going to get into the digital precision that we've had in the past because it isn't the story per se.

23:55 Yeah Matt, John here. With respect to '27, I mean I'm gonna give you the standard you know it's too early to talk about the bids with respect to our strategy obviously for competitive reasons. I will say I feel about as comfortable as I've ever felt about our overall product strategy and the amount of work that went into

24:21 it this year. I feel very very strong about it and a lot of these investments we've been talking about are designed to realize scale and portability. That's what we think, we need to prove and that you are looking for us to focus on. And everything is designed around that. It's scale and portability. I'm really happy, like really, really happy about our progress along that front and so that gives me confidence with our ability to support the growth we expect in 2017. With respect to the industry I think you're going have more of a mixed bag you know I think you got people still that are going be more margin focused than others but I think they're going to be one or two maybe three players that come out of the woodwork that have not been aggressive over the last few years they're going be a little bit more aggressive just given some of the market chatter that we're hearing.

25:24 Guys. Thank you. Our next question comes from the line of John Stencil with JPMorgan. Your line is open. Great. Thanks for taking my question. It seems like the upcoming MA technical rule has arrived at OMB somewhat sooner than some industry observers expected, and I think some have concluded that might mean it's a bit of a larger, more substantive rule. In your discussions, do you have a view or an expectation of what we might see from CMS when they roll out the new technical rule? Thanks. John if you've got something new can you share because we're not privy to it frankly. I don't know sure we're all looking at each other going did we miss something?

26:21 John you there? It was no it's just at the it's under review at OMB already the '28 technical rule. Oh, oh, oh yeah, no we've heard that we don't have visibility to it. If there's anything that would have caused it to get there this early it probably would be around SARS would be my guess. But I don't know. We've heard the saying that the ruling is in there now

26:52 but we don't know what it is technically. Thank you. Please stand by for our next question. Our next question comes from the line of Kevin Fischbeck with Bank of America. Your line is open.

27:14 Great, thanks. I guess last quarter there's a bit of focus on MLR performance within California versus outside of California. I wonder if you could provide a little bit of disclosure about how those two sets of businesses performed. Thanks. Yeah, there's been some focus on the statutory filings in California as signal to broader performance. I just would remind you that these are statutory financials. They're not linked necessarily to our GAAP consolidated parent company financials. But I would say the following that

27:49 we've got a mature California market that's performing quite well and you've got pretty substantial growth over the last two years in our non California markets. And the right way to think about it is cohort maturation. If you've a more mature portfolio with our care model and our model that we employ, we actually see MLRs improving. And so if the average kind of member is in three, four years versus one, two, you're going to see a better MLR. And so there's a lot of embedded value in the ex California states, but we feel very pleased with how they're performing right now year to date. And so I guess you'll see some of that in the filings, but we generally don't operationally focus on those statutory filings as a proxy for our business. We run our business differently, but I know investors have been focused on it and we just feel like the we're tracking to our expectations across both of those arenas.

28:55 Right. Thanks. Thank you. Our next question comes from the line of Jessica Tasson with Piper Sandler. Your line is open. Hi, guys. Thanks for taking the question. So in terms of your long term MBR, I think in your 25 JPMorgan deck, you all implied 93% year 182.1% year five MBR. That was based on 2024. Is that framework still valid after three years of V28? Or should we assume some degradation? And then just in light of the MBR opportunity on tenured members, should we kind of expect stable benefits in existing markets and existing products in 2027? John, you mentioned two to three competitors could be more aggressive next year. So just interested if you could talk about how Alignment is positioning, for that change or for that expected change.

29:46 Thank you. Jess, the cohort tracking and trending is directionally consistent with what we shared last year. There's really no change. The positioning around the embedded earnings potential that I spoke about is predicated on that. And so the way we're interpreting this kind of notion of portability is to realize the same kind of earnings power that we've been able to generate in California is to plant those seeds in these new markets.

30:31 And so when you're doing that you're inherently going to have a higher MLR because you've got so much growth as a proportion of your base. So the more we're going to grow ex California, the stronger the earnings potential there is going to be. And then a lot of the work that we're focusing on the investments is again designed to really scale this thing, really scale it. And again I am really really happy about the operational work we've done. The workflow processes, the technology, the addition of new teammates, all of which is terrific.

31:17 So I'm very, very happy. And I think we mentioned we're going to be entering new markets in '27 not new states necessarily but really gearing up for that for '28. Again all of that's in the kind of the longer term strategy to get to a million lives and we're doing it. I'm really happy with our progress. Please stand by for our next question. Our next question comes from the line of Scott Fidel with Goldman Sachs. Your line is open. Hi, thanks. Good evening. Wanted to just ask about the activities that you were implementing earlier this year around centralizing some of those sort of critical functions around some of the clinical and medical management exercises and sort of moving away from some of the delegated sort of capitation that you had around that. How that's going? And then also just around the clinical investments that you're making in the third quarter and maybe in the fourth quarter, do some of those relate also to sort of completing or continuing some of those centralization functions that relate into some of the inpatient sort of management, particularly in the non California

32:50 markets? Hey Scott, John here. Yeah, it's actually a very, very good question. It's a very strategic question that we have paid a lot of attention to. And we are building out the end to end operational business model that incorporates different types of contracting strategies. And so in other words whether we're globally capping with a provider or we're doing a shared risk kind of arrangement that's delegated or it's a shared risk arrangement that's de delegated where we will do a lot of the administrative work And or as we are growing our number of directly contracted providers that we're fully at risk for both the professional and the institutional side, we are literally building out the end to end competency to take that risk and manage that risk such that we can really take advantage of the efficacy of Care Anywhere.

33:52 We're not diluting any of the hard work on lowering overall admissions that result from the Care Anywhere rollout. And so we're a lot of the way through that process right now and it will enable us to expand ex California irrespective of the type of contracts we enter into. This gives us a huge amount of strategic flexibility to engage providers at their comfort level And the whole idea is to create alignment with that provider, with that health system. I think that gives us a big differential advantage over everybody else. And then you layer it in Care Anywhere on top of that.

34:39 And so the investments that we're making are just continuations of that theme and it's and I alluded to it in the script, know we're making investments in the stratification model to have that become more precise. We're making investments in, know, I'll call it chart prep, you know, automation to make workflows easier for our nurses. We are making investments in AI around all the back end administrative functions like MRA, like SARs reconciliation. All of that is starting to pay off now and you know we have a lot of good people that have worked for a long time that have had a lot of value.

35:27 We're adding to that great team of people now with some leaders that have abilities and experience scaling. It's all about getting the scale is the way I'm looking at this. Hey, John. Can I just ask a quick follow-up question relating to this, and Jim, Just around that issue, at least sort of the activities you're taking to address those issues earlier in the year? Just curious, of the $6,000,000 in negative PYD, was that just sort of flow through from these same dynamics that you had talked about earlier in this year or is that unrelated to that? Thanks. Unrelated, unrelated. We just took a look at prior year 2025 and wanted to bolster our reserves.

36:14 What we talked about in the last quarter was really just a January '26 issue that we resolved and I would just say as a footnote to that, has been outstanding year to date. The strategy is working and the reason it's working is we're surplusing and gain sharing more with the providers. Mean so you develop that kind of operational muscle to consistently surplus with providers. We're not fully there where I want to be with all providers yet but we're making huge progress to create alignment, it's the whole point of alignment, to create alignment with the providers in each market with full transparency for the benefit of vaccine.

37:08 That's what we're trying to do and and we're starting to make that work outside of California where my confidence level is we're going to start to deploy some capital, heading into '27 and then more in '28. Okay, thank you. It's kind of consistent with what we've been saying all along. There's nothing really new there. We're just actually executing it now. Thank you. Our next question comes from the line of Andrew Mock with Barclays. Your line is Hi. We've seen a meaningful upward drift in STARS cut points in recent years. As we shift focus to bonus year '28 STARS, what are your expectations for further movement in those thresholds?

37:53 And how confident are you in your ability to perform against those benchmarks? Thanks. Yeah hey Andrew, we're not sure. We're not sure about what you just said. We're very comfortable you know we're going through all the CAHPS data, we just got the CAHPS data, we're going through that, we expect to get other visibility to Haas data, Part D data, etcetera down the line. I think it's a little early to start speculating about it. I will say that I think the regulatory and kind of legal footing surrounding STARS is a little shaky right now and a lot of outcomes could be different based on how some of these regulatory changes are actually implemented.

38:55 It's all related to a lot of the litigation that one of our competitors, we really don't compete with them, but another MA plan, one that sued and that has pretty significant implications for the rest of the industry. And all we want really is a consistent and fair regulatory landscape. So I don't know is the answer to your question, but I feel good about some of our position. Great, appreciate the color. Thank you. Our next question comes from the line of Whit Mayo with Leerink Partners. Your line is open. Hey, sorry, wanted to go back just to the PYD.

39:44 Know we're just going to get the question. The Q says the PYD was due to deteriorating collections and higher costs. So I'm just trying to reconcile your comments on proactive strengthening. I know these aren't big numbers, but just wanted to flesh that out. Yes, it's consistent. You've got two things going on in prior year, your payment integrity activity, collections, and then you've got your just how you're looking at the paid claims coming through. And that's, you know, we look at all of our dates of service across all the triangles and just make sure we're positioned well and I think our MD and A is pretty accurate on that but it you know we feel good about our reserve positioning when you have a prior year adjustment you have to call it out in your financials but we do this all it's just normal course of business across all our triangles.

40:34 That's helpful and just John I don't know if you're going to share what new markets you plan to enter but maybe what are some of the underlying characteristics of those markets? Yeah in '20 and you're right we're not going to share where until the bids are out. I mean the final product bids are out public in October but you know we thought it best be prudent for us to still have that balanced growth and margin profile in '27 with pretty meaningful market expansions within the existing state footprint that we have. And then the expectation is to expand the number of states in 2018.

41:23 As we get closer to that I'll give you a little bit more visibility on how many. But again all the work we're doing in 2526 and part of '27, we got to file service area expansions in February of twenty seven, four twenty eight. So really a lot of the operational preparedness is anticipation for scaling the business. And then again coming back to you with proof points on getting the same kind of embedding earnings leverage in some of these newer markets. Okay. Thanks. Yes. Please stand by for our next question. Our next question comes from the line of Jonathan Young with UBS. Your line is open.

42:11 Hey, thanks for taking the question. I just want to go back to the cost that's coming in 3Q and 4Q. I guess, are any of these one time in nature or should we consider these ongoing costs? And then kind of similarly, as we think about how 'twenty seven will shape up in relation to your growth strategy for 'twenty eight, will we see these kind of investments where there may be a bolus kind of leading up into the 'twenty eight period? Thanks. Yeah, a really good question. And I think in the near term, the second half of this year, saw some opportunity to make some investment but I think the cardinal rule is it's always inside our commitments on our guidance but also on our commitments to continue to take our SG and A level down. So one of the themes that you'll hear from us consistently is we want to make investments in the business to lower costs and then we want to take some of that savings and reinvest it back in the business and I think you're seeing that in action in the second half of this year. On the SG and A front, investing back into new markets and branding.

43:19 On the clinical side, we think we make those investments and we're going to get return in terms of two really important things. Our members benefit because we're helping to make them healthier and we're avoiding costs. And so we think that that's a win win across the board. So all these investments we're making have returns and we want to keep it inside the guardrails of what we're committing to. Thanks. Thank you. Our next question comes from the line of Parker Schmoor with Raymond James. Your line is open. Hey, good afternoon. I was just wondering if you could talk about your performance in your versus non SNP members and how those are tracking relative to expectations.

44:06 And just a follow on on that, you're adding a fair amount of C SNP members this year, and you mentioned some higher acuity in your new member mix. Just curious if those two dynamics are related. Related and intentional. Year we added 50% of our new members were in C SNP eligible, D SNP eligible, and dual eligible, so like kind of the more acute categories. And what the implications are, at least in the early part, that the MLR is a little bit elevated compared to a typical new member. But we're making that investment very intentionally because we think we can do very well with this cohort.

44:53 Our care model is really tailor made to help these populations and make them healthier and reduce costs. When we positioned ourselves in 2026, we intentionally understood that there was going to be a little bit of a burden on our MLR in the beginning. We think we can make these members create an MLR that's very favorable over time. So that was the investment we made. Again, this is back to this balancing act between staying in line with our commitments but also investing for the future. Thank you. Thank you. Our next question comes from the line of Ryan Langston with TD Cowen. Your line is open.

45:42 Great, thanks. Maybe on the 27 bids, just putting aside the particular makeup, could we still expect that you're targeting a 20% enrollment growth in 2027? I think that's fair. Yeah, no, I think that's fair. Got it. And then just just want to make sure maybe I missed this I'm sorry if I did but like taking into account the sweeps benefit that wasn't guided for the $5,000,000 EBITDA guidance raise at the midpoint and the investments you called out, I think you said potentially double digit millions of EBITDA. Is it fair to say you could have raised the guide by that double digit million of EBITDA? Or were some of those investments already planned when you originally set the full year guide? Thanks. Yeah, I understand the point.

46:37 Could just say pass on the sweep so to speak in and of itself? And I do think we did make some, we're consciously making some incremental investments in the second half that are a little bit above and beyond what we originally had planned for in our guidance so inside the year we're sticking to our commitments but we're seeing some opportunity to make some further investments. Yeah look I'll answer it this way you know if you guys look at the 10 ks you'll see management is highly incentivized to get to at least 55 a share. And so the way we're thinking about this is how do we do that and part of that is in fact making these investments now in a year in which we're meeting high end expectations.

47:29 I mean it's like why wouldn't we do that and so passing along it to you in a race may not have been in the best interest of our long term ability to get through that target number. This is all about long term and the guys are going in and out, sorry, but everything we're doing here is going to be I'm pretty sure everything we said we would do we have done consistently. And the one thing we're very focused on is this portability and scale issue. Thanks. Thank you. Ladies and gentlemen, I am showing no further questions in the queue.

48:15 That concludes today's conference call. Thank you for your participation. You may now disconnect.