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Apollo Medical Holdings, Inc. Reports Second Quarter 2021 Results, Raises Full-Year 2021 Guidance
Aug 5 2021
3 min read

Apollo Medical Holdings, Inc. Reports Second Quarter 2021 Results, Raises Full-Year 2021 Guidance

Company to Host Conference Call Today at 2 p.m. PT/5 p.m. ET

ALHAMBRA, Calif., Aug. 5, 2021 /PRNewswire/ -- Apollo Medical Holdings, Inc. ("ApolloMed," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: AMEH), a leading physician-centric, technology-powered healthcare company focused on enabling providers in the successful delivery of value-based care, today announced its consolidated financial results for the second quarter and six months ended June 30, 2021.

ameh logo (PRNewsfoto/Apollo Medical Holdings, Inc.)

Financial Highlights for the Second Quarter and Six Months Ended June 30, 2021:

  • Q2 earnings per share - diluted ("EPS - diluted") of $0.28 per share, up 47% from $0.19 per share for the prior-year quarter
  • Q2 total revenue of $175.6 million, up 6% from $165.2 million for the prior-year quarter
  • Q2 net income of $59.5 million, compared to $81.0 million for the prior-year quarter (additional detail provided in the Q2 GAAP financial review below)
  • Q2 net income attributable to ApolloMed of $12.7 million, up 80% from $7.0 million for the prior-year quarter
  • Total revenue of $351.7 million for the six months ended June 30, 2021, up 6% from $330.3 million for the prior-year period
  • Net income of $74.0 million for the six months ended June 30, 2021, compared to $84.0 million for the prior-year period
  • Net income attributable to ApolloMed increased to $25.8 million for the six months ended June 30, 2021, from $11.1 million for the prior-year period
  • Cash and cash equivalents of $177.3 million at June 30, 2021

Recent Operating Highlights:

  • In June 2021, ApolloMed completed the successful refinancing of its existing term loan and revolving credit facility with a new five-year revolving credit facility to the Company of $400.0 million, which includes a letter of credit sub-facility of up to $25.0 million and a swingline loan sub-facility of $25.0 million. Available cash of $58.7 million and a portion of the new revolving credit facility were used to pay off the Company's existing and remaining $175.8 million term loan and $60.0 million drawn on the prior revolving credit facility maturing in September 2024. The new revolving credit facility will also be used to finance future acquisitions and investments, and provide for working capital needs and other general corporate purposes.
  • In June 2021, ApolloMed entered into a definitive agreement to purchase 49% of the aggregate issued and outstanding shares of capital stock of Sun Clinical Laboratories ("Sun Labs") for an aggregate purchase price of $4.0 million. Sun Labs is a CLIA-certified full-service lab that operates 19 locations in southern California. Sun Labs gives ApolloMed the added capacity of rapid COVID testing and access to genetic testing for its patients. Closing is expected to take place in the third quarter of 2021.
  • In July 2021, ApolloMed announced that its affiliate AP-AMH 2 Medical Corporation entered into a definitive agreement to acquire 80% of the fully diluted capitalization of Access Primary Care Medical Group ("APCMG"). Primarily serving patients in the northern California counties of San Mateo and San Francisco, APCMG is a risk-bearing organization that has successfully provided professional services to seniors under capitation arrangements with its contracted payer partners since 2016. Closing is expected to take place in the third quarter of 2021.

Guidance:

ApolloMed is raising its full-year 2021 guidance, previously disclosed on March 10, 2021, and subsequently reiterated on May 5, 2021, as the result of positive organic growth trends, increased risk pool revenues from reduced utilization at ApolloMed's partner hospitals in 2020, and increased fee-for-service revenues from increased utilization at ApolloMed's surgery and heart centers due to their reopening. Net income and EBITDA include the impact of Allied Physicians of California, a Professional Medical Corporation ("APC")'s investment in a payer partner that completed an initial public offering to become a publicly traded company on June 24, 2021. As APC's investment in the aforementioned payer partner is an excluded asset solely for the benefit of APC and its shareholders, any gains or losses as a result of this investment do not affect the net income attributable to ApolloMed and adjusted EBITDA attributable to ApolloMed. The revised net income and EBITDA guidance ranges assume the payer partner's closing share price of $8.49 on August 3, 2021. These assumptions are based on the Company's existing business, current view of existing market conditions and assumptions for the year ending December 31, 2021.

2021 Guidance Range

2021 Guidance Range

(in millions)

(as of March 10, 2021)

(as of August 5, 2021)

Year Ending

Year Ending

December 31, 2021

December 31, 2021

Low

High

Low

High

Total revenue

$

690.0

$

710.0

$

700.0

$

720.0

Net income

$

50.0

$

60.0

$

56.0

$

66.0

Net income attributable to ApolloMed

$

35.0

$

45.0

$

48.0

$

58.0

EBITDA

$

95.0

$

105.0

$

100.0

$

119.0

Adjusted EBITDA

$

115.0

$

125.0

$

120.5

$

130.5

See "Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See "Forward-Looking Statements" below for additional information.

Management Commentary:

Kenneth Sim, M.D., Executive Chairman and Co-Chief Executive Officer of ApolloMed, stated, "We saw the public health situation in our local communities steadily improve over the course of the second quarter of 2021 as vaccination rates increased and COVID-19 cases declined. During the second quarter, we achieved 6% growth on the top line and 80% growth in net income attributable to ApolloMed to $12.7 million, primarily as a result of organic membership growth in our existing IPAs and decreased utilization at our partner hospitals in 2020 when the pandemic first began, which resulted in increased risk pool settlements and incentives revenue. While utilization of elective care services did increase during the period, it did not increase as much as anticipated due to mounting concerns surrounding the delta variant. As such, we did see some continued benefit from the trend of decreased utilization but have seen increased utilization at our surgery and heart centers, as compared to the same period in 2020, following their reopening in 2021. As a result of these trends and our continued organic growth, we are raising our guidance for the full-year 2021."

Dr. Sim continued, "During the 2021 second quarter, we were pleased to have entered into an agreement with Sun Labs, a CLIA-certified full-service lab that operates 19 locations in southern California, whereby ApolloMed will serve as the exclusive administrator of all daily business functions of Sun Labs. We are particularly excited about the additional rapid COVID testing resources and innovative work in genomic testing that Sun Labs will provide for our members. We continue to work closely with the team at Sun Labs and look forward to integrating its organization into ApolloMed's comprehensive care delivery platform. Subsequent to quarter-end, we announced that our affiliate had entered into a definitive agreement to acquire a controlling interests in Access Primary Care Medical Group, which primarily serves senior patients in the northern California counties of San Mateo and San Francisco. ApolloMed has provided management services to APCMG since 2016, and we are thrilled to be expanding our partnership with them by bringing our technology and operations platform to their over 120 primary and specialty care providers serving approximately 1,000 Medicare Advantage members. Following our successful debt refinancing in June, we are well positioned with increased financial flexibility to execute on our growth strategy of establishing partnerships with like-minded physicians and physician groups seeking to participate in risk-bearing, value-based care arrangements. We remain confident in ApolloMed's platform, business model and value proposition as we continue focusing on enabling providers to achieve better outcomes and healthcare experiences for their patients."

GAAP Financial Review for the Second Quarter Ended June 30, 2021:

  • Total revenue of $175.6 million for the quarter ended June 30, 2021, an increase of 6%, compared to $165.2 million for the quarter ended June 30, 2020, primarily due to (i) a $3.6 million increase in capitation revenue primarily as a result of organic membership growth at APC and Alpha Care Medical Group, (ii) a $4.2 million increase in risk pool settlements and incentives revenue driven by reduced utilization at ApolloMed's partner hospitals resulting from the suspension of non-emergency medical procedures in early 2020 when the COVID-19 pandemic first began, as these revenues from ApolloMed's partner hospitals reflect a 15-18 month lag, and (iii) a $2.4 million increase in fee-for-service revenue as a result of more patient visits with the reopening of ApolloMed's surgery and heart centers as the local public health situation improved with vaccination rates increasing and cases of COVID-19 declining.
  • Capitation revenue, net, of $144.6 million for the quarter ended June 30, 2021, an increase of 3%, compared to $140.9 million for the quarter ended June 30, 2020. Capitation revenue represented 82% of total revenue for the quarter ended June 30, 2021.
  • Risk pool settlements and incentives revenue of $16.2 million for the quarter ended June 30, 2021, an increase of 35%, compared to $12.0 million for the quarter ended June 30, 2020.
  • Net income was $59.5 million for the quarter ended June 30, 2021, compared to $81.0 million for the quarter ended June 30, 2020. The increased net income in the prior-year period was primarily driven by a $99.6 million gain on sale by Universal Care Acquisition Partners, LLC ("UCAP") of its 48.9% investment in Universal Care, Inc. ("UCI") to Bright Health Company of California ("Bright"). UCAP is a 100% owned subsidiary of APC, and its 48.9% investment in UCI is an excluded asset that remains solely for the benefit of APC and its shareholders. Net income for the current period was positively impacted by an $83.8 million unrealized gain, recognized under other income, as a result of the 1-to-3 conversion of Bright's preferred shares to common stock as a result of Bright becoming a public company. This increase was partially offset by a $15.7 million write-off of the Company's beneficial interest in Bright. Both of these gains relate to excluded assets that did not affect net income and adjusted EBITDA attributable to ApolloMed.
  • Net income attributable to ApolloMed of $12.7 million for the quarter ended June 30, 2021, an increase of 80%, compared to $7.0 million for the quarter ended June 30, 2020. The increase from the prior-year quarter was primarily due to the reasons stated above and increased preferred dividends ApolloMed received from APC.
  • EPS - diluted of $0.28 per share for the quarter ended June 30, 2021, an increase of 47%, compared to $0.19 per share for the quarter ended June 30, 2020.

GAAP Financial Review for the Six Months Ended June 30, 2021:

  • Total revenue of $351.7 million for the six months ended June 30, 2021, an increase of 6%, compared to $330.3 million for the six months ended June 30, 2020, primarily due to (i) a $7.9 million increase in capitation revenue primarily as a result of organic membership growth at APC and Alpha Care Medical Group, as well as higher average capitation rates at APC, during the period, (ii) an $11.0 million increase in risk pool settlements and incentives revenue driven by the reduced utilization at our partner hospitals as noted above, as well as a $4.5 million settlement received that was related to a prior year risk pool, and (iii) a $2.0 million increase in fee-for-service revenue as noted above.
  • Net income of $74.0 million for the six months ended June 30, 2021, compared to $84.0 million for the six months ended June 30, 2020.
  • Net income attributable to ApolloMed increased to $25.8 million for the six months ended June 30, 2021, from $11.1 million for the six months ended June 30, 2020. The increase from the prior-year period was primarily due to the reasons stated above and increased preferred dividends ApolloMed received from APC.
  • EPS - diluted of $0.58 per share for the six months ended June 30, 2021, an increase of 93%, compared to $0.30 per share for the six months ended June 30, 2020.

Non-GAAP Measures for the Second Quarter Ended June 30, 2021:

  • EBITDA of $90.0 million for the quarter ended June 30, 2021, compared to $119.3 million for the quarter ended June 30, 2020.
  • Adjusted EBITDA increased to $30.7 million for the quarter ended June 30, 2021, an increase of 30%, compared to $23.6 million for the quarter ended June 30, 2020.

Non-GAAP Measures for the Six Months Ended June 30, 2021:

  • EBITDA of $116.6 million for the six months ended June 30, 2021, compared to $130.5 million for the six months ended June 30, 2020.
  • Adjusted EBITDA increased to $59.9 million for the six months ended June 30, 2021, an increase of 60%, compared to $37.4 million for the six months ended June 30, 2020.

Balance Sheet Highlights:

  • As of June 30, 2021, ApolloMed's cash and cash equivalents and investments in marketable securities increased to $364.5 million, working capital increased to $342.5 million, and total stockholders' equity increased to $404.6 million; from cash and cash equivalents and investments in marketable securities of $261.2 million, working capital of $223.6 million and total stockholders' equity of $330.9 million, respectively, as of December 31, 2020.

See "Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See "Forward-Looking Statements" below for additional information.

For more details on ApolloMed's financial results for the quarter ended June 30, 2021, please refer to ApolloMed's Quarterly Report on Form 10-Q to be filed with the U.S. Securities Exchange Commission ("SEC"), which is accessible at www.sec.gov.

Conference Call and Webcast Information:

ApolloMed will host a conference call at 2 p.m. PT/5 p.m. ET today (Thursday, August 5, 2021), during which management will discuss the results of the second quarter ended June 30, 2021. To participate in the conference call, please use the following dial-in numbers about 5 minutes prior to the scheduled conference call time:

U.S. & Canada (Toll-Free):        +1 (844) 407-9500International (Toll):                     +1 (862) 298-0850

The conference call can also be accessed at: https://www.webcaster4.com/Webcast/Page/2749/42204.  

An accompanying slide presentation will be made available 30 minutes prior to the start of the conference call on the "IR Calendar" page of the Company's website (https://www.apollomed.net/investors/news-events/ir-calendar) and will be filed as an exhibit to ApolloMed's current report on Form 8-K to be filed with the SEC, accessible at www.sec.gov.  

Those who are unable to attend the live conference call may access the recording at the above webcast link, which will be made available shortly after the conclusion of the call.

Note About Consolidated Entities

The Company consolidates entities in which it has a controlling financial interest. The Company consolidates subsidiaries in which it holds, directly or indirectly, more than 50% of the voting rights, and variable interest entities ("VIEs") in which the Company is the primary beneficiary. Noncontrolling interests represent third party equity ownership interests in the Company's consolidated entities (including certain VIEs). The amount of net income attributable to noncontrolling interests is disclosed in the Company's consolidated statements of income.

Note About Stockholders' Equity, Certain Treasury Stock and Earnings Per Share

As of the date of this press release, 143,052 holdback shares have not been issued to certain former shareholders of the Company's subsidiary, Network Medical Management, Inc. ("NMM"), who were NMM shareholders at the time of closing of the merger, as they have yet to submit properly completed letters of transmittal to ApolloMed in order to receive their pro rata portion of ApolloMed's common stock and warrants as contemplated under that certain Agreement and Plan of Merger, dated December 21, 2016, among ApolloMed, NMM, Apollo Acquisition Corp. ("Merger Subsidiary") and Kenneth Sim, M.D., as amended, pursuant to which Merger Subsidiary merged with and into NMM, with NMM as the surviving corporation. Pending such receipt, such former NMM shareholders have the right to receive, without interest, their pro rata share of dividends or distributions with a record date after the effectiveness of the merger. The Company's consolidated financial statements have treated such shares of common stock as outstanding, given the receipt of the letter of transmittal is considered perfunctory and ApolloMed is legally obligated to issue these shares in connection with the merger.

Shares of ApolloMed's common stock owned by APC, a VIE of the Company, are legally issued and outstanding but excluded from shares of common stock outstanding in the Company's consolidated financial statements, as such shares are treated as treasury shares for accounting purposes. Such shares, therefore, are not included in the number of shares of common stock outstanding used to calculate the Company's earnings per share.

About Apollo Medical Holdings, Inc.

ApolloMed is a leading physician-centric, technology-powered, risk-bearing healthcare company. Leveraging its proprietary end-to-end technology solutions, ApolloMed operates an integrated healthcare delivery platform that enables providers to successfully participate in value-based care arrangements, thus empowering them to deliver high quality care to patients in a cost-effective manner.

Headquartered in Alhambra, California, ApolloMed's subsidiaries and affiliates include management services organizations (MSOs), affiliated independent practice associations (IPAs), and a Next Generation Accountable Care Organization (NGACO). For more information, please visit www.apollomed.net.  

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, such as statements about the Company's guidance for the year ending December 31, 2021, continued growth, acquisition strategy, ability to deliver sustainable long-term value, ability to respond to the changing environment, operational focus, strategic growth plans and merger integration efforts, operations and financial results. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company's reports to the SEC, including, without limitation the risk factors discussed in the Company's Annual Report on Form 10-K for the year ended December 31, 2020, filed with the SEC and any subsequent quarterly reports on Form 10-Q.

FOR MORE INFORMATION, PLEASE CONTACT:

Investor Relations(626) 943-6491investors@apollomed.net

Carolyne Sohn, The Equity Group(415) 568-2255csohn@equityny.com

APOLLO MEDICAL HOLDINGS, INC.

 CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)

(UNAUDITED)

June 30,

December 31,

2021

2020

Assets

Current assets

Cash and cash equivalents

$

177,287

$

193,470

Investment in marketable securities

187,206

67,695

Receivables, net

16,540

7,058

Receivables, net – related parties

68,767

49,260

Other receivables

4,562

4,297

Prepaid expenses and other current assets

12,188

16,797

Loan receivable – related party

4,000

Total current assets

470,550

338,577

Noncurrent assets

Land, property and equipment, net

40,738

29,890

Intangible assets, net

80,227

86,985

Goodwill

239,053

239,053

Loans receivables

594

480

Loans receivables – related parties

4,145

Investments in other entities – equity method

37,372

43,292

Investments in privately held entities

896

37,075

Restricted cash

500

Operating lease right-of-use assets

16,928

18,574

Other assets

8,072

18,915

Total noncurrent assets

423,880

478,909

Total assets(1)

$

894,430

$

817,486

Liabilities, mezzanine equity and stockholders' equity

Current liabilities

Accounts payable and accrued expenses

$

53,792

$

36,143

Fiduciary accounts payable

9,092

9,642

Medical liabilities

59,307

50,330

Income taxes payable

2,215

4,224

Dividend payable

536

485

Finance lease liabilities

110

102

Operating lease liabilities

2,831

3,177

June 30,2021

December 31,2020

Current portion of long-term debt

205

10,889

Total current liabilities

128,088

114,992

Noncurrent liabilities

Deferred tax liability

21,242

10,959

Finance lease liabilities, net of current portion

249

311

Operating lease liabilities, net of current portion

14,513

15,865

Long-term debt, net of current portion and deferred financing costs

182,705

230,211

Other long-term liabilities

1,195

Total noncurrent liabilities

219,904

257,346

Total liabilities(1)

347,992

372,338

Mezzanine equity

Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation

141,856

114,237

Stockholders' equity

Series A Preferred stock, par value $0.001; 5,000,000 shares authorized (inclusive of Series B Preferred stock); 1,111,111 issued and zero outstanding

Series B Preferred stock, par value $0.001; 5,000,000 shares authorized (inclusive of Series A Preferred stock); 555,555 issued and zero outstanding

Common stock, $0.001 par value per share; 100,000,000 shares authorized, 44,246,796 and 42,249,137 shares outstanding, excluding 10,885,732 and 12,323,164 treasury shares, at June 30, 2021, and December 31, 2020, respectively

44

42

Additional paid-in capital

305,736

261,011

Retained earnings

95,580

69,771

401,360

330,824

Noncontrolling interest

3,222

87

Total stockholders' equity

404,582

330,911

Total liabilities, mezzanine equity and stockholders' equity

$

894,430

$

817,486

(1) The Company's consolidated balance sheets include the assets and liabilities of its consolidated variable interest entities ("VIEs"). The consolidated balance sheets include total assets that can be used only to settle obligations of the Company's consolidated VIEs totaling $1,347.6 million and $801.3 million as of June 30, 2021 and December 31, 2020, respectively, and total liabilities of the Company's consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $107.1 million and $111.3 million as of June 30, 2021 and December 31, 2020, respectively.

 

APOLLO MEDICAL HOLDINGS, INC.

CONSOLIDATED STATEMENTS OF INCOME

(IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)

(UNAUDITED)

Three Months Ended

June 30,

Six Months Ended

June 30,

2021

2020

2021

2020

Revenue

Capitation, net

$

144,550

$

140,949

$

289,290

$

281,370

Risk pool settlements and incentives

16,214

12,003

34,224

23,239

Management fee income

8,143

8,690

16,693

17,505

Fee-for-service, net

4,621

2,270

7,707

5,697

Other income

2,110

1,257

3,782

2,463

Total revenue

175,638

165,169

351,696

330,274

Operating expenses

Cost of services, excluding depreciation and amortization

136,214

136,079

276,829

280,283

General and administrative expenses

14,199

11,556

23,663

23,390

Depreciation and amortization

4,237

4,628

8,434

9,330

Total expenses

154,650

152,263

308,926

313,003

Income from operations

20,988

12,906

42,770

17,271

Other income

(Loss) income from equity method investments

(3,134)

834

(3,812)

2,888

Gain on sale of equity method investment

99,647

99,647

Interest expense

(1,853)

(2,673)

(3,376)

(5,541)

Interest income

563

863

912

1,792

Other income

67,886

1,282

69,190

1,384

Total other income, net

63,462

99,953

62,914

100,170

Income before provision for income taxes

84,450

112,859

105,684

117,441

Provision for income taxes

24,920

31,858

31,696

33,453

Net income

59,530

81,001

73,988

83,988

Net income attributable to noncontrolling interest

46,872

73,957

48,179

72,892

Net income attributable to Apollo Medical Holdings, Inc.

$

12,658

$

7,044

$

25,809

$

11,096

Earnings per share – basic

$

0.29

$

0.20

$

0.60

$

0.31

Earnings per share – diluted

$

0.28

$

0.19

$

0.58

$

0.30

 

Reconciliation of Net Income to EBITDA and Adjusted EBITDA (in thousands)

Three Months Ended

June 30,

Six Months Ended

June 30,

2021

2020

2021

2020

Net income

59,530

81,001

73,988

83,988

Interest expense

1,853

2,673

3,376

5,541

Interest income

(563)

(863)

(912)

(1,792)

Provision for income taxes

24,920

31,858

31,696

33,453

Depreciation and amortization

4,237

4,628

8,434

9,330

EBITDA

89,977

119,297

116,582

130,520

Loss (income) from equity method investments

3,134

(834)

3,812

(2,888)

Gain on sale of equity method investment

(99,647)

(99,647)

Other income

(67,886)

(1,282)

(69,190)

(1,384)

Provider bonus payments

2,000

2,000

Net loss adjustment for recently acquired IPAs

5,514

4,070

8,708

8,833

Adjusted EBITDA

30,739

23,604

59,912

37,434

 

Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA

2021 Guidance Range

2021 Guidance Range

(as of March 10, 2021)

(as of August 5, 2021)

Year Ending

Year Ending

December 31, 2021

December 31, 2021

(in thousands)

Low

High

Low

High

Net income

$

50,000

$

60,000

$

56,000

$

66,000

Interest expense

8,000

8,500

6,000

8,400

Interest income

(3,000)

(5,000)

(1,500)

(2,400)

Provision for income taxes

23,000

24,000

24,000

29,000

Depreciation and amortization

17,000

17,500

15,500

18,000

EBITDA

95,000

105,000

100,000

119,000

Income from equity method investments

(500)

(1,000)

3,500

(500)

Investment in Bright Health Group, Inc.

(9,000)

(9,000)

Provider bonus payments

6,000

6,000

6,000

6,000

Net loss adjustment for recently acquired IPAs

14,500

15,000

20,000

15,000

Adjusted EBITDA

$

115,000

$

125,000

$

120,500

$

130,500

 

Use of Non-GAAP Financial Measures

This press release contains the non-GAAP financial measures EBITDA and adjusted EBITDA, of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles ("GAAP") is net income. These measures are not in accordance with, or alternatives to GAAP, and may be different from other non-GAAP financial measures used by other companies. The Company uses adjusted EBITDA as a supplemental performance measure of our operations, for financial and operational decision-making, and as a supplemental means of evaluating period-to-period comparisons on a consistent basis. Adjusted EBITDA is calculated as earnings before interest, taxes, depreciation and amortization, excluding income from equity method investments, provider bonuses, impairment of intangibles, provision for doubtful accounts and other income earned that are not related to the Company's normal operations. Adjusted EBITDA also excludes the effect on EBITDA of certain IPAs we recently acquired.

The Company believes the presentation of these non-GAAP financial measures provides investors with relevant and useful information, as it allows investors to evaluate the operating performance of the business activities without having to account for differences recognized because of non-core or non-recurring financial information. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures, investors are provided with a more meaningful understanding of the Company's ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the Company uses as a basis for evaluating operational performance, allocating resources, and planning and forecasting future periods. Non-GAAP financial measures are not intended to be considered in isolation, or as a substitute for, GAAP financial measures. To the extent this release contains historical or future non-GAAP financial measures, the Company has provided corresponding GAAP financial measures for comparative purposes. The reconciliation between certain GAAP and non-GAAP measures is provided above.

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SOURCE Apollo Medical Holdings, Inc.