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      Cano Health Announces Financial Results for the Third Quarter 2021

      Increases Full Year 2021 and 2022 Guidance

      (PRNewsfoto/Cano Health, LLC)

      News provided by

      Cano Health, Inc.

      Nov 09, 2021, 06:30 ET

      Share this article

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      MIAMI, Nov. 9, 2021 /PRNewswire/ -- Cano Health, Inc. ("Cano Health" or the "Company") (NYSE: CANO), a leading value-based primary care provider for seniors and underserved communities, today announced financial results for the third quarter and nine months ended September 30, 2021.

      Third Quarter Highlights:

      • Total membership of 210,663 including Medicare capitated members of 120,086, an increase of 105% and 65%, respectively, year-over-year
      • Total revenue of $526.8 million, an increase of 100% year-over-year
      • Net loss of $40.9 million
      • Adjusted EBITDA(1) of $35.2 million, an increase of 53% year-over year
      • Raised 2021 and 2022 guidance for total membership, total revenue, and Adjusted EBITDA

      "Our third quarter results once again demonstrate the successful execution of our operating model and growth strategy.  We have the privilege of serving more members than ever before, because we have continued to produce better outcomes for our patients at lower costs.  Our strategy to build, buy, and manage medical centers is driving scale and density in key markets, which is fueling our profitable growth.  I am pleased that we have already met our full year goal of being operational in eight states plus Puerto Rico.  As a result of our continued momentum, we are raising our guidance for 2021 and 2022," said Dr. Marlow Hernandez, Co-Founder, Chairman, and CEO of Cano Health.

      Third Quarter Financial Results:

      • Total revenue of $526.8 million for the third quarter of 2021, compared to $263.1 million for the third quarter of 2020
      • Net loss of $40.9 million for the third quarter of 2021, compared to a net loss of $11.1 million for the third quarter of 2020
      • Adjusted EBITDA(1) of $35.2 million for the third quarter of 2021, compared to $23.0 million for the third quarter of 2020

      The Company had 171.6 million shares of Class A common stock and 305.7 million shares of Class B common stock outstanding at September 30, 2021. Our total share count for the purposes of calculating our market capitalization was 480.0 million as of November 5, 2021.

      (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."

      COVID-19 Update
      For Cano Health members, as of October 31, we have observed a seven-day daily average of 1.4 cases  compared to a seven-day daily average of 24.0 cases at Cano Health's pandemic peak in January 2021, and 1.2 COVID-19 average monthly hospital admissions per 1,000 in October as compared to Cano Health's pandemic peak of 21.2 in July 2020.  Our COVID-19 mortality rate continues to be at least 50% lower than the senior population in Florida.  Additional detail is provided in our Third Quarter 2021 Financial Supplement found on the Investor Relations section of our website, canohealth.com/investors.

      The medical claims expense ratio for the third quarter 2021 was 75.6%, compared to 77.0% in the second quarter for 2021.   The sequential decline was primarily driven by the continued effectiveness of our care and utilization management programs.

      For the first nine months of 2021, the medical claims expense ratio was 75.4%.  For the full year of 2021, we continue to project a medical claims expense ratio of approximately 75.0%, reflecting an anticipated medical claims expense ratio of approximately 74.0% in the fourth quarter.

      Acquisition and Market Update

      • Completed acquisition of Doctor's Medical Center on July 2 for $300 million, adding approximately 52,000 members and 18 medical centers in Florida
      • In July 2021, acquired a behavioral health specialty group in South Florida to better serve the mental health needs of Cano Health members and others in the communities we serve
      • Also, in July 2021, acquired two medical centers in Las Vegas, Nevada, adjacent to our four existing medical centers
      • In August 2021, deployed approximately $170 million ($140 million in cash and $30 million in equity) to acquire medical practices and infrastructure managing affiliates in four states: Florida, New York, New Jersey, and New Mexico
      • Launched Healthy Heart by Dr. Juan, a program targeting cardiovascular disease prevention, led by Dr. Juan Rivera, a nationally recognized cardiologist, and Chief Medical Correspondent for the Univision television network
      • Increased density in southeast Texas by opening four de novo medical centers in the Rio Grande Valley and Corpus Christi, bringing our total medical centers in the region to ten
      • Expanded into Los Angeles and Chicago, while increasing our presence in Albuquerque, through the addition of seven de novo medical centers
      • Including de novo medical centers in Florida and Nevada we have thus far opened 16 de novo medical centers in 2021
      • Total medical center footprint is currently 126

      Balance Sheet and Cash Flow

      • As of September 30, 2021, Cano Health had approximately $209 million of cash, cash equivalents and restricted cash and $952 million of debt
      • On September 30, 2021, Cano Health issued senior unsecured notes in the principal amount of $300 million, proceeds of which were used to repay in full its $250 million bridge loan; the company also added an incremental $100 million to its existing term loan
      • In the third quarter, the Company deployed net cash of approximately $450 million in connection with acquisitions as described above in "Acquisition and Market Update"
      • Cash used in operating activities for the nine months ended September 30, 2021 was $91 million

      Guidance
      The Company is updating its previous guidance from August 12, 2021. Consistent with that guidance, the guidance below does not include the impact of any additional acquisitions.

      The updated outlook for 2021 is expected to be as follows:

      • Membership: Approximately 218,000, an increase from the prior guidance of approximately 215,000
      • Total revenue of approximately $1.7 billion, an increase from the prior guidance of $1.6 billion
      • Adjusted EBITDA of approximately $118 million, reflecting an increase from the prior guidance of approximately $115 million
      • The Company expects to open approximately 20 de novo medical centers and operate approximately 130 owned medical centers by the end of 2021

      The updated outlook for 2022 is expected to be as follows:

      • Membership in the range of 280,000 to 285,000; an increase from the prior guidance of 275,000 to 280,000
      • Total revenue in the range of $2.6 billion to $2.7 billion; an increase from the prior guidance of $2.5 billion to $2.6 billion
      • Adjusted EBITDA in the range of $170 million to $175 million; an increase from the prior guidance of $165 million to $170 million
      • The Company continues to expect to open 54 to 59 de novo medical centers, and expects to operate 184 to 189 owned medical centers in 2022

      We have not reconciled our expectations as to non-GAAP measures in future periods to their most directly comparable GAAP measure because certain costs and expenses are outside of our 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 our results computed in accordance with GAAP.

      Conference Call Information
      Cano Health will host a conference call today at 8:30 AM Eastern Time to review the Company's business and financial results for the third quarter ended September 30, 2021.

      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 Third Quarter 2021 Earnings Conference Call. The conference call will also be webcast live in the "Events & Presentations" section of the Investor page of the Cano Health website.

      Following the conclusion of the live call, 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, 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 2021 and 2022 fiscal years, our business strategies, the expected amount of investments and capital expenditures, the anticipated impact of the recent transactions on our business and future financial and operating results, the expected amount and timing of synergies from the recent transactions, 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; 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; changes in laws and regulations applicable to our business; our ability to maintain our relationships with health plans and other key payors; the impact of COVID-19 on our business and results of operation; 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"), including the risk factors identified in the definitive Proxy Statement/Prospectus filed with the SEC on May 7, 2021 and incorporated by reference into our Super 8-K filed on June 9, 2021 and in subsequent Quarterly Reports on Form 10-Q. 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 GAAP net income (loss) before interest expense, 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 losses incurred in the twelve months after the opening of a new facility), acquisition transaction costs (consisting of transaction costs, fair value adjustments in contingent consideration, management fees and corporate development payroll costs), restructuring and other charges, loss on extinguishment of debt, changes in fair value of an embedded derivative, 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 in 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 operates value-based primary care medical centers and supports affiliated medical practices that specialize in primary care for seniors in Florida, Texas, Nevada, New York, New Jersey, New Mexico, California, Illinois, and Puerto Rico, with additional markets in development.  As part of its care coordination strategy, Cano Health provides sophisticated, high-touch population health management programs including telehealth, prescription home delivery, wellness programs, transition of care, and high-risk and complex care management.

      Cano Health's personalized patient care and proactive approach to wellness and preventive care sets it apart from competitors.  Cano Health has consistently improved clinical outcomes while reducing costs, affording patients the opportunity to lead longer and healthier lives.  Cano Health serves a predominantly minority population (80% of its patients are Latino or African American) and low-income population (50% of its members are dual eligible for Medicare and Medicaid).  For more information visit www.canohealth.com or www.canohealth.com/investors/.

      Investor Relations Contacts:
      Alan Oshiki or Sydney Isaacs
      Abernathy MacGregor
      (212) 371-5999 / (713) 817-9346
      [email protected] / [email protected]

      Media Relations Contact:
      Patricia Graue
      Brunswick Group
      (212) 333-3810
      [email protected]

      CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

      UNAUDITED




      Three Months Ended


      Nine Months Ended



      September 30,


      September 30,

      (in thousands, except share and per share data)


      2021


      2020


      2021


      2020

      Revenue:









      Capitated revenue

      $

      501,780


      $

      252,974


      $

      1,148,041


      $

      544,617


      Fee-for-service and other revenue


      25,018



      10,159



      52,055



      25,020


      Total revenue


      526,798



      263,133



      1,200,096



      569,637


      Operating expenses:









      Third-party medical costs


      379,316



      184,926



      866,177



      382,279


      Direct patient expense


      57,708



      31,108



      135,777



      71,441


      Selling, general and administrative expenses


      75,926



      27,391



      157,348



      70,234


      Depreciation and amortization expense


      16,955



      5,379



      30,746



      12,741


      Transaction costs and other


      6,528



      7,716



      32,140



      29,854


      Total operating expenses


      536,433



      256,520



      1,222,188



      566,549


      Income (loss) from operations


      (9,635)



      6,613



      (22,092)



      3,088


      Other income and expense:









      Interest expense


      (16,023)



      (12,346)



      (36,363)



      (21,728)


      Interest income


      1



      80



      4



      239


      Loss on extinguishment of debt


      —



      —



      (13,225)



      —


      Change in fair value of embedded derivative


      —



      (5,138)



      —



      (5,444)


      Change in fair value of warrant liabilities


      (14,650)



      —



      24,565



      —


      Other expenses


      (29)



      —



      (54)



      (150)


      Total other expense


      (30,701)



      (17,404)



      (25,073)



      (27,083)


      Net loss before income tax benefit (expense)


      (40,336)



      (10,791)



      (47,165)



      (23,995)


      Income tax benefit (expense)


      (547)



      (326)



      762



      (294)


      Net loss


      (40,883)



      (11,117)



      (46,403)



      (24,289)


      Net loss attributable to non-controlling interests


      (26,246)



      —



      (41,283)



      —


      Net loss attributable to Class A common stockholders

      $

      (14,637)


      $

      —


      $

      (5,120)


      $

      —











      Net loss per share attributable to Class A common stockholders, basic

      $

      (0.09)



      N/A


      $

      (0.03)



      N/A


      Net loss per share attributable to Class A common stockholders, diluted

      $

      (0.09)



      N/A


      $

      (0.08)



      N/A


      Weighted-average shares used in computation of earnings per share:









      Basic


      170,871,429



      N/A



      168,100,210



      N/A


      Diluted


      170,871,429



      N/A



      169,312,258



      N/A


      CONDENSED CONSOLIDATED BALANCE SHEETS

      UNAUDITED




      As of,

      (in thousands)


      September 30,
      2021


      December 31,
      2020

      Assets





      Current assets:





      Cash, cash equivalents and restricted cash

      $

      208,913


      $

      33,807


      Accounts receivable, net of unpaid service provider costs


      223,644



      76,709


      Inventory


      1,777



      922


      Prepaid expenses and other current assets


      30,788



      8,937


      Total current assets


      465,122



      120,375


      Property and equipment, net


      64,156



      38,126


      Goodwill


      765,511



      234,328


      Payor relationships, net


      584,265



      189,570


      Other intangibles, net


      256,327



      36,785


      Other assets


      4,703



      4,362


      Total assets


      2,140,084



      623,546


      Liabilities and stockholders' equity / members' capital





      Current liabilities:





      Current portion of notes payable


      6,493



      4,800


      Current portion of equipment loans


      513



      314


      Current portion of capital lease obligations


      1,006



      876


      Current portion of contingent consideration


      8,406



      —


      Accounts payable and accrued expenses


      76,654



      33,180


      Deferred revenue


      1,815



      988


      Current portions due to sellers


      24,687



      27,129


      Other current liabilities


      20,000



      1,333


      Total current liabilities


      139,574



      68,620


      Notes payable, net of current portion and debt issuance costs


      916,111



      456,745


      Warrants liabilities


      138,493



      —


      Equipment loans, net of current portion


      1,454



      873


      Capital lease obligations, net of current portion


      1,559



      1,580


      Deferred rent


      5,387



      3,111


      Deferred revenue, net of current portion


      4,698



      4,277


      Due to sellers, net of current portion


      170



      13,976


      Contingent consideration


      38,300



      5,172


      Other liabilities


      36,325



      11,648


      Total liabilities


      1,282,071



      566,002


      Stockholders' Equity / Members' Capital





      Shares of Class A common stock


      17



      —


      Shares of Class B common stock


      31



      —


      Members' capital


      —



      157,591


      Additional paid-in capital


      363,060



      —


      Accumulated deficit


      (52,547)



      (99,913)


      Notes receivable, related parties


      —



      (134)


      Total Stockholders' Equity / Members' Capital

      attributed to Class A


      310,561



      57,544


      Non-controlling interests


      547,452



      —


      Total Stockholders' Equity / Members' Capital


      858,013



      57,544


      Total Liabilities and Stockholders' Equity / Members' Capital

      $

      2,140,084


      $

      623,546


      CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

      UNAUDITED




      Nine Months Ended



      September 30,

      (in thousands)


      2021


      2020

      Cash Flows from Operating Activities:





      Net loss

      $

      (46,403)


      $

      (24,289)


      Adjustments to reconcile net loss to net cash used in operating activities:





      Depreciation and amortization expense


      30,746



      12,741


      Change in fair value of contingent consideration


      (4,152)



      —


      Change in fair value of embedded derivative


      —



      5,444


      Change in fair value of warrant liabilities


      (24,565)



      —


      Loss on extinguishment of debt


      13,225



      —


      Amortization of debt issuance costs


      7,653



      3,851


      Write off of other receivables


      —



      531


      Equity-based compensation


      12,148



      177


      Changes in operating assets and liabilities:





      Accounts receivable, net


      (95,991)



      (33,286)


      Inventory


      (856)



      (484)


      Other assets


      (6,578)



      217


      Prepaid expenses and other current assets


      (27,358)



      163


      Accounts payable and accrued expenses


      56,626



      10,480


      Deferred rent


      2,236



      868


      Deferred revenue


      1,147



      —


      Other liabilities


      (9,376)



      2,544


      Net cash used in operating activities


      (91,498)



      (21,043)







      Cash Flows from Investing Activities:





      Purchase of property and equipment


      (23,221)



      (9,442)


      Acquisitions of subsidiaries including non-compete intangibles, net of cash acquired


      (1,068,661)



      (205,325)


      Payments to sellers


      (24,148)



      (38,748)


      Other


      —



      (39)


      Net cash used in investing activities


      (1,116,030)



      (253,554)







      Cash Flows from Financing Activities:





      Contributions from member


      —



      95,782


      Business combination and PIPE financing


      935,362



      —


      Interest accrued due to sellers


      1,208



      1,082


      Payments of long-term debt


      (656,294)



      (2,378)


      Debt issuance costs


      (17,689)



      (5,655)


      Proceeds from long-term debt


      1,120,000



      184,096


      Proceeds from revolving credit facility


      —



      9,700


      Repayments of revolving credit facility


      —



      (9,700)


      Proceeds from insurance financing arrangements


      4,401



      2,864


      Payments of principal on insurance financing arrangements


      (3,939)



      (2,388)


      Repayments of equipment loans


      (233)



      (57)


      Repayments of capital lease obligations


      (316)



      (518)


      Settlement of note receivable


      134



      —


      Net cash provided by financing activities


      1,382,634



      272,828







      Net increase (decrease) in cash, cash equivalents and restricted cash


      175,106



      (1,769)


      Cash, cash equivalents and restricted cash at beginning of year


      33,807


      29,192

      Cash, cash equivalents and restricted cash at end of period

      $

      208,913


      $

      27,423


      Reconciliation of Non-GAAP

      Adjusted EBITDA




      Three Months Ended

      September 30,


      Nine Months Ended

      September 30,

      (in thousands)


      2021


      2020


      2021


      2020

      Net income (loss)

      $

      (40,883)


      $

      (11,117)


      $

      (46,403)


      $

      (24,289)


      Interest income


      (1)



      (80)



      (4)



      (239)


      Interest expense


      16,023



      12,346



      36,363



      21,728


      Income tax expense (benefit)


      547



      326



      (762)



      294


      Depreciation and amortization expense


      16,955



      5,379



      30,746



      12,741


      EBITDA

      $

      (7,359)


      $

      6,854


      $

      19,940


      $

      10,235


      Stock-based compensation


      8,909



      66



      12,148



      177


      De novo losses (1)


      9,016



      2,025



      21,496



      4,373


      Acquisition transaction costs (2)


      7,825



      7,827



      35,163



      30,121


      Restructuring and other


      2,123



      1,113



      5,513



      1,829


      Loss on extinguishment of debt


      —



      —



      13,225



      —


      Change in fair value of embedded derivative


      —



      5,138



      —



      5,444


      Change in fair value of warrant liabilities


      14,650



      —



      (24,565)



      —


      Adjusted EBITDA

      $

      35,164


      $

      23,023


      $

      82,921


      $

      52,179



      ______________________________

      (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 $1.3 million and $0.1 million of corporate development payroll costs for the three months ended September 30, 2021 and 2020, respectively, and $3.0 million and $0.3 million of corporate development payroll costs for the nine months ended September 30, 2021 and 2020, 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
      September 30,





      2021


      2020


      % Change

      Members:







      Medicare


      120,086



      72,806



      64.9

      %

      Medicaid


      63,871



      19,169



      233.2

      %

      ACA


      26,706



      10,792



      147.5

      %

      Total members


      210,663



      102,767



      105.0

      %








      Member months:







      Medicare


      360,439



      216,353



      66.6

      %

      Medicaid


      187,212



      53,511



      249.9

      %

      ACA


      81,437



      32,285



      152.2

      %

      Total member months


      629,088



      302,149



      108.2

      %








      Per Member Per Month ("PMPM"):







      Medicare

      $

      1,241


      $

      1,020



      21.7

      %

      Medicaid

      $

      271


      $

      585



      (53.7)

      %

      ACA

      $

      47


      $

      33



      42.4

      %

      Total PMPM

      $

      798


      $

      837



      (4.7)

      %








      Owned medical centers


      113



      71






      Nine Months Ended

      September 30,





      2021


      2020


      % Change

      Members:







      Medicare


      120,086



      72,806



      64.9

      %

      Medicaid


      63,871



      19,169



      233.2

      %

      ACA


      26,706



      10,792



      147.5

      %

      Total members


      210,663



      102,767



      105.0

      %








      Member months:







      Medicare


      867,520



      483,878



      79.3

      %

      Medicaid


      321,581



      136,658



      135.3

      %

      ACA


      195,290



      92,577



      110.9

      %

      Total member months


      1,384,391



      713,113



      94.1

      %








      Per Member Per Month ("PMPM"):







      Medicare

      $

      1,162


      $

      942



      23.4

      %

      Medicaid

      $

      414


      $

      631



      (34.4)

      %

      ACA

      $

      36


      $

      26



      38.5

      %

      Total PMPM

      $

      829


      $

      764



      8.5

      %








      Owned medical centers


      113



      71




      SOURCE Cano Health, Inc.

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