美国健康科技与分销二季度预览：AI、消费主义与价值医疗为核心

2Q Preview: AI, Consumerism, and Value-Based Care Take CenterStage Daniel GrosslightAC+1-212-816-9180daniel.grosslight@citi.comLuismario Higueraluismario.higuera@citi.com CITI'S TAKE Our health tech coverage has staged an impressive recovery following 1Qresults. This rebound was largely fueled by (1) renewed confidence in VBCenablers (AGL is up +330% since earnings; EVH is up ~50%); (2) strategicturnaround execution (TDOC is making significant progress in scaling itsinsurance business at BetterHelp while HCAT has sold off non-core assets);and (3) general interest in growth assets. Looking ahead to 2Q, we see mostupside from PRVA as we think they will raise guidance on continued sharedsavingsstrength and new acquisition integration,and TDOC withBetterHelp poised to beat on continued insurance acceleration and DTCstabilization. We are more cautious on AGL and EVH as we think the run-upin these stocks leaves little room for upside. Downgrading AGL to Sell / High Risk and EVH to Neutral / High Risk—We aredowngrading AGL and EVH as we believe their risk/reward set-ups have become lessfavorable with the significant run-ups in their stock prices. For AGL, while we expectcontinued MLR improvement and ACO REACH performance, after a +650% run-upthis year, the stock now trades at a 38% premium to peers which we think is too richgiven AGL still faces significant risks as MA plans seek to retain margin heading intoFY27. For EVH, significant unknowns remain regarding HIX dis-enrollment, acuityshifts, and potential Medicaid headwinds next year which we don’t think is fullyreflected in FY27 cons. EBITDA estimates. Most Bullish on PRVA and TDOC—We think the 2Q set-ups are most favorable forPRVA and TDOC. ON PRVA, mgmt has a well-established habit of guidingconservatively, and after a strong 1Q beat they left the full-year outlook largelyunchanged. Given the momentum in Shared Savings and further integration ofrecently acquired provider groups, we think this sets the stage for another beat-and-raise quarter. On TDOC, the BetterHelp turnaround looks to be ahead ofschedule as the insurance-covered offering will surpass $125M of runrate revenueby yearend with early signs that the core DTC business is finding its floor. That said,we remain Neutral/High Risk rated on TDOC as we need to see more durable BH andchronic care growth before we turn more constructive. HIMS Remains Our Most Hotly Debated Stock—We think expectations are highinto the print and we do not see much upside to numbers (excluding the acquisitionof Eucalyptus). While membership adds from the Novo partnership are likely to beimpressive, the continued shift to monthly shipping cadences coupled with highchurn is likely to keep sales relatively subdued. Additionally, while our recent surveyshowed HIMS’ sales will likely accelerate as the TRT, HRT, and (maybe) Peptidescategories mature, this is unlikely to have a meaningful near-term impact. AI, Consumerism, and Value-BasedCare Take Center Stage Our health tech coverage has staged an impressive recovery following 1Q results.Nearly all of our coverage has traded up DD, with WAY the lone stock thatcontinues to struggle given fears around AI disintermediation and volumeheadwinds. As seen in Figure 1, performance has been bifurcated with the rebound fueled byrenewed confidence in the risk-taking VBC enablers (namely AGL and EVH) andturnarounds at TDOC and HCAT. We have also seen general rotation in SMID-capgrowth assets over the past 3 months. Agilon Health (AGL.N) Sell / High Riskfrom Neutral / High Risk|TPUS$105.00from US$80.00|Price US$119.88 (22 Jul 2616:00) Turnaround Progressing Well, but Valuation is Frothy —AGL’s 1Q earningsclearly demonstrated that the company has reached an inflection point, withimpressive MLR improvement (largely driven by improved pricing and favorablecost trend), strong BOI performance, minimization of Part D exposure, datapipeline enhancements, the scaling of clinical pathways, and better-than-expected ACO REACH contribution. With cost trend likely to come belowexpectations in 2Q (7% net), we think the momentum will continue for theremainder of the year, and we now expect AGL to come at the high end of guidancefor medical margin (our estimates call for $130M of Medical margin in 2Q26 and$400M for FY26) and near the high end for adj. EBITDA (our estimates now call for$25M of adj. EBITDA in 2Q26 and $36M for FY26). That said, in our view, even if AGL reaches the top end of the guidance range,valuation has become a bit too frothy as AGL’s stock is up +630% YTD (+350%since 1Q earnings), and now trades at ~22x our adj. EBITDA estimates and ~4x ourmedical margin estimates. This now represents a ~13% premium to where AGL hastraded over the past 3 years (on a medical margin multiple). As such we downgradeAGL to sell, but we raise our target price to $105 (from $80) which contemplates a20x EBITDA multiple on our upwardly revised estimates (vs 19x previously). Wethink multiple expansion i