The opioid crisis' economic impact in Michigan
Why it matters: The cost burden falls unevenly across the country, with states in a belt stretching through Appalachia to New England typically having bigger caseloads and a higher cost per case.
Context: Opioid use disorder — defined as frequent opioid use and unsuccessful efforts to quit — is estimated to affect more than 6 million people in the United States, costing the nation an estimated $4 trillion last year, per health care consulting firm Avalere Health.
The cumulative economic burden on patients, including years of life lost and reduced quality of life, exceeded $3 trillion in 2024, Avalere estimated.
Zoom in: Michigan borders the states with the highest share of opioid misuse cases.
At $742,799, our average cost per case is slightly higher than the national average, per the analysis from Avalere, which used 2017 figures to project 2024 net costs.
Zoom out: Private businesses absorbed more than $467 billion in costs from lost productivity and health insurance costs, while the federal government bore about $118 billion in Medicare and other federal insurance costs, lost taxes and criminal justice expenses.
It cost state and local governments more than $94 billion, with about $42 billion of that going toward criminal justice costs.
What they're saying: Reports such as Avalere's help local officials across the state better understand the opioid crisis and how to address it with the state's $1.6 billion in opioid settlement funds, Joyce Fetrow, project director of the Northern Michigan Opioid Response Consortium, tells Axios.
Every dollar spent on recovery provides a 10% return, Fetrow says. Investment in recovery services leads more people to spend on housing, transportation and other needs instead of their addiction.
Follow the money: The projected cost of opioid use disorder in 2024 ranged from $419,527 per case in Idaho to more than $2.4 million in D.C.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
5 hours ago
- Yahoo
‘You turn 65, you join the club.' U.S. Rep. Richard Neal celebrates anniversary of Medicare and Medicaid Act
WILBRAHAM – U.S. Rep. Richard E. Neal, D-Springfield, celebrated the coming 60th anniversary of the Medicare and Medicaid Act, contrasting the legislative achievement of President Lyndon B. Johnson with the Big Beautiful Bill Act that Neal expects will be reversed over time. This month's legislation will impose $1.2 trillion in cuts, mostly to Medicaid and food stamps, the Associated Press has said. It will impose work requirements on able-bodied people seeking medical care, including some parents and older Americans, making sign-up eligibility more stringent and changing federal reimbursements to states. Neal spoke Monday at Life Care Center of Wilbraham, showing a video of Johnson signing the legislation on July 30, 1965, at the Harry S. Truman Library in Independence, Missouri. The video is available on the website of the LBJ Presidential Library at With 123 beds, about 60% of the center's residents are on Medicaid, said Dennis P. Lopata, senior executive director. Another 10% are covered by Medicare and the rest are private pay. Neal said the recent bill also puts financial pressure on Medicare, the insurance program for the seniors that's an earned benefit. 'You turn 65, you join the club,' Neal said. 'We don't ask about any qualifications.' The nonpartisan Congressional Budget Office found that as a result of the Trump legislation, 11.8 million more Americans would become uninsured by 2034. 'The actual cuts to Medicaid don't take place until after the next election,' said Neal, the ranking Democrat on the House Ways & Means Committee. 'Pretty contrived.' Health care providers and insurers are already under pressure, Neal said. But there is a chance the cuts won't happen. 'My guess is that a lot of them will be – in time – changed. Because they are so unpopular,' said. Electing a Democratic majority in the House would be the way to do it, Neal said. 'Well, if we win next year, which seems likely, I intend to offer legislation to reverse all of those cuts right away across the board. A trillion dollars in cuts to Medicaid over the next 10 years. They can't be sustained.' President Johnson, riding a wave of popularity after the 1964 election, signed the bill in Missouri to honor Truman's work on health care, Neal said. Truman had been a New Deal-era Democratic senator from Missouri before briefing becoming FDR's vice president in 1945, then president. A current Missouri senator, Josh Hawley, has proposed legislation aimed at reversing Medicaid cuts in the Big Beautiful Bill, after voting for that legislation. 'I think a 'no' vote would have been the better vote,' Neal said. Neal also spoke Monday about Social Security. 'We have always repaired Social Security and Medicare, and we always will,' Neal said. 'We intend to propose expanded Social Security benefits, and we will also propose how to pay for it.' Stories by Jim Kinney How much trash does a courthouse produce? Inquiring bidders want to know in Springfield Friendly's parent company sold to NJ franchisee This Springfield eatery, silenced by fire, has a new owner Read the original article on MassLive.
Business Wire
6 hours ago
- Business Wire
AdaptHealth Corp. to Participate in Upcoming Investor Conference
PLYMOUTH MEETING, Pa.--(BUSINESS WIRE)-- AdaptHealth Corp. (NASDAQ: AHCO) ('AdaptHealth' or the 'Company'), a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment, medical supplies, and related services, announced today that they will participate in the Canaccord Genuity 45th Annual Growth Conference, being held in Boston, on Wednesday, August 13, 2025, including a fireside chat at 8:00am ET. The webcast link will be available on the Company's website, under 'Investor Relations.' About AdaptHealth Corp. AdaptHealth is a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment, medical supplies, and related services. The Company operates under four reportable segments that align with its product categories: (i) Sleep Health, (ii) Respiratory Health, (iii) Diabetes Health, and (iv) Wellness at Home. The Sleep Health segment provides sleep therapy equipment, supplies and related services (including CPAP and BiLevel services) to individuals for the treatment of obstructive sleep apnea. The Respiratory Health segment provides oxygen and home mechanical ventilation equipment and supplies and related chronic therapy services to individuals for the treatment of respiratory diseases, such as chronic obstructive pulmonary disease and chronic respiratory failure. The Diabetes Health segment provides medical devices, including continuous glucose monitors and insulin pumps, and related services to patients for the treatment of diabetes. The Wellness at Home segment provides home medical equipment and services to patients in their homes including those who have been discharged from acute care and other facilities. The segment tailors a service model to patients who are adjusting to new lifestyles or navigating complex disease states by providing essential medical supplies and durable medical equipment. The Company is proud to partner with an extensive and highly diversified network of referral sources, including acute care hospitals, sleep labs, pulmonologists, skilled nursing facilities, and clinics. AdaptHealth services beneficiaries of Medicare, Medicaid, and commercial insurance payors, reaching approximately 4.2 million patients annually in all 50 states through its network of approximately 660 locations in 47 states.
Business Wire
6 hours ago
- Business Wire
agilon health Reports Second Quarter 2025 Results
WESTERVILLE, Ohio--(BUSINESS WIRE)--agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, today announced results for the second quarter ended June 30, 2025. As announced in a separate press release today, Steven Sell has stepped down as President, CEO and a Director of the Board, and the Company's co-founder and Board Chairman Ronald A. Williams has been appointed Executive Chairman while the Board conducts a search for a permanent CEO. 'agilon's value-based care model delivers significant value to our physician partners and their senior patients across the U.S. with a proven ability to serve as the long-term solution for practices focused on outcomes,' said Ronald A. Williams, Executive Chair. 'We have continued advancing strategic initiatives in 2025 to improve performance – including enhancing our platform, data visibility, quality and delivery programs and contract economics – that we expect to fully realize the benefit of next year given the nature of our business cycle. Nevertheless, as we progressed through this transition year, it's become clear that the industry headwinds are more acute than previously expected, and our enhanced data platform is providing visibility that indicates our 2024 and 2025 risk adjustment is also lower than previously expected, which is impacting near-term results. It is clear we need to further improve execution and more fully optimize agilon against broader market-based complexities. 'We will accomplish this by taking decisive action to increase ownership of the elements within our control and execute with the discipline and operational excellence required by the current environment. We are confident that our ongoing actions to reduce market risks and improve contract economics, combined with increased rigor on execution and an updated Medicare reimbursement model taking effect next year, we will be positioned to drive financial improvement into 2026 and deliver long-term results for our physician partners and value for our shareholders.' Second Quarter 2025 Results: Compared to previous guidance, second quarter 2025 was negatively impacted by additional information received from payors in the second quarter. This includes prior period development of $66 million, of which $20 million was associated with exited markets and $13 million is associated with Part D costs from payers who have agreed to carve out Part D in 2025, as well as a $37 million reduction in risk adjustment revenue for 2024 offset by slight favorability in quality incentives. Additionally, included in the quarter results is a reduction in risk adjustment revenue of $48 million year-to-date for 2025 informed by our enhanced data platform representing 72% of our membership. Total members on the agilon platform decreased to 614,000 as of June 30, 2025, including 498,000 Medicare Advantage members and 116,000 ACO REACH model beneficiaries. Year-over-year changes to membership reflect previously disclosed market exits. Total revenue of $1.39 billion in the second quarter 2025 decreased 6% compared to $1.48 billion in the second quarter 2024. Revenue reflects membership growth in new markets and same geography growth more than offset by the impact from market exits as well as the aforementioned reduction to risk adjustment revenue contribution. Gross profit was negative $52 million in the second quarter 2025 compared to positive $32 million in the second quarter 2024. Net loss of $104 million in the second quarter 2025 compared to $31 million in the second quarter 2024. Medical margin was negative $53 million during the second quarter 2025, compared to positive $106 million in the second quarter 2024. Medical Margin for the second quarter 2025 includes the impact from the aforementioned items. Adjusted EBITDA loss was $83 million in the second quarter 2025 compared to $3 million in the second quarter 2024. Capital Position and Balance Sheet agilon health's balance sheet as of June 30, 2025 included cash and cash equivalents and marketable securities of $327 million and total debt of $35 million. At the end of the quarter, agilon health had $176 million of cash associated with the Company's unconsolidated ACO model entities. Suspends 2025 Guidance and Assumptions In conjunction with the announcement of agilon's leadership change and the evaluation of additional actions to optimize operating performance, as well as continued execution of ongoing initiatives and market uncertainty which may impact future results, agilon is suspending its previously issued full-year 2025 financial guidance and related assumptions. Webcast and Conference Call agilon health will host a conference call to discuss second quarter 2025 results on Monday, August 4, 2025, at 5:30 PM Eastern Time. The conference call can be accessed by dialing (833) 470-1428 for U.S. participants and +1 (404) 975-4839 for international participants and referencing participant code 938716. A simultaneous listen-only, live webcast can be accessed by visiting the 'Events & Presentations' section of agilon's Investor Relations website at A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call. About agilon health agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,200+ primary care physicians (PCPs) that allow its physician partners to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30 diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information visit and connect with us on LinkedIn. Forward-Looking Statements Statements in this release that are not historical factual statements are 'forward-looking statements' within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include, among other things, statements regarding our and our officers' intent, belief or expectation as identified by the use of words such as 'believes,' 'expects,' 'may,' 'will,' 'shall,' 'should,' 'would,' 'could,' 'seeks,' 'aims,' 'projects,' 'is optimistic,' 'intends,' 'plans,' 'estimates,' 'anticipates' or the negative versions of these words or other comparable terms. Examples of forward-looking statements include, among other things: statements regarding our confidence in future financial improvements, expectations about 2025 being a transition year, anticipated benefits from our strategic initiatives, potential optimization actions under review, our leadership transition and CEO search process, our expectations related to operating and financial results, our ability to efficiently exit unprofitable markets, our expectations regarding the Medicare Advantage environment, and our long-term opportunities and strategic growth plans and alignment with the macro environment, expected revenue, medical costs, net income and gross profit, total and average membership, Adjusted EBITDA, Medical Margin, geography entry costs and other financial projections and assumptions, including our fiscal year and second quarter 2025 guidance. Forward-looking statements reflect our current expectations and views about future events and are subject to risks and uncertainties that could significantly affect our future financial condition and results of operations. While forward-looking statements reflect our good faith belief and assumptions we believe to be reasonable based upon current information, we can give no assurance that our expectations or forecasts will be attained. Forward-looking statements are subject to known and unknown risks and uncertainties, many of which may be outside our control. These risks and uncertainties that could cause actual results and outcomes to differ from those reflected in forward-looking statements include, but are not limited to: our history of net losses and the expectation that our expenses will increase in the future; failure to identify and develop successful new geographies, physician partners and payors, or execute upon our growth initiatives; success in executing our operating strategies or achieving results consistent with our historical performance; medical expenses incurred on behalf of our members may exceed revenues we receive; our ability to maintain and secure additional contracts with Medicare Advantage payors on favorable terms, if at all; our ability to grow new physician partner relationships sufficient to recover startup costs; availability of additional capital, on acceptable terms or at all, to support our business in the future; significant reduction in our membership; transition to a Total Care Model may be challenging for physician partners; public health crises, such as pandemics or epidemics, could adversely affect us; inaccuracy in estimates of our members' risk adjustment factors, medical services expense, incurred but not reported claims, and earnings pursuant to payor contracts; the impact of restrictive clauses or exclusivity provisions in some of our contracts with physician partners; our ability to hire and retain qualified personnel; our ability to realize the full value of our intangible assets; security breaches, cybersecurity attacks, loss of data and other disruptions to our information systems; our ability to protect the confidentiality of our know-how and other proprietary and internally developed information; our reliance on our subsidiaries to perform and fund their operations; our use of artificial intelligence and machine learning in our business and challenges with properly managing the development and use of these technologies; our reliance on a limited number of key payors; the limited terms of contracts with our payors and our ability to renew them upon expiration; our ability to navigate the changing healthcare payor market; our reliance on our payors, physician partners and other providers to operate our business; our ability to obtain accurate and complete diagnosis data; our reliance on third-party software, data, infrastructure and bandwidth; consolidation and competition in the healthcare industry; the impact of changes to, and dependence on, federal government healthcare programs; uncertain or adverse economic and macroeconomic conditions, including a downturn or decrease in government expenditures; regulation of the healthcare industry and our and our physician partners' ability to comply with such laws and regulations; federal and state investigations, audits and enforcement actions; repayment obligations arising out of payor audits; negative publicity regarding the managed healthcare industry generally; our use, disclosure and processing of personally identifiable information, protected health information, and de-identified data; failure to obtain or maintain an insurance license, a certificate of authority or an equivalent authorization; changes in tax laws and regulations, or changes in related judgments or assumptions; our indebtedness and our potential to incur more debt; our dependence on our subsidiaries for cash to fund all of our operations and expenses; provisions in our governing documents; our ability to achieve a return on investment depends on appreciation in the price of our common stock; lawsuits not covered by insurance and securities class action litigation; sustainability issues; our stock price may be volatile; and risks related to management transitions, including the search for a permanent CEO, and our ability to effectively manage leadership changes; and risks related to other factors discussed in our filings with the Securities and Exchange Commission (the 'SEC'), including the factors discussed under 'Risk Factors' in our Annual Report on Form 10-K for the fiscal year ended December 31, 2024, which can be found at the SEC's website at Additionally, the suspension of our previously issued full-year 2025 financial guidance, ongoing implementation of performance initiatives, leadership changes, and dynamic market conditions create additional uncertainty regarding our future operating and financial performance. Except as required by law, we do not undertake, and hereby disclaim, any obligation to update any forward-looking statements, which speak only as of the date on which they are made. agilon health, inc. Condensed Consolidated Statements of Operations In thousands, except per share data (unaudited) Three Months Ended June 30, Six Months Ended June 30, Revenues: Medical services revenue $ 1,392,039 $ 1,479,579 $ 2,921,918 $ 3,080,774 Other operating revenue 2,943 3,179 5,846 6,338 Total revenues 1,394,982 1,482,758 2,927,764 3,087,112 Expenses: Medical services expense 1,445,245 1,374,060 2,847,112 2,817,902 Other medical expenses 2,164 76,523 82,357 161,947 General and administrative 56,281 69,612 122,237 146,034 Depreciation and amortization 7,319 5,907 14,195 11,751 Total expenses 1,511,009 1,526,102 3,065,901 3,137,634 Income (loss) from operations (116,027 ) (43,344 ) (138,137 ) (50,522 ) Other income (expense): Income (loss) from equity method investments 5,412 9,955 18,084 15,639 Other income (expense), net 7,879 4,841 17,140 10,733 Interest expense (1,572 ) (1,697 ) (3,087 ) (2,981 ) Income (loss) before income taxes (104,308 ) (30,245 ) (106,000 ) (27,131 ) Income tax benefit (expense) (62 ) (417 ) (258 ) (284 ) Income (loss) from continuing operations (104,370 ) (30,662 ) (106,258 ) (27,415 ) Discontinued operations: Income (loss) before gain (loss) on sales — — — (518 ) Adjustments on sale of assets, net — — 14,000 (8,763 ) Total discontinued operations — — 14,000 (9,281 ) Net income (loss) (104,370 ) (30,662 ) (92,258 ) (36,696 ) Noncontrolling interests' share in (earnings) loss — (20 ) — (50 ) Net income (loss) per common share, basic and diluted Continuing operations $ (0.25 ) $ (0.07 ) $ (0.25 ) $ (0.07 ) Discontinued operations $ — $ — $ 0.03 $ (0.02 ) Weighted average shares outstanding Basic and diluted 413,836 411,271 413,388 409,152 Expand agilon health, inc. Condensed Consolidated Statements of Cash Flows In thousands (unaudited) Six Months Ended June 30, 2025 2024 Cash flows from operating activities: Net income (loss) $ (92,258 ) $ (36,696 ) Adjustments to reconcile net income (loss) to net cash used in operating activities: Depreciation and amortization 14,195 11,751 Stock-based compensation expense 32,101 35,116 Loss (income) from equity method investments (18,084 ) (15,639 ) Distributions of earnings from equity method investments — 3,340 Adjustments on sale of assets, net (14,000 ) 3,784 Other noncash items (3,107 ) (837 ) Changes in operating assets and liabilities: 14,081 (67,312 ) Net cash provided by (used in) operating activities (67,072 ) (66,493 ) Cash flows from investing activities: Purchase of property and equipment (7,099 ) (6,451 ) Purchase of intangible assets (9,717 ) (17,893 ) Investment in loans receivable and other (1,000 ) (9,742 ) Investments in marketable securities (60,154 ) (12,006 ) Proceeds from maturities of marketable securities and other 125,339 115,747 Net cash provided by (used in) investing activities 47,369 69,655 Cash flows from financing activities: Proceeds from (payments for) equity issuances, net (2,741 ) 1,345 Repayments of long-term debt — (2,500 ) Net cash provided by (used in) financing activities (2,741 ) (1,155 ) Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents (22,444 ) 2,007 Cash, cash equivalents and restricted cash and equivalents, beginning of period 193,860 114,329 Cash, cash equivalents and restricted cash and equivalents, end of period $ 171,416 $ 116,336 Expand agilon health, inc. Key Operating Metrics In thousands (unaudited) GROSS PROFIT (LOSS) Three Months Ended June 30, Six Months Ended June 30, 2025 2024 2025 2024 Total revenues $ 1,394,982 $ 1,482,758 $ 2,927,764 $ 3,087,112 Medical services expense (1,445,245 ) (1,374,060 ) (2,847,112 ) (2,817,902 ) Other medical expenses (1) (2,164 ) (76,523 ) (82,357 ) (161,947 ) Gross profit (loss) $ (52,427 ) $ 32,175 $ (1,705 ) $ 107,263 Expand ____________________________________ (1) Represents physician compensation expense related to surplus sharing and other care management expenses that help to create medical cost efficiency. Includes costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended June 30, 2025 and 2024, costs incurred in implementing geographies were $0.2 million and $18,000, respectively. For the six months ended June 30, 2025 and 2024, costs incurred in implementing geographies were $(1.0) million and $0.6 million, respectively. Expand ____________________________________ (1) Represents direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. (2) Includes transaction-related costs. Expand Our platform support costs, which include regionally-based support personnel and other operating costs to support our geographies, are expected to decrease over time as a percentage of revenue as our physician partners add members and our revenue grows. Our operating expenses at the enterprise level include resources and technology to support payor contracting, clinical program development, quality, data management, finance, and legal and compliance functions. ____________________________________ (1) Gross profit (loss) is defined as total revenues less medical services expense and other medical expenses. Expand ADJUSTED EBITDA Three Months Ended June 30, Six Months Ended June 30, 2025 2024 2025 2024 Net income (loss) (1) $ (104,370 ) $ (30,662 ) $ (92,258 ) $ (36,696 ) (Income) loss from discontinued operations, net of income taxes — — (14,000 ) 9,281 Interest expense 1,572 1,697 3,087 2,981 Income tax expense (benefit) 62 417 258 284 Depreciation and amortization 7,319 5,907 14,195 11,751 Severance and related costs 119 868 644 3,283 Stock-based compensation expense 15,381 18,207 32,101 35,116 EBITDA adjustments related to equity method investments (2) 4,366 1,404 11,209 5,306 Other (3) (7,782 ) (668 ) (18,002 ) (5,082 ) Adjusted EBITDA $ (83,333 ) $ (2,830 ) $ (62,766 ) $ 26,224 Expand ____________________________________ (1) Includes direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended June 30, 2025 and 2024, (i) $0.2 million and $18,000, respectively, are included in other medical expenses and (ii) $4.2 million and $4.8 million, respectively, are included in general and administrative expenses. For the six months ended June 30, 2025 and 2024, (i) $(1.0) million and $0.6 million, respectively, are included in other medical expenses and (ii) $10.8 million and $15.3 million, respectively, are included in general and administrative expenses. (2) Includes elimination of certain administrative services provided by agilon health, inc. to equity method investments. (3) Includes interest income, transaction-related costs and elimination of certain administrative services provided by agilon health, inc. to equity method investments. Expand agilon health, inc. Supplemental Financial Information In thousands (unaudited) Three Months Ended June 30, 2025 Six Months Ended June 30, 2025 Medicare Advantage (Consolidated) CMS ACO Models (Unconsolidated) Medicare Advantage (Consolidated) CMS ACO Models (Unconsolidated) Medical services revenue $ 1,392,039 $ 434,806 $ 2,921,918 $ 848,271 Other operating revenue 2,943 — 5,846 — Total revenues 1,394,982 434,806 2,927,764 848,271 Medical services expense (1,445,245 ) (401,902 ) (2,847,112 ) (753,755 ) Other medical expenses (2,164 ) (17,848 ) (82,357 ) (54,090 ) Gross profit (loss) (52,427 ) 15,056 (1,705 ) 40,426 Other operating revenue (2,943 ) — (5,846 ) — Other medical expenses 2,164 17,848 82,357 54,090 Medical margin $ (53,206 ) $ 32,904 $ 74,806 $ 94,516 Expand Certain of our operations are not consolidated for the period presented because we do not have the ability to control certain activities due to another party's control of the entities' board of directors. Although revenues of the unconsolidated operations are not recorded as revenues by us, income (loss) from equity method investments is nonetheless a significant portion of our overall earnings. See Note 14 to the Condensed Consolidated Financial Statements in the Quarterly Report on Form 10-Q for the period ending June 30, 2025 for additional discussion on our equity method investments. In addition to providing results that are determined in accordance with GAAP, we present Medical Margin and Adjusted EBITDA, which are non-GAAP financial measures. We define Medical Margin as medical services revenue after medical services expense is deducted. Medical services expense represents costs incurred for medical services provided to our members. As our platform matures over time, we expect Medical Margin to increase in absolute dollars. However, Medical Margin per member per month (PMPM) may vary as the percentage of new members brought onto our platform fluctuates. New membership added to the platform is typically dilutive to Medical Margin PMPM. We believe this metric provides insight into the economics of our capitation arrangements as it includes all medical services expense directly associated with our members' care. We define Adjusted EBITDA as net income (loss) adjusted to exclude: (i) income (loss) from discontinued operations, net of income taxes, (ii) interest expense, (iii) income tax expense (benefit), (iv) depreciation and amortization, (v) stock-based compensation expense, (vi) severance and related costs, and (vii) certain other items that are not considered by us in the evaluation of ongoing operating performance. We reflect our share of Adjusted EBITDA for equity method investments by applying our actual ownership percentage for the period to the applicable reconciling items on an entity-by-entity basis. Gross profit (loss) is the most directly comparable GAAP measure to Medical Margin. Net income (loss) is the most directly comparable GAAP measure to Adjusted EBITDA. We believe Medical Margin and Adjusted EBITDA help identify underlying trends in our business and facilitate evaluation of period-to-period operating performance of our operations by eliminating items that are variable in nature and not considered by us in the evaluation of ongoing operating performance, allowing comparison of our recurring core business operating results over multiple periods. We also believe Medical Margin and Adjusted EBITDA provide useful information about our operating results, enhance the overall understanding of our past performance and future prospects, and allow for greater transparency with respect to key metrics we use for financial and operational decision-making. We believe Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures are widely used by investors, securities analysts, ratings agencies, and other parties in evaluating companies in our industry as a measure of financial performance. Other companies may calculate Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures differently from the way we calculate these metrics. As a result, our presentation of Medical Margin and Adjusted EBITDA may not be comparable to similarly titled measures of other companies, limiting their usefulness as comparative measures.
