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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, DC 20549

 

FORM 10-Q

 

(Mark One)

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2021

OR

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                      to                     

Commission File Number: 001-39427

 

Oak Street Health, Inc.

(Exact Name of Registrant as Specified in its Charter)

 

 

Delaware

84-3446686

(State or other jurisdiction of

incorporation or organization)

(I.R.S. Employer

Identification No.)

 

 

30 W. Monroe Street

Suite 1200

Chicago, Illinois 60603

60603

(Address of principal executive offices)

(Zip Code)

 

Registrant’s telephone number, including area code: (312) 733-9730

 

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class 

 

Trading

Symbol(s) 

 

Name of each exchange

on which registered 

 

 

 

 

 

Common Stock, $0.001 par value

 

OSH

 

NYSE

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes      No  

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

 

Large accelerated filer

Accelerated filer

Non-accelerated filer

Smaller reporting company

Emerging growth company

 

 

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).      Yes      No  

As of November 4, 2021, the registrant had 240,927,344 shares of common stock, $0.001 par value per share, outstanding.

 

 

 


 

 

 

PART I.

FINANCIAL INFORMATION

5

 

 

 

Item 1.

Financial Statements

5

 

 

 

 

Consolidated Balance Sheets as of September 30, 2021 (unaudited) and December 31, 2020

6

 

 

 

 

Consolidated Statements of Operations for the Three and Nine-Months Ended September 30, 2021 and 2020 (unaudited)

8

 

 

 

 

Consolidated Statements of Comprehensive Loss for the Three and Nine-Months Ended September 30, 2021 and 2020 (unaudited)

9

 

 

 

 

Consolidated Statements of Changes in Redeemable Investor Units and Stockholders’ Equity/Members’ (Deficit) for the Three and Nine-Months Ended September 30, 2021 and 2020 (unaudited)

10

 

 

 

 

Consolidated Statements of Cash Flows for the Nine-Months Ended September 30, 2021 and 2020 (unaudited)

14

 

 

 

 

Notes to Consolidated Financial Statements

16

 

 

 

Item 2.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

33

 

 

 

Item 3.

Quantitative and Qualitative Disclosures about Market Risk

46

 

 

 

Item 4.

Controls and Procedures

46

 

 

 

PART II.

OTHER INFORMATION

47

 

 

 

Item 1.

Legal Proceedings

47

 

 

 

Item 1A.

Risk Factors

47

 

 

 

Item 2.

Unregistered Sale of Equity Securities and Use of Proceeds

51

 

 

 

Item 3.

Defaults upon Senior Securities

51

 

 

 

Item 4.

Mine Safety Disclosures

51

 

 

 

Item 5.

Other Information

51

 

 

 

Item 6.

Exhibits

52

 

 

 


 

 

FORWARD-LOOKING STATEMENTS

Throughout this Quarterly Report on Form 10-Q, we make “forward-looking statements” within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements describe future expectations, plans, results or strategies and can often be identified by the use of terminology such as “may,” “will,” “estimate,” “intend,” “plan,” “continue,” “believe,” “expect,” “anticipate,” “target,” “should,” “could,” “potential,” “opportunity,” “goal” or similar terminology. The forward-looking statements contained in this Quarterly Report on Form 10-Q are generally set forth under the heading “Management’s Discussion and Analysis of Financial Condition and Results of Operations” but may be found in other sections as well. These statements are based upon management’s current expectations, assumptions and estimates and are not guarantees of timing, future results or performance. Therefore, you should not rely on any of these forward-looking statements as predictions of future events. Actual results may differ materially from those contemplated in these statements due to a variety of risks and uncertainties and other factors, including, among other things:

 

our history of net losses and our ability to achieve or maintain profitability in an environment of increasing expenses;

 

the impact of the Coronavirus disease (“COVID-19”) pandemic or any other pandemic, epidemic or outbreak of an infectious disease in the United States or worldwide on our business, financial condition and results of operations;

 

the effect of our relatively limited operating history on investors’ ability to evaluate our current business and future prospects;

 

the viability of our growth strategy and our ability to realize expected results;

 

our ability to successfully integrate a newly acquired business or achieve the expected growth, cost savings or synergies from such integration;

 

our ability to attract new patients;

 

the dependence of our revenues and operations on a limited number of key payors;

 

the risk of termination or non-renewal of the Medicare Advantage contracts held by the health plans with which we contract, or the termination or non-renewal of our contracts with those plans;

 

the impact on our business from changes in the payor mix of our patients and potential decreases in our reimbursement rates;

 

our ability to manage our growth effectively, execute our business plan, maintain high levels of service and patient satisfaction and adequately address competitive challenges;

 

our ability to compete in the healthcare industry;

 

our ability to timely enroll new physicians and other providers in governmental healthcare programs before we can receive reimbursement for their services;

 

the impact on our business of reductions in Medicare reimbursement rates or changes in the rules governing the Medicare program;

 

our dependence on reimbursements by third-party payors and payments by individuals;

 

our assumption under most of our agreements with health plans of some or all of the risk that the cost of providing services will exceed our compensation;

 

the impact on our business of renegotiation, non-renewal or termination of capitation agreements with health plans;

 

risks associated with estimating the amount of revenues and refund liabilities that we recognize under our risk agreements with health plans;

 

the impact on our business of security breaches, loss of data or other disruptions causing the compromise of sensitive information or preventing us from accessing critical information;

 

our ability to develop and maintain proper and effective internal control over financial reporting;

 

the impact on our business of disruptions in our disaster recovery systems or management continuity planning;

 

the potential adverse impact of legal proceedings and litigation;

 

the impact of reductions in the quality ratings of the health plans we serve;

 

the risk of our agreements with the physician equity holder of our practices being deemed invalid;

 

our ability to maintain and enhance our reputation and brand recognition;

3


 

 

 

our ability to effectively invest in, implement improvements to and properly maintain the uninterrupted operation and data integrity of our information technology and other business systems;

 

our ability to obtain, maintain and enforce intellectual property protection for our technology;

 

the potential adverse impact of claims by third parties that we are infringing on or otherwise violating their intellectual property rights;

 

our ability to protect the confidentiality of our trade secrets, know-how and other internally developed information;

 

the impact of any restrictions on our use of or ability to license data or our failure to license data and integrate third-party technologies;

 

risks associated with our use of “open-source” software;

 

our dependence on our senior management team and other key employees;

 

the concentration of our primary care centers in Illinois, Michigan, Pennsylvania, Ohio and Texas;

 

the impact on our business of an economic downturn;

 

our ability to attract and retain highly qualified personnel;

 

our management team’s limited experience managing a public company;

 

the impact on our business of the termination of our leases, increases in rent or inability to renew or extend leases;

 

the impact of failures by our suppliers, material price increases on supplies, lack of reimbursement for drugs we purchase or limitations on our ability to access new technology or products;

 

our ability to maintain our corporate culture;

 

the impact of competition for physicians and nurses, shortages of qualified personnel and related increases in our labor costs;

 

our ability to attract and retain the services of key primary care physicians;

 

the risk that our submissions to health plans may contain inaccurate or unsupportable information regarding risk adjustment scores of members;

 

our ability to accurately estimate incurred but not reported medical expense;

 

the impact of negative publicity regarding the managed healthcare industry;

 

the impact of state and federal efforts to reduce Medicaid spending;

 

the impact on our centers of adverse weather conditions and other factors beyond our control;

 

factors related to our issuance of Convertible Senior Notes (as defined later within this Quarterly Report on Form-10-Q); and

 

other factors disclosed in the section entitled “Risk Factors” in this Quarterly Report on Form 10-Q and in similar sections in our other filings with the Securities and Exchange Commission (“SEC”).

We derive many of our forward-looking statements from our operating budgets and forecasts, which are based on many detailed assumptions. While we believe that our assumptions are reasonable, we caution that it is very difficult to predict the impact of known factors, and it is impossible for us to anticipate all factors that could affect our actual results. Important factors that could cause actual results to differ materially from our expectations, or cautionary statements, are disclosed under the sections entitled “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in this Quarterly Report on Form 10-Q. All written and oral forward-looking statements attributable to us, or persons acting on our behalf, are expressly qualified in their entirety by these cautionary statements as well as other cautionary statements that are made from time to time in our other SEC filings and public communications. You should evaluate all forward-looking statements made in this Quarterly Report on Form 10-Q in the context of these risks and uncertainties.

We caution you that the important factors referenced above may not contain all of the factors that are important to you. In addition, we cannot assure you that we will realize the results or developments we expect or anticipate or, even if substantially realized, that they will result in the consequences or affect us or our operations in the way we expect. The forward-looking statements included in this Quarterly Report on Form 10-Q are made only as of the date hereof. We undertake no obligation to update or revise any forward-looking statement as a result of new information, future events or otherwise, except as otherwise required by law.

4


 

PART I

FINANCIAL INFORMATION

Item 1.

FINANCIAL STATEMENTS

OAK STREET HEALTH, INC.

 

CONSOLIDATED FINANCIAL STATEMENTS

For the quarterly period ended September 30, 2021

5


 

OAK STREET HEALTH, INC.

CONSOLIDATED BALANCE SHEETS

($ in millions, except shares/units and per share data)

 

 

 

September 30, 2021 (unaudited)

 

 

December 31, 2020

 

Assets

 

 

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

 

 

Cash

$

 

241.7

 

$

 

409.3

 

Restricted cash

 

 

16.6

 

 

 

10.4

 

Other patient service receivables, net (Humana comprised $0.1 and $0.0 as of September 30, 2021 and December 31, 2020, respectively)

 

 

0.5

 

 

 

7.6

 

Capitated accounts receivable (Humana comprised $118.8 and $65.7 as of September 30, 2021 and December 31, 2020, respectively)

 

 

464.0

 

 

 

248.9

 

Marketable debt securities

 

 

771.3

 

 

 

-

 

Prepaid expenses

 

 

9.6

 

 

 

6.8

 

Other current assets (Humana comprised $5.9 and $0.0 as of September 30, 2021 and December 31, 2020, respectively)

 

 

11.1

 

 

 

4.2

 

Total current assets

 

 

1,514.8

 

 

 

687.2

 

 

 

 

 

 

 

 

 

 

Long-term assets:

 

 

 

 

 

 

 

 

Property and equipment, net

 

 

112.7

 

 

 

78.8

 

Security deposits

 

 

1.6

 

 

 

1.3

 

Operating lease right-of-use assets (Humana comprised $60.8 and $0.0 as of September 30, 2021 and December 31, 2020, respectively)

 

 

145.9

 

 

 

-

 

Goodwill

 

 

12.5

 

 

 

9.6

 

Intangible assets, net

 

 

2.7

 

 

 

3.0

 

Other long-term assets

 

 

0.8

 

 

 

1.1

 

 

 

 

 

 

 

 

 

 

Total assets

$

 

1,791.0

 

$

 

781.0

 

 

 

 

 

 

 

 

 

 

Liabilities and stockholders' equity

 

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

 

 

Accounts payable

$

 

30.2

 

$

 

8.8

 

Accrued compensation and benefits

 

 

38.4

 

 

 

32.0

 

Liability for unpaid claims (Humana comprised $97.8 and $78.5 as of September 30, 2021 and December 31, 2020, respectively)

 

 

442.3

 

 

 

262.1

 

Other liabilities (Humana comprised $16.6 and $4.6 as of September 30, 2021 and December 31, 2020, respectively)

 

 

34.0

 

 

 

12.6

 

Total current liabilities

 

 

544.9

 

 

 

315.5

 

 

 

 

 

 

 

 

 

 

Long-term liabilities:

 

 

 

 

 

 

 

 

Long-term operating lease liabilities (Humana comprised $56.6 and $0.0 as of September 30, 2021 and December 31, 2020, respectively)

 

 

153.0

 

 

 

-

 

Deferred rent expense (Humana comprised $0.0 and $0.8 as of September 30, 2021 and December 31, 2020, respectively)

 

 

-

 

 

 

13.5

 

Other long-term liabilities (Humana comprised $36.2 and $20.1 as of September 30, 2021 and December 31, 2020, respectively)

 

 

39.7

 

 

 

28.8

 

Long-term debt

 

 

900.3

 

 

 

-

 

 

 

 

 

 

 

 

 

 

Total liabilities

 

 

1,637.9

 

 

 

357.8

 

Commitments and contingencies (See Notes 6 & 10)

 

 

 

 

 

 

 

 

Stockholders' equity:

 

 

 

 

 

 

 

 

Preferred stock, par value $0.001; 50,000,000 shares authorized as of September 30, 2021 and December 31, 2020; no shares issued and outstanding as of September 30, 2021 and December 31, 2020

 

 

-

 

 

 

-

 

Common stock, par value $0.001; 500,000,000 shares authorized as of September 30, 2021 and December 31, 2020; 240,919,956 and 240,756,714 shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively

 

 

0.2

 

 

 

0.2

 

Additional paid-in capital (Humana comprised $50.0 and $50.0 as of September 30, 2021 and December 31, 2020, respectively)

 

 

977.6

 

 

 

971.8

 

Accumulated other comprehensive loss

 

 

(0.2

)

 

 

-

 

Accumulated deficit

 

 

(826.6

)

 

 

(555.8

)

Total stockholders' equity allocated to Oak Street Health, Inc.

 

 

151.0

 

 

 

416.2

 

Non-controlling interests

 

 

2.1

 

 

 

7.0

 

Total stockholders' equity

 

 

153.1

 

 

 

423.2

 

 

 

 

 

 

 

 

 

 

Total liabilities and stockholders' equity

$

 

1,791.0

 

$

 

781.0

 

 

6


 

 

 

The accompanying notes are an integral part of these consolidated financial statements.

7


 

OAK STREET HEALTH, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

($ in millions, except shares/units and per share data)

 

 

 

Three-Months Ended

 

 

Nine-Months Ended

 

 

 

September 30, 2021

 

 

September 30, 2020

 

 

September 30, 2021

 

 

September 30, 2020

 

Revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Capitated revenue (Humana comprised $130.7 and $92.3 for the three-months ended September 30, 2021 and 2020, respectively, and $379.2 and $286.1 for the nine-months ended  September 30, 2021 and 2020, respectively)

$

 

376.7

 

$

 

211.8

 

$

 

1,014.6

 

$

 

616.4

 

Other patient service revenue (Humana comprised $2.8 and $0.8 for the three-months ended September 30, 2021 and 2020, respectively, and $4.5 and $2.4 for the nine-months ended September 30, 2021 and 2020, respectively)

 

 

12.0

 

 

 

6.1

 

 

 

23.9

 

 

 

17.7

 

Total revenues

 

 

388.7

 

 

 

217.9

 

 

 

1,038.5

 

 

 

634.1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operating expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical claims expense (Humana comprised $99.1 and $62.2 for the three-months ended September 30, 2021 and 2020, respectively, and $277.7 and $186.0 for the nine-months ended September 30, 2021 and 2020, respectively)

 

 

309.7

 

 

 

154.5

 

 

 

790.9

 

 

 

442.3

 

Cost of care, excluding depreciation and amortization (Humana comprised $2.8 and $1.5 for the three-months ended September 30, 2021 and 2020, respectively, and $7.1 and $3.9 for the nine-months ended September 30, 2021 and 2020, respectively)

 

 

76.3

 

 

 

43.2

 

 

 

203.6

 

 

 

126.5

 

Sales and marketing

 

 

30.5

 

 

 

15.5

 

 

 

80.5

 

 

 

37.4

 

Corporate, general and administrative expenses

 

 

77.0

 

 

 

57.2

 

 

 

224.3

 

 

 

112.5

 

Depreciation and amortization

 

 

4.5

 

 

 

2.9

 

 

 

11.7

 

 

 

8.1

 

Total operating expenses

 

 

498.0

 

 

 

273.3

 

 

 

1,311.0

 

 

 

726.8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Loss from operations

 

 

(109.3

)

 

 

(55.4

)

 

 

(272.5

)

 

 

(92.7

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other (expense)/income:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense, net

 

 

(0.6

)

 

 

(3.9

)

 

 

(1.8

)

 

 

(8.8

)

Other

 

 

-

 

 

 

-

 

 

 

-

 

 

 

0.2

 

Total other (expense)

 

 

(0.6

)

 

 

(3.9

)

 

 

(1.8

)

 

 

(8.6

)

Net loss

 

 

(109.9

)

 

 

(59.3

)

 

 

(274.3

)

 

 

(101.3

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net loss attributable to non-controlling interests

 

 

0.6

 

 

 

0.1

 

 

 

3.5

 

 

 

0.5

 

Net loss attributable to Oak Street Health, Inc.

$

 

(109.3

)

$

 

(59.2

)

$

 

(270.8

)

$

 

(100.8

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Undeclared and deemed dividends

$

 

-

 

$

 

(5.4

)

$

 

-

 

$

 

(27.2

)

Net loss attributable to common stock/unitholders

$

 

(109.3

)

$

 

(64.6

)

 

 

(270.8

)

$

 

(128.0

)

Weighted average common stock outstanding - basic and diluted1

 

 

223,435,698

 

 

 

218,261,866

 

 

 

221,932,624

 

 

 

218,261,866

 

Net loss per share – basic and diluted

$

 

(0.49

)

$

 

(0.15

)

$

 

(1.22

)

$

 

(0.15

)

 

The accompanying notes are an integral part of these consolidated financial statements.

 

1 Basic and diluted earnings per share of common stock is applicable only for periods after the Company's IPO that was completed on August 10, 2020

 

8


 

 

OAK STREET HEALTH, INC.

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS

(Unaudited)

($ in millions, except shares/units and per share data)

 

 

 

Three-Months Ended

 

 

Nine-Months Ended

 

 

 

September 30, 2021

 

 

September 30, 2020

 

 

September 30, 2021

 

 

September 30, 2020

 

Net loss

$

 

(109.9

)

$

 

(59.3

)

$

 

(274.3

)

$

 

(101.3

)

Other comprehensive loss:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net unrealized gain (loss) on marketable debt securities, net of tax

 

 

0.1

 

 

 

-

 

 

 

(0.2

)

 

 

-

 

Comprehensive loss

 

 

(109.8

)

 

 

(59.3

)

 

 

(274.5

)

 

 

(101.3

)

Less: Comprehensive loss attributable to non-controlling interests

 

 

0.6

 

 

 

0.1

 

 

 

3.5

 

 

 

0.5

 

Comprehensive loss attributable to Oak Street Health, Inc.

$

 

(109.2

)

$

 

(59.2

)

$

 

(271.0

)

$

 

(100.8

)

 

The accompanying notes are an integral part of these consolidated financial statements.

 

 

9


 

 

OAK STREET HEALTH, INC.

CONSOLIDATED STATEMENTS OF CHANGES IN

REDEEMABLE INVESTOR UNITS AND STOCKHOLDERS’ EQUITY/MEMBERS’ (DEFICIT)

(Unaudited)

($ in millions, except shares/units and per share data)

 

 

 

Three-Months Ended

 

 

 

Redeemable Investor Units

 

 

Members’ Capital

 

 

Common Stock

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares

Issued

 

 

Amount

 

 

Shares

Issued

 

 

Amount

 

 

Shares

Issued

 

 

Amount

 

 

Additional Paid-In Capital

 

 

Accumulated

Deficit

 

 

Non-controlling

Interest

 

 

Total

Equity/(Deficit)

 

Balances June 30, 2020

 

 

12,472,242

 

$

 

545.0

 

 

 

3,461,459

 

$

 

3.4

 

 

 

-

 

$

 

-

 

$

 

-

 

$

 

(409.5

)

$

 

4.9

 

$

 

(401.2

)

Conversion of redeemable preferred stock into common stock upon closing of initial public offering

 

 

(12,472,242

)

 

 

(545.0

)

 

 

-

 

 

 

-

 

 

 

184,787,783

 

 

 

0.2

 

 

 

544.8

 

 

 

-

 

 

 

-

 

 

 

545.0

 

Conversion of members' capital into common stock upon closing of initial public offering

 

 

-

 

 

 

-

 

 

 

(1,117,312

)

 

 

(7.0

)

 

 

15,498,529

 

 

 

-

 

 

 

7.0

 

 

 

-

 

 

 

-

 

 

 

-

 

Conversion of members' capital into restricted stock upon closing of initial public offering

 

 

-

 

 

 

-

 

 

 

(2,339,322

)

 

 

-

 

 

 

22,612,472

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

Issuance of common stock upon closing of initial public offering, net

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

17,968,750

 

 

 

-

 

 

 

351.2

 

 

 

-

 

 

 

-

 

 

 

351.2

 

Issuance of Common Units

 

 

-

 

 

 

-

 

 

 

 

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

Exercise of Options

 

 

-

 

 

 

-