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Segment Reporting
 12 Months Ended
Jun. 30, 2023
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company applies ASC Topic 280, “Segment Reporting,” which establishes requirements to report selected segment information quarterly and to report annually entity-wide disclosures about operations, major customers and the geographies in which the entity holds material assets and reports revenue. An operating segment is defined as a component that engages in business activities whose operating results are reviewed by the Company’s chief executive officer, who is the chief operating decision maker (“CODM”), and for which discrete financial information is available. The Company has determined that it has five operating segments, three of which are related to the Company’s PACE offering. The PACE-related operating segments are based on three geographic divisions, which are West, Central, and East. Due to the similar economic characteristics, nature of services, and customers, we have aggregated our West, Central, and East operating segments into one reportable segment for PACE. The Company’s remaining two operating segments relate to Homecare and Senior Housing, which are immaterial operating segments, and are shown below as “Other” along with certain corporate unallocated expenses.
As of June 30, 2023, the Company served approximately 6,400 PACE participants, making it the largest PACE provider in the U.S. based upon participants served, and operated 17 PACE centers across Colorado, California, New Mexico, Pennsylvania and Virginia. PACE, an alternative to nursing homes, is a managed care, capitated program, which serves the frail elderly in a community-based service model. Participants receive all medical services through a comprehensive, consolidated model of care. Capitation payments are received from Medicare parts C and D; Medicaid; VA, and private pay sources. The Company is at risk for all health and allied care costs incurred with respect to the care of its participants, although it does negotiate discounted rates with its provider network consisting of hospitals, nursing homes, assisted living facilities, and medical specialists. Additionally, under the Medicare Prescription Drug Plan, CMS shares part of the risk for providing prescription medication to the Company’s participants.
The Company evaluates performance and allocates capital resources to each segment based on an operating model that is designed to maximize the quality of care provided and profitability. The Company does not review assets by segment and therefore assets by segment are not disclosed below. For the periods presented, all of the Company’s long-lived assets were located in the U.S. and all revenue was earned in the U.S.
The Company’s management uses Center-level Contribution Margin as the measure for assessing performance of its segments. Center-level Contribution Margin is defined as total segment revenues less external provider costs and cost of care (excluding depreciation and amortization). The Company allocates corporate level expenses to its segments with a majority of the allocation going to the PACE segment.
The following table summarizes the operating results regularly provided to the CODM by reportable segment for the twelve months ended:
June 30, 2023June 30, 2022
in thousandsPACE
All other(1)
TotalsPACE
All other(1)
Totals
Capitation revenue$686,836 $— $686,836 $696,998 $— $696,998 
Other service revenue347 904 1,251 403 1,239 1,642 
Total revenues687,183 904 688,087 697,401 1,239 698,640 
External provider costs374,528 — 374,528 383,046 — 383,046 
Cost of care, excluding depreciation and amortization211,707 564 212,271 178,904 1,318 180,222 
Center-Level Contribution Margin100,948 340 101,288 135,451 (79)135,372 
Overhead costs(2)
135,264 — 135,264 125,948 (94)125,854 
Depreciation and amortization14,959 460 15,419 13,491 433 13,924 
Equity loss— — — — — — 
Other operating (income) expense— — — — — — 
Interest expense, net1,342 180 1,522 2,335 191 2,526 
Loss on extinguishment of debt— — — — — — 
Gain on equity method investment— — — — — — 
Other expense (income)(124)— (124)305 — 305 
Income (Loss) Before Income Taxes$(50,493)$(300)$(50,793)$(6,628)$(609)$(7,237)
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(1)Center-level Contribution Margin from segments below the quantitative thresholds are attributable to two operating segments of the Company. Those segments consist of Homecare and Senior Housing. Neither of those segments has ever met any of the quantitative thresholds for determining reportable segments.
(2)Overhead consists of the Sales and marketing and Corporate, general and administrative financial statement line items.