BrightSpring Health Services, Inc.

and thank you for standing by. Welcome to the Bright Spring Health Services third quarter 2025 earnings conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 1 1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1 1 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, David Deichler, Investor Relations. Please go ahead.

Good afternoon. Thank you for participating in today's conference call. My name is David Deichler with Investor Relations for Bright Spring. I'm joined on today's call by John Rousseau, Chief Executive Officer, and Jen Phipps, Chief Financial Officer. Earlier today, Bright Spring released financial results for the quarter ended September 30th, 2025. A copy of the press release and presentation is available on the company's investor relations website. Please note that today's discussion will include certain forward-looking statements that reflect our current assumptions and expectations, including those related to our future financial performance and industry and market conditions. Such forward-looking statements are not guarantees of future performance. These forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially from our expectations. We encourage you to review the information in today's press release and presentation as well as our quarterly report on Form 10-Q that will be filed with the SEC, including the specific risk factors and uncertainties discussed in our Form 10-K and Form 10-Q. Such factors may be updated from time to time in our periodic filings with the SEC, and we do not undertake any duty to update any forward-looking statements except as required by law. During the call, we will use non-GAAP financial measures when talking about the company's financial performance and financial condition. You can find additional information on these non-GAAP measures and reconciliations of our non-GAAP financial measures to their most directly comparable GAAP financial measures to the extent available without unreasonable effort in today's earnings press release and presentation, which again are available on our Investor Relations website. This webcast is being recorded and will be available for replay on our Investor Relations website. And with that, I will turn the call over to John Rousseau, Chief Executive Officer.

Good afternoon, everyone. And thank you for joining Bright Spring's third quarter 2025 earnings call. First off, I would like to thank all of our Bright Spring employees in the field and in administrative support roles who make a real impact for patients and people every day. I'm grateful for their continued dedication and commitment to providing the high quality and compassionate care and services to the individuals we serve. Bright Spring is a leading health services provider in home and community settings. in large and growing pharmacy and provider markets. And we believe a scaled platform in home and community healthcare differentiates and positions us well for the future. Today, we reported third quarter financial results that are in line with the preliminary financial results we announced on October 20th. The third quarter exceeded our expectations and our ongoing commitment to high value and high quality services, operational execution, and continuous improvement, all hallmarks of our company culture, have driven the financial results so far this year. Before discussing Bright Spring's third quarter performance, I would like to remind you that the company's financial results in 2025 guidance pertain to the continuing operations and do not include results from the community living business. At this time, we now expect the community living divestiture transaction to close in the first quarter of 2026. which remained subject to final federal regulatory approvals and typical closing conditions. For the third quarter, Bright Springs revenue grew approximately 28% and adjusted EBITDA grew approximately 37% versus last year's comparable quarter. Total company revenue was $3.3 billion, with pharmacy solutions revenue of $3.0 billion increasing 31% year-over-year, and provider services revenue of $367 million, increasing 9% year-over-year. Total company adjusted EBITDA of $160 million in the quarter grew 37% compared to the same period last year, driven by strength across the businesses. EBITDA margin for the company was 4.8%, which grew approximately 30 basis points compared to the third quarter of last year and up 30 basis points versus second quarter. Margin expansion was primarily driven by disciplined operating expense management and modest revenue mix shift within pharmacy with greater contribution from generics. On cash flow, the company realized over $100 million of cash flow from operations in the third quarter and leveraged decline to 3.3 times at the end of the quarter, sooner than previously communicated expectations, with an updated goal of three times by year end as is. and below three times pro forma for both the Amedisys and LHC home health branch acquisitions and the community living sale. The company continues to deliver growth, reflective of each business line executing on our internal goals. Given the third quarter update today and current expectations for the fourth quarter of 2025, we are increasing total revenue and adjusted EBITDA guidance for 2025. A week ago, in the October 20th release, we increased our adjusted EBITDA guidance to a range of 605 to 615 million, which compares to 590 to 605 million communicated in August following our second quarter results. As a reminder, this 2025 guidance excludes community living and any M&A activity not yet closed. We continue to expect the emeticists and LAC branches to close later this quarter and expect this to be immaterial to our 2025 results. We look forward to having the emeticists and LAC colleagues join BrightSpring, and Jen will discuss BrightSpring's third quarter financial results and 2025 outlook in more detail shortly. At Bright Spring, we're focused on quality and continuous improvement in our people and services to deliver comparatively low-cost, timely, and attentive patient-centric care to complex populations. Quality and patient satisfaction scores across our service lines in the third quarter remained at very high levels. In home health, 94% of our branches are at four stars or greater, with timely initiation of care at an industry-leading level of 99%. In hospice, we continue to be a top 5% ranked hospice program in the U.S., with a CAPS overall hospice rating of 89%, up from 85% in the second quarter. Overall, hospice quality index scores and the number of visits we provide patients per month on average remain well above national average. In rehab, our patient satisfaction scores remain exceptionally high, and in personal care, we have strong internal client records, and quality indicator audit scores, along with a satisfaction score of 4.54 out of 5. In infusion, our patient satisfaction score was approximately 95%, and our discharge rate due to completion of therapy was stable at 96%. Home and community pharmacy demonstrated 99.5% order completeness and on-time delivery of 97.2%. In specialty pharmacy, our medication possession ratio remains much higher than the national average at approximately 95%, and we have a time to first fill of 3.7 days. Our company continues to demonstrate high levels of execution and customer satisfaction across service lines. Turning to the company's financial results by segment, total pharmacy solutions revenue grew 31% in the third quarter, and adjusted EBITDA grew 42% versus the prior year, with total pharmacy census growth facilitating total pharmacy script volume of 10.8 million in the quarter. Those script volumes demonstrated strong growth in both specialty and infusion, with over 30% script growth in the subsegment. Total pharmacy volumes declined 1% versus the prior year due to the majority of scripts being in home and community pharmacy and a decline in the home and community pharmacy total scripts dispensed. Due to divestitures associated with the customer that previously declared bankruptcy, as well as flu season beginning later in 2025 as compared to 2024, operational decisions made to exit specific uneconomic customers, and a difficult comparison to last year when we added the same aforementioned customer in the third quarter. In the specialty and infusion business, revenue grew 42% year over year, which exceeded expectations. The performance in specialty and infusion was driven by limited distribution drug launches, generic drug utilization from conversions over the past year, strong commercial execution from the team, and excellent patient service. Specialty scripts grew approximately 40% in the third quarter, driven by strength in both brand LDDs and generics. We ended Q3 with 144 LDDs, including five LDD launches in the quarter. Through the end of October, our LDD portfolio has now expanded to 145 therapies, and we continue to expect 16 to 18 additional LDD launches over the next 12 to 18 months. We are honored and proud to have been chosen as a preferred specialty pharmacy partner for these new therapies that are being utilized to treat a range of cancers and rare and orphan diseases. We work diligently to deliver high-quality care to patients, and gain the trust of manufacturers prescribing physicians and patients to support long-term therapy innovation and growth. Within Infusion, performance in the quarter was in line with expectations, driven by solid double-digit volume growth and continued benefit from operational improvements and procurement initiatives to streamline the business and improve profitability, with strong year-over-year EBITDA growth well into the double digits. Our strategy is a broad-based one in terms of both acute and chronic therapies. We remain excited about the acute market where we believe there exists a multi-billion dollar market where our leadership team can leverage best practices and scale the business in new geographic markets efficiently. We also remain constructive on our ability to expand chronic infused therapy offerings as we look to innovate delivery to patients living with chronic disease. In home and community pharmacy, revenue performance in the quarter was in line with our expectations, and we continue to optimize the go-to-market strategy and customer mix to ensure profitable growth in attractive and targeted end markets. Under a new and expanded leadership team, we continue to implement operational initiatives to augment efficiency with year-over-year events outside of several unusual items in the quarter. Over time, we expect to continue to expand our presence in target markets with industry-leading operational processes, quality, and efficiency. Turning to the provider segment, we are pleased by the performance across each of our service lines in the third quarter. Provider revenue grew 9% year over year, and segment-adjusted EBITDA grew 16%, with a segment-adjusted EBITDA margin in the quarter of 16.5%, up approximately 90 basis points year over year. Home health care, which represents about 50% of the revenue and provider segment, and is comprised of home health, hospice, and primary care, grew 12% year over year. The home health care business continues to perform very well, driven by strong quality metrics and patient satisfaction scores. Ongoing operational investments and advancements, de novo expansions, and preferred provider Medicare Advantage contracts are continuing to advance. Average daily census in home health care was 29,592 in the third quarter, representing a 3% increase year-over-year, with hospice increased approximately 15% year-over-year in the quarter. In the third quarter, home health settings in five states were awarded accreditation by the Accreditation Commission for Health Care, or ACHC, reflecting compliance with ACHC standards and CMS's conditions of participation. highlighting our commitment to providing safe and high-quality care to patients. Home-based primary care also delivered solid growth in the quarter. We believe primary care at home remains a large opportunity as we continue to build out the business, particularly as it relates to the benefits of our integrated services and ACO and ISNIP payment models, which we continue to make steady progress on. Moving to rehab care, which represented approximately 20% of provider revenue in the third quarter Growth was 9% year-over-year, underpinned by 11% growth in person-served and approximately 17% growth in hours billed in the core neuro-rehab services. We have continued to see a long history of performance and positive momentum in the rehab business, and the expansion of our rehab into ALF and home settings with Part B rehab for seniors is now ongoing. As we went live in the quarter with a key milestone, and integrated home health and rehab offering in ALS. In personal care, which represented approximately 30% of provider revenue in the third quarter, revenue grew 6%. Personal care growth, operations, and performance remained very steady, including solid growth in person served. Overall, we continue to realize and see many benefits from our high-value services and targeted markets with one integrated and coordinated enterprise. Finally, we are excited to announce that we will be hosting an Investor Day on March 17th in Louisville. We look forward to the opportunity to review our company strategy with the investment community, discuss each of our service lines, and outline the prospects for each in the years to come. To close, we are pleased with BrightSpring's operating performance and financial results in the third quarter and the progress we have made so far in 2025, and we look forward to entering 2026 from a position of strength with continuing investments for long-term differentiation and sustainable growth across the organization. With that, I'll turn the call over to Jen.