Viemed Healthcare, Inc.

Greetings and welcome to the ViMed Healthcare fourth quarter year-end quarterly earnings call. At this time, all participants are in a listen-only mode. A brief question and answer session will follow the formal presentation. Should anyone require operator assistance during the conference, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Trey Fitzgerald, CFO. Thank you. You may begin.

Thank you and good morning, everyone. Please note that our remarks on this conference call may include forward-looking statements under the U.S. federal securities laws or forward-looking information under applicable Canadian securities legislation, which we collectively refer to as forward-looking statements. Such statements reflect the company's current views and intentions with respect to future results or events and are subject to certain risks and uncertainties, which could cause actual results or events to vary from those indicated in forward-looking statements. Examples of such risks and uncertainties are discussed in our disclosure documents filed with the SEC or the security regulatory authorities in certain provinces of Canada. Because of these risks and uncertainties, investors should not place undue reliance on forward-looking statements. The forward-looking statements made in this conference call are made as of today, and the company undertakes no obligations to update or revise any forward-looking statements except as required by law. The fourth quarter financial supplement and financial news release, as well as the related financial statements, are available on the SEC's website. With that, I'll turn it over to our CEO, Casey Hoyt.

Casey Hoyt Thank you, Trey. And good morning, everyone. We appreciate you joining us. Today, we'll recap our 2025 performance, discuss the progress we achieved, strengthening the platform, and outline how we see the business evolving as we enter 2026. 2025 was a milestone year for us. We delivered record revenue and record-adjusted EBITDA, generated significantly higher free cash flow, and made real progress diversifying the business in ways you can clearly see in our results. We are building MyMed into a cash-generating home care platform with multiple growth engines, and we continue to differentiate ourselves through our high-touch clinical model and technology-enabled approaches we scaled. As we move into 2026, we're doing it from a position of strength. We continue to execute well. We're seeing good early signals in the business, and we feel great about the long-term opportunity in front of us. You can see that in the momentum we're continuing to build in sleep and resupply, the progress we're making in maternal health, and the way our technology investments are helping us operate at a higher and more capable level across the platform. None of it happens without our people. I want to thank our team for the compassion, professionalism, and commitment they bring to patients every day. We continue to build our workforce in a disciplined way, including developing talent pipelines through VibeMed Healthcare staffing and integrating new team members from acquisitions. We ended the year with 1,382 employees across the country, and I'm proud of how consistently they deliver high-quality care and execute with integrity. That level of commitment matters most when caring for chronically ill patients in the home, and it's at the core of our complex respiratory offerings. In-home ventilation drives real and significant outcomes for patients, and we continue to see a meaningful long-term opportunity here, given the underserved and underpenetrated population, coupled with the increasing clinical demand. During the fourth quarter, we did see some moderation in ventilator patient growth, and it's largely what we expected. The industry is continuing to work through the updated national coverage determination, and the changes are twofold. First, there's a natural operational effort when implementing new documentation and process requirements under the NCD. Our team and processes at Vymed were well ahead of the curve in proactively addressing the new requirements. The Engage patient platform, which is our proprietary technology deployed in the homes of our patients, has played an instrumental role in providing data that helps our therapists manage and report on real-time compliance metrics. We have also spent a ton of time in the field re-educating our physician referral sources and patients on how these new requirements affect qualification and ongoing care. Second, the updated criteria means some patients who previously may have qualified under the prior framework may not qualify today. What's critical to understand is that the underlying demand and clinical need remain strong. This is primarily a coverage and execution transition. And throughout 2025, we invested in the infrastructure to navigate it well. That includes strengthening our compliance capabilities, supporting physician education, and tightening our internal workflows to align with the updated requirements so we can serve the right patients the right way under the current criteria. More importantly, the move towards more objective criteria is something we've long supported. Our view is that over time, the new NCD changes will reduce uncertainty across the system and ultimately put scale providers like BiMed in a stronger position. We're already seeing progress entering 2026. A number of patients who previously were denied coverage under more subjective Medicare Advantage criteria are now qualifying under the new NCD standards. Under the new NCD, we have had 100% success rate at the administrative law judge level on the Medicare Advantage denials we have appealed, which reinforces the appropriateness of the patients we serve and the strength of our documentation. We are also seeing denials resolved earlier in the Medicare Advantage appeals process, which improves reimbursement timing and reduces uncertainty. January was one of the strongest new ventilator setup months in our history. That gives us confidence that as referral partners get more comfortable with the criteria and our execution continues to improve, we will establish a more consistent growth cadence. So, in summary, on the NCD, while there's been some short-term friction as the industry adjusts, the work we've completed early positions us well going forward and supports a long runway for growth in our complex respiratory market. More broadly, as we think about the regulatory environment, I also want to briefly address the recent CMS update regarding the next round of competitive bidding. Based on the categories identified by CMS, we do not expect the announced round of competitive bidding to apply to any of our current product offerings, including ventilators, or to have a material impact on our business. That said, the broader compliance and program integrity elements included in the update continue to favor scale providers with strong documentation, operational controls, and national infrastructure. Those are areas where we've invested for many years, and we know we are well-positioned. As regulatory clarity continues to improve, it creates a stable foundation for growth across the platform. That stability is allowing us to progressively move into areas that are scaling quickly, particularly sleep and resupply. What started as a complimentary service has become a meaningful and accelerated growth job at ProvideMed. As of December 31st, 2025, our PAT therapy patient count reached 34,528, which represents growth of 62% year over year. During 2025, new sleep patient setups increased 70% compared to the prior year. That growth reflects strong execution by our sales and operational teams, and solid demand in the market. And it also translates into a strong pipeline for future residual resupply sales. We ended the year serving 36,561 resupply patients, up 49% year over year. As the PAP base grows, more patients move into long-term resupply relationships, which creates recurring and predictable revenue over the life of the patient. We're encouraged with the progress, and we still see room to improve conversion rates and deepen patient engagement, which gives us additional runway heading into 2026. We are also experiencing real tailwinds behind this category. Shrugged asleep apnea remains significantly underdiagnosed. Clinical awareness continues to increase, and broader conversations around metabolic health and GLP-1 therapies are bringing more patients into screening and treatment. Sleep is and will continue to be an important pillar of our growth strategy. That progress in sleep is a good example of how our platform is evolving, and the Lehan acquisition is another strong example of that continued evolution and action as we expand into maternal health. Since closing the acquisition of Lehan's medical equipment on July 1st, the business has performed well and integrated smoothly. Transaction has been accretive out of the gate, generating positive net income contribution in both quarters since closing. What excites us going forward is the ability to scale maternal health beyond Lehan's original footprint. Lehan brought deep expertise in the category and a strong operating team. BiMed brings a national infrastructure we've built over many years, including payer relationships, clinical operations, intake, billing, and compliance. Together, that allows us to take what Lehan does well and expand it through the ViMed platform to reach more patients in more places. We began billing our first maternal health claim outside of the Lehan footprint late in the third quarter, and early signs have been very encouraging. In 2025, approximately $9 million of our revenue was associated with maternal health products across existing Lehan markets and new ViMed markets. Maternal health further strengthens our diversification. It broadens our payer mix, reduces our concentration in Medicare, and adds another recurring DME category, making our overall revenue base more balanced and resilient. As we continue to build payer relationships, referral pathways, and operational capacity, we expect maternal health to become a more meaningful contributor as we expand in 2026. We view maternal health as a scalable extension of our platform and an important long-term growth opportunity for BiMed. As we have scaled the business at a high growth rate, we are pleased with how well our forecasting process has performed. In particular, our adjusted EBITDA performance has consistently tracked in line with our expectations. The key driver has been the reliability of our highest margin offerings, which have continued to perform to plan and provide a stable earnings foundation. While lower margin offerings such as staffing can move around from period to period, that variability is inherent in the model and does not change the underlying earnings profile of the business. Overall, we view our track record of delivering against our adjusted EBITDA outlook as a highly valuable strength as we continue to grow BiMed as an integrated platform. Reflecting on our success, the reason we can grow and diversify the way we have is because of the processes we've built over time and the strength of our operations every day. For nearly two decades, we've proudly focused on execution, clinical quality, and doing things the right way. At the center of that execution is our high-touch clinical model. Our respiratory therapists and clinical teams stay closely connected to patients in the home through frequent touch points, education, and monitoring. We support that with our proprietary clinical platform, which connects devices, clinicians, and workflows so we can improve patient adherence, clinical outcomes, and efficiencies as we scale. We also benefit from embedded relationships through our staffing business, which sustains relationships with hospitals and discharge pathways and supports a steady flow of opportunities across our service lines. And we've invested heavily in the capabilities that matter in this industry. especially documentation, compliance, and reimbursement, so that we can operate effectively as coverage criteria evolve and scale new categories, such as behavioral health, with confidence. The other critical piece is our payer platform. We built a nationwide network of payer relationships and reimbursement capabilities over many years, and that foundation is difficult to replicate. It's a big reason we can expand it to areas like sleep and maternal health and scale them more efficiently because the contracting relationships, operational processes, and reimbursement expertise are already in place. Put all the pieces together, and we have a differentiated platform in home-based care. That's what gives us extreme confidence we can keep growing, keep diversifying, and keep expanding cash flow over time. With that, I'll turn the call over to Todd to walk through our financial performance and capital allocation priorities in more detail.