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spk08
I would now like to hand the conference over to the first speaker today, Jackie Marcus, Investor Relations. You may begin.
spk05
Thank you, operator. Hello, everyone, and welcome to the Owens & Miner fourth quarter 2023 earnings call. Our comments on the call will be focused on the financial results for the fourth quarter of 2023, as well as our outlook for 2024, both of which are included in today's press release. The press release, along with the supplemental slides, are posted on the investor relations section of our website. Please note that during this call, we will make forward-looking statements. The matters addressed in these statements are subject to risks and uncertainties, which could cause actual results to differ materially from those projected or implied here today. Please refer to our SEC filings for a full description of these risks and uncertainties, including the risk factors section of our annual report on Form 10-K and quarterly reports on Form 10-Q. In our discussion today, we will reference certain non-GAAP financial measures and information about these measures and reconciliations to the most comparable GAAP financial measures, which are included in our press release. Today, I'm joined by Ed Paseka, President and Chief Executive Officer, and Alex Bruni, Executive Vice President and Chief Financial Officer. I will now turn the call over to Ed. Ed?
spk09
Thank you, Jackie. Good morning, everyone, and thank you for joining us on the call today. As you saw in our press release this morning, we closed out 2023 with strong positive momentum and we exited the year in a position of strength. Our patient direct segment continued to outpace market growth as we leveraged our proven commercial model in one of the fastest growing areas of healthcare, the home. Our products and healthcare services segment successfully pivoted as we reset our approach post-pandemic We did this by leveraging the operating model realignment program, executing at a high level, and winning new business, which collectively put our P&HS segment on a positive trajectory for revenue growth and margin expansion. We also finished the year by launching a five-year strategic plan to drive growth and enhance profitability. And we didn't wait until 2024 to begin executing on this strategy. as we began to invest in both of our segments during the fourth quarter. And finally, we launched our purpose and vision in the fourth quarter, which will continue to solidify a results-oriented culture at Owens & Miner. I'll provide additional comments on our long-term strategy later in my prepared remarks, but now let me focus on 2023. When I reflect on our performance in 2023, I'm extremely proud of how our organization continues to perform against our objectives. And the proof of that hard work and strong execution is evident across our financial results. For example, in fiscal 2023, we generated over $740 million of operating cash flow, which was an annual record for Owens & Miner. This cash flow performance helped to significantly strengthen our financial profile as we reduced debt by nearly $600 million during the year. And this strengthened balance sheet will support many of the value creation initiatives included in our five-year strategic plan. Next, during the year, we delivered more than $40 million in operating model realignment benefits, and we exited the year with more than $100 million of run rate. This program helped our product and healthcare services segment deliver meaningful revenue growth and profit improvement in the fourth quarter. Finally, we delivered significant sequential improvement in key performance areas, with adjusted EPS growing from $0.05 in Q1 to $0.69 in Q4, and adjusted operating margin improving from 1.9% in Q1 to 4.2% in Q4. While revenue declined 8% in Q1, it increased to a positive 4.1% in Q4 on a year-over-year basis. With our patient direct segment leading the way with full year 2023 organic revenue growth of nearly 10% and continues to outperform the market, while remaining well-positioned for further expansion as demand for home-based care accelerates. So as you can see, we're excited about our business right now, given the substantial flexibility we've established and the strong performance in 2023. Let me close with a quick summary of each segment. In terms of our market-leading patient direct segment, we had an outstanding year. We grew the business double digits, continued to expand the overall profit contributions, further the integration of Apria, and began investing in additional growth initiatives. As we look forward, we maintain our belief that we can continue to outpace the market and expand our position as a true leader in home-based care. In terms of our product and healthcare services segment, during 2023, we utilized our operating model realignment program to lower our cost to serve, expand our profits, and increase our cash flows, all of which have repositioned the business for long-term success. Before I share my thoughts on 2024 and the future for Owens & Miner, I would like to turn the call over to our Chief Financial Officer, Alex Bruni, to discuss our financial performance and our 2024 guidance.
spk10
Alex? Thank you, Ed. Good morning, everyone. Diving into our fourth quarter performance, On the top line, we posted consolidated revenue of $2.7 billion, up more than 4% over the prior year. This uptick in revenue was driven by a nearly 8% year-over-year improvement in our patient direct segment, with growth across several product categories. We also saw 3% growth in our products and healthcare services segment compared to the prior year. Notably, there was growth in both the medical distribution and global products divisions in the quarter. For the full year, we reported revenue of $10.3 billion up 4% year over year. Our fourth quarter gross margin was $570 million or 21.5% of revenue compared to $407 million or 16% of revenue in the fourth quarter of 2022. Full year gross margin was $2.1 billion or 20.6% of revenue up 221 basis points. Our gross margin improvement can be attributed to the growing contribution from our patient direct segment and the efficiency and productivity gains in the products and healthcare services segment. Additionally, the comparison to the prior year was impacted by the non-recurrence of the fourth quarter 2022 inventory valuation adjustment of $92.3 million. Turning to expenses, distribution, selling, and administrative expenses for the quarter were $457 million, making up 17.2% of revenue. in line with the fourth quarter of 2022. For the full year, DSNA expenses were $1.8 billion, or 17.5% of revenue. The DSNA percentage of revenue reflects the growing contribution from PatientDirect, including a full year of APRIA. GAAP operating income for the quarter was $60 million, and adjusted operating income was $111 million. For the full year 2023, GAAP operating income was $105 million, and adjusted operating income was $305 million. These results reflect a notable improvement in operating income, increasing by 212% and a 65% growth in adjusted operating income compared to the fourth quarter of 2022. Notably, both the patient direct and products and healthcare services segments exhibited sequential increases in segment income from the third to the fourth quarter of 2023. Interest expense for the fourth quarter was $37 million, a 10% decrease from the fourth quarter of last year, largely due to our significant debt reduction during the year. Interest expense for the full year was $158 million, a 23% increase from the prior year, driven primarily by the funding from the APRI acquisition in early 2022. GAAP net income for the quarter was $0.23 per share, and adjusted EPS was $0.69. For the full year, GAAP net loss was $0.54 per share, and adjusted EPS was $1.36. Adjusted EBITDA in the fourth quarter was $170 million, and for the full year was $526 million, or 5.1% of revenue. For the operating model realignment program, we delivered an excess of $40 million of adjusted operating income benefit, exceeding our goals of $30 million in a year, and exiting the year with an annual run rate of over $100 million. Moving to cash flow in the balance sheet, we continued to generate substantial operating cash flow of $112 million for the quarter and reached a full year total of $741 million, driven by robust working capital management and operating results. As a result of this significant cash flow, we reduced total debt by $49 million for the fourth quarter and by $403 million for the full year, bringing the balance to $2.1 billion at year end. In addition, we reduced net debt by $76 million in the fourth quarter and by $577 million for the full year, bringing the balance to $1.9 billion. Netbook leverage was 3.5 times at the end of the fourth quarter. Now let's look at our full year 2024 guidance. Consistent with what we discussed on the third quarter call and at investor day, we expect net revenue to be in the range of $10.5 billion to $10.9 billion adjusted EBITDA to be in the range of $550 million to $590 million, and adjusted EPS to be in the range of $1.40 to $1.70. Also, as previously discussed, we expect the earnings trajectory to follow our normal seasonal pattern throughout the year. To help some of you with your models, we'd expect that seasonality to lead to a roughly one-third, two-thirds split across the first and second halves of the year from an earnings perspective. and we'd expect to deliver improvement in each sequential quarter. Looking ahead, we remain committed to delivering the outlook for both segments, having outpaced market growth in our patient-direct segment and delivered year-over-year profit improvement in products and healthcare services. As we enter 2024, we're excited to sustain this momentum and to continue on the initial phase of our five-year strategy and investment plan, laying the groundwork for continued future success. I'd now like to turn the call back over to Ed for his thoughts on 2024 and Owens & Miner's role in the future of healthcare. Ed? Thank you, Alex.
spk09
So again, we had great execution in 2023, and we remain laser-focused on maintaining and accelerating our business momentum as we move forward in 2024. At our investor day in December, we shared our Vision 2028 plan and I outlined three key pillars that are critical to our future growth. These include accelerating growth in the high potential areas of the business, optimizing all of our businesses to drive stronger long-term profitability, and leveraging our strong balance sheet by investing across our platforms to drive long-term value. In terms of the near-term priorities that support these pillars, let's start with our growth engine, and that's our patient direct segment. We have a proven commercial model across our core categories, including sleep, home respiratory, diabetes, ostomy, urology, and wound care. These are areas for investment as we fill geographic gaps, add commercial resources, and invest in technology to improve customer satisfaction, grow revenue, and expand margins. The technology investments will include e-commerce enhancements in our patient management platform and innovative digital marketing. Overall, we will use technology to rethink the patient journey. Lastly, we'll focus to grow outside of our traditional areas and into adjacencies and other comorbid conditions. The results of these investments, combined with continued strong execution, will enable the patient direct segment to continue to grow above market rates, and we believe we can continue to do so by at least 200 basis points per year. Moving to our products and healthcare services segment, we're going to optimize this business by better leveraging our scale, growing our proprietary product portfolio, and expanding into adjacent markets and channels. As you can see from our results, we are already making progress in delivering on our promises. Andy and his team are investing where the customers find differentiation, and they're taking costs out where they don't, ultimately lowering our cost to serve. They are also looking at our footprint to make sure our distribution and manufacturing costs are optimized. While lowering costs to serve remains a priority in PNHS, we are also investing to expand our higher margin proprietary product portfolio combined with investments to enhance the customer experience. And finally, we're investing in our business and our teammates for both short and long term. As I mentioned earlier, during 2023, we generated over $740 million of operating free cash flow. That's a tremendous number. We also had over $575 million in net debt reduction, another incredible milestone for our company. So with this momentum in mind, we are focused on deploying capital both thoughtfully and timely with a focus on supporting expansion, technology, and investments in inventory to support new wind implementations, enhanced service, and portfolio expansion. We'll also continue to explore additional M&A to expand and scale our business. In conclusion, I'm incredibly excited about the momentum we're bringing into 2024, and I look forward to sharing our progress with all of you as the year progresses. I'd like to now turn the call over to the operator to open it up for questions. Operator?
spk08
Thank you. As a reminder, if you would like to ask a question, please press star one on your telephone keypad. Your first question comes from the line of Daniel Grosslight from Citi. Please go ahead.
spk01
Hi, thanks for taking the question. And it's good to hear that in PNHS it's both the products and the distribution that's growing this quarter. I had a question just around PPE inventory levels at your clients and how that's shaping up for 24. Some of the large hospitals have commented that they're hoping to save money on inventory this year. Curious how that may impact you. And then on the third-party distributors who are buying your PPE, any more clarity on how their inventory levels are shaping up?
spk09
Yes. I think probably the biggest factor, Daniel. Well, first of all, Daniel, thanks for joining us this morning on the call. I think the first factor is, and you alluded to that and you said that up front, is we actually saw growth in both parts of the business this quarter, both product and healthcare services as well as patient direct. If I think about the divisions within product and healthcare services, we have seen, I don't want to say the bottom, but we're starting to see, we've seen it level out within our products business specifically. We're starting to see, while the demand has been consistent, we're now starting to see that slightly uptick. We do still have some customers that have some additional stock, and we're helping them burn through that. We've also done a nice job beginning to burn through some of our excess inventory during 2023. So as we look into 2024, we expect that to start to ramp in the upward direction. and provide some momentum. So that's how we're thinking about the PPE specifically. There's some categories where we're seeing faster growth than other. I think surgical is a great example of that. We're starting to see demand for PPE escalate as people have burned through those products and we're seeing the surgery rates starting to slightly increase. So that's how we're seeing it from a qualitative standpoint.
spk01
Got it. Okay. And then you kind of alluded to this as well at the end here, but one of the key initiatives of the model realignment plan is rethinking your manufacturing footprint, including potentially producing more products overseas. I'm curious if the current conflict in the Red Sea has changed how you're thinking about your manufacturing footprint, potentially keeping more sites in North and South and Central America. or if anything has changed.
spk09
Sure, just at a high level. I mean, one, we really haven't, you know, when we think of, let me step back a minute. When we think about where our manufacturing footprint should be, we don't think it should be in one specific geographic location. You know, we take all the different circumstances and all the different issues that potentially can run as we look at it. If you look at our footprint today, it's primarily in the Americas, both, you know, North America, Central America, With the one exception is our gloves, which are in Thailand. You know, and I think if we think about where our shipping channels are today, it really is not impacted by those issues that are in the market today because we're shipping really, you know, directly to the west coast. And if we do, we go through the Panama Canal if we have to get to the east coast. And, you know, we look at our shipping partners on the Panama Canal. We have preset slots. that enable us to get through. And we've seen about a one to three day delay at most within that. But generally speaking, we have our time slots, we have it lined up, and it hasn't impacted us. As we think about the manufacturing footprint more broadly going forward, we'll continue to look at where does it create opportunities for us to get the products that we need at the right price that the customers demand and be able to service them. So I guess, you know, overall, the current situation, you know, in Suez Canal is not impacting us because it's not a primary shipping channel for us. If we think about where we are today, you know, primarily we have to use one of those canals. We use Panama Canal or we ship to the West Coast. And based on our footprint, you know, it's a different footprint we have today. And as we go into the future, we'll take those things into consideration as we continue to remap out our manufacturing footprint.
spk07
Your next question comes from the line of Kevin Caliendo from UBS.
spk08
Please go ahead.
spk11
Good morning. Thanks for taking my question. go through the EBITDA guidance for 24 and just sort of understand what some of the assumptions are in there. First, how much is embedded for the cost savings realignment? You mentioned there was a run rate of 100 million exiting 23. How much of that is sort of captured in the 550 to 590? And also, can you talk about the the net headwinds or is there a net headwind from the DME POS benefit versus the 75-25 rule?
spk09
Maybe I can start and then Alex hand some colors. Let me just talk a little bit about the operating model realignment and the carry forward. And the bulk of that's going to end up in actually our profits or our earnings before the interest, the really earnings part of EBITDA. And one of the things I think we've tried to clearly state both at Investor Day as well as, you know, on some of our prepared remarks was the fact that, you know, the savings that we've gained from that in addition to the run rate we have, you know, the vast majority of that is going to be reinvested back into the business. You know, and we're pretty comfortable in the range where we are from both EBITDA as well as EPS for 2024. And if I think about some of that, I think it's important to understand where are the big buckets we're going to be investing in that. And I'll talk about it in the two segments. You know, the one is on the patient direct side. You know, so we're aggressively adding commercial people because we believe with the proven commercial model we have, as we scale that up, that can drive long-term growth. You know, and we started adding personnel in the fourth quarter, teammates in the fourth quarter. We're continuing that in Q1 and Q2. You know, what also should be noted is if we're going to add 70, you know, call it 70 plus, you know, teammates in the commercial organization on that side of the business. Those teammates don't have a positive return or they break even after around 12 months and then they start to show very strong positive returns. So that's an example of taking some of that profit or savings and putting it into long term profit investments. The other thing in patient direct is really around, you know, focusing on the sleep journey and making sure that we can have unique technology to capture and maintain, you know, our patients in that side of the business. So those are just two simple examples on that side of the business. The other aspect on the savings is, again, pouring it back into investments, you know, and, again, not just pulling it through to earnings. But on product and healthcare services, it's really around a couple areas. It's around our investment in our category management. And I think the thing that's important on that is, as a company, we've been talking for years about expanding our proprietary portfolio. We're putting in the infrastructure so that way we can do that. So there's significant investment being made in personnel to expand that proprietary product portfolio, understand the marketing, partnering with our customers, and then the commercial front, you know, on the front end of that. In addition to that, investments in technology around some of our services we offer are as well as in data analytics. So I say that as a backdrop because what I don't want the market to get confused on is we have operating model realignment that generated more than $40 million of benefit this year, $100 million run rate, that all of that's just going to get pushed through to the bottom line. We're actually taking that and reinvesting that in the business for future growth and future EBITDA benefits as we move forward. So that, I think, helps capture the earnings part of EBITDA. Alex, I think if there's any other... Highlights outside of that, you know, besides covering in the operating model realignment, how that carries through.
spk10
Yeah, thanks, Ed. And good morning, Kevin. So on adjusted EBITDA, we, you know, we were obviously, you know, working hard to deliver in line with our guidance last year and fell a little bit short, frankly, of where we expected to be. And so as we head into 2024, we do feel good about where we've reset. for the year. And it does reflect, as Ed mentioned, the investment. It also reflects some of the normalization of PPE pricing. So for gloves, for instance, at the end of 2023 and into 2024, we think that that sort of normalizes here in the first half of the year. So those are a couple of areas from a broad brushstroke standpoint. And then, you know, as we think about some of the more You know, the complexities around LIFO and stock comp, we expect both of those to normalize this year, which should provide us greater visibility and just less volatility around adjusted EBITDA.
spk09
And then I'll add one last comment on the 75-25 comment. Obviously, you know, legislation continues to be discussed through our Congress on that. But the way we thought about it is, you know, we built in the impact that it would have on us, you know, in addition to that, you know, identifying ways to offset that as we move forward throughout the year.
spk11
Got it. Can I ask one quick follow-up? I know that was a long answer, but just in terms of free cash flow this year, I know you had some benefits from working capital in 23 AR and the like. Would you expect the free cash flow to sort of match what we did or what you did in 2023 and 2024? Is there any directional guidance you can give us around maybe working capital if you don't want to give us the free cash flow numbers?
spk10
Sure. Yeah, Kevin, great question. In 2024, we expect cash flow to normalize. You know, we obviously had an extraordinary year in 2023. We expect to end the year with some debt pay down and just to be slightly north of the three times leverage.
spk09
And then I'll just add one other comment. You know, as we start to see growth in our medical distribution and our global products business, you know, whether that's through implementation of new WINS, whether that's through expanding our proprietary product portfolio. We are going to make the appropriate investments in inventory so that way as we scale and that business grows, we have the ability to service our customers. In addition to that, just so everyone understands the cycle of bringing on new proprietary products, generally you're going to have them in inventory before you start to sell them in the market. In addition to that, you want to make sure you bring in the right amount so as that ramps, you don't have service issues. You know, there are going to be some investments in inventory in 2024 really related to three things. One is new wind implementations. The second aspect of that is proprietary product portfolio expansion. And the third is, you know, ability to drive higher levels of service.
spk11
Great. Thank you so much, guys.
spk03
And those are all good reasons to add inventory.
spk08
Your next question comes from the line of John Stancil from J.P. Morgan. Please go ahead.
spk00
Great, thanks for taking the question. Just kind of following up on that around the new SKU launches that you highlighted at Investor Day, it sounds like what you're saying is that, you know, this is part of the driver for SG&A uptick, and it'll be more of a contributor in 2025. Is that the right way to kind of frame the significant investment you're making in product line expansion? Or should we think about it as a near-term driver, too?
spk09
No, I think it's more of a long-term driver. And I think, you know, I use two examples and one in both sides of each segment, you know, on the personnel ads and the teammate ads on the commercial side and a patient direct business. We know clearly that, you know, that's after 12 months or so that becomes breakeven and then highly profitable as it accelerates. So yes, on patient direct side and then very similar on the product and healthcare services side of the business. is, you know, in that in building out the teams to do that, that is going to be a capital, I'm sorry, a SG&A investment up front with benefit as time progresses.
spk00
Great. And then just going back to yesterday, you called out a new medical customer win, I believe. Can you help qualitatively frame how that's contributing to the 2024 guide and what services are being sold there?
spk09
Yeah, that's one that should start to implement. Well, should. It's going to start implementing in March. So next month we'll start to implement that business. And that's going to, you know, we haven't quantified the dollar amount, you know, but it's a meaningful win. That'll end up being one of our top 10 customers overall, you know, once we put it into the system. And it is a combination of a portion of a customer, which we did have, and then expansion in. So, is a meaningful win, and that'll begin in March.
spk00
Great. And if I can just squeeze one quick one in at the end, more of a long-term question. I know that in December, there was some chatter around potential changes to CMS reimbursement for CGMs. Now, I know only 20% of your patient direct revenue comes from government sources. How are you thinking about potential changes around CGM reimbursement from someone like CMS? Is that something, as you think about out years, that is meaningful or not really for the patient direct business?
spk10
Thanks, John. It's Alex Rooney. So, yeah, this is certainly something we continue to watch. We noted the press release in November with the OIG looking at the CGM reimbursement. They don't expect to have findings until 2025, so we'll continue to watch this space, but we don't expect, you know, any implications at this point for us.
spk07
Perfect. Thank you. Your next question comes from the line of Stephanie Davis from Barclays. Please go ahead.
spk06
Hey, guys. Thank you for taking my question. So while I understand the ramp to the 2028 plan wasn't meant to be linear, the 24 EBITDA guidance does imply a pretty healthy step up in the out years. So I was hoping you could help us bridge this and call any maybe one-timers or areas of potential conservatism to get you there.
spk09
Yeah, I think, you know, Stephanie, you're right. It's not linear. And we wanted to make sure that when we talk about an investor day, we gave a 2028, you know, full year end of year target there. And, you know, part of it is the investments that are being made. Again, I use two different examples. You know, again, one is on the commercial aspect of what we're going to do in our patient direct business. The second aspect is some of the technology we're using in patient to direct you know, both of those are going to have, you know, benefits associated with them. And again, they're going to have benefits after they get implemented. So, you know, those are things that have meaningful paybacks, you know, 12 months plus out. I think very similar on the product and healthcare services business, you know, you're absolutely right. If we think about the portfolio expansion, you know, those are things that take time to develop. You know, again, it's something that Owens & Mines has been trying to do for years, but you have to make sure you have the investments up front. And part of what we're leveraging is the operating model realignment savings we have. We're redeploying that back into longer-term investments like the product aspect. The other aspect is network rationalization and optimization. That's something that doesn't happen overnight. You know, it's something that we're aggressively looking at right now. but we know that's going to take time to execute on, and then that will provide material benefits as we get into the future. So, you know, that's why when we looked at our internal strategic plan for the five-year period of time, you know, we believe we're going to, you know, in 2024, you know, if you look at our range, it provides, you know, we think, you know, pretty good reasonable returns, but also it's enabling us to make significant investments to provide those higher longer-term returns.
spk06
So if I had a bridge from here to your long-term guidance, is the right way to think of this as 2024 is more of an investment year and then we'll start to see it step up in 25? Or is it being more of a gradual bridge as some of these things come through?
spk09
I think probably your first assumption is closer. 2024 is more of an investment year, but it's still going to provide, if you just take the midpoint of our range, it's still providing double-digit growth in EPS, adjusted EPS. at the midpoint of our guidance. You know, in addition to that, I think, you know, so what we're trying to do is balance that as we get into, as we go through 2024 with the right investments for long-term, but still providing, you know, the right level of returns in the short term. You know, I think as you exit 24 and, you know, there's still some, you know, things that are going to take longer, you know, the network rationalization and optimization, you know, that's something that will bleed into 25. But as we continue to come out of 24 and into 25 and then continue to progress, you'll see that ramp accelerate in the out years even faster. And that's really been the beauty of what we've done with the operating model realignment program is it's enabled us to take costs out. It's enabled us to drive, you know, improve cash flow and profitability and then take those dollars and invest them in areas that may take a longer term to get a payback. but still not impact the short-term returns. Again, taking the midpoint of adjusted EPS from 23 to 24 is still going to be a double-digit growth. And then while we're still investing materially in the business for long-term success.
spk06
Super helpful. Thank you, Vogue.
spk08
Again, if you'd like to ask a question, please press star 1. Your next question comes from the line of Eric Coldwell from Baird. Please go ahead.
spk04
Thank you very much and good morning. I had a couple here. First on the commentary about cash flow normalizing in 2024. To be fair, Ed, I'm not sure there's really been a normal year since you got to the company. Cash flow 114 in 2019, then it was 280, then it was 74, then it was 158. Of course, this year was a blowout. What is normal? And, you know, do we just take the simple average of the four years before this year and call it 150 of free cash flow? Or is there a ratio you can share with us that you think is a normal ratio of some sort to get a better sense on this year?
spk03
Yeah, thanks, Erica.
spk10
This is Alex. Good morning. So definitely a fair question and a fair observation about, you know, not having a normal year. So as we go forward, at Investor Day, we talked about having $400 million of cash, pre-cash flow, operating cash flow in 2028. So I think as we see the impact of the investments that Ed has talked about this morning, we would expect to ramp up over the next few years to be in line with that. We think that that reflects kind of a good goal of operating cash flow once our investments take place.
spk04
So would 24 be, in theory, I know things can bounce around a lot and even calendar days can have an impact each year, but is 24, in theory, the low point and then a ramp up to that $400 million in 28, pretty linear? Is that the process?
spk10
I'm not sure it's exactly linear, but I think that's a fair approximation of how I would think about it. Yeah.
spk04
Okay. And then on EBITDA, I know there are some variables that are included in your EBITDA ad backs that are probably next to impossible to precisely forecast. definitely give some hall passes on that. But technically, you did miss EBITDA by about 10 to 30 million on the range for 2023. And I think a chunk of that was a lower LIFO charge add back probably than you expected in the fourth quarter. I was hoping you could quantify that. And then for 2024 guidance, you know, again, you said LIFO would normalize and Frankly, just not sure what that means. What is the 2024 guidance inclusion for a LIFO charge or credit or whatever it is, and how does that compare to the absolute amount in 23?
spk10
Yeah, thanks, Eric. So, yeah, on this complexity here, so just to kind of go back, when we reset or redefined the adjusted EBITDA in Q1, We talked about having $25 million in 2022 and about $30 million in 2023 combined for LIFO and Stockholm. That is roughly where we ended the year, although I will say our projections did fluctuate, and so that was part of the difficulty in 2023. There was about $2 million of LIFO in 2023 and about $23 million of Stockholm. We expect that to normalize in 2024 and to be just north of $50 million combined.
spk03
50 million of ad back? Yes.
spk04
Okay. Thank you very much for that, Alex. And last one, I'm going to go a little away from the call here. We did recently notice a headline that the West Virginia University WVU medicine deal has been delayed, or at least some of the ramp, the build out of the site has been delayed by a year. Can you tell us what's going on there? And is that having any kind of an impact on the 2024 results or outlook?
spk09
Eric, no impact at all. You know, it's actually working with the contractor to get the facility built. That's the delay on the construction. You know, it's still a, you know, we've actually extended our long-term deal with WVU. And, you know, so there's zero impact on 2024. That business we've had for the last two years, it's been served out of another distribution center. It'll continue to be served out of another distribution center until we get the facility completed. WVU has been an incredible partner to us, and there'd be no impact at all in 2024 because we are serving the business out of another distribution center, and it's just a matter of getting the new one up and running for them.
spk04
Perfect. Okay, guys. Thanks very much for the answers.
spk08
We have no further questions in our queue at this time. I will now turn the call back to Ed Casita for closing remarks.
spk09
Thank you, operator. First of all, I want to thank everyone who joined us on the call today. Besides those on the call, I want to thank our teammates across the globe that have really worked tremendously in 2023 to position us to where we are today. I also want to thank our customers, our patients, our partners, as well as our shareholders. As we reflect on where we are, we firmly believe that we have the right team in place, and even more than that, we have the right strategy. That strategy is going to enable us to continue the momentum that we've accelerated during the year, as we saw tremendous progress from Q1 to Q2 to Q3 to Q4, and exited the year with strength. As you can see, I'm pretty excited about where we are right now, but even more excited about the future. And I look forward to sharing our progress with you as the year progresses. So just again, thank you everyone for joining us today and look forward to talking again after the first quarter results. Thank you.
spk08
This concludes today's conference call. Thank you for your participation and you may now disconnect.
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