UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 FORM 10-Q For the quarterly period ended September 30, 2025 For the transition period from to (Mark One) ☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 Commission File Number: 001-41938 BrightSpring Health Services, Inc. (Exact Name of Registrant as Specified in its Charter) OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 | Delaware | 82-2956404 | | - ...

BrightSpring Health Services, Inc. Reports Preliminary Third Quarter 2025 Financial Results and Increases Full Year 2025 Guidance LOUISVILLE, Ky., October 20, 2025 — BrightSpring Health Services, Inc. ("BrightSpring" or the "Company") (NASDAQ: BTSG), a leading provider of home and community-based health services for complex populations, today announced preliminary financial results for the third quarter ended September 30, 2025, increased Revenue and Adjusted EBITDA 1 guidance, and provided details regardin ...

PART I. FINANCIAL INFORMATION This section presents the company's unaudited condensed consolidated financial statements and management's discussion and analysis of financial condition and results of operations [Item 1. Financial Statements (Unaudited)](index=5&type=section&id=Item%201.%20Financial%20Statements%20(Unaudited)) This section presents the unaudited condensed consolidated financial statements, including balance sheets, statements of operations, comprehensive income (loss), shareholders' equity, and cash flows, along with detailed notes explaining significant accounting policies, discontinued operations, revenue, acquisitions, goodwill, debt, equity units, income taxes, balance sheet accounts, EPS, common stock, fair value, commitments, related party transactions, and segment information [Condensed Consolidated Balance Sheets](index=5&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) This statement provides a snapshot of the company's financial position, detailing assets, liabilities, and equity at specific points in time - The **balance sheet** shows an **increase** in **total assets**, driven by current assets held for sale, and an **increase** in **total equity**, while **total liabilities decreased**[16](index=16&type=chunk) | Metric | June 30, 2025 (in thousands) | December 31, 2024 (in thousands) | Change | | :------------------------------------ | :----------------------------- | :------------------------------- | :----- | | Total Assets | $5,943,597 | $5,926,140 | $17,457 | | Current assets held for sale | $850,455 | $131,447 | $719,008 | | Total Liabilities | $4,198,174 | $4,274,555 | $(76,381) | | Total Equity | $1,742,607 | $1,647,855 | $94,752 | [Condensed Consolidated Statements of Operations](index=6&type=section&id=Condensed%20Consolidated%20Statements%20of%20Operations) This statement outlines the company's financial performance over specific periods, reporting revenues, expenses, and net income or loss - The company reported a **net income** of **$27.5 million** for Q2 2025, **up from** **$19.4 million** in Q2 2024. For the six months, **net income** was **$56.6 million**, a **significant improvement** from a **net loss** of **$(26.9) million** in the prior year. **Revenue** saw **substantial growth** across both periods[19](index=19&type=chunk) Three Months Ended June 30 | Metric | 2025 (in thousands) | 2024 (in thousands) | Change (YoY) | % Change (YoY) | | :---------------------------------------------------------------- | :------------------ | :------------------ | :------------ | :-------------- | | Total Revenues | $3,147,698 | $2,438,254 | $709,444 | 29.1% | | Gross Profit | $374,852 | $312,176 | $62,676 | 20.1% | | Operating Income | $48,557 | $38,653 | $9,904 | 25.6% | | Net Income (Loss) | $27,542 | $19,441 | $8,101 | 41.7% | | Net Income (Loss) attributable to BrightSpring Health Services, Inc. and subsidiaries | $28,208 | $19,919 | $8,289 | 41.6% | | Basic EPS | $0.14 | $0.10 | $0.04 | 40.0% | | Diluted EPS | $0.13 | $0.10 | $0.03 | 30.0% | Six Months Ended June 30 | Metric | 2025 (in thousands) | 2024 (in thousands) | Change (YoY) | % Change (YoY) | | :---------------------------------------------------------------- | :------------------ | :------------------ | :------------ | :-------------- | | Total Revenues | $6,025,827 | $4,724,020 | $1,301,807 | 27.6% | | Gross Profit | $713,221 | $604,667 | $108,554 | 18.0% | | Operating Income | $99,296 | $23,318 | $75,978 | 325.8% | | Net Income (Loss) | $56,552 | $(26,944) | $83,496 | n.m. | | Net Income (Loss) attributable to BrightSpring Health Services, Inc. and subsidiaries | $57,750 | $(25,831) | $83,581 | n.m. | | Basic EPS | $0.29 | $(0.14) | $0.43 | n.m. | | Diluted EPS | $0.27 | $(0.14) | $0.41 | n.m. | [Condensed Consolidated Statements of Comprehensive Income (Loss)](index=7&type=section&id=Condensed%20Consolidated%20Statements%20of%20Comprehensive%20Income%20(Loss)) This statement presents the company's net income or loss and other comprehensive income or loss, reflecting all changes in equity from non-owner sources - **Total comprehensive income** for BrightSpring Health Services, Inc. and subsidiaries **increased significantly** to **$25.7 million** for Q2 2025 from **$15.8 million** in Q2 2024. For the six months, it **improved** from a **loss** of **$(19.4) million** in 2024 to an **income** of **$52.0 million** in 2025[22](index=22&type=chunk) Three Months Ended June 30 | Metric | 2025 (in thousands) | 2024 (in thousands) | Change (YoY) | % Change (YoY) | | :---------------------------------------------------------------- | :------------------ | :------------------ | :------------ | :-------------- | | Net income (loss) | $27,542 | $19,441 | $8,101 | 41.7% | | Total other comprehensive (loss) income, net of tax | $(2,461) | $(4,090) | $1,629 | (39.8)% | | Total comprehensive income (loss) attributable to BrightSpring Health Services, Inc. and subsidiaries | $25,747 | $15,829 | $9,918 | 62.7% | Six Months Ended June 30 | Metric | 2025 (in thousands) | 2024 (in thousands) | Change (YoY) | % Change (YoY) | | :---------------------------------------------------------------- | :------------------ | :------------------ | :------------ | :-------------- | | Net income (loss) | $56,552 | $(26,944) | $83,496 | n.m. | | Total other comprehensive (loss) income, net of tax | $(5,748) | $6,481 | $(12,229) | (188.7)% | | Total comprehensive income (loss) attributable to BrightSpring Health Services, Inc. and subsidiaries | $52,002 | $(19,350) | $71,352 | n.m. | [Condensed Consolidated Statements of Shareholders' Equity](index=8&type=section&id=Condensed%20Consolidated%20Statements%20of%20Shareholders'%20Equity) This statement details the changes in the company's shareholders' equity over time, including contributions, net income, and other comprehensive income - **Total shareholders' equity increased** from **$1.65 billion** at December 31, 2024, to **$1.74 billion** at June 30, 2025, primarily due to **net income**, **share-based compensation**, and **exercise of stock options**, partially offset by **other comprehensive loss**[16](index=16&type=chunk)[28](index=28&type=chunk) Total Shareholders' Equity | Date | Amount (in thousands) | | :------------------- | :-------------------- | | June 30, 2025 | $1,742,607 | | December 31, 2024 | $1,647,855 | | Change | $94,752 | | % Change | 5.75% | - Key drivers for the **increase** in **equity** for the six months ended June 30, 2025, include **net income** of **$57.8 million**, **share-based compensation** of **$38.5 million**, and **exercise of stock options** of **$9.1 million**, offset by **other comprehensive loss** of **$(5.7) million**[28](index=28&type=chunk) [Condensed Consolidated Statements of Cash Flows](index=10&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) This statement reports the cash generated and used by the company across its operating, investing, and financing activities - For the six months ended June 30, 2025, the company generated **significant net cash from operating activities** (**$150.7 million**), a **substantial improvement** from a **net cash use** in the prior year. **Investing activities used less cash**, while **financing activities shifted** from providing cash to using cash, primarily due to **debt repayments**[32](index=32&type=chunk)[254](index=254&type=chunk) Six Months Ended June 30 | Activity | 2025 (in thousands) | 2024 (in thousands) | Variance (YoY) | | :------------------------------------------ | :------------------ | :------------------ | :------------- | | Net cash provided by (used in) operating activities | $150,674 | $(94,084) | $244,758 | | Net cash used in investing activities | $(47,434) | $(88,630) | $41,196 | | Net cash (used in) provided by financing activities | $(94,261)

BrightSpring Health Services, Inc. Reports Second Quarter 2025 Financial Results and Increases Full Year 2025 Guidance Adjusted EBITDA 1 of $143 million, up 28.8% compared to $111 million in the second quarter of 2024. 1Adjusted EBITDA is a non-GAAP financial measure. Please see "Non-GAAP Financial Information" and the end of this press release for a reconciliation of Adjusted EBITDA to net income (loss) from continuing operations, the most directly comparable financial measure prepared in accordance with G ...

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 March 31, 2025 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: 001-41938 BrightSpring Health Services, Inc. (Exact Name of Registrant as Specified in its Charter) | Delaware | 82-2956404 | | --- | ...

Financial Performance - Net Revenue for Q1 2025 was $2,878 million, a 25.9% increase from $2,286 million in Q1 2024[3] - Gross Profit for Q1 2025 reached $338 million, up 15.7% compared to $292 million in Q1 2024[3] - Net Income from Continuing Operations was $9.2 million, a significant improvement from a Net Loss of $56.0 million in Q1 2024[3] - Adjusted EBITDA for Q1 2025 was $131 million, reflecting a 28.2% increase from $102 million in Q1 2024[4] - Total Segment Adjusted EBITDA for Q1 2025 was $167 million, a 24% increase from $135 million in Q1 2024[6] - Total revenues for Q1 2025 reached $2,878,129, a 26% increase from $2,285,766 in Q1 2024[28] - Gross profit for Q1 2025 was $338,369, compared to $292,491 in Q1 2024, reflecting a 15.7% increase[28] - Net income attributable to BrightSpring Health Services, Inc. was $29,542 for Q1 2025, a significant recovery from a net loss of $45,750 in Q1 2024[28] - Adjusted EBITDA for Q1 2025 was $131,062, up from $102,215 in Q1 2024, indicating a 28.3% growth[32] Revenue Breakdown - Pharmacy Solutions Revenue for Q1 2025 was $2,532 million, a 28% increase from $1,977 million in Q1 2024[6] - Provider Services Revenue for Q1 2025 was $346 million, up 12% from $309 million in Q1 2024[6] Guidance and Projections - Full Year 2025 Revenue guidance increased to $12,000 - $12,500 million, representing a growth of 19.1% to 24.1%[9] - Adjusted EBITDA guidance for 2025 is set at $570 - $585 million, indicating a growth of 23.9% to 27.2%[9] Cash Flow and Assets - The company reported a net cash provided by operating activities of $101,598 for Q1 2025, a turnaround from a net cash used of $78,859 in Q1 2024[30] - Cash and cash equivalents decreased to $52,337 as of March 31, 2025, down from $60,954 at the end of 2024[26] - Total current assets increased to $2,528,448 as of March 31, 2025, compared to $1,893,054 at the end of 2024, marking a 33.6% rise[26] - Total assets decreased to $5,846,945 as of March 31, 2025, from $5,926,140 at the end of 2024, a decline of 1.3%[26] - Long-term debt, net of current portion, decreased to $2,489,339 as of March 31, 2025, from $2,561,858 at the end of 2024, a reduction of 2.8%[26] Earnings Per Share - Basic income per share from continuing operations was $0.05 for Q1 2025, compared to a loss of $0.31 in Q1 2024[28] - For Q1 2025, diluted EPS from continuing operations was $0.05, compared to $(0.31) in Q1 2024[34] - Adjusted EPS for Q1 2025 was $0.19, an increase from $0.09 in Q1 2024[34] - The weighted average common shares outstanding used in calculating diluted EPS increased to 214,927 thousand in Q1 2025 from 175,531 thousand in Q1 2024[34] Cost Contributions - Non-cash share-based compensation contributed $0.06 to adjusted EPS in Q1 2025, down from $0.13 in Q1 2024[34] - Acquisition, integration, and transaction-related costs contributed $0.04 to adjusted EPS in Q1 2025, compared to $0.05 in Q1 2024[34] - Restructuring and divestiture-related costs contributed $0.08 to adjusted EPS in Q1 2025, down from $0.13 in Q1 2024[34] - The income tax impact on adjustments was $(0.04) for Q1 2025, compared to $(0.11) in Q1 2024[34] Divestiture Plans - The planned divestiture of the Community Living business to Sevita is on track to be completed this year[5]

Acquisitions and Growth Strategy - The company acquired Abode Healthcare in April 2021, enhancing its service offerings in applied behavioral analysis[9] - The company’s growth strategy includes identifying and successfully completing acquisitions, which is critical for expanding market share[19] - The company acquired BrightSpring Health Holdings Corp. and its subsidiaries in March 2019, contributing to its growth strategy[150] Financial Performance and Indebtedness - The company reported a substantial indebtedness of approximately $2.7 billion as of December 31, 2024, which may impact future financial flexibility[20] - Approximately 47% of the company's revenue comes from 10 states, highlighting its geographic concentration and market presence[31] - The company is well-positioned for future growth, with significant opportunities in the $90 billion expected revenue from oncology drugs not yet launched by 2032[39] Patient Satisfaction and Quality of Care - The patient satisfaction survey from April 1, 2023, to June 30, 2023, indicated that a significant percentage of family members would recommend the company based on their experience[9] - The Net Promoter Score (NPS) is utilized to gauge patient satisfaction, with scores above 50 considered "excellent" and above 80 "world class"[11] - The overall rating of care reflects assessments based on eight quality measures, indicating the company's commitment to high-quality service delivery[11] - The company achieved 99.99% order accuracy and 98.63% order completeness in its pharmacy services, with a patient satisfaction rate of 97% in outpatient rehab services[28][35] - The outpatient rehab services received a 97% patient satisfaction score, with 97% of patients willing to recommend the services[51] Regulatory and Compliance Challenges - The company is subject to extensive federal, state, and local regulations that could materially affect its operations and financial condition[97] - The Stark Law prohibits physicians with financial relationships from making referrals for designated health services, with penalties including denial of payment and civil penalties up to $27,750 per service[105][108] - Violations of the Stark Law can lead to civil penalties, including refunds of amounts collected and potential exclusion from federal healthcare programs[108] - The False Claims Act allows for penalties ranging from $5,500 to $11,000 per false claim, with potential treble damages, impacting the company's financial condition[114] - The company must notify CMS of overpayments within 60 days, or risk liability under the False Claims Act, which could adversely affect its operations[113] Market and Competitive Landscape - The company operates in a highly competitive industry, which poses risks to maintaining patient referral sources and overall financial performance[17] - The company operates in a highly competitive U.S. healthcare industry, facing intense competition in both Pharmacy Solutions and Provider Services segments[155] - The company faces significant competition in attracting and retaining qualified pharmacy professionals, which could adversely affect its business[66] Operational Efficiency and Technology Investments - The company emphasizes operational excellence as a key driver for growth, focusing on continuous improvement in volume and cost efficiency[59] - The implementation of the PMO-led continuous improvement program has resulted in approximately $67.5 million of annual savings in 2024[60] - The company has invested over $200 million annually in quality, compliance, and safety initiatives as part of its "Quality First" framework[64] - The company is investing in technology resources and systems to improve operational efficiency and patient care[90] Healthcare Policy and Reimbursement Risks - Changes in Medicare and Medicaid payment methods could materially affect the company's business operations and financial results[17] - Legislative changes, including the ACA and Bipartisan Budget Act of 2018, continue to impact Medicare and Medicaid reimbursement rates, affecting revenue streams[142][143] - The implementation of the Patient-Driven Groupings Model (PDGM) for home health payments resulted in a 4.36% reduction to reimbursement rates[164] - The company faces risks related to maintaining relationships with patient referral sources, which are critical for growth and profitability[160] Employee Retention and Labor Relations - The company has seen a 50% increase in compensation over the last four years to attract and retain employees[95] - Approximately 68% retention rate for clinical positions in home health care, hospice care, and rehab care from December 31, 2023, to December 31, 2024[94] - The ability to attract and retain qualified healthcare professionals is critical; failure to do so may negatively impact service quality and financial performance[198] Billing and Collection Challenges - The complexity of billing and collection processes may lead to increased accounts receivable aging and working capital shortages[206] - The company experiences significant delays in reimbursement from Medicare and Medicaid programs, particularly under managed care, which pay claims slower than traditional programs[207] - The company's billing and collection processes are subject to complex regulations that are continuously evolving, increasing the risk of payment delays[206] Drug Pricing and Supply Chain Risks - Changes in drug utilization and pricing, as well as PBM contracts, may negatively impact profitability, particularly in the Pharmacy Solutions segment[184] - The company faces risks from potential supply shortages and changes in relationships with pharmaceutical suppliers, which could adversely affect financial results[191] - Increased scrutiny over drug pricing practices may lead to legislative changes that could impact the company's operations and profitability[190]

Financial Performance - Fourth quarter net revenue reached $3,053 million, a 28.6% increase from $2,375 million in Q4 2023[4] - Fourth quarter net income was $15.4 million, compared to a net loss of $7.2 million in Q4 2023[5] - Full year net revenue for 2024 was $11,266 million, up 27.6% from $8,826 million in 2023[6] - Full year Adjusted EBITDA for 2024 was $588 million, a 9.3% increase from $538 million in 2023[7] - Total revenues for the year ended December 31, 2024, increased to $11,266,472, up 27.8% from $8,826,175 in 2023[30] - The company reported an operating income of $206,374 for the year ended December 31, 2024, compared to $147,180 in 2023, marking a 40.2% increase[30] - EBITDA for the year ended December 31, 2024, was $398,130,000, an increase from $349,516,000 in 2023, reflecting a growth of approximately 13.9%[33] - Adjusted EBITDA for the three months ended December 31, 2024, was $167,418,000, up from $142,599,000 in 2023, representing a year-over-year increase of about 17.4%[33] Revenue Breakdown - Pharmacy Solutions revenue for 2024 was $8,754 million, a 34% increase from $6,522 million in 2023[8] - Provider Services revenue for 2024 was $2,512 million, a 9% increase from $2,304 million in 2023[8] Guidance and Projections - 2025 revenue guidance is set between $11,600 million and $12,100 million, reflecting a growth of 15.2% to 20.1% over 2024[9] - Adjusted EBITDA guidance for 2025 is projected to be between $545 million and $560 million, indicating an 18.4% to 21.7% growth over 2024[15] Divestiture and Strategic Moves - The company announced a divestiture of the Community Living business to Sevita for $835 million[5] - The company expects the divestiture to enhance capital flexibility and growth rates moving forward[3] Assets and Liabilities - Cash and cash equivalents increased significantly to $61,253 as of December 31, 2024, compared to $13,071 in 2023[28] - Accounts receivable rose to $1,028,654, up from $881,627 in 2023, indicating a 16.7% increase[28] - Total assets increased to $5,926,140 as of December 31, 2024, compared to $5,532,721 in 2023, reflecting a growth of 7.1%[28] - Long-term debt decreased to $2,561,858 as of December 31, 2024, down from $3,331,941 in 2023, a reduction of 23.1%[28] - The company reported a total of $2,566,000,000 in long-term debt borrowings for the year ended December 31, 2024, with repayments totaling $(3,396,334,000) during the same period[32] Expenses and Income - Selling, general, and administrative expenses for the year ended December 31, 2024, were $1,382,061, an increase from $1,286,614 in 2023[30] - The provision for credit losses increased to $33,998,000 for the year ended December 31, 2024, from $23,237,000 in 2023, marking a rise of approximately 46.3%[32] - The company incurred $54,866,000 in interest expense for the three months ended December 31, 2024, compared to $83,054,000 in 2023, reflecting a decrease of approximately 34.0%[33] Shareholder Information - The weighted average shares outstanding for basic shares increased to 192,997 for the year ended December 31, 2024, compared to 117,868 in 2023[30] - The company reported a diluted EPS of $0.08 for the three months ended December 31, 2024, compared to a diluted EPS of $(0.06) in the same period of 2023[36] Cash Flow - The net cash provided by operating activities for the three months ended December 31, 2024, was $90,612,000, a decrease from $162,400,000 in the same period of 2023[32]

Revenue Growth - Revenue for Q3 2024 increased by $650.3 million, or 28.8%, reaching $2.9 billion compared to Q3 2023[73] - Pharmacy Solutions segment revenue grew by $592.5 million, or 35.4%, totaling $2.3 billion[73] - Provider Services segment revenue increased by $57.7 million, or 9.9%, to $641.1 million[73] - Revenues for the three months ended September 30, 2024, were $2,906.8 million, an increase of $650.3 million or 28.8% compared to $2,256.5 million for the same period in 2023[92] - Revenues for the nine months ended September 30, 2024, were $8,213.7 million, an increase of $1,762.0 million or 27.3% compared to $6,451.6 million for the same period in 2023[97] - Product revenues increased by $1,620.2 million or 34.2% to $6,357.2 million for the nine months ended September 30, 2024, compared to $4,737.0 million in 2023[98] - Revenues for the Pharmacy Solutions segment for the three months ended September 30, 2024, were $2,265.7 million, an increase of $592.5 million or 35.4% from $1,673.2 million in 2023[105] - Revenues for the nine months ended September 30, 2024, were $6,357.2 million, an increase of $1,620.2 million or 34.2% compared to the same period in 2023[108] - Revenues for the Provider Services segment for the nine months ended September 30, 2024, were $1,856.4 million, an increase of $141.8 million or 8.3% year-over-year[120] Profitability and Loss - Net loss decreased by $121.1 million, from $130.1 million to $9.0 million[73] - Adjusted EBITDA rose by $20.5 million, or 15.7%, to $151.0 million[73] - Pharmacy Solutions segment EBITDA increased by $13.1 million, or 15.2%, to $99.2 million[73] - Provider Services segment EBITDA grew by $11.8 million, or 14.4%, to $93.2 million[73] - Loss per share decreased by $0.14, from $0.18 to $0.04[73] - Adjusted EPS improved by $0.19, from $(0.08) to $0.11[73] - Adjusted EBITDA for the three months ended September 30, 2024, was $151.0 million, an increase of $20.5 million or 15.7% from $130.5 million in the prior year[97] - Adjusted EBITDA for the nine months ended September 30, 2024, was $420.7 million, reflecting an increase of $25.4 million or 6.4% from $395.2 million in 2023[104] - The net loss for the nine months ended September 30, 2024, was $35.9 million, an improvement from a net loss of $149.6 million for the same period in 2023[127] Expenses and Costs - Cost of goods for the three months ended September 30, 2024, was $2,077.1 million, an increase of $567.3 million or 37.6% from $1,509.8 million in the prior year[95] - Cost of goods for the nine months ended September 30, 2024, was $5,816.0 million, an increase of $1,589.9 million or 37.6% from $4,226.1 million in the prior year[97] - Selling, general, and administrative expenses for the three months ended September 30, 2024, were $351.3 million, a decrease of $59.3 million or 14.4% from $410.5 million in the prior year[96] - Selling, general, and administrative expenses were $1,039.2 million for the nine months ended September 30, 2024, an increase of $53.1 million or 5.4% from $986.2 million in 2023[99] - Interest expense, net for the three months ended September 30, 2024, was $56.1 million, a decrease of $27.6 million or 33.0% from $83.7 million in the prior year[95] - Interest expense, net decreased by $68.0 million or 28.2% to $173.5 million for the nine months ended September 30, 2024, compared to $241.5 million in 2023[99] Acquisitions and Corporate Actions - The company completed three acquisitions within its Provider Services segment[73] - The company completed its IPO on January 30, 2024, raising net proceeds of $656.5 million from the sale of 53,333,334 shares at $13.00 each[86] - The company plans to use IPO proceeds to repay $343.3 million under the First Lien Facility and other debts, with remaining funds allocated for general corporate purposes[86] - The company has granted approximately $163.3 million in non-cash share-based compensation related to equity awards in connection with the IPO[87] Legal and Regulatory Matters - The total financial impact of a legal settlement reached in May 2024 is $120 million, concluding the Silver matter without admitting liability[89] - The company received a quality incentive payment of approximately $30 million for its Infusion and Specialty Pharmacy services during Q2 2023, but did not receive any QIP during the nine months ended September 30, 2024[88] Cash Flow and Liquidity - The principal sources of cash have historically been from operating activities, with future capital requirements dependent on acquisitions and operational results[130] - The company believes its operating cash flows and available cash will be sufficient to meet cash requirements for the next twelve months and beyond[130] - Total liquidity at the end of the period was $416.9 million, a decrease from $431.5 million at the end of 2023[132] - Net cash used in operating activities was $66.8 million for the nine months ended September 30, 2024, compared to net cash provided of $48.4 million in the same period of 2023, reflecting a variance of $115.2 million[133] - Net cash used in investing activities increased to $124.5 million in 2024 from $117.4 million in 2023, primarily due to an $8.9 million increase in property and equipment purchases[134] - Net cash provided by financing activities was $214.2 million for the nine months ended September 30, 2024, significantly higher than $67.0 million in 2023, driven by net proceeds from IPO offerings[135] Debt and Financing - Total debt as of September 30, 2024, was $2.73 billion, down from $3.41 billion at the end of 2023[140] - The company had $97.1 million of borrowings outstanding under the Revolving Credit Facility as of September 30, 2024, compared to $50.7 million at the end of 2023[138] - The company’s leverage ratio was 4.39x as of September 30, 2024, improved from 5.86x at the end of 2023[140] - The company incurred a loss on extinguishment of debt of $12.7 million related to the repayment of the Second Lien Facility[139] - The First Lien Credit Agreement was refinanced with a remaining balance of $2.57 billion at a rate of SOFR plus 3.25%[137] - The company issued 8 million Tangible Equity Units (TEUs) with a stated amount of $50.00 per unit, commencing quarterly cash installments in May 2024[139] - As of September 30, 2024, the company's outstanding debt was $2.7 billion, with three interest rate swaps totaling a notional value of $2.0 billion designated as cash flow hedges[143] - A hypothetical 1% increase in interest rates would result in an annual increase in net loss and a decrease in cash flows by $6.5 million based on the borrowing level as of September 30, 2024[143] Operational Challenges - The company faces significant challenges in managing labor costs due to inflation and a shortage of qualified caregivers, impacting the healthcare industry[142] - Rising healthcare costs, typically higher than inflation, continue to affect the company's employee benefit plans[142] - The company has implemented supply chain efforts to manage and mitigate inflationary impacts over recent years, although future cost increases remain unpredictable[142] Accounting and Reporting - There have been no material changes to the company's critical accounting policies and estimates from those disclosed in the Annual Report for the year ended December 31, 2023[141]

Financial Performance - Net revenue for Q3 2024 was $2,907 million, representing a 28.8% increase from $2,257 million in Q3 2023[1] - Adjusted EBITDA for Q3 2024 was $151 million, up 15.7% from $131 million in Q3 2023[3] - The net loss for Q3 2024 was $9.0 million, significantly improved from a net loss of $130.1 million in Q3 2023[2] - Pharmacy Solutions revenue increased by 35% to $2,266 million, while Provider Services revenue grew by 10% to $641 million[4] - Full year 2024 revenue guidance is increased to between $11,000 million and $11,300 million, indicating a growth of 24.6% to 28.0% over 2023[6] - Adjusted EBITDA guidance for 2024 is set at $580 million to $585 million, reflecting a growth of 14.2% to 15.2% over 2023[6] - The company reported a gross profit of $408 million for Q3 2024, which is a 13.9% increase compared to $358 million in Q3 2023[2] - Operating income for the three months ended September 30, 2024, was $56,840, a significant improvement from an operating loss of $(52,253) in the same period of 2023[27] - The company reported a basic loss per share of $(0.04) for the three months ended September 30, 2024, compared to $(1.11) for the same period in 2023, showing an improvement of approximately 96.4%[27] - Adjusted EPS for the three months ended September 30, 2024, was $0.11, while it was $(0.08) for the same period in 2023[30] Cash Flow and Assets - Cash and cash equivalents increased to $35,973 as of September 30, 2024, compared to $13,071 as of December 31, 2023, showing a growth of about 175.5%[22] - Accounts receivable increased to $1,025,711 as of September 30, 2024, from $881,627 as of December 31, 2023, representing a rise of approximately 16.3%[22] - Total assets as of September 30, 2024, were $5,785,967, up from $5,532,721 as of December 31, 2023, indicating an increase of about 4.6%[24] - The company reported a net cash provided by operating activities of $27.246 million for the three months ended September 30, 2024, compared to $33.691 million for the same period in 2023[28] - The company experienced a net cash used in investing activities of $36.908 million for the three months ended September 30, 2024[28] - Cash and cash equivalents at the end of the year were $35.973 million, up from $11.641 million at the end of the previous year[28] Liabilities and Debt - Total liabilities decreased to $4,166,870 as of September 30, 2024, from $4,920,172 as of December 31, 2023, reflecting a reduction of approximately 15.3%[25] - The company’s total current liabilities increased to $1,263,922 as of September 30, 2024, from $1,248,437 as of December 31, 2023, representing a slight increase of about 1.2%[25] - Long-term debt borrowings were $2.566 billion for the nine months ended September 30, 2024[28] Operational Efficiency - The company aims to drive operational excellence and efficiencies while increasing scale to deliver high-quality care[1] - The Pharmacy Solutions segment's EBITDA was $99 million, up 15% from $86 million in the same quarter last year[4] - Provider Services segment's EBITDA increased by 14% to $93 million from $81 million in Q3 2023[4] Adjustments and Costs - Total adjustments to reconcile net loss to Adjusted EBITDA amounted to $43.569 million for the three months ended September 30, 2024[29] - The company incurred $11.767 million in acquisition, integration, and transaction-related costs for the three months ended September 30, 2024[29] - The company reported a provision for credit losses of $8.778 million for the three months ended September 30, 2024, compared to $6.753 million for the same period in 2023[28] - Legal costs and settlements had a significant impact, contributing $0.04 to the adjusted EPS for the three months ended September 30, 2024, compared to $0.93 in the same period of 2023[30] - The company reported a total of $0.14 from restructuring and divestiture-related costs for the nine months ended September 30, 2024[30]