AdaptHealth Q4 Earnings Call Highlights

Core Insights - AdaptHealth reported a challenging Q4 2025 with a net revenue of $846.3 million, down 1.2% year over year, attributed mainly to business dispositions in the Wellness at Home segment [5][6] - The company achieved full-year net revenue of $3.245 billion, slightly down 0.5% from the previous year, but with organic growth of 1.7% [6][7] - Management highlighted record patient census in multiple segments, indicating strong operational performance despite revenue declines [5][11] Financial Performance - Q4 net revenue breakdown: - Wellness at Home: $137.3 million, down 16.1% [2] - Diabetes Health: $158.5 million, down 7.4% [3] - Respiratory Health: $178.2 million, up 7.8% [4] - Sleep Health: $372.3 million, up 4.4% [4] - Adjusted EBITDA for 2025 was $616.7 million, with a margin of 19.0%, while Q4 Adjusted EBITDA was $163.1 million, with a margin of 19.3% [8] - Free cash flow for Q4 was $79.3 million, and for the full year, it was $219.4 million, exceeding guidance [9] Operational Developments - The company implemented a new operating model in 2025 to standardize workflows and improve service delivery, resulting in improved setup times for Sleep Health and Respiratory Health [11] - Technology pilots, including AI tools for order intake and patient scheduling, are expected to enhance operational efficiency in the future [12] - A new capitated contract went live in December 2025, covering about 50,000 members, with expectations to serve over 10 million patients nationwide [13] Guidance and Future Outlook - For 2026, AdaptHealth expects revenue growth of 6%-8% over 2025, with organic growth of 7.5%-9.5% [15] - Q1 2026 revenue growth is projected at 2%-3% year over year, with an Adjusted EBITDA margin of approximately 16% [16] - The company anticipates negative free cash flow in Q1 2026, with improvements expected as capitated revenue ramps up [16] Strategic Initiatives - AdaptHealth expanded its footprint with a Hawaii-based HME acquisition, marking its presence in the 48th state [17] - The company received a favorable outcome from CMS regarding competitive bidding, providing long-term stability for its core products [18] - A $14.5 million legal settlement related to a debt collection class action was finalized, with improvements in the company's control environment noted [19][20]