Financial Data and Key Metrics Changes - For Q2 2025, revenue grew 15% to $344.3 million, driven by solid low double-digit organic growth and contributions from recent acquisitions and greenfields [22] - Adjusted EBITDA was $25 million, up 15% year over year, with margins holding steady at 7.2% [23] - Adjusted EPS came in at $0.23, and the company maintained adjusted EBITDA margins at 7.2%, consistent with the prior year [6][22] - Cash position increased by approximately $4.8 million from Q1, ending the quarter with $18.8 million in cash [23] Business Line Data and Key Metrics Changes - Resident count increased 12% to over 195,000 [22] - The company added three new pharmacies this quarter, two via acquisition and one greenfield startup [9][10] - The recent acquisitions and greenfield startups are expected to account for a high single-digit percentage of 2025 revenue but will not contribute to EBITDA for the full year [26][27] Market Data and Key Metrics Changes - The company is expanding its presence in high-growth markets, including a new pharmacy in Naples, Florida, and acquisitions in Kansas and Washington [9][10] - The company anticipates typical seasonality in Q4 driven by COVID and flu vaccine activity, which turned profitable last year [24] Company Strategy and Development Direction - The company is focused on disciplined expansion into attractive high-growth markets and views M&A as an attractive use of capital [7][10] - The company is committed to operational excellence and customized service tailored to the communities served [10] - The long-term growth thesis remains intact, with a focus on organic growth, strategic greenfield opportunities, and a robust acquisition pipeline [21][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in funding future growth with internally generated cash and highlighted the strong year-to-date performance [6][7] - The company is proactively addressing changes in the policy environment, particularly regarding the Inflation Reduction Act and its impact on drug pricing [14][15] - Management remains optimistic about the ability to resolve pricing challenges and is engaged in constructive discussions with PBMs [18][19] Other Important Information - The company completed a non-dilutive secondary offering, nearly doubling its public float and improving trading dynamics [13] - The company recorded $1.1 million in costs associated with being a public company that did not exist in the prior year quarter [23] Q&A Session Summary Question: Is the vaccine program at a steady state or is there still potential for growth in Q4? - Management indicated that the vaccine program is at a steady state with general growth of the overall business [33] Question: When do PBM negotiations typically conclude? - Management stated that they are making good progress in negotiations and will update guidance as they approach Q4 [34] Question: Has being a public company changed the prospects or visibility of the company? - Management noted that increased visibility in public markets is a strong affirmation of the company and its services [36] Question: Can you elaborate on the organic growth drivers? - Management highlighted that organic growth is driven by share gain, patient acuity, and more complex drug regimens [43] Question: What is the current state of the acquisition pipeline? - Management confirmed that the acquisition pipeline remains strong, with human capital being the main limiting factor [44][45] Question: Can you provide figures on the recent managed healthcare pharmacy acquisition? - Management described the acquisition as typical in size and expressed excitement about the leadership team and market opportunities [48] Question: What is the expected resident count by the end of Q3? - Management indicated that they will continue the organic growth trajectory and layer in the impact of recent acquisitions [57]

Financial Data and Key Metrics Changes - Adjusted operating income for Q2 2025 was $551 million, and adjusted earnings per share were $2.95, with free cash flow at $157 million [16][15] - The company reaffirmed its guidance for adjusted operating income between $2.01 billion and $2.16 billion and adjusted earnings per share between $10.20 and $11.30 for the full year [14][15] Business Line Data and Key Metrics Changes - US treatments per day declined by 1.1% year-over-year, primarily due to a higher than expected mistreatment rate, which was influenced by the cyber incident [17][30] - Revenue per treatment (RPT) increased by approximately $4.5 compared to Q1, but was negatively impacted by the cyber incident and lower dispensing volumes of binders [18][19] - Patient care costs per treatment decreased by approximately $3.5 sequentially, attributed to higher treatment counts, improved labor productivity, and lower binder dispensing volumes [20][21] Market Data and Key Metrics Changes - The company anticipates a year-over-year decline in treatment volume of 75 to 100 basis points, revised from a previous estimate of down 50 basis points [17][18] - International adjusted operating income increased by $6 million compared to Q1, primarily due to a one-time benefit [21] Company Strategy and Development Direction - The company is focused on clinical innovation and improving patient outcomes through advanced technologies and pharmaceuticals, including new drug classes and next-generation devices [6][7] - The company is committed to maintaining operational excellence and cost control, which is expected to continue even as treatment volumes normalize [76][77] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about entering a new wave of clinical innovation that could improve patient care and outcomes [6][7] - The company acknowledged the ongoing impact of the cyber incident but believes that the effects on adjusted results will be limited moving forward [11][30] Other Important Information - The company repurchased 3.1 million shares during Q2 and an additional 2.7 million shares since the end of the quarter [23] - The company raised $1 billion in senior unsecured debt and repriced its term loan, reducing the spread by 25 basis points [23] Q&A Session Summary Question: How did census and treatments track following the cyber attack? - Management indicated that while there were initial challenges, operations have normalized since the incident, but mistreatment rates spiked unexpectedly [30][31] Question: Can you provide phosphate binder contribution to RPT and CPT in the quarter? - The RPT contribution was in the low eights, and CPT was in the high sixes, with lower dispensing volumes attributed to adherence issues rather than a mix problem [34][35] Question: How is the company maintaining guidance despite treatment growth challenges? - The company is managing costs effectively, particularly in labor, and has seen better-than-expected performance in international operations [41][42] Question: What is the reason for the elevated mortality rates? - Management believes the elevated mortality is a holdover from COVID, with delays in care and sicker patients contributing to the trend [71][72] Question: What is the expected impact of new technologies on patient care? - The company is actively monitoring and conducting studies on new technologies, with a focus on improving patient outcomes through better clearance of middle-sized molecules [90][91]