Core Viewpoint - Optima Health plc has announced the acquisition of Cognate Health Limited for a total cash consideration of up to €9 million, which will enhance its geographic reach and service capabilities in the occupational health sector [4][10]. Company Overview - Optima Health is the UK's leading provider of technology-enabled corporate health and wellbeing solutions, with a focus on improving workplace health and safety [4][10]. - Cognate Health Limited is an occupational health services company based in the Republic of Ireland, recognized as a leading provider in the region [8]. Acquisition Details - The acquisition involves the purchase of the entire issued share capital of Cognate Health on a cash-free, debt-free basis, with an initial payment of €7 million and potential earn-out consideration of up to €2 million based on performance [9][11]. - The deal will add approximately €7 million in revenue and €1 million in EBITDA to Optima Health [10]. Strategic Implications - The acquisition will create a base in the Republic of Ireland with around 30 clinic sites and approximately 60 experienced employees, including a network of 35 Occupational Health Physicians [5][10]. - This move aligns with Optima Health's strategic focus on expanding its presence in the occupational health sector and enhancing its ability to service multinational clients [6][8]. Growth Opportunities - The Board of Optima Health believes there are significant opportunities for growth and plans to continue evaluating further acquisitions and consolidation in the market [7][8].

Financial Data and Key Metrics Changes - Revenue for Q4 2024 was $465 million, a 5.5% increase from $440.7 million in Q4 2023 [5] - Adjusted EBITDA rose to $77.5 million, up 13.6% from $68.3 million in the same quarter last year [5] - Net income was $22.8 million, with earnings per share at $0.17, slightly better than preliminary estimates but lower than the same quarter last year due to IPO recapitalization [6] - Adjusted EBITDA margin increased from 15.5% in Q4 2023 to 16.7% in Q4 2024 [5] Business Line Data and Key Metrics Changes - Occupational Health Center segment revenue was $437 million, a 5.4% increase year-over-year [11] - Workers' compensation revenue increased by 7% to $289.1 million, representing 66% of total center operating segment revenue [11][12] - Employer services revenue increased by 1.3% to $137.2 million, with visits per day declining by 4.8% [12] - On-site revenue grew by 7% to $17.1 million, with 10 new on-site centers expected to open soon [13] Market Data and Key Metrics Changes - Total patient visits per day were 46,800, a 2.1% decline year-over-year, driven by a 4.8% decrease in employer services visits [7][8] - Revenue per visit increased by 5.8% compared to the same quarter last year, driven by both workers' compensation and employer services [9] Company Strategy and Development Direction - The company aims to improve the health of America's workforce and continues to execute on strategic initiatives, including the acquisition of Nova Medical Centers [4][19] - The Nova acquisition, valued at $265 million, is expected to enhance the company's footprint and service offerings [19] - The company plans to continue its de novo strategy, with several new centers opening in 2025 [16][17] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about stabilizing hiring rates and improving employer services volumes in 2025 [8][50] - The company expects to generate approximately $2.1 billion in revenue for 2025, a 10.5% increase over 2024 [25] - Adjusted EBITDA for 2025 is projected to be between $410 million and $425 million, an 11% increase over 2024 [26] Other Important Information - The company declared a quarterly cash dividend of $0.0625 per share, payable on April 1, 2025 [15] - The net leverage ratio at the end of 2024 was 3.46x, with a target of approximately 3.0x within the next 18 to 24 months [15][23] Q&A Session Summary Question: Integration approach for Nova - Management highlighted their experience with similar integrations, emphasizing the overlapping infrastructure and support systems that will facilitate the process [33][35] Question: Deleveraging pathway post-Nova acquisition - The company plans to reduce net leverage to approximately 3.5x by the end of 2025, driven by cash flow generation and EBITDA growth [36][38] Question: Exposure to tariffs and impact on volumes - Management does not foresee significant headwinds from tariffs affecting employer clients at this time [45] Question: Economic drivers for guidance in 2025 - The guidance reflects a combination of improved employer services growth and stable trends in workers' compensation, influenced by broader economic conditions [48][50] Question: P&L considerations for Q4 performance - Management noted stable cost levels for services and G&A, with some seasonality in Q4 expenses [52][54] Question: Expected improvement in Employer Services - Management anticipates trends will improve, moving towards flat year-over-year growth and slight positive growth later in the year [60] Question: Rate updates for workers' compensation and employer services - Both categories are expected to see slightly elevated rates due to inflation, with a positive outlook for 2025 [62][64] Question: Long-term growth outlook - The company expects mid to high single-digit revenue growth driven by visit growth and rate increases, alongside M&A activities [65] Question: Development activities and new centers - The guidance includes planned openings for new centers and normal growth for on-site business, with no additional M&A included [67] Question: Government pay exposure - The company has minimal exposure to Medicare and Medicaid, with less than 1% of revenue from these sources [69]