Financial Data and Key Metrics Changes - Fourth quarter revenue was effectively flat year-over-year but exceeded the midpoint of guidance by 3%, with Sleep Health and Respiratory Health segments showing growth while Diabetes Health contracted [6][30] - Adjusted EBITDA for the fourth quarter contracted 2% year-over-year but was above the high end of guidance, with an adjusted EBITDA margin of 23.4%, slightly down from 23.8% in the prior year [7][38] - Free cash flow for the fourth quarter was $73 million, up 10% year-over-year and well above guidance [7][40] Business Line Data and Key Metrics Changes - Sleep Health revenue increased 3.4% year-over-year to $356.5 million, with new starts surpassing 120,000 for the third consecutive quarter [31] - Respiratory Health revenue was $165.3 million, up 1% year-over-year, with a record oxygen census of over 330,000 patients [33] - Diabetes Health revenue decreased 7.3% year-over-year to $171.3 million, but showed sequential growth of $30.2 million over the third quarter [34] - Wellness at Home revenue was $163.5 million, down 0.8% year-over-year, primarily due to the sale of certain custom rehab assets [35] Market Data and Key Metrics Changes - Full year 2024 net revenue was $3.26 billion, growing 1.9% year-over-year despite pressures from divestitures and reimbursement changes [30] - Sleep Health segment grew 4.5%, Respiratory Health grew 6.0%, while Diabetes Health declined 6.9% for the full year [30] Company Strategy and Development Direction - The company is focusing on five areas: One Adapt initiative, AI and automation, clinical relevance, organic growth, and strengthening the balance sheet [8][24] - A new segment structure was implemented to enhance visibility into customer needs and improve service excellence [12] - The company aims to lead in innovation within the home health industry and expand the value delivered to patients [13][16] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the company's progress and the potential for growth, particularly in the Sleep Health and Respiratory Health segments [5][51] - The company anticipates 2025 to be a transition year for growth, with expectations for accelerated growth in 2026 and beyond [51] Other Important Information - The company reduced debt by $170 million over the past year, with a net leverage ratio of 2.8x at year-end 2024 [24][42] - The company expects 2025 revenue guidance of $3.22 billion to $3.36 billion, reflecting a slight decline to modest growth [46] Q&A Session Summary Question: Can you talk more about the conversations with carriers over additional capitated arrangements? - Management confirmed ongoing discussions with various proposed capitated arrangements and noted a strong relationship with Humana, which has been complimentary about performance [55][56] Question: Can you discuss your working capital outlook and cash flow improvement? - Management expressed satisfaction with free cash flow performance in 2024 and expects continued improvement in days sales outstanding and inventory management [57][59] Question: What are your thoughts on the Diabetes business contribution to 2025 guidance? - Management indicated that while there are improving trends, they are cautious about committing to growth in the Diabetes segment until proven [66][68] Question: Can you elaborate on the changes made in the Diabetes resupply outreach program? - Management highlighted the implementation of a new leadership team and a focus on better patient outreach, which has led to improved retention and reduced attrition [86][90] Question: What is the impact of the purchase versus rental revenue situation? - Management explained that the shift is primarily in the Sleep segment, with revenue being recognized differently due to changes in reimbursement practices [100][102] Question: Can you provide updates on the capitated contract with Humana? - Management confirmed that the extension of the Humana contract was a positive development, with both parties satisfied with the ongoing relationship [109][111]