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    BTSG
    Earnings call· Jun 2026(Q2 FY26)

    BrightSpring Health Services Q2 FY26 earnings call BTSG

    Jul 31, 2026 Source

    Executive summary

    BrightSpring Q2 FY26 — Strong Revenue and EBITDA Growth Driven by Specialty Pharmacy and Provider Services

    BrightSpring Health Services reported a strong second quarter, surpassing expectations with robust revenue and EBITDA growth across its Pharmacy Solutions and Provider Services segments. The company demonstrated effective operational execution, leveraging scale and technology to drive profitability and reduce leverage. Despite ongoing IRA headwinds impacting Home and Community Pharmacy revenue, management remains confident in its full-year guidance and strategic growth initiatives, including disciplined M&A and expansion into new markets.

    Highlights

    5
    • Total company revenue grew 23% year-over-year to $3.9 billion, exceeding baseline expectations.

    • Adjusted EBITDA increased 44% year-over-year to $206 million, with an 80 basis point margin improvement to 5.3%.

    • Pharmacy Solutions revenue grew 22% to $3.4 billion, driven by 30% growth in Specialty and Infusion business.

    • Provider Services revenue grew 30% to $466 million, with Home Health Care revenue up 51%.

    • Leverage reduced to 2.15x as of June 30, 2026, with ratings upgrades from Moody's and S&P.

    Concerns

    3
    • Home and Community Pharmacy revenue declined 8% year-over-year due to a $50 million impact from the IRA and the exit of certain uneconomic customers.

    • The IRA is expected to result in a total revenue impact of approximately $200 million for Home and Community Pharmacy in FY26, with a $15 million EBITDA impact.

    • Specialty Pharmacy faces a $175 million revenue headwind from the IRA in FY26.

    Guidance & targets

    12
    CategoryTargetConfidence
    Total Revenue
    $15.1 billion to $15.425 billion
    high materiality
    High
    Pharmacy Solutions Revenue
    $13.2 billion to $13.5 billion
    medium materiality
    High
    Provider Services Revenue
    $1.9 billion to $1.925 billion
    medium materiality
    High
    Total Adjusted EBITDA
    $820 million to $845 million
    high materiality
    High
    Operating Cash Flow
    approximately $600 million
    medium materiality
    High
    Leverage Ratio
    below 2x
    high materiality
    High
    Amedisys and LHC assets EBITDA contribution
    approximately $35 million
    medium materiality
    High
    IRA impact on Home and Community Pharmacy revenue
    approximately $45 million
    medium materiality
    High
    IRA impact on Home and Community Pharmacy revenue
    approximately $200 million
    medium materiality
    High
    IRA impact on Home and Community Pharmacy EBITDA
    $15 million
    medium materiality
    High
    IRA impact on Specialty Pharmacy revenue
    $175 million
    medium materiality
    High
    IRA impact on Home and Community Pharmacy revenue
    about 50% of 2026 impact
    medium materiality
    Medium

    Segment performance

    2
    SegmentRevenueYoYQoQMargin
    Pharmacy Solutions
    Continued business momentum in Specialty and Infusion driven by branded oncology LDD portfolio, expansion into rare/orphan therapies, and solid contribution from generic scripts. Home and Community Pharmacy volume and revenue impacted by IRA and customer exits, but profitability improved due to automation and technology investments.
    Adjusted EBITDA: $180 millionAdjusted EBITDA growth YoY: 44%Specialty and Infusion revenue: $2.9 billionSpecialty and Infusion revenue growth: 30%Specialty and Infusion script growth: 31%LDDs added in Q2: 2Total LDDs: 155LDDs launched YTD: 12 (4 exclusive, 8 ultra-narrow)Home and Community Pharmacy revenue: $540 millionHome and Community Pharmacy revenue growth YoY: -8%
    $3.4 billion22%Adjusted EBITDA margin of 5.3%
    Provider Services
    Strong performance driven by need for services, volume growth above industry levels, de novo investments, and successful integration of Amedisys and LHC branches. Hospice, Rehab Care, and Personal Care also showed strong quality metrics and growth.
    Adjusted EBITDA: $75 millionAdjusted EBITDA growth YoY: 33%Home Health Care revenue: $278 millionHome Health Care revenue growth YoY: 51%Amedisys and LHC branches revenue contribution: $78 millionAmedisys and LHC branches adjusted EBITDA contribution: $8 millionRehab Care revenue: $82 millionRehab Care revenue growth YoY: 12%Personal Care revenue: $107 millionPersonal Care revenue growth YoY: 7%
    $466 million30%Adjusted EBITDA margin of 16.1%

    Operational metrics

    43
    Adjusted EBITDA margin
    5.3%up 80 bps YoY
    Q2 FY26

    Profitability benefited from scale, diversification, operational execution, procurement, lean programs, technology, and acquisition integration.

    Net debt outstanding
    $1.7 billion
    Q2 FY26

    As of June 30, 2026.

    Share repurchases
    $120 million
    YTD FY26

    Included in leverage ratio calculation.

    Term loan repricing
    SOFR + 200vs SOFR + 325 at IPO
    Q2 FY26

    Repaid approximately $300 million of the term loan with proceeds from Community Living sales.

    Corporate expense increase drivers
    increased
    Q2 FY26

    Looking for the benefit of these to come on either later in the year or very early next year.

    Home and Community Pharmacy EBITDA performance
    performed wellyear-over-year
    Q2 FY26

    Notwithstanding external IRA and any payer impacts, due to internal continued operational process improvement underpinned by the deployment of new technologies.

    Home Health Care branches 4-star or better
    nearly 95%
    Q2 FY26

    All while we continue to have nearly 95% of our branches at 4 star or better.

    Hospice CAHPS overall rating
    89%well above national average
    Q2 FY26

    Hospice quality measures continue to be well above the national average.

    Rehab patient satisfaction scores
    above 97%
    Q2 FY26

    Rehab patient satisfaction scores above 97%.

    Personal Care client satisfaction scores
    4.6 out of 5
    Q2 FY26

    Client satisfaction scores of 4.6 out of 5 in Personal Care.

    Home and Community Pharmacy dispensing accuracy
    99.98%
    Q2 FY26

    Dispensing accuracy with 99.98% in Home and Community Pharmacy.

    Home and Community Pharmacy order completeness
    99%
    Q2 FY26

    Order completeness was 99% in Home and Community Pharmacy.

    Home and Community Pharmacy on-time delivery
    94.3%
    Q2 FY26

    On-time delivery was 94.3% in Home and Community Pharmacy.

    Infusion patient satisfaction score
    94%
    Q2 FY26

    Infusion patient satisfaction score was 94%.

    Infusion discharges due to completion of therapy
    94%
    Q2 FY26

    94% of Infusion discharges due to completion of therapy.

    Specialty Pharmacy medication possession ratio
    93%well above national average
    Q2 FY26

    Delivering a high medication possession ratio of 93%.

    Specialty Pharmacy time to first fill
    3.7 days
    Q2 FY26

    Time to first fill of 3.7 days.

    Specialty Pharmacy Net Promoter Scores
    industry-leading
    Q2 FY26

    With industry-leading Net Promoter Scores.

    IRA impact on Home and Community Pharmacy revenue
    $50 million
    Q2 FY26

    Impacted Home and Community Pharmacy revenue decline of 8% year-over-year.

    IRA impact on Home and Community Pharmacy EBITDA
    $15 million
    FY26

    Total expected EBITDA impact for the year.

    IRA impact on Specialty Pharmacy revenue
    $175 million
    FY26

    Revenue headwind, no EBITDA impact.

    Lean Sigma certified employees
    almost 300
    Q2 FY26

    Received Lean Sigma certification of various belts while completing Lean projects.

    Clinical liaisons
    near 1,000
    Q2 FY26

    Across service lines, doing educational and support work in doctor offices and hospital systems.

    Infusion volume growth
    over 20%7 to 8x market growth
    YoY

    Achieved volume year-over-year.

    Chronic Infusion volume growth
    close to 20%
    YoY

    Volume growth on the chronic side of the business year-over-year.

    Infusion LDD wins
    5
    past 6 months

    Turning focus from oncology LDDs to Infusion.

    Gross profit per script
    upsequentially (normalized)
    Q2 FY26

    When normalized for typical seasonality and Q1 items.

    Fee-for-service contribution to margin
    meaningful
    Q2 FY26

    Probably top 3 or 4 contributor to margin in the business.

    Total company revenue growth
    23%
    YoY

    Total company revenue growth year-over-year.

    Total company adjusted EBITDA growth
    44%
    YoY

    Total company adjusted EBITDA growth year-over-year.

    Pharmacy Solutions revenue growth
    22%
    YoY

    Pharmacy Solutions segment revenue growth year-over-year.

    Pharmacy Solutions adjusted EBITDA growth
    44%
    YoY

    Pharmacy Solutions adjusted EBITDA growth year-over-year.

    Provider Services revenue growth
    30%
    YoY

    Provider Services segment revenue growth year-over-year.

    Provider Services adjusted EBITDA growth
    33%
    YoY

    Provider Services adjusted EBITDA growth year-over-year.

    Specialty and Infusion revenue growth
    30%
    YoY

    Specialty and Infusion business revenue growth year-over-year.

    Specialty and Infusion script growth
    31%
    YoY

    Specialty and Infusion business script growth year-over-year.

    Home Health Care revenue growth
    51%
    YoY

    Home Health Care revenue growth year-over-year.

    Rehab Care revenue growth
    12%
    YoY

    Rehab Care revenue growth year-over-year.

    Personal Care revenue growth
    7%
    YoY

    Personal Care revenue growth year-over-year.

    Provider Services organic growth
    just a touch under 20%
    YoY

    Organically, on the Provider side.

    LDDs added in Q2
    2
    Q2 FY26

    Ultra-narrow network LDDs.

    Total LDDs
    155
    Q2 FY26

    Total number of LDDs.

    LDDs launched YTD
    12
    YTD FY26

    Launched through Q2.

    Industry KPIs

    2
    MetricValueDetails
    Pharmacy scripts specialty31%%
    Adjusted EPS EBITDA leverage guidanceAdjusted EBITDA $206 millionUSD

    Deals & partnerships

    1
    Amedisys and LHCIntegration of Home Health branches

    Integration going well, all branches now on home-based system.

    Risks & headwinds

    3
    IRA impact on Home and Community Pharmacy revenueFY26

    $50 million impact in Q2 FY26; expected $45 million in each remaining quarter of FY26, totaling $200 million for FY26.

    Mitigation: Internal operational process improvements, deployment of new technologies, payer contracting, regulatory advocacy.

    IRA impact on Specialty Pharmacy revenueFY26

    $175 million revenue headwind for FY26.

    Mitigation: No EBITDA impact expected; internal operational adjustments.

    Potential generic tariffsPotential impact pushed to 2028.

    Not currently impacting the company.

    Mitigation: Flexible purchasing contracts, monitoring closely, not seen as worrisome for long-term growth.

    What to watch in Q3 FY26

    4

    Home and Community Pharmacy IRA impact

    next quarter
    Current$50 million revenue impact in Q2 FY26
    TargetApproximately $45 million revenue impact in Q3 FY26

    Why it matters

    To track the ongoing financial headwind from the IRA on this segment's revenue.

    On the IRA impact for the balance of the year, we continue to see a revenue impact at Home and Community Pharmacy of approximately $45 million in each of the remaining quarters in 2026, bringing the total year IRA impact to Home and Community pharmacy revenue of approximately $200 million.

    Q&A highlights

    6

    Inquired about the contribution of generic Revlimid to growth and asked about the increase in corporate expenses.

    Management clarified Revlimid has been generic for years and had no recent impact. Corporate expense increase was due to key hires and investments in AI/automation technology projects, with benefits expected later in the year or early next year.

    From a corporate standpoint, Charles, we did see an increase as we continue to increase some investments across key hires, including some key hires we have in a couple of different business roles as well as corporate leaders that we're really excited about that are going to help drive value. We also did continue to invest in AI and automation technology projects throughout the quarter.

    asked by Charles Rhyee · answered by Jennifer Phipps

    2 min read7 chapters

    Detailed Narrative

    01

    Operational Excellence and Technology Investment

    BrightSpring continues to invest in and progress on key clinical, HR, and operational systems, leveraging new automation and AI tools in areas such as hiring, onboarding, intake, documentation, medication reviews, and patient care plans. The company has seen almost 300 employees receive Lean Sigma certification, completing Lean projects across the organization to institutionalize lean business processes and drive efficiency.

    02

    Strategic Growth Drivers

    The company's strategy is aligned with secular trends in U.S. healthcare, focusing on strong execution, thoughtful innovation, and continuous improvement. This includes expanding into adjacent and new markets, executing preferred MA and ACO contracts, and making de novo investments. These efforts, combined with leading quality results, are driving volume growth above industry levels, particularly in Home Health Care.

    03

    Specialty and Infusion Business Momentum

    The Specialty and Infusion business delivered strong performance with 30% revenue growth and 31% script growth, driven by the branded oncology LDD portfolio. The company is leveraging its capabilities to expand into other targeted therapeutic areas, including rare, orphan, and complex therapies, securing noteworthy partnership wins. In Q2, 2 ultra-narrow network LDDs were added, bringing the total to 155, with 12 LDDs launched year-to-date.

    04

    Home and Community Pharmacy Optimization

    Despite a revenue impact from the IRA and the strategic exit of certain uneconomic skilled nursing customers, the Home and Community Pharmacy business improved its profitability year-over-year. This was achieved through continued investment in automation and technology to enhance efficiency and service across its scaled national footprint, serving growing end markets like assisted living, behavioral, hospice, and skilled nursing.

    05

    Provider Services Integration and Quality

    The integration of acquired Amedisys and LHC branches into Home Health has progressed extremely well, particularly in HR and IT, with nearly 95% of branches maintaining 4-star or better ratings. Hospice services continue to demonstrate industry-leading quality metrics and strong census growth, while Rehab Care and Personal Care also show consistent performance and high patient satisfaction scores.

    06

    Capital Allocation and M&A Strategy

    BrightSpring maintains a full and robust M&A pipeline, focusing on disciplined execution of tuck-in acquisitions and geographical expansions that meet strategic objectives and offer accretive value. The company leverages its scale and operational capabilities to integrate these deals, aiming to increase the frequency of smaller tuck-ins while remaining disciplined on valuations for larger transactions, especially given its improved balance sheet and strong operating cash flow.

    07

    Regulatory Environment and Advocacy

    CMS released preliminary rates for home health services for calendar year 2027, which include a positive annual payment update, marking the first such upward adjustment in several years. BrightSpring continues to engage with CMS and Congress, advocating for the positive health outcomes and lower Medicare cost profile associated with high-quality home health services.

    AI-generated summary of the company’s earnings call. Not investment advice.