Aveanna at RBC Conference: Strategic Growth Amidst Challenges

On Tuesday, 20 May 2025, Aveanna Healthcare Holdings (NASDAQ:AVAH) presented at the RBC Capital Markets Global Healthcare Conference 2025. The company shared its strategic vision, emphasizing growth in home-based healthcare services while acknowledging challenges in rate adjustments and geographic expansion. CEO Jeff Shaner highlighted their confidence in Medicaid developments, balanced by the complexities of operating across diverse regulatory landscapes.

Key Takeaways

• Aveanna anticipates a strong 2025, driven by strategic transformations and government affairs.
• The company aims to integrate Thrive fully by the end of 2025 to expand its market presence.
• Financial performance in Q1 2025 showed significant growth in PDS volume and revenue.
• Operational focus includes securing Medicaid rate wins and expanding preferred payer agreements.
• Challenges remain in California’s reimbursement rates, impacting financial dynamics.

Financial Results

Aveanna reported a robust start to 2025, with notable growth across key metrics:

• Q1 2025 saw a 6.1% year-over-year increase in PDS volume and a 16.5% rise in revenue.
• An $11 million influx from old accounts receivable and retro rate increases boosted finances.
• The company aims to maintain cash flow positivity and enhance EBITDA through equity growth.
• Efforts to reduce leverage resulted in a full turn decrease in Q1, targeting below 5 turns within 18 months.

Operational Updates

The company’s operational strategies focused on expanding partnerships and improving service delivery:

• Five Medicaid rate wins secured in Q1, with a goal of over ten wins in 2025.
• Aveanna has 22 preferred payers and 10 value-based agreements, with two new preferred payer wins in Q1.
• The company reported 54% of volume with preferred payers, aiming for 60% by year-end.
• Emphasis on episodic care remains strong, with 77% of home health services falling under this category.

Future Outlook

Aveanna is optimistic about its growth trajectory and strategic initiatives:

• PDS volume growth is expected to normalize to 3-5% in the long term.
• The home health business is projected to generate 3-5% revenue growth in the near term, increasing to 5-7% eventually.
• The Thrive acquisition is a key part of Aveanna’s strategy to densify and scale operations in five markets.

Q&A Highlights

Key discussions during the Q&A session included:

• Medicaid remains a bipartisan issue, with potential compromises on the horizon.
• Concerns over work requirements and rate increases create uncertainty.
• Protecting Medicaid benefits and securing additional rate wins are top priorities.
• California’s reimbursement rate of $44.12 per hour poses a significant challenge.

For further insights, readers are encouraged to refer to the full transcript of the conference call.

Full transcript - RBC Capital Markets Global Healthcare Conference 2025:

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Hello, everybody. Welcome to our presentation with Aviana Healthcare. My name is Ben Hendrix. I’m the health care services and managed care analyst here at RBC Capital Markets. Very pleased to have Aviana Healthcare join us again this year, and we’re hosting Jeff Shaner, chief executive officer, and Matt, Matt Buchalter, chief financial officer of Aviana.

Thank you guys for joining us today.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Thanks, Ben. Yeah. Maybe we

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: can kinda start with just get your, view of the world, in a dynamic health care environment with policy changes and what have you, just kinda how you’re thinking about things, and we can get into questions.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Awesome. Thanks, Ben. Matt and I are glad to be here. And, I I guess, our view on the world, we continue to think about all things in the home. So even even as 2025 has started and, you know, all of the all the noise throughout the federal budget process that seems to be working itself out, you know, here in the first half of the year, our focus continues to be all things in the home, all health care focus in the home.

We still think that as all the macro environments play out and then the microstate environments play out in 2025, which they will over the course of the next four or five months, we think, we continue to stay focused on the lowest cost care setting, the patient preferred setting where everyone wants to receive health care is still in the home. So I think as as the as the trade winds of the year play out, both macro and micro, people will still wanna be cared for in the home, and that’s where I’ll be honest, built its business model around. So, again, we think as sitting here in May, our confidence level is higher as it relates to all things Medicaid as it relates to the federal government. And I think as we think about May turning into August and kinda late summer, the level of certainty will play we think will play itself out with between the house and the senate and ultimately getting to a resolution that protects the Medicare Medicaid integrity, but also achieves some level of savings for federal government. So we think we’re well positioned in that.

We think Aviana’s was created to be on the right side of health care to make sure that we care for patients in the lowest cost care setting. We think that as this plays out, we end up being in a pretty good position.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Maybe you could just expand on that last point, considering, you know, that your patient mix, the type of patients you cover, it seems like you would be fairly insulated from any kind of, you know, cuts that are on the table or even any the ones that, you know, have been on the, on the table prior. Just Yep. Can kinda talk talk about that for second.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Yeah. I I think what what we’ve seen in the last three months is really a a better bipartisan conversation around Medicaid. We we and I I think both whether you’re Republican or you’re Democrat, both parties, I think, understand that there is true integrity that needs to be retained to the Medicaid programs throughout The United States Of America, and I think that that’s a good thing for us. That’s that that’s our that’s our politicians and legislatures doing what they’re supposed to do, which is finding compromise. At the end of the day, I think everybody wants to see some level of savings in Medicaid, so do we.

Right? So does Aviana. I think our patient base is is mainly insulated from any kind of direct cuts to, like, work requirements or potentially even ACA rollback from the 9090% FedMAC match to potentially the state’s match of FMAP. We’re well insulated for that. I think where we have seen this cause some level of uncertainty is just in our state legislative process, which most states are every year, it’s created choppiness and anxiety and uncertainty at the state level of of our so as we’re talking to governors and Medicaid directors and state policymakers, their uncertainty around what their funding could be is really the headwind that we’ve played with or are playing through at Aviana.

And so that, you know, that’s it’s not a direct hit to our business, but it’s the it’s the lost opportunity of that time that we get in the legislative process every year where legislatures, you know, are not able to make certain decisions because they don’t know their funding yet. So, you know, we’ll we we talked about 2025 being a muted we use the word muted year for us. As you know, we we’ve started the year with five, state rate increases. We had a strong start to the year, but we do see that rate increases being muted throughout the summer until there is certainty, you know, in in the legislative process, which we do think will will ultimately happen by late summer, early fall.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Yeah. And can you talk a little bit more maybe about your government affairs strategy, Jesse? I think you said you had maybe, several more updates, maybe, like, not as big as some of the others, but some updates coming, down the pike. And just wanted to get some idea of your government affairs strategy and Yeah. And kinda how

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: you focus.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: I I think this year’s a little bit different because of what we just talked Each year, we go into the year focusing on a certain amount of states where we think we need to move the PDN or PDS rate primarily because of the need for additional wages to to nurses and caregivers and clinicians. This year, we kinda split split our efforts and said, you know, 50% of our effort needs to be protecting the core Medicaid. We call it protecting Medicaid rate integrity, and that’s nationally for us. It’s across all 34 states. So so that’s that’s the key focus going into the year was protecting, you know, the integrity of our of our business.

The second half of it was in in the same time, we still need to to win, government affairs rate rate wins in in 2020, five so we can pass that through to to caregivers. And and so we set our goal this year being more than 10. The last three years, we’ve been significantly more than 10 Medicaid rate wins per year. But this year, we said we wanted to be more than 10. With a strong start to the year of five of those rate wins in q one, it’s highly likely we’ll achieve the 10, but we expected this year to be a little bit more prudent and balanced that and we’ve had years of 19 rate rate increases, I think 13 or 15.

We didn’t think that was probably this year. And protecting the Medicaid benefit for us was just as important as the additional rate wins. Mhmm. With that said, our preferred payer strategy has picked up momentum and continues. We ended last year with 22 preferred PDS preferred payers and about about 10 value based agreements attached to that.

We had two nice preferred payer wins in in q one, so we picked up two two additional. Our goal for the year is 30 total preferred payers in our PDS segment. We’re well underway to achieving achieving that goal. So I think globally, some years, you know, the government affairs side of our business is up more than the preferred payers. I think this will be a year where our preferred payer wins probably outpaced the government affairs wins, and that’s probably it’s why part of the reason why we have both of those strategies.

Mhmm. I think the thing we can tell you with clarity is and certainty is our managed care partners want more clinical capacity. So our our our payer partners continue to want more and more from us. So so the idea is of continuing to shift our, private duty services volume over towards our preferred payers. We we have a volume indicator.

It was 54% of our volume. The end of q one was with a preferred payer. We think that will continue just to gain momentum, and it’s grown nicely in ’23 and ’4. We think it’ll continue to get, you know, the high fifties, you know, approaching 60% by the end of twenty twenty five. So we continue to give more to our preferred payer partners.

They expect more from us, and I think that that relationship will continue to grow.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Yeah. I mean, I will think that’s a really important point because, you know, when we you’re you’re not constrained by these any kind of budgetary stalemate that you run into or could potentially run into in a state. It really is, you were taking the active lead in in building these relationships out. So maybe you can kind of provide some more information on the economic differential in these preferred payers and kind of what specifically it is you target. Yeah.

And I I think

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: that’s the you you read it right, like, that the our managed care partners don’t have to wait till legislative cycle to make a decision. They can make a decision this week, today, and and they really benefit from the idea of 5 or $6,000 a day. And then, Nick, you pick you inpatient setting cost compared to, you know, 5 or $600 a day in total cost of care at home. And they have families that are stuck in children’s hospitals that just can’t get out. So they know these families by name, the payers do.

And so that that priority to move now, not not six months from now, not next year, but to move now, and then to lean in with a partner like Aviana that that has size, scale, sophistication, density of services and really can move the needle from a caregiver standpoint to them is really what makes the preferred payer strategy works, work, both on our pediatric side as well as our geriatric side because we have a preferred payer strategy, as you know, Ben, on the geriatric side. So we see the acceleration of this strategy just playing out because of because of our size scale and sophistication, but also just the pure economics of saving 4 or $5,000 a day. You know, Matt Matt knows there’s just a lot of money to be saved, and they’re able to move fast on that.

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: And, also, just the dollars that we continue to invest in our clinical innovations are just top tier compared to, you our peers or the market itself. That’s an area of focus for Aviana and hasn’t been for the past few years, but our payer partners are seeing the benefits of that playing through. Mhmm. And they’re seeing those clinical outcomes, those, you know, reduction of hospitalizations, those reductions of infections, the, you know, the closeness to our Medicaid distribution that we have, they are very tight onto those pieces, and that’s what really drives our value based care upside conversations that we have with them as well. And so just that sophistication that we’re bringing to the market and to the industry is really paying dividends, not only for our payers, but most importantly for our patients Well

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: said. Great. We’ve certainly seen really strong volume growth on the PDN side. And maybe you can kind of comment to how much of that is related to the pass through of way of these, of these PDN contract, income to wages. How much is it to your clinical investments that you just, noted, and, kinda where are you seeing the most traction?

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Let me start with I know this is a great question. I’ll expand it to how we started the year. Right? Then then Matt Matt will talk about our how our growth rate plays out over time. But, clearly, we had a strong start.

Q one was a very strong start for us, both in organic growth rates, but also revenue growth and adjusted EBITDA growth. Part of that was tied to the conversation we were just having. You know, five rate wins right out of the right out of the gate, preferred payer wins. So a lot of momentum coming out of ’24 into early twenty five. But I also think to Matt’s point, it’s partly it is we’re now in year three of our strategic transformation.

Mhmm. So it’s no longer new. It’s it’s now the the the maturation, if you will, of the strategy is really trying is is really not only maturing, but it’s just getting more and more and more efficient. So we have been on the upper end of our growth rates in our Medicaid side of our business, and and eventually, I think we’ll see that Mature

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: long term. Yeah. And just kind

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: of normalizing is is probably the the the the direction we’ve extended that being in that six plus percent volume growth for us is pretty strong on the on the PDS side of the business, and I do think we’ll see that moderate normalize over time. Now with that said, 2025 is gonna end up being a great year for us, you know, and I think it’ll I think as we think about the story of the last three years, it’ll probably be equal to or, you know, as good or better than than any we’ve had. And I and I I tie it back to everyone in Aviana now understands the strategy of how to help our payer partners and our our government partners, and it’s really mobilizing the entire force of Aviana to to help

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: grow this business. I would just like to add on to that. The answer is yes to all of that. The reason that we’re driving high volume, 6.1%, you know, year over year in Q1 for PDS on a volume standpoint is because of the governor affairs and the payer relations strategy that we have. The 16.5% revenue growth in that division year over year is driven all from that, and it’s taking those dollars, reinvesting them to our caregivers, attracting more caregivers into the market, and providing more care.

There’s a lot of pent up demand, Ben. Mean, a tumultuous time out there where caregivers weren’t available or weren’t available in our market to address the demands that we have. We’re addressing that pent up demand right now. Eventually, this will normalize back out to that 3% to 5% range. We think we’ll be on the high end of that on the volume side of it through the remainder of the year, but in the long term growth, that 3% to 5% should be what we think about that division.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Got you. And then on the rate side, I know we saw some unusual dynamics this past quarter because we saw an influx in reimbursements where they kind of widened out our spread rate a little bit. Maybe you can kind of talk about those dynamics and how we think that normalizes through the back of the year.

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: Yeah. We did have a really nice Q1 and are really pleased with what the team did. There was a little bit of influx in there, know, about $11,000,000 that we addressed out there prior bin. You know, half of it related to old AR that was fully reserved that our RCM teams, operation teams, and our payer relations teams went out and worked with our partners to make sure that we were appropriately reimbursed for our services. That kind of hit through and dropped straight to the bottom line.

We also had about, you know, roughly $5,000,000 of retro rate increases in there that were back to 07/01 that, you know, got pulled forward in the quarter that we didn’t have time to pass through to our caregivers yet either. We’re doing so right now with those rates that Jeff alluded to, not only the two preferred payers from Q1, but also the five rate wins and the additional contracts that we’re continuing to sign, we’re pushing those through to our market and to our caregivers right now. You will see a little bit of elevation in that in Q2, but it should be normalized and fully passed through in Q3 and Q4, and then we’ll get back into our normal $10 to $11 range on our spread per hour.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: And and I think Matt said it well. We we do think that’ll take some time to ultimately play back down to that that normal range that we operate in. As we think about ’26 and beyond, we still target to be in that 10 to $11, you know, spread range, and we think that is the right messaging to our payer partners that you gave us rate with the intent is intention to hire more nurses and apply more nurses. We’re passing that rate through in the form of additional wage, but but it does take time for that to play out.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: So as that plays out, we should expect a little bit of a kind of a an easing of the labor backdrop a little bit, which is kind of what you guys are passing through. But then as we think about the macro and kind of how some of the macro, whether it be policy issues or other, I guess, consumer confidence concerns were there, how how was that impacting the the labor market?

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Know, we we haven’t seen not that we’re in a recession, but recession like, normally, that would drive more variable caregivers back into the workforce for kind of variable income, we’ll call it. We’ve not seen that yet, Ben. We’ve not seen, like, a step up in just overall labor coming back into the market. I I don’t know what to read of that other than maybe not just not enough times played off, thank god we’re not in a a true recession, which I think is a good thing. But but I think what we see, the accelerated growth rates are directly tied to the strategy we just talked about.

So where we’re winning, where we’re hiring more nurses on a material basis or more clinicians, it’s because the rate and the wage makes sense. Up I use California because we talked about California a lot over the last couple of years. California today is the only state that we have left. Out of the 34 states we’re in, California is the last state where the Medicaid reimbursement rate no longer works with the wage environment, and it hasn’t for the last, I’ll call it, two and a half years. We’re not expecting a a we’re not we’re not in the governor’s budget this year.

We’re not for the third year in a row, we’re not expecting the PDN rate increase, but the dynamics in California no longer work. We’re not able to effectively staff cases in the Medi Cal program because the reimbursement rate is so unbelievably low. So I I use that example to Matt’s point. Four years ago, we had 20 California states. You know, we we had two thirds of the states we were in did not work.

The rate wage dynamics don’t work. Each year, we’ve knocked that number down, and, literally, we’re down to one state at this point. And we won’t give up. In California, we will continue to advocate. We will continue to partner.

We will continue to communicate on behalf of the families because it’s really the families that are suffering, but we’re we’re literally down to that one state after three years of work where we have fixed or materially fixed all the rest of our states and payers. And then, in

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: the interim, as we’re kind of, we’re still working on California from the legislative perspective, How are things progressing with payers in that state? Kinda how is the I know it’s a little bit of a different dynamic. It is. Right? So, like, with Kaiser and those

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Yeah. Maybe you can So I’d say it’s it’s still I mean, I’ll I’ll call

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: it three fourths and one fourth. Predominantly Medi Cal. Yeah.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: But but it’s still the majority of the families receive their benefit through Medi Cal, which is the which is the issue. Where we do have small markets in California where it is an MCO strategy or they call it whole child model strategy. It’s it’s a county by county model. It works great because the reimbursement is significantly above the the Medi Cal rate because those payers understand to get nursing in the home, I have to pay more so you can pay more in wage. So I I do think it’s and we we we’ve shared that with the department in California that, hey.

In these pockets with these payers in your state, this is how much more you have to pay than the the Medi Cal rate is $44.12 an hour is what the reimbursement rate is. But this is how much more you have to pay in these markets to get nurses hired. Mhmm. And so I think part of that data will help ultimately solve you no choice but to raise the rates. There there’s there’s there is no other option.

Labor is not going down in that state. It’s not it’s not decreasing in value. So we will solve it. But I think to your point in that state, about a fourth of our business in that state, a little bit less than that, is with other payers, and those payers pay significantly higher. And, therefore, we are able to admit them.

We’re able to staff the cases. The families are able to get what they deserve. Now over time, we’ve the value of that Medi Cal issue to Aviana has diminished as the rest of our business has grown, which I think is a good thing for our strategy. We we’ve we’ve not not that we’ve we still work on behalf of those families. We still want to help them everywhere we can, but our business has grown in that real estate more materially that has diminished the downside of us for California Medi Cal.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: That makes sense. And then moving on, smaller piece of the business, but the home health side, I wanna talk about that, you know, hiring and also the, preferred payer strategy there. Clearly, home health is top of mind for a lot of folks given potential for a clawback in Medicare rate. But just how are y’all navigating that, and what are you seeing in the preferred payer side?

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Yeah. We’re we’re we’re we’re a home health and hospice business, but but we think of it home health first. We’re we’re home health folk. We’re one of the few companies left that are still home health focused. As you said, our goal was to be above 70% episodic in that business.

Last quarter, we were 77% episodic. We’ve been in that mid to high seventies now for about a year. We equate that with a very disciplined approach to that business. We we think we think episodic is the right way. You know, great clinical outcomes, good margins, and and we think it works in that business model.

I think you’ll see us being disciplined in nature. You know, we were flat year over year last quarter in total episodes. We expect to be slightly positive in q two, which is, I think, is the right trend for us. Our goal ultimately is to be between 12% positive year over year volume growth. We are we are a net winner today from TPS scores, which is the value based side of of of Medicare reimbursement.

So we are a net winner in that. So so we are receiving rate increases in home health because of our clinical outcome scores. We’d like to be total revenue growth between about, you know, you know, 35% in the near term, and, ultimately, we think that that business can get to five to 7% total revenue growth. But you will see us continue to be incredibly disciplined around the episodic rate. I mean, we we would be fine with the low seventies percent with a little bit more growth, but I don’t think you’ll see us drop below 70%.

We think it’s that important to to drive great clinical outcomes and good financial outcomes in that business.

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: It drives our clinical scores so much as well, being able to provide episodic care and just take care of the patient opposed to, Hey, you have four visits, you have six visits, and that’s all you’re allocated to do. Going and working and doing what’s in the best interest of the patient, we think is the right outcome.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: And what governs the payers’ decision whether or not they wanna decide to go ahead and commit to an episodic relationship or say, okay. No. We’ll we’ll pay you higher per on a per visit basis.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Yeah. It’s it’s a it’s an evolution. I I will say the more that the provider community has come around to episodic as the most efficient reimbursement strategy and the best clinical outcome strategy, the more the payers have reluctantly got there. If everyone says yes to per visit, the payers would never go to episodic. So I think as more of the payercom provider community has come around to the episodic reimbursement model is the most efficient model with the best outcomes.

It is cost effective that that ultimately the payers have started coming around to it. At the end of the day, we we love saying the word no, so we’re very good at saying no to our payer partners. And and, ultimately, we we will not give away our clinical capacity for low rates and or not doing what’s right for the patient. And these patients are highly vulnerable at the end, you know, the end of life, and and they need the right amount of care in the home. We’re not gonna do half of that care and then and then discharge them so they end up back in the hospital.

We’re gonna do the entire care model that that the episodic model sets up well for. And, again, that’s something that we’ve stayed incredibly disciplined on. It’s driven great outcomes. Clinical outcomes has driven good financial outcomes, so I don’t think we’ll move from that strategy.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Let’s in the last couple minutes here, maybe we can talk a little bit about your capital allocation strategy, you know, where where you’re looking to grow and and then where you might see opportunities for more internal investment.

Matt Buchalter, Chief Financial Officer, Aviana Healthcare: Yeah. No. Great question. I mean, we’re really excited about what our teams have been able to accomplish to just be a generating free cash flow company at Aviana, have been for years now. We’ll continue to be on a stand alone basis.

In our cash outflows, q one’s got a little bit of outflow just due to timing of DSOs and how it works with some prepayments that occur, but we’ll expect to be a stand alone basis, positive free cash flow company, operating cash flow company in ’25 once again. We’ll take those dollars and appropriately move them into equity or, you know, growing up our EBITDA, growing up our revenue through small tuck ins of m and a, but continue to be able to add to it. Thrive is a great example of being able to do this through cash as well as stock and bringing the bringing that story and that great business into Ariana’s story as well is gonna be really rewarding. That’s where you’ll see us kind of on a on a go forward basis allocate capital to.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: I also think, Matt, in in the the the what we call RCM, which has been in collections, have done a phenomenal job. You know, the the our cash collections have been incredible, and q one was what was the highest cash collection quarter we’d ever had. So the team is doing a great job of collecting the cash. The payer strategy helps that. So our payer relations team help us in our collections, also just deleveraging the company.

You know, we we were we were a healthy leverage company a few years ago. Mhmm. Some would some would say very healthy leverage company. We’ve we’ve materially delevered the company. We continue to delever the company.

We delevered one full turn in q one Mhmm. Alone. So continuing to deleverage below seven, eventually below six. And, ultimately, our target is to get the leverage below five five turns, and and we can now see that in the next year, year and a half, really continuing the story through just great organic revenue growth, you know, EBITDA growth. And then, as Matt said, companies like Thrive that just make sense, that just fit right into our model, continue to delever us by using our our cash generation and our and our equity as as value.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Yeah. That’s one thing I I didn’t touch on before, but maybe in the last minute here, you can kinda give us the sixty second sound bite on Thrive and what it brings to the organization.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Yeah. It just as I said, just we say it checks all the boxes. It just it’s it’s a clinically clinical excellence driven company. It does exactly what we do in PDN and therapy, pediatric therapy. So and it fits five of the seven states fit right into our geography today, so it so it densifies and scales us in those five markets.

We had New Mexico and Kansas. New Mexico is mainly a Medicaid state, but it’s one of the better Medicaid states, so we’re excited to be in New Mexico. And then Kansas is an MCO state, and our national Medicaid payer partners are in Kansas and wanted us to grow there. So, again, it just fits all the right boxes. And the fact that we could do it with majority equity and cash, you know, it helps us delever almost an additional half a turn Yep.

Is just a great outcome. Our teams are already totally engaged in integration planning. We’ll we’ll we’ll spend the majority of the summer, you know, integrating the business, but we we think the first three or four months, we’ll do the majority of the integration of that that business. And, certainly, by the end of twenty five, we’ll have the business fully integrated in Davion.

Ben Hendrix, Health care services and managed care analyst, RBC Capital Markets: Excellent, guys. Well, thank you very much. I think that brings us to the end.

Jeff Shaner, Chief Executive Officer, Aviana Healthcare: Thanks, man. Appreciate you. Appreciate it.

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