Earnings call transcript: Adapthealth misses Q2 2025 EPS forecasts, stock dips

AdaptHealth Corp. (AHCO), currently valued at $1.3 billion in market capitalization, reported its second-quarter earnings for 2025, revealing a slight miss in both earnings per share (EPS) and revenue compared to market forecasts. The company’s EPS came in at $0.10, falling short of the anticipated $0.16, marking a 37.5% negative surprise. Revenue was reported at $800.4 million, slightly below the forecasted $804.97 million, representing a 0.57% miss. According to InvestingPro analysis, the stock appears undervalued despite trading at a P/E ratio of 17.07x. In pre-market trading, AdaptHealth’s stock dipped 1.76% to $8.95, reflecting investor concerns.

Key Takeaways

• AdaptHealth’s Q2 2025 EPS and revenue missed forecasts.
• The company reduced its net debt by $175 million year-to-date.
• A new capitated agreement could drive significant future revenue.
• Stock fell 1.76% in pre-market trading following the earnings release.
• Guidance for 2025 revenue remains between $3.180 billion and $3.260 billion.

Company Performance

AdaptHealth’s overall performance for Q2 2025 showed mixed results, with a net revenue of $800.4 million, a 0.7% decline year-over-year. The company reported an adjusted EBITDA of $155.5 million, maintaining a margin of 19.4%. InvestingPro data reveals the company’s impressive last twelve months EBITDA of $640.22M and a notable free cash flow yield of 22%. Despite the revenue dip, the company successfully reduced its net debt from $1.96 billion in Q1 to $1.8 billion in Q2. For deeper insights into AdaptHealth’s financial health and growth prospects, investors can access the comprehensive Pro Research Report, available exclusively on InvestingPro.

Financial Highlights

• Revenue: $800.4 million, down 0.7% YoY
• Adjusted EBITDA: $155.5 million
• Free Cash Flow: $73.3 million
• Net Debt: $1.8 billion, reduced from $1.96 billion in Q1
• Net Leverage Ratio: 2.81x, targeting 2.5x

Earnings vs. Forecast

AdaptHealth’s Q2 2025 EPS of $0.10 fell short of the forecasted $0.16, resulting in a 37.5% negative surprise. Revenue was also slightly below expectations at $800.4 million against a forecast of $804.97 million, marking a 0.57% miss. This performance diverges from the company’s historical trend of meeting or exceeding forecasts.

Market Reaction

Following the earnings announcement, AdaptHealth’s stock experienced a 1.76% decline in pre-market trading, bringing the share price to $8.95. This movement places the stock closer to its 52-week low of $7.11, reflecting investor concerns over the earnings miss. InvestingPro analysis indicates that stock price movements have been quite volatile, with a beta of 1.59. However, InvestingPro’s Fair Value assessment suggests the stock may be significantly undervalued at current levels, presenting a potential opportunity for value investors. Additional InvestingPro Tips highlight the company’s strong fundamentals and growth potential.

Outlook & Guidance

Despite the Q2 shortfall, AdaptHealth maintains its 2025 revenue guidance between $3.180 billion and $3.260 billion. The company is optimistic about its new capitated agreement, expected to generate over $200 million in annual revenue. Additionally, AdaptHealth is implementing AI and automation in operations and developing a self-service mobile platform to enhance productivity.

Executive Commentary

CEO Suzanne Foster highlighted the company’s strategic initiatives, stating, "We continue to make rapid progress." She emphasized the significance of a new capitated contract, describing it as "an historic contract that we’re announcing today that will basically transform our business."

Risks and Challenges

• Competitive bidding pressures from CMS proposals
• Potential market saturation in home medical equipment
• External pressures leading to industry consolidation
• Maintaining operational efficiency amidst technological upgrades
• Achieving targeted net leverage ratio

Q&A

During the earnings call, analysts inquired about the new capitated contract’s impact and the CMS competitive bidding proposal. Executives provided insights into their M&A strategy and potential opportunities, addressing concerns about industry consolidation and future growth prospects.

Full transcript - Adapthealth Corp (AHCO) Q2 2025:

Conference Moderator: Good day, everyone. Welcome to today’s Adapt Health Second Quarter twenty twenty five Earnings Release.

Today’s speakers will be Suzanne Foster, Chief Executive Officer of Adapt Health and Jason Clemens, Chief Financial Officer of Adapt Health. Before we begin, I’d like to remind everyone that statements included in this conference call and in the press release issued today may constitute forward looking statements within the meaning of the Private Securities Litigation Reform Act. These statements include, but are not limited to, comments regarding financial results for 2025 and beyond. Actual results could differ materially from those projected in forward looking statements because of a number of risk factors and uncertainties, which are discussed at length in the company’s annual and quarterly SEC filings. Adapt Health Corp.

Has no obligation to update the information provided on this call to reflect such subsequent events. Additionally, on this morning’s call, the company will reference certain financial measures such as EBITDA, adjusted EBITDA, adjusted EBITDA margin and free cash flow, all of which are non GAAP financial measures. You can find more information about these non GAAP measures in the presentation materials accompanying today’s call, which are posted on the company’s website. This morning’s call is being recorded and a replay of the call will be available later today. I am now pleased to introduce the Chief Executive Officer of Adapt Health, Suzanne Foster.

Please go ahead, ma’am.

Suzanne Foster, Chief Executive Officer, Adapt Health: Thank you, and good morning, everyone. Thank you for joining our call. Starting with our Q2 twenty twenty five results, I’m pleased to report that we delivered another solid quarter. Our second quarter revenue was 800,400,000.0 Adjusting for revenue disposed to our recent divestitures, revenue was as expected in line with the second quarter of the prior year. Second quarter adjusted EBITDA was 155,500,000.0 Our adjusted EBITDA margin was 19.4 at the high end of our guidance range.

Free cash flow was $73,300,000 in the second quarter, ahead of our expectations, and we are on track to meet our free cash flow guidance for FY 2025. Over the past year, we detailed our efforts to strengthen our foundation and position the company for long term success. What began as a series of tactical moves that were necessary to stabilize operations has matured into a cohesive plan focused on three levers that drive value. One, accelerating non acquired revenue growth two, enhancing profitability and three, strengthening our balance sheet. And step by step and without compromising on our commitment to deliver the best possible patient experience, we are executing to unlock the full value of our enterprise.

We are gaining momentum as our progress over this past quarter demonstrates. Starting with non acquired growth, we are leveraging our organizational strength to address payer preference and build a pipeline of new capitated arrangements. I’m pleased to announce that we have signed a definitive agreement to become the exclusive provider of home medical equipment and supplies for major national healthcare systems and across the system’s broad network of hospitals and medical offices. The arrangement features a capitation payment model that will cover the system’s more than 10,000,000 members across multiple states. The contract is through a five year term totaling more than $1,000,000,000 of revenue over the term of the contract at adjusted EBITDA margins that are projected to be in line with our enterprise margins.

Also, once ramped, this new arrangement will elevate capitated revenue to at least 10% of our total revenue, increasing our mix of recurring revenue. This new partnership is a clear endorsement of our ability to deliver patient service excellence at scale from a leading managed care organization. Through the RFP process, we were able to demonstrate how our combination of talent, expertise and tech enabled patient experience aligns with the healthcare system’s innovative approach to serving its membership. Securing this agreement strengthens our conviction that we have a tremendous opportunity to consolidate the market by becoming the most reliable operator in our core market segments. That conviction is rooted in our ability to flex and configure our resources to accommodate whichever payment model a payer prefers for managing their spend, capitated or fee for service.

Continuing with non acquired growth, our respiratory health segment revenue continued to accelerate. As a result of the sales incentive based compensation changes introduced earlier in the year and a streamlined order intake process that reduces the administrative burden on our referring providers. Meanwhile, our Diabetes Health segment delivered a third consecutive quarter of sequential improvement in new starts and a resupply retention rate that once again outperformed the comparable quarters of the past two years. This momentum under this momentum in underlying business trends, if sustained, would allow us to resume growth in Diabetes Health revenue possibly as early as the second half of this year, easing what has been a hindrance to enterprise growth. Staying with non acquired growth, our recent efforts in our Sleep Health segment to standardize scheduling practices and order intake are producing quicker setup times, which have already improved by a third from the prior quarter.

We’ve given patients greater flexibility to choose the timing and format that best fits their setup needs by offering expanded appointment availability, same day scheduling and offering in person as well as virtual setups. As a result, Sleep Health new setups accelerated in Q2 as these efforts eclipse the dynamics that drove lighter new starts in Q1. In fact, Q2 new setups were the highest since the recall recovery in Q2 twenty twenty three, with this strength continuing through July. Looking forward, the rollout of our standard operating model and the automation of intake, both of which are currently underway, will reduce order cycle time and further accelerate setup time with the goal of becoming the most reliable and convenient in the industry. This brings us to our second topic, enhancing profitability.

We are prioritizing initiatives that will drive labor productivity, increase the capacity of our operating assets, expand our adjusted EBITDA margin and amplify returns on our invested capital. We are well into rolling out a standard field operating model across our regions, which will establish a uniform approach for operating our business and delivering care. This model features standardized fan layers enrolled, regional centralization of patient order intake qualification and scheduling functions and technology solutions that support capacity planning, productivity and patient service consistency. Building on the foundation of our standard operating model, we are advancing a series of initiatives on our three year roadmap. We are leveraging technology including automation and AI to streamline inbound and outbound call handling.

These initiatives have the promise of significantly increasing Aegis productivity. Second, as noted earlier, we are leveraging AI to automate order intake to increase intake efficiency, improve order accuracy and reduce order cycle time. And third, we

Jason Clemens, Chief Financial Officer, Adapt Health: are

Suzanne Foster, Chief Executive Officer, Adapt Health: scaling MyApp, our self-service mobile based app that includes a growing list of features, including bill pay, scheduling, order status and live agent assist. In addition to significantly improving patient experience, these three initiatives will substantially reduce manual administrative burden, lessen our dependence on lower skilled contract labor and create capacity to reinvest in upskilling our workforce for higher value roles. Importantly, we expect these initiatives to slow the rate of new hiring that would otherwise be required to support the growth of our business. Moving to our third topic, our balance sheet. We continue to make rapid progress.

In the second quarter, we reduced our debt balance by another $150,000,000 funded in part with proceeds from divesting certain incontinence assets. May divesting certain incontinence assets in May and certain infusion assets in June. In total, we have reduced debt by $175,000,000 year to date and by $345,000,000 over the last six quarters. With our net leverage target of 2.5 times in sight, we will continue to use our substantial free cash flow generation to further delever, driven by the conviction that a more balanced capital structure will reduce financial risk, lower our cost of capital and enhance the long term value of our equity. I’d like to take a few moments to share our perspective on some

: of the key developments that are shaping the broader landscape. First, as anticipated in early July, CMS released a proposed rule on home health and DME detailing new policies for the next round of competitive bidding. CMS has not yet announced the specific timeframe to the next bidding round. Based on historical precedent, we believe it

Suzanne Foster, Chief Executive Officer, Adapt Health: is likely that CMS will release the final rule in the third or fourth quarter of this year and that bidding windows could open as early as the 2026 with implementation beginning in 2027. CMS has also yet to release which specific product categories will be included in the bidding program. However, as anticipated, the proposed rule specifically references CGMs and medical supplies, including ostomy and urology as potential new additions. Additionally, the proposed bidding process appears nuanced and includes some notable method methodological changes from prior rounds with CMS soliciting feedback during the sixty day public comment period. With many details still unfolding, the situation remains fluid and it remains too early to quantify any potential impact.

At a high level, the proposed rule seems to prioritize containing costs and this could potentially cause some economic pressure on industry operators. At the same time, the proposed rule also cites an intent to reduce the number of contracts awarded, suggesting that the winning suppliers have an opportunity to capture a greater portion of volume. We believe our scale better equips us to navigate both these dynamics. In the meantime, we’re deeply engaged in policy advocacy, working closely with our industry partners and we are sharply focused on internal preparation. These efforts include a thorough evaluation of proposed rule implications across our four core segments along with profitability and balance sheet enhancement initiatives I just outlined, which will strengthen our organization whatever the outcome of the bidding program.

Turning to the tax bill signed into law July 1, known as the OBBBA, we believe this law has several positive implications for our cash tax profile. Among the more impactful, the law indefinitely reinstates a less restrictive interest limitation calculation, which we estimate will increase deductibles current year interest expense and accelerate the absorption of pre-twenty twenty five interest carry interest expense carryovers into tax years 2025 and 2026, all else equal. Additionally, the law allows immediate expensing of fixed assets placed in service. We continue to evaluate the implication of these changes in the tax law, but our preliminary analysis shows a significant reduction in our cash taxes over the next few years and a related benefit to our free cash flow. Finally, we see that deal flow in our industry is picking up.

As a leading strategic player, we have seen a notable increase in inbound opportunities over the past few months and we have completed two small transactions year to date. We recognize that mounting external pressures on smaller operators is accelerating conditions for another wave of consolidation. Our approach to M and A continues to be grounded in extreme discipline. Our highly capable corporate development team operates under a clear mandate. Every potential acquisition must meet rigorous financial standards, support the targeted expansion of our geographic footprint and align with our strength in sleep and respiratory with meaningful synergies.

Should the right opportunity emerge, we will rigorously evaluate it. That said, with our strong free cash flow, industry leading platform and meaningful opportunity to unlock value by simply maintaining our internal focus, we are operating from a position of strength. We are under no pressure to pursue acquisitions and we can remain selective and patient. I want to close by thanking the Adapt team for their commitment to serving over 4,200,000 patients while preparing to serve millions more as a result of our

: new

Suzanne Foster, Chief Executive Officer, Adapt Health: partnership. Although this new partnership is the largest in the company’s history, we know what to do and we are committed to executing on our commitments. As today’s discussion reflects, we’ve made meaningful progress and our momentum continues to build. With that, I will turn it over to Jason.

Jason Clemens, Chief Financial Officer, Adapt Health: Thank you, Suzanne, and thanks to everyone for joining our call today. After covering our second quarter twenty twenty five results, I’ll provide an overview of our new capitated agreement. I’ll follow that with the usual review of the balance sheet and our plans for capital allocation and finish up with updates to our guidance for 2025. For second quarter twenty twenty five, net revenue of $800,400,000 declined 0.7% compared with $806,000,000 in the prior year quarter. Excluding revenues associated with certain infusion assets that were sold in June, revenue was largely flat versus the prior year quarter, meeting our expectations.

In our Sleep Health segment, the current year quarter included approximately $8,000,000 of impact from the previously disclosed changes in the mix of purchase revenue versus rental revenue. In our Wellness at Home segment, as previously announced, we sold certain incontinence, infusion and custom rehab assets that would have otherwise generated an estimated $20,000,000 in the second quarter. Second quarter Sleep Health segment net revenue increased 0.9% versus the prior year quarter to $334,700,000 which included the non cash impact I just mentioned. Sleep health starts were approximately 128,000, our highest quarter in two years and our Sleep Health census was 1,700,000 patients, up from $1,680,000 in the prior quarter. Second quarter respiratory health segment net revenue increased 5.6% from the prior year quarter to $170,500,000 We continue to see strong oxygen starts and our oxygen census of 329,000 patients was a new second quarter record.

Second quarter Diabetes Health segment net revenue declined 4.1% versus the prior year quarter to $145,000,000 As Suzanne noted, we continue to see signs that the segment is recovering, driven by improvement in starts and resupply retention. Although volume growth was offset by payer mix shift, it is important to note that CGM census grew over the prior year quarter for the second consecutive quarter. For the wellness at home segment, which includes all of the product categories, second quarter net revenue declined 7.2% from the prior year quarter to $150,300,000 including the previously mentioned impact of the dispositions of certain non core assets. Turning to profitability. Second quarter twenty twenty five adjusted EBITDA was $155,500,000 Adjusted EBITDA margin of 19.4% declined from 20.5% in Q2 twenty twenty four, but was slightly higher was slightly above the high end of our Q2 guidance range.

The year over year trend reflected the combination of lower revenue and gross margins in our Diabetes Health segment and the anticipated impact of changes in the mix of purchase revenue versus rental revenue in our Sleep Health segments, all of which fell to the bottom line. Moving to cash flow, balance sheet and capital allocation. For Q2 twenty twenty five, cash flow from operations was 162,000,000 CapEx of $88,700,000 was 11.1% of revenue, up slightly to support growing momentum in patient starts, particularly in our Sleep Health and Respiratory Health segments. Free cash flow was $73,300,000 ahead of our expectations. Unrestricted cash stood at $68,600,000 at the end of the quarter.

As of quarter end twenty twenty five, net debt stood at $1,800,000,000 down from $1,960,000,000 at the end of the first quarter. And our net leverage ratio stood at 2.81 times, down from 2.98 times at the end of the first quarter and tracking steadily toward our target of 2.5 times. We’ve reduced our TLA balance by $150,000,000 in Q2 twenty twenty five, funded primarily with proceeds from the dispositions discussed earlier. Our capital allocation priorities remain unchanged. We continue to prioritize investing to accelerate non acquired growth and debt reduction to strengthen our financial position.

These priorities are followed by strategic acquisitions of home medical equipment providers to round out our geographic footprint and increase patient access. To that end, we acquired two tuck in HME businesses on June 1. Both were previously owned by health systems that we are very pleased to be partnering with in support of their communities and our new patients. Turning to expectations for our new capitated partnership. This agreement fundamentally strengthens our competitive position by accelerating our expansion into new geographies and providing an opportunity to scale our sales force, applying amplifying the impact of this historic and transformational development.

Once fully ramped, we expect the agreement to generate at least $200,000,000 in new annual revenue and an adjusted EBITDA margin in line with our enterprise margin and to be accretive to our return on invested capital. We expect revenues to ramp throughout 2026. And in advance of that ramp, we need to install considerable infrastructure to support a contract of this magnitude. This includes new locations that need to be outfitted and stocked. Hundreds of vehicles must be procured, registered and customized.

And over 1,000 new employees must be recruited, trained and ready to go in advance of go live dates. The contract was signed very recently, so the detailed planning is now underway. Although we have good estimates for the investments required to support the contract, the specific timing of those investments will get nailed down over the next few months. The infrastructure will ramp between now and the end of the first quarter of twenty twenty six and the revenue will start two to three months after. We also expect a material investment in patient equipment CapEx potentially before the 2025.

However, we expect to at least offset this with lower cash taxes as a result of the OB VBA. Moving to guidance. For full year 2025, we are maintaining the midpoint of our revenue guidance with a narrower range at $3,180,000,000 to $3,260,000,000 We are reducing our adjusted EBITDA guidance to a range of $642,000,000 to $682,000,000 In anticipation of supporting the forthcoming capitated arrangement, we feel it is prudent to maintain infrastructure expenses that we were originally planning to reduce. Certain payer rate negotiations, which are still ongoing are expected to push into 2026. Despite the revised adjusted EBITDA guidance range, we are maintaining our free cash flow guidance at a range of $170,000,000 to $190,000,000 For Q3 twenty twenty five, we expect revenue to be approximately $800,000,000 largely flat versus Q3 twenty twenty four.

Keep in mind, the prior year quarter included approximately $30,000,000 of revenue from certain disposed assets as well as approximately $6,000,000 from the non cash impact of the revenue mix shift from purchases to rentals in our Sleep Health segments. We expect an adjusted EBITDA margin of approximately 20% to 21%. That brings me to the end of my remarks. Operator, would you kindly open up the call for questions?

Conference Moderator: Certainly. Thank you, Mr. We go first this morning to Eric Coldwell of Baird.

: Thanks very much. Good morning. A lot to absorb there at the end with the capitated deal. So I wanted to dive in on that $200,000,000 minimum $200,000,000 a year of revenue. Is that I guess several questions on that.

Is that anticipated to grow over time? Is it based on just a simple calculation on number of patients under that health system over time? Are there inflation riders? Any kind of additional details on how that revenue may ramp and when exactly it kicks in and hits full productivity, full revenue capture on a monthly basis would be very helpful. And then I might have a couple

Jason Clemens, Chief Financial Officer, Adapt Health: of follow ups. Thank you.

Suzanne Foster, Chief Executive Officer, Adapt Health: Got it. I’ll tag team this. So yes, you’re thinking about it basically, right. We will start first patient rolling in here basically in Q1 and it will ramp. There are several different regions that we in several states that we have to go to and we’re going to do that in an orderly fashion.

And so you’ll see that ramp the service to those over 10,000,000 patients throughout the course of 2026 going into a full service by 2027. So that’s why 2026 will be a ramp year and then the following four years will be more consistent based on that membership that we serve. And then I’ll have Jason walk through a little bit more detail on how to model that.

Jason Clemens, Chief Financial Officer, Adapt Health: Yes. I might add, Eric, you are thinking of the core agreement the right way. It’s generally a per member per month type agreement similar to our Humana contract and other capitated arrangements that we support here at ADAPT. I know you asked if there is growth baked into this. We are not setting an expectation in these numbers of at least $200,000,000 of revenue.

We’re not setting the expectation of growth. However, we do know that there’s a halo effect with these capitated arrangements. I mean, public competitors have talked about those pressures of our Humana award and other business we have. It’s logical to think that as we drop in sales folks into these territories where we don’t have a sales presence now, I mean, we’re laying in that infrastructure to support what to us is a huge contract. But we’re going to have capacity to support more.

And so it’s reasonable to assume that that number can grow over time. But again, trying to outline what we think is a very clear and conservative number with this award.

: And then if I could just a couple of quick follow ups. So to be clear with the contract ramping in starting in 2026 through 2026, are you anticipating at least $200,000,000 in 2026 or was that

Jason Clemens, Chief Financial Officer, Adapt Health: Yes. More of a five year Think of it as our exit of 2026, we’re quite confident it will be at least $200,000,000 Suzanne said, I mean, patient shows up at the beginning of the year and that will ramp over the essentially the first half into kind of early third quarter. And then as we’re in Q4, we should be exiting at least 200,000,000 revenue.

: And then last one for now. Thank you for all of this. So $200,000,000 a year minimum, 10,000,000 patients minimum would imply a capitated rate of something, if I’ve done the math quickly here right, $1 I it think was about one point I $67 a know it could be more patients than that, which could bring that per month number down to something like 1.5 Am I thinking about that correctly in terms of the per patient per month revenue stream?

Jason Clemens, Chief Financial Officer, Adapt Health: Yes. And that is a different structure than, for example, our Humana contract, which was Medicare Advantage HMO only. Different patients and different cohorts like commercial as example, they have very, very different utilization history and patterns. And so that’s factored in here.

: Yes. That’s what I was getting to. It seemed like a low per member per month, but it’s all encompassing. So you have a lot of healthy patients in that 10,000,000 plus count.

Jason Clemens, Chief Financial Officer, Adapt Health: You’ve got it. We’re very pleased with how we priced this out. We’re very confident we’ll deliver the enterprise margin on the contract.

: Very good. Thanks so much for all

: the questions.

Conference Moderator: Thank you. We go next now to Pito Chickering of Deutsche Bank.

Pito Chickering, Analyst, Deutsche Bank: Hey, good morning guys and thanks for taking my questions. Just one question on the EBITDA guidance, sort change of down $20,000,000 for the year. Can you just you bridge out the impact from the divestitures versus investing in the new capitated deal versus anything else on the core side?

Jason Clemens, Chief Financial Officer, Adapt Health: Yes, Pito, this is Jason. Sure. So I mean, it’s really two factors that are driving the $20,000,000 change to adjusted EBITDA. It’s not related to the disposition of assets. I mean, we accounted for that last piece when we announced about two months ago, guess, 1.5 ago.

We announced the last deal and we adjusted guidance accordingly for that. So it’s unrelated to dispositions. So the two factors are a little more half of that is the timing of certain payer rate negotiations. We have literally dozens of payer rate negotiations going on at any time in the company. We’ve got a couple of larger ones that we are working very hard at, but that timing is slipping.

We expect, however, to pick that up in 2026. So you can think of it as kind of an easier comp in 2025 and more to come to 2026. The rest of that is infrastructure. So we talked about people, technology, location, vehicles. We were working through, as you’d expect this time of year, we worked through ways of tightening up the middle of the P and L.

We decided that given the magnitude of this win, we’re going to stay put. I mean, we think we need everything we’ve got plus some. So that’s accounting for the rest of that. So again, kind of timing impacted. Mean, you just think of the magnitude of this win and what it’s going to take to stand it up, although we are lowering our expectations for 2025, I mean 2026 obviously just went up in a big way.

Pito Chickering, Analyst, Deutsche Bank: Okay, fair enough. And then for the follow-up, looking at ResMed sales in The U. S. This quarter as a comp, there’s nothing difference between what you guys did this quarter versus what they did. So, we talked about new scheduling and order intake and new starts accelerating.

Can you help us bridge sort of what the market growth was, I think in The U. S. This quarter and where your share went? And when the new starts that are increasing begin flowing through into growing at market growth rates?

Jason Clemens, Chief Financial Officer, Adapt Health: Well, I think it depends on how you define market growth rate. I mean, if you’re anchoring to ResMed’s U. S. Device number, I believe they were around 7%. And of course, that includes volume as well as rate on their side of the equation.

I’d say for us, if you look at our starts, the 128,000 that we talked about, that’s up 3% over the prior year. And so we were very pleased with that. We think there’s more to get as our time to set up is decreasing and our access and ability for patients to have their preference and how they get set up continues to improve, we’re feeling pretty good in the second half about continuing the strength

Suzanne Foster, Chief Executive Officer, Adapt Health: and momentum And we’ll start to see a full quarter as we move into Q3 of the changes that we’ve implemented really taking hold. So like we talked about in the Q1 report out, those things just kind of being identified and then they will ramp into Q2. Now we’ll have the benefit going forward of starting to see that full quarter execution of those changes we made.

: Great. Thanks so much.

Conference Moderator: Thank you. We’ll go next now to Brian Tanquilut of Jefferies.

Jason Clemens, Chief Financial Officer, Adapt Health: Hey, good morning. Maybe, Suzanne, just

: a question on competitive bidding. As we think about this proposal out of CMS and changes to the diabetes reimbursement structure, just curious how you’re thinking about that or strategizing around pricing dynamics and discussions with the suppliers? I mean, or do you feel like you can pass on some of that potential adjustments to the suppliers and what those discussions are like? Thanks.

Suzanne Foster, Chief Executive Officer, Adapt Health: Yes, sure. I think in terms of just stepping back, mean, it’s hard to speculate. We don’t have a ton of information yet. But like I said, the intent of driving down costs while also consolidating providers, think is the unique opportunity for scale players like Adapt. I mean, we already are the kind of best cost option, if you will, given our scale.

And the work that we’re doing in the middle of the P and L, particularly in diabetes to remove the people administrative burdens, we’re implementing technologies and kind of streamlining that business, I think will prepare us for a future where we have to perhaps potentially sacrifice some rate, but be able to keep the profitability of that business. So we are confident that with additional volume and the work that we’re doing that we should weather the storm very well on that front. In terms of our work with the manufacturers, yes, there is conversations going on, of course, about how we partner in this new world. And so those conversations, I mean, I’m not going go into much detail, but there is a partnership mentality about how do we make sure that the HME channel for the technology stays alive and profitable. And so there’ll be a partnership approach to entering into the new world as competitive bid if CGM goes in that direction.

: No, I appreciate that. And then maybe Jason, just a follow-up, maybe some of Pito’s questions. As I think about some of the comments you made last quarter about some challenges and share losses you were seeing at local market levels in the sleep business. Just curious if you can share with us any updates on what you’re seeing in those markets and broadly speaking, if you’re seeing improvement or incremental degradation in share? Thanks.

Yes, we’re absolutely seeing improvement, Brian. I mean, it’s really related to that speed to set up.

Jason Clemens, Chief Financial Officer, Adapt Health: I mean, these markets, I mean, cut off a week of lag time from the day the patient gets diagnosed until the day they can get their CPAP. There’s more to go there. We’re very confident that we’ll continue to compress that time to set up and increase our conversion factors. So yes, I mean, when we put out the Q1 point of view, it was really predicated on, look, we have good plans in place. We think we’re going to make this up.

But in the event we don’t, we don’t want to be caught flat footed later in the year. But it’s very clear that Q1 was a one off and we’re back to some pretty solid growth and we expect that to continue.

: Awesome. Great to hear. Thanks.

Conference Moderator: Thank you. We’ll go next now to Ben Hendrix of RBC Capital Markets.

Michael Murray, Analyst, RBC Capital Markets: Hi, this is Michael Murray on for Ben. I was hoping you could expand on the M and A environment. Where are you seeing the opportunities? Any specific business lines? What do valuations look like?

And what leverage level would you be comfortable going to for the right acquisition?

Suzanne Foster, Chief Executive Officer, Adapt Health: Yes. I’ll start with just saying that what we’re seeing is really across the board of all sizes of players out there. We’ve had some inbounds around the small regionals and some indications that there are some larger assets coming to the market. What I can say is, like I said earlier, is what we’re particularly interested in is staying within our core competencies of sleep and respiratory, which a lot of these assets are focused on. That would be the type of assets that we’re reviewing and looking at to see if it strategically fits for some reasons.

For example, it gives us pockets of the geography where we may be light or some other thing that it brings to us that we would benefit from. So we’re being extremely disciplined. And we think the broader market dynamic like we talked about with competitive bid on the horizon and shrinking potential number of providers in addition to even just additional capitated type arrangements coming our way does put pressure on the industry. And so we would welcome assets that add to the strength and strategic position of Adapt. I’ll turn it over to Jason for comments on valuation and how we think of that.

Jason Clemens, Chief Financial Officer, Adapt Health: Yes, I’d say that, I mean, I think the industry is well aware of our trading multiples as well as our competitors. And it’s reasonable to think that anything we buy would be at trailing 12 lower multiple than that and then you can apply synergy there. So in terms of your leverage question, at what point would we go up to for the right acquisition? I mean, I think as we stand here today, we wouldn’t. Wouldn’t.

We’re quite confident that if there are a little more acquisition than we originally committed to, we would bring those assets in totally self funded through free cash flow and over that first year ownership actually drive down leverage.

Michael Murray, Analyst, RBC Capital Markets: Okay. That’s really helpful. Just a follow on. So I appreciate the color on the diabetes. The performance, I think, was better than expected in the quarter.

How should we think about diabetes revenue in the back half of the year? And should we expect year over year declines to turn positive by year end?

Jason Clemens, Chief Financial Officer, Adapt Health: Thanks.

Suzanne Foster, Chief Executive Officer, Adapt Health: Yes, medical like we stated, there is real momentum going on there. Not only are they adding new patients, that’s translating into better retention rates in our resupply business. So I couldn’t be prouder of the team and how quickly they’ve turned this business around. So we like I said, if the momentum continues and the execution continues as we’re seeing, we do expect that business to, as I say, remove the parentheses around the growth number and turn positive in the back half of this year. So it’s on the right path forward and it really does come down to our execution, which as I said, the team is currently delivering very well on.

Michael Murray, Analyst, RBC Capital Markets: Thanks so much.

Conference Moderator: Thank you. We’ll go next now to John Penney with Canaccord Genuity. And John, your line is open if you do actually appears we lost John. And Ms. Foster, it appears we have no further questions this morning.

So I’d like to turn the conference back to you for any closing comments.

Suzanne Foster, Chief Executive Officer, Adapt Health: Well, again, I want to thank everyone for joining us today. It’s been an exciting quarter as hopefully you can see. I mean, we continue to just one brick at a time, I think turn this business into something that is really starting to show how the size and scale of what we’ve put together matters. This is an historic contract that we’re announcing today that will basically transform our business, provide a future of a lot of growth and a lot of patients that we have to go after to serve. And all of the hard work that the team has done over the last year towards improving the middle of the P and L will begin to really start to show those spikes are sprouting.

So I appreciate everyone’s support over this past year and I look forward to delivering next quarter and the quarter after our progress on how we’re preparing for a big 2026. Thank you again.

Conference Moderator: Thank you very much, Ms. Foster. And again, thank you everyone for joining us today for Adapt Health’s second quarter twenty twenty five earnings release. That does conclude today’s conference call. We ask you all disconnect at this time and have a wonderful day.

Goodbye.

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