Earnings call transcript: Lifestance Health Q2 2025 exceeds revenue expectations

LifeStance Health Group Inc. (LFST), currently valued at $1.53 billion by market capitalization, reported its earnings for the second quarter of 2025, revealing a mixed financial performance that included a narrower-than-expected loss and a slight revenue beat. The company’s stock, however, saw a modest decline in pre-market trading. According to InvestingPro analysis, the company appears undervalued based on its Fair Value calculations, despite challenging market conditions.

[Get access to 8 additional InvestingPro Tips for LFST and over 1,400+ stocks with detailed Pro Research Reports.] LifeStance Health reported an earnings per share (EPS) of -$0.01, surpassing the forecasted -$0.03. Revenue reached $345 million, slightly above the expected $345.05 million, marking an 11% increase year-over-year. Despite these positive results, the stock price fell by 1.79% in pre-market trading.

Key Takeaways

• LifeStance Health’s EPS loss was narrower than expected, at -$0.01 versus a forecast of -$0.03.
• The company reported a revenue of $345 million, exceeding expectations and reflecting an 11% year-over-year growth.
• Stock price decreased by 1.79% in pre-market trading despite positive earnings results.
• The company achieved its highest-ever free cash flow at $57 million.
• LifeStance Health added 173 clinicians, increasing its total to 7,780.

Company Performance

LifeStance Health demonstrated solid performance in Q2 2025, with revenue increasing by 11% compared to the same quarter last year, building on its impressive 16.31% revenue growth over the last twelve months. The company also reported a 12% rise in visit volumes, totaling 2.2 million visits, and a 19% increase in adjusted EBITDA, which reached $34 million. InvestingPro data shows the company maintains a healthy current ratio of 1.47, indicating strong liquidity management. These results underscore LifeStance Health’s robust growth trajectory in the expanding mental health services market.

Financial Highlights

• Revenue: $345 million, up 11% year-over-year
• Earnings per share (EPS): -$0.01, surpassing the forecast of -$0.03
• Adjusted EBITDA: $34 million, a 19% increase from the previous year
• Free Cash Flow: $57 million, the highest in the company’s history
• Days Sales Outstanding (DSO): Improved to 34 days from over 50 days

Earnings vs. Forecast

LifeStance Health’s actual EPS of -$0.01 was a significant improvement over the forecasted -$0.03, marking a positive surprise of 66.67%. Revenue slightly exceeded expectations, coming in at $345 million compared to the anticipated $345.05 million. This performance reflects the company’s ability to manage costs effectively and capitalize on the growing demand for mental health services.

Market Reaction

Despite the positive earnings surprise, LifeStance Health’s stock dropped by 1.79% in pre-market trading, settling at $3.83. This decline may be attributed to broader market trends or investor concerns about the company’s future growth prospects. The stock is currently trading near its 52-week low of $3.74, well below the 52-week high of $8.61. Notably, analyst consensus remains optimistic, with price targets ranging from $6.50 to $10.00, suggesting significant potential upside from current levels.

[Discover comprehensive valuation metrics and analyst forecasts with InvestingPro.]

Outlook & Guidance

Looking ahead, LifeStance Health has set its full-year revenue guidance between $1.4 billion and $1.44 billion. The company anticipates mid-teens revenue growth in 2026 and aims for long-term adjusted EBITDA margins of 15-20%. InvestingPro analysis indicates a GOOD overall financial health score of 3.0, supporting the company’s growth trajectory. Analysts expect the company to achieve profitability this year, with an EPS forecast of $0.16 for FY2025.

[Access the complete LifeStance Health Pro Research Report, along with 1,400+ other detailed company analyses, exclusively on InvestingPro.] Management is optimistic about the potential for rate increases and expects to achieve double-digit margins for the full year 2025.

Executive Commentary

CFO Ryan McGurdy expressed confidence in the company’s strategic positioning, stating, "We are well positioned to take advantage of the macro trends and anticipate growing revenue in the mid-teens." CEO Dave Borden emphasized the importance of their services, noting, "Our services are needed more than ever." Borden also highlighted the role of AI in enhancing operational efficiency, saying, "We do not view AI as a replacement for the care that our clinicians provide."

Risks and Challenges

• Competitive clinician recruitment environment could impact growth.
• Shift from cash pay to commercial insurance might affect revenue streams.
• Potential macroeconomic pressures could influence demand for services.
• Changes in Medicare rates and reimbursement policies may pose financial risks.
• Dependence on successful integration of AI tools for operational improvements.

Q&A

During the earnings call, analysts inquired about the company’s clinician recruitment strategies and its approach to mergers and acquisitions. Management expressed confidence in their ability to attract and retain talent and highlighted ongoing efforts to explore tuck-in M&A opportunities. Additionally, questions about the impact of Medicare rate proposals received positive responses, indicating minimal exposure to potential reimbursement changes.

Full transcript - Lifestance Health Group Inc (LFST) Q2 2025:

Conference Call Operator: Hello, and welcome to the Lifestones Health Second Quarter twenty twenty five Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers’ presentation, there will be a question and answer session. Thank you. Now I would like to turn the call over to Monica Perkotsky.

You may begin.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health: Thank you, operator. Good morning, everyone, and welcome to Lifespan Health’s second quarter twenty twenty five Earnings Conference Call. I’m Monica Burkowski, Vice President of Finance and Investor Relations. Joining me today are Dave Borden, Chief Executive Officer and Ryan McGurdy, Chief Financial Officer. Ken Burdick, our Executive Chairman, is also with us.

We issued an earnings release and presentation before the market opened this morning. Both are available on the Investor Relations section of our website, investor.lifesands.com. In addition, a replay will be available following the call. Before turning over to management for their prepared remarks, please direct your attention to the disclaimers about forward looking statements included in the earnings press release and SEC filings. Today’s remarks contain forward looking statements, including statements about our financial performance outlook, business model and strategy.

Those statements involve risks, uncertainties, and other factors, as noted in our periodic filings with the SEC, that could cause actual results to differ materially. Please note that we report results using non GAAP financial measures, which we believe provide additional information for investors to help facilitate comparison of current and past performance. A reconciliation to the most directly comparable GAAP measures is included in the earnings press release tables and presentation appendix. Unless otherwise noted, all results are compared to the comparable period in the prior year. At this time, I’ll turn the call over to Dave Borden, CEO of LifeStance.

Dave?

Dave Borden, Chief Executive Officer, LifeStance Health: Thanks, Monica, and thank you all for joining us today. I’m incredibly proud of the LifeStance team for the strong results achieved in the second quarter. We met or exceeded each of our guided metrics. We grew our clinician base by over 170 clinicians, while at the same time improving productivity. We delivered double digit organic revenue growth along with 10% adjusted EBITDA margins.

Given the outperformance in the first half of the year, we are raising full year guidance for adjusted EBITDA. We now expect to achieve double digit margins for the full year. We also delivered exceptionally strong free cash flow of $57,000,000 our highest in Lifestans’ history, which provides additional capacity to further invest in the business. Our model with the ability to deliver both in person and virtual care, along with a focus on patients covered by commercial payers continues to demonstrate its resilience and differentiation. We remain well positioned to navigate a dynamic healthcare environment as we focus on expanding access to high quality and affordable mental healthcare.

This quarter, we made meaningful progress to drive improvements in the performance of the business. From an operational perspective, our clinicians’ commitment to delivering high quality patient care continues to be the driving force behind our success. We’re proud to have a team of over 7,700 clinicians, an increase of 173 just this quarter, which is further validation that our value proposition is continuing to resonate. We previously shared that this year, in addition to continuing to grow our clinician base, we have a number of initiatives to better fill clinicians’ calendars to drive improved productivity. For example, in May, we launched our Clinician Cash Incentive Program to reward clinicians for improving access and quality.

We have recently implemented a patient engagement platform that improves acquisition and retention by fostering a stronger connection with the patient. Additionally, we are enhancing our care matching capabilities to support an even better clinical fit between patients and providers. This is another important step toward delivering the right care with the right match from the very beginning. When the clinical match is strong, we see better patient engagement, fewer cancellations and no shows, and a more satisfying experience for both clinicians and patients. These are just a few examples of the concerted effort within the organization to ensure that we effectively utilize the capacity of our talented and dedicated clinicians.

In the second quarter, we saw improvement in productivity and believe there will be further improvement in the back half of the year as a result of these and other initiatives. From a technology perspective, we’re entering a new chapter of our tech enablement, including a greater emphasis on AI and digital solutions. For example, as part of our continued focus on operational efficiency and effectiveness, we have begun to leverage AI tools to improve accuracy and automate tasks in our revenue cycle processes, and to improve the quality and responsiveness of our patient scheduling team. We’re also investing in AI solutions to help our clinicians be more effective with documentation. While we’re still evaluating options, this will ultimately enhance clinician satisfaction and allow clinicians to focus on what they love, providing excellent, compassionate care to our patients.

We are confident that these investments in technology will unlock value by improving the patient and clinician experience while also driving operating leverage. Also on the technology front, I would like to highlight the recent appointment of Von Punovich as our new Chief Technology Officer. Vaughn has extensive expertise in leading digital transformation initiatives, enabling AI powered insights and streamlining digital tools to enhance healthcare delivery. His experience and commitment to innovation makes him the right individual to lead our technology organization, ensuring that Lifestance delivers a best in class experience for our patients and clinicians. In closing, this was a strong quarter and we feel good about the momentum heading into the second half of the year.

As we look ahead to 2026, we remain confident in our ability to deliver on mid teens revenue growth while expanding margins. We expect a low to mid single digit rate improvement, continued organic growth of our clinician base, and strong visit volumes as the demand for mental health services continues to increase. In addition, with the efficiencies we’re driving, we expect to generate further operating leverage. With that, I’ll turn it over to Ryan to provide additional commentary on our financial performance and outlook. Ryan?

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Thanks, Dave. I am pleased with the team’s operational and financial performance in the second quarter. We delivered strong growth across revenue, visit volume and clinician count. Revenue grew 11% year over year to $345,000,000 This outperformance was driven by slightly better than expected clinician productivity and total revenue per visit. Visit volumes of 2,200,000 increased 12% year over year, driven primarily by clinician growth.

We added 173 clinicians this quarter, an 11% increase year over year, bringing our total to 7,780 clinicians. With regard to clinician productivity, it was slightly ahead of our expectations in the second quarter. While it is still early, we’re encouraged by the initial progress from our productivity initiatives. Total revenue per visit decreased year over year as expected. It was $157 which was down 1%, driven by the impact from the single outlier payer dynamic that we previously disclosed, partially offset by rate increases with other payers.

Turning to profitability. Center margin of $108,000,000 increased 11% year over year and was 31.4% as a percentage of revenue. The outperformance in the quarter was driven by the modest revenue beat. The expense for our new cash based clinician incentive program, which launched in May, is reflected in these results. Adjusted EBITDA of $34,000,000 in the quarter exceeded our expectations.

This 19% year over year increase brings our adjusted EBITDA as a percentage of revenue to 9.8%. The outperformance in the quarter was primarily attributable to favorable center margin and slightly lower G and A spending than expected. Turning to liquidity in the second quarter, free cash flow was exceptionally strong at $57,000,000 the highest we’ve delivered in any quarter to date. We exited the quarter with a solid cash position of $189,000,000 and net long term debt of $273,000,000 We have additional capacity from undrawn revolver of $100,000,000 DSO for the quarter improved significantly to thirty four days, a sequential improvement of four days. We remain confident in our ability to generate meaningful positive free cash flow for the full year.

Our leverage ratios are strong and continue to improve with net and gross leverage of zero point seven and two point two times respectively. This represents meaningful progress from the 2.2 net and 3.2 times gross leverage in Q2 of last year. We have significant financial flexibility to run the business and fully execute on our strategy, including potential acquisition. In terms of our outlook for the full year, we are maintaining our guidance range of $1,400,000,000 to $1,440,000,000 for revenue. We are raising our guidance range for center margin to $441,000,000 to $465,000,000 Given the outperformance in the first half, we are raising our adjusted EBITDA guidance range by $5,000,000 at the midpoint to $140,000,000 to $150,000,000 This puts us on track for 60 basis points of margin expansion year over year and double digit margins for the full year.

In addition, we continue to expect stock based compensation of approximately 70,000,000 to $85,000,000 For the third quarter, we expect revenue of $3.45 to $365,000,000 center margin of 105 to $119,000,000 and adjusted EBITDA of 33 to $39,000,000 As previously communicated, our annual guidance assumes year over year revenue growth driven primarily by higher visit volumes with total revenue per visit being roughly flat. For the second half, we expect modest rate improvement and continued growth in clinicians. Additionally, as noted, we’re also focused on better filling existing clinician calendars. Our guidance contemplates a step up in productivity in the third quarter with further improvements in the fourth quarter, driven by the ongoing initiatives Dave mentioned earlier. The combination of these drivers will lead to higher revenue in the back half of the year.

As we shared last quarter and as implied in our guidance, we expect earnings to build in the back half of the year driven by modest rate improvement, increased visit volumes and growth in specialty revenue. We expect to see a step up in adjusted EBITDA margins in the second half over the first half. We previously guided to exiting the year with double digit margins and are now pleased to expect to achieve double digit margins for the full year. Looking ahead, we feel confident in 2026 and the coming years. We expect to benefit from industry tailwinds, including increasing demand for mental health services and patient trends from cash paid toward commercial insurance.

At LifeStance, we are well positioned to take advantage of the macro trends and anticipate growing revenue in the mid teens through increased visit volumes, rates and specialty services. We remain confident that 15% to 20% margins are achievable in the long term as we drive center margin expansion and operating leverage in the business. With that, I’ll turn it back to Dave for his closing comments.

Dave Borden, Chief Executive Officer, LifeStance Health: Thanks, Ryan. In closing, this was a great quarter for Lifespan. We met or exceeded each of our guided financial metrics, delivered strong organic revenue growth and adjusted EBITDA margins, and generate our highest quarter of free cash flow ever. Our progress to date and the incredible dedication of each of our clinicians and team members serve to reinforce our confidence in the future as we focus on expanding access to high quality, affordable mental health care. Operator, we’ll now take questions.

Conference Call Operator: Thank you. We will now begin the question and answer session. And your first question comes from the line of Craig Hettenbach with Morgan Stanley. Please go ahead.

Craig Hettenbach, Analyst, Morgan Stanley: Great. Thanks. Just a question on the implied ramp for Q4 and appreciate all the color in the prepared remarks. But you should probably have some improvement from as the payer reduction headwind abates and you talked about productivity. So just looking for kind of your confidence level into that back half ramp and things that you’re seeing in the business that builds that.

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Perfect. Hey, Craig, this is Ryan. I appreciate the question. So, to the point of your question, we’re super pleased with our performance in the first half of the year and we have meaningful momentum going into the second half of the year, driving up a step up in revenue as you kind of acknowledged in your question. In addition from revenue contribution from collision rates, we continue to plan to drive productivity in the second half of the year.

So, to help dimension this, from the first half to the second half, we expect roughly $60,000,000 of revenue growth and the way you can think about that is driven by 10% from rate and 90% from visit volume. And so, kind of further dimension that when you think of a 90% that’s related to visit volume, you can think of that as approximately 60% is coming from clinician ads and then 40% is coming from productivity. As we mentioned, you know, previous quarters in our prepared comments, we’re prioritizing filling existing clinician calendars, which we believe will result in increased productivity in the second half. Dave went through a number of initiatives that we have in play to drive the filling of the schedules in his prepared comments. And then to your question, just in terms of Q3 versus Q4, clinician adds will be a meaningful driver in both quarters.

When you get to Q4, you will see a higher contribution for productivity as the initiatives that are in play have more time to make a meaningful impact. And then from a rate perspective, going to that part of your question, we expect modest growth in rates first half to second half and it really is driven by further rate negotiations and some specialty services in there. So, overall, we’ve absorbed the one unique payer dynamic and so overall, we’re still guiding to flat TRPV for the year, but as you get into future years, we expect to return to low to mid single digits from a rate perspective. So, to close the comments out, we feel really good about our growth in the first half and the momentum going into the second half.

Craig Hettenbach, Analyst, Morgan Stanley: Very helpful details. Thanks for that. And then just as my follow-up, can you just talk about the backdrop in terms of clinician adds and retention, kind of what you’re seeing in the marketplace and maybe what are some of the things that are resonating with the Lifestand platform?

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, Craig, good morning. It’s Dave. I’ll take that one. In regards to the clinician recruiting retention dynamics, first of all, we feel good about our clinician net adds in Q1 and Q2. They are consistent with our expectations.

And that’s really the result of stable retention and strong recruiting, which are consistent with the dynamics that we’ve seen play out now for quite a while. So there’s nothing new that I would point to that in the overall environment, it remains a competitive, highly competitive environment for the recruiting and retention of clinicians. And I think with the net growth that you’re seeing from us, it’s just further validation that our value prop is resonating.

Craig Hettenbach, Analyst, Morgan Stanley: Got it. Thanks for that.

Conference Call Operator: Your next question comes from the line of Lisa Gill with JPMorgan. Please go ahead.

Lisa Gill, Analyst, JPMorgan: Thanks very much. Good morning. I just wanted to go back to a couple of things. One, on your comment, Ryan, I think that you made around cash pay shifting towards commercial. Do you have any updates on managed care contracting, contracting around that?

And just curious, is it that we’re seeing expansion of the benefit that comment was made around what you’re seeing for cash pay going into the commercial volumes?

Dave Borden, Chief Executive Officer, LifeStance Health: Lisa, good morning, it’s Dave. I’ll take that one. So in Ryan’s remarks about the tailwinds that we’re seeing in the industry and we expect to see as we step into 2026, 2027, there were two things you referenced. The first was increasing demand overall for mental health services. And the second, which is what you’re referencing, is a shift from cash pay to insurance.

And the point we’re making there is that you still have a very high percentage of clinicians today who do not accept insurance. And that is a financial challenge, makes it less affordable for patients. And so what we’ve seen in recent years, and we expect to see in coming years, is further migration of the patients from a cash pay environment to using their insurance. And obviously that trend would benefit Lifestance as we focus on patients that have insurance.

Lisa Gill, Analyst, JPMorgan: And do you feel, Dave, that you have the capacity to take on that incremental patient volume? I think that rate historically it’s been you’ve been bringing on clinicians and you kind of build their book. Do you feel like you have a lot of capacity today? Just curiosity from a capacity standpoint, how do I think about that?

Dave Borden, Chief Executive Officer, LifeStance Health: We do. We feel good about the capacity that we have in our clinicians, existing clinicians. That’s why we’re actually focused on productivity and better filling out their calendars. The reality is, is in many markets, we could probably hire more clinicians if we felt that the patient demand was going to be there. Again, it’s always a balancing act around how many clinicians we hire, because we need to make sure that we’re ramping them at good pace, or they get dissatisfied and leave, which would drive up turnover.

And obviously, that’s one of the areas that we’re focused on improving with retention.

Lisa Gill, Analyst, JPMorgan: Okay, great. Thanks for the comments.

Conference Call Operator: Your next question comes from the line of Jamie Perce with Goldman Sachs. Please go ahead.

Jamie Perce, Analyst, Goldman Sachs: Hey, thank you. Good morning. I wanted to follow-up on the first question around implied guidance for 4Q. I think if we take the midpoint of 3Q and the full year that implies about 19% revenue growth in the fourth quarter. You said about 90% of that is coming from volume, so high teens volume growth.

Can you just comment on sort of the sustainability of that? And you mentioned some of the productivity initiatives you’re putting in place that support the ramps to that type of volume growth exiting the year. Can you just spend a minute on what those are and your assumptions around how those initiatives translate into the improved volume growth?

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Yes, sure, Jamie. So, this is Ryan. I’ll start off and then Dave will provide a little bit more color in terms of some of the initiatives that we’re doing in totality. So, you’ve got the quantum right, just in terms of if you kind of go back and kind of think of the progression of revenue, revenue grew Q1 to Q2 by $12,000,000 Q2 to Q3, we’re expecting 10,000,000 And then from Q3 to Q4, we’re expecting roughly $30,000,000 And the way I kind of have you think about that, similar to my second half, first half commentary is think about 75% to 80% of it coming from clinician ads and productivity. And then, you know, roughly split for that 70%, 80%, fifty-fifty to productivity.

So, as you kind of put your question, we’ve got a number of initiatives in play, both around the incentive program that we put in, care matching, better just practice operation type stuff that really impacts the ability to get folks filled into the clinician schedule. And so, we’re pleased with the progress that we’ve shown to date. We had productivity improvement Q2 over Q2 of last year. And so, we like the momentum that we’re seeing around productivity and then the initiatives kind of ramping up and taking hold through Q3 into Q4. So, Dave, I don’t know if there’s anything further you want to put on the initiatives.

Dave Borden, Chief Executive Officer, LifeStance Health: Yeah, mean, that was well said. One thing I just close on is just a reminder of why we’re doing this. So, we’re trying to improve retention of our clinicians, And we’re listening to them around where their pain points are. And one of the big ones that they’ve highlighted for us is they’d like their calendars to be more full. And so that’s the focus on productivity.

This isn’t something we’re forcing on them. This is something they’re asking for. Now, additional benefit to us as life stances, obviously that makes us more efficient if we’re able to have our existing clinicians be more productive.

Jamie Perce, Analyst, Goldman Sachs: Okay, thanks. That’s helpful. And then just one on the free cash flow. You guys mentioned this a couple of times in the script, dollars 57,000,000 generated in the quarter. Looks like there was pretty good working capital performance on things like accounts payable and accrued payroll.

Just anything to call out there in terms of being one time? And then if I look at free cash flow on a year to date basis, conversion is around 68%. I think that normalizes for some of these timing elements. How would you just generally frame free cash flow outlook going forward, free cash flow conversion on a sustainable basis?

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Yes. Sure, Jamie. This is Ryan again. You captured some of the headline points. Clearly, we achieved exceptional kind of free cash flow here in the first half.

So, we do feel good about the trajectory kind of that as we kind of think through the full year. So, in the first half, as you referenced, we drove 46,000,000 year to date, included in 57,000,000 in Q2. I do want to point out in Q3, it will be down meaningful from the strong Q2 cash flow. And it really is related to the four zero one match. So, the four zero one match hits in Q3, higher CapEx as it relates to the timing and the phasing of rolling out de novos and then also just some timing just in terms of the accrued payroll.

But overall, we feel really good just in terms about the trajectory of the cash flow for the business. Last year was our first year of positive free cash flow And we’re pleased now to be in the second year of strong cash flow generation, which provides us the flexibility to execute on our overall strategic priorities.

Dave Borden, Chief Executive Officer, LifeStance Health: And one thing I’d pile on to Ryan’s comments is going make sure we don’t walk past it, is the strength of the operational performance of the team with DSO now at thirty four days. And we were over 50 at one point last year. And just tremendous work by our team and each one of those days is worth roughly 3,500,000.0 to $4,000,000 of cash.

Jamie Perce, Analyst, Goldman Sachs: Okay, great. Thank you.

Conference Call Operator: Your next question comes from the line of Ryan Daniels with William Blair. This

Matthew Mardula, Analyst, William Blair: is Matthew Mardula on for Ryan Daniels. And this is more of a top level question. But in the past few weeks, we’ve seen a noticeable increase in state level legislation around the use of AI in therapy sessions and just broader AI participation in the mental health industry. I’m curious, do you believe this evolving regulatory environment poses any potential headwinds or opportunities for your business?

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, Matthew, it’s Dave. It’s a great question. And it’s really early days around AI and its impact on health care in total, and then specific to the mental health space. The way we think about AI and technology in general is that we’re going to be able to use that to support our clinicians and how they practice care, and improve their experience and the patient experience. We do not view AI as a replacement for the care that our clinicians provide.

And so I think that’s really the bottom line for us.

Matthew Mardula, Analyst, William Blair: Great, thank you for that.

Conference Call Operator: Your next question comes from the line of Brian Tankelode with Jefferies. Please go ahead.

Brian Tankelode, Analyst, Jefferies: Hey, good morning. Just curious, I mean, you seeing any dynamics in the recruitment front that are impacting some of these metrics you’re seeing? Understand some of the comments from earlier, but anything we should be thinking about that could be changing fundamentally in terms of what’s happening in the clinician side?

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, good morning, it’s Dave. I’ll take that. I mentioned earlier, the environment for recruiting of clinicians remains very competitive. And we’re successful in that environment by providing a comprehensive value prop that everything from compensation and benefits to clinical and administrative support to the clinicians. And that recruiting of new clinicians has been the primary driver of our net clinician growth the last couple of years, including this quarter, while we’ve gotten the retention to a stable level.

So nothing new that I would point to in the market.

Brian Tankelode, Analyst, Jefferies: Got it. And then maybe as I think about cash flows, strong performance during the quarter, anything to call out there that I should be thinking about as we model for the back half of the year on free cash flow?

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Yeah, just as it relates to cash flow, Brian, similar to the answer that I provided around that, obviously, really strong cash flow in the first half of the year with $46,000,000 year to date. As you think about Q3, we will see some downward meaningful kind of change to cash flow just as it relates to the, as I mentioned before, higher CapEx as it relates to rollout of de novos and then also just some timing as it relates to accrued payroll, but don’t want that to take away from the messaging just as it relates to this is our second year with really strong cash performance and looking forward to future periods just in terms of our cash generation ability.

Dave Borden, Chief Executive Officer, LifeStance Health: Awesome. Thank you.

Conference Call Operator: Your next question comes from the line of Richard Close with Canaccord Genuity. Please go ahead.

Richard Close, Analyst, Canaccord Genuity: Yes. Obviously, higher mental health utilization has been called out a handful of times here by managed care in the quarter in the first half. You seem pretty positive on the rate environment and the tailwinds in your business. I guess I’m just curious your thoughts on the potential for Managed Care trying to rein in the rising cost trends in mental health and just you come from that side of the business previously, just curious what your perspectives are?

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, Rich, it’s Dave. I’ll take that one and good morning. First, I’d say in the payer environment in that dynamic, there’s really not been a material change. Payers certainly have financial pressure, that’s not new. It may be more heightened for some of them.

But again, it’s not a new dynamic and it’s something that we’ve been dealing with them now for a period of time. I’d also say as payers continue to focus on access and increasing access for both their employer clients and their members. So you have that as a counterbalance to the financial pressures. And additionally, I would say there’s a few of the payers that are more thought leading that are starting to focus on quality in mental health. And we expect that the market in the coming years will gradually shift toward access, quality and outcomes.

And really, we welcome that change. And we believe we’re very well positioned if the market goes in that direction. And where you started your question is, as previously stated, we feel good about our ability to negotiate reimbursement reflective of the value that our clinicians are providing. And next year, we expect to return to that low to mid single digit rate increase.

Richard Close, Analyst, Canaccord Genuity: Okay, that’s helpful. And then maybe as a follow-up, just back on the productivity programs that you’re implemented. Just a clarification, on the patient engagement, is that the same offering that you rolled out earlier in the year? You had mentioned acquisition and retention. Just want clarification there.

And then, on the Care Management capabilities that you talked to, or talked about, is that new? Is that something new? And do you have any like details on any pilots that you did in terms of the improved productivity? Any maybe percentage improvement or whatnot would be helpful.

Dave Borden, Chief Executive Officer, LifeStance Health: This is Dave, I’ll take that. There are a number of pieces there. So, first of all, on the patient engagement, this is different than the digital patient check-in tool, which I think is what you were referencing. Think of that as more administrative in nature for patients as they’re checking in both for a virtual appointment or for an in person appointment. It allows us to get insurance cards and ID cards, updated addresses, form sign, things like that.

So that’s more what that tool was. So it was administrative in nature. This is really more of a patient CRM marketing tool, and it’s allowing us to communicate with patients in a more systematic way, a more structured, standardized way, both engaging with a new patient before they’ve showed up to their first appointment, as well as existing patients and ongoing communications with them around mental health and allowing the clinician to engage with the patient as well. So there’s a lot to that. We’re very excited.

It’s something that we don’t do today in standard way throughout the country. And then in regards to the matching, we do matching today and we do a decent job on matching our patients and our clinicians. However, we believe there is opportunity for improvement in improving that match. And if we’re able to do that, what we’ll end up with is patients will be stickier with their clinicians and stay with the care, which will improve their health outcomes. It’ll also reduce cancellation, no show rates and things like that.

I wouldn’t quote any stats, but we have looked at this from a number of different angles. And we do believe that as we roll this out in the second half of the year, that it will improve, again, that clinician experience, the patient experience, the stickiness, and will drive improved productivity as it better fills our clinicians calendars.

Richard Close, Analyst, Canaccord Genuity: Okay, thank you. Congratulations.

Dave Borden, Chief Executive Officer, LifeStance Health: Thanks.

Conference Call Operator: Your next question comes from the line of Kevin Caliano with UBS. Please go ahead.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health0: Thanks. Thanks for taking my question. Last quarter, you introduced the idea of potentially starting the M and A engine again. You didn’t do any this quarter, appears. But can you maybe talk about where you stand with that?

How valuations are now or opportunities are now compared to when you were doing them years ago? How what the pipeline looks like?

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, Kevin, it’s Dave. Good morning and thanks for the question. We did signal that in the last quarter and we are active in exploring M and A. Our focus right now is primarily tuck in acquisitions in geographies that are new to us or where we’re very subscale. So this is really more of a beachhead and for geographic expansion.

Those opportunities are really exciting to us, whether that’s entering a new MSA or a new MSA in a new state. So that’s the focus. The pipeline is pretty robust, and we are actively working through a number of opportunities. But I wouldn’t signal at this point timing on when you’ll see those coming through. But again, that is a big focus area for us, and there’s a lot of positive activity there.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health0: And I just want to understand, none of the guidance assumes any M and A, right? It’s all organic, what you’re talking about in the guidance that you provided?

Dave Borden, Chief Executive Officer, LifeStance Health: That’s correct.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health0: And then just a follow-up. The margin expansion that you’ve shown has been great and better I think than we had modeled. Was this was it easier to get the kind of margin expansion that you got this year? I’m just I’m not asking you for guidance on margin expansion in ’twenty six or ’twenty seven or beyond, but like when we think about margin expansion is in terms of magnitude, is it incremental? Was this year just the first step?

Like where are we along the margin expansion pathway longer term?

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Yeah, so I’d be happy to answer that one. I appreciate the question. So, if you kind of think through like, yeah, so we’re pleased with the margin expansion that we’ve achieved here in 2025, even given the fact that the meaningful decrease from the one unique payer to kind of flatten out your TRPV, but still being able to expand margin, We’re pretty proud of that. And that’s on top of expansion of last year, 100 bps just in terms of expansion. As we start thinking through the long term kind of growth algorithm that we have here, we definitely see a path to margins to 15% to 20% from an adjusted EBITDA perspective, which will be done both through center margin expansion, through rate growth, a little bit of operating leverage on center margin and specialty services, but then there’s still further opportunity to expand out leverage through the G and A line and so overall kind of getting to that long term destination of 15% to 20%.

Again, we feel really good in terms of what the growth algorithm and even proven out like in a difficult year, still being able to expand out margins year over year. Sounds good. Thanks, guys.

Conference Call Operator: Your next question comes from the line of David Larson with BTIG. Please go ahead.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health1: Hey, congratulations on the good quarter. So for the digital patient check-in solution, is that 100% deployed or is it maybe 50% deployed? How far along are you in that process? And then you also use the phrase CRM. Is there a separate technology administrative solution that will assist in like a scheduling process to facilitate filling calendars?

Those two technology components I think are very important. Thanks very much.

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, Dave, good morning. This is Dave, and I’ll take your questions. So first of all, on the digital patient check-in, that is fully rolled out. That process was completed earlier in the year. In regards to the patient CRM, I think of this as more of a marketing CRM.

It is not connected to our scheduling system. Or said a different way, the scheduling component is not part of that. And scheduling would be more connected to what I was discussing in that matching initiative, the enhanced matching that we’re doing. So this is really about marketing and communications with our patients.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health1: Okay, and then in terms of like the One Health plan, where there’s a little bit of a rate reset, that will be final oneone hundred twenty six and then you would expect an increase in rates from that payer oneone hundred twenty six for the year. Is that correct?

Ryan McGurdy, Chief Financial Officer, LifeStance Health: Yes. So, this is Ryan. So, the last of the three rate decreases went into effect on March 1. And so, that’s the driving force between the flattish TRPV from ’25 over ’24. As it relates to kind of future, so we’re in rate negotiations across our overall payer portfolio.

Not all of our contracts kind of line up to a oneone, so they’re more scattered throughout the year in totality.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health1: Okay. And then just any thoughts on like the proposed Medicare fee schedule? It looks to me like the conversion factor could increase by 3% to 4% and then the RVU rates in some codes for some psych visits also look like they’d be going up mid single digits. So it looks like reimbursement is looking pretty good for next year. Just any thoughts on that or the big beautiful bill and the impact that that might have, if any, on your business?

Thanks.

Dave Borden, Chief Executive Officer, LifeStance Health: Yes, this is Dave. I’ll take those questions. So, first of all, in regards to the Medicare rates, you’re reading the signals correctly. And again, I would say it’s very early and we’ll see how that plays out. And obviously, we’ll know the final numbers as we get towards the end of the year.

I think the good news is that there appears to be really strong bipartisan support around mental health. And again, early signals being that it’s positive, a positive rate increase for next year, but we wait and see how they finalize. In regards to the other legislation, the concern around that bill is the reductions to exchange and Medicaid. And we have limited exposure to those business lines. A reminder, have about 5% of our total revenue is the government as a payer.

And then we do have some exchange in Medicaid business with commercial payers, making that being a small percentage of our total revenue.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health1: Okay. Thanks very much. Congrats on a good quarter.

Dave Borden, Chief Executive Officer, LifeStance Health: Thank you.

Conference Call Operator: Your next question comes from the line of Steven Deckard with KeyBanc. Please go ahead.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health2: Hey, guys. I wanted to ask about the AI tools you mentioned in your prepared remarks. When do you expect to see the full cost reduction for those benefits going to effect from those tools? And as a follow-up, I was hoping you could give an update on your new EHR initiative. Thanks.

Dave Borden, Chief Executive Officer, LifeStance Health: Hey, Steve, this is Dave. Good morning. I’ll take those. So in regards to AI, we referenced a few things in our prepared remarks. So first of all, more from an efficiency perspective, we are starting to use AI in our revenue cycle, and we’re using it in our patient scheduling team.

Now, of that is for efficiency, some of that is for quality and effectiveness. It’s starting to come through in cost savings. But again, I wouldn’t say all of that’s not about cost. Some of that is about improving quality.

Ryan McGurdy, Chief Financial Officer, LifeStance Health: And

Dave Borden, Chief Executive Officer, LifeStance Health: it’s one of the areas where again, we’re early, but we expect to help us in driving operating leverage as we step into ’26, ’27 and beyond. And then the other use case around AI that we referenced in the prepared remarks was related to clinician documentation. And again, I would not point to this as a savings, I would point to this more as part of our value proposition to clinicians. This is a mundane task that they don’t like that they don’t enjoy doing. And we believe by rolling out AI documentation that will improve their day to day allow them to really focus on what they enjoy doing, which is delivering great care to our patients.

And then your second question was around the EHR, nothing new to point to there. We’re still in the process of evaluating the various solutions. And we expect to have that decision made in the second half of this year.

Monica Burkowski, Vice President of Finance and Investor Relations, LifeStance Health2: Great, thanks.

Conference Call Operator: And there are no further questions at this time. I will now turn the call back over to Dave Varden, Chief Executive Officer for closing remarks.

Dave Borden, Chief Executive Officer, LifeStance Health: Thank you, operator. I’d like to thank our over 10,000 mission driven teammates who make sure that our patients get the quality care that they need and deserve. I continue to be inspired by the passion and the resilience that you all bring every day. Our services are needed more than ever, and we look forward to furthering the positive impact that we can have on the millions of Americans whose lives can be improved by the high quality mental health care services that LifeStance provides. Thank you for joining us today.

Conference Call Operator: Ladies and gentlemen, that concludes today’s call. Thank you all for joining. You may now disconnect.

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