Option Care Health at Bank of America 2025 Healthcare Conference: Strategic Growth Insights

On Tuesday, 13 May 2025, Option Care Health (NASDAQ:OPCH) presented at the Bank of America 2025 Healthcare Conference, showcasing a robust first-quarter performance. The company emphasized its strategic growth across therapy areas, highlighting both opportunities and challenges in a competitive market. While Option Care exceeded internal expectations, it remains vigilant in navigating drug pricing pressures and biosimilar competition.

Key Takeaways

• Option Care achieved strong growth in Q1 2024, surpassing internal benchmarks.
• Key growth drivers include acute and chronic therapies, and payer relationships.
• The company is expanding infrastructure with new pharmacies and infusion suites.
• A significant portion of gross profit comes from generic or biosimilar therapies.
• Option Care remains focused on M&A and share repurchases for capital deployment.

Financial Results

• EBITDA growth, excluding Stelara headwind, was approximately 20% at the midpoint.
• Capital expenditures are projected at $30 million to $40 million annually.
• Free cash flow is expected to exceed $250 million for the year.
• $117 million was deployed in Q1 for the Intramed Plus acquisition.
• Over 3 million shares were repurchased in Q1 for $100 million.
• The leverage ratio stood at 2.1 at the end of Q1.
• 75% of gross profit is derived from generic or biosimilar therapies.

Operational Updates

• Growth is driven by acute therapies, chronic therapies, and payer relationships.
• New pharmacies are being established in New York, Tampa, and Richmond.
• Over 750 infusion suite chairs are available across the U.S.
• The company is expanding its portfolio with advanced practitioners to manage complex patients.
• Option Care efficiently managed the Stelara biosimilar impact, retaining most patients.
• Partnerships with manufacturers and channel partners are actively pursued.

Future Outlook

• Guidance reiterates a 2025 Stelara headwind of $60 million to $70 million.
• Focus remains on new product launches and rare/orphan drugs.
• Increased interest from payers in site-of-care initiatives is expected.
• Capital deployment will continue through M&A and share repurchases.
• The company is prepared to adapt to changes in drug pricing dynamics.

Q&A Highlights

• Initial focus on Stelara biosimilars is on self-administered patients.
• Uncertainty exists around the executive order on drug pricing.
• Tariffs are not expected to materially impact sourcing and medical supplies.
• Free cash flow will be deployed in shareholder-friendly ways, primarily through M&A and share repurchases.

For further details, readers are encouraged to refer to the full transcript below.

Full transcript - Bank of America 2025 Healthcare Conference:

Elisa, Analyst, Bank of America: I’m Elisa, Bank of America Coving Healthcare Facilities and Managed Care Names, and thank you so much for joining our conference. And we are going to start the day with Option Care, the largest home infusion provider in The U. S. And today with us, we have John Rademacher, who’s the President and CEO and Mike Shapiro, CFO. And I guess, John, you want to have some introductory remarks before I go into Q and A?

John Rademacher, President and CEO, Option Care: Certainly. First and foremost, as always, we may be making some forward looking statements in today’s presentation. We ask that you review our safe harbor language on our investor website for full disclosures as that as we move ahead. I’d like to start by just saying really strong first quarter. We were really pleased with the progress that the organization made, really balanced in the portfolio as we looked at execution.

A lot of moving pieces as we were exiting the fourth quarter with some of the things like the bag shortages and some of the competitive exits, but the team responded extremely well. Our ability to utilize our national scale with local responsiveness was something that we take great pride in, but really pleased with the progress that the team made as well as the execution during that period of time. Pretty much every measure that we have put out there, again, don’t give quarterly guidance, but as we set our internal markers, pretty much every measure that we had, we were at or exceeded as we exited the first quarter. So really strong results, really feel like we’re well positioned to continue that and deliver a good year.

Elisa, Analyst, Bank of America: Great. Thank you so much. I guess let’s start on the core business. I know there’s a lot of questions around policy things and such. But maybe first, to continue on your thought in terms of the guidance for this year, right, when you exclude the Stelara headwind, it calls for 20% EBITDA growth, call it, at a midpoint or so.

So maybe walk us through the drivers, right? Like is this the growth sustainable? How much, I guess, is the benefit of CVS, I guess, exiting and you’re gaining share, but also maybe some EBITDA comps from last year? So kind of walk us through the build to that core number.

John Rademacher, President and CEO, Option Care: Yes. I would say, again, you’ll hear the word balanced, but really balanced results. And as we were looking at the year and the guidance that we put forward, our expectations were continued strength of growth in the acute therapies, certainly capitalizing on competitive exits and the opportunities that, that creates for us in those markets in which the exit. But we believe there’s a halo effect associated with that as well. We’re seeing growth, not just in those exit markets, but growth in other markets as we continue to execute.

We think part of that is, you know, as hospital and health systems, you know, expand and are across multiple MSAs, their ability to have partners who are reliable, that can provide consistent high quality care are ones that they seek and that ability for us to continue to execute. We were really pleased on the progress. Again, we think that is part of that growth driver. We continue to see strong execution in the chronic space, whether it’s in our rare and orphan and to continue to capitalize on the platform that we have from that perspective as well as our core products, whether it’s chronic inflammatory disease as well as our IG portfolio of products. So really feel as if the growth is going to come from all those dimensions.

When you pull out some of the impacts of the Stelara on that, another strong year of top and bottom line performance. We feel really good about the composition of that and the balance that, that brings, given the value proposition that we bring into the marketplace. And that value proposition, I’d say, is both with the referral sources, again, that responsiveness that we have, the reliability, the consistency of the clinical outcomes, but also as we’re working with the payer community and looking for opportunities to deepen our relationships there, especially as they’re working with through challenges with medical loss ratios and others. They’re looking for partners that can help to reduce the total cost of care. And when you think of what we can do, offering high quality care in an appropriate cost in a setting in which their members want to receive that, we’re really well positioned to continue to deepen those relationships and provide real value to those two key stakeholders.

Elisa, Analyst, Bank of America: Yes. So our stopping of today is Hi, Trent. So maybe as it relates to your relationship with managed care, can you talk about their strategies when they

John Rademacher, President and CEO, Option Care: try to address the trend and the changes and all these other things? Is it something that you can leverage on your end to kind of do do more, I guess, with managed care plans as they try to address these issues? Yes. A lot of our conversations are when you think of the value that we create for a payer, it really when you look at the different portfolios of products that we have, helping them manage bed days by being able to safely and effectively transition patients out of the higher cost inpatient settings into the home or into one of our infusion suites is significant value when you’re looking at the total cost of care. And so a lot of our conversations with payers is how do we help and support that?

How do we utilize our pharmacy infrastructure, our nursing community to be able to support that transition in a very efficient and effective way? And when they’re looking at the total cost of care, not just the unit cost of a product or a service, they’re looking at that total cost of care, home infusion is significantly less expensive than going to a skilled nurse facility or staying in an inpatient setting. So a lot of the conversations that we’re having with the network management people is how do we facilitate that in a more efficient and effective way? How do we bring that more to your members? Similar thing in the chronic conversations when we’re talking about their membership, that have chronic conditions that require the infusion services that we can offer.

The ability for us to work with them on-site of care initiatives to be able to help their members identify areas in which they can receive care at a high quality, but at that lower cost, moving out of the hospital outpatient departments that tend to be 20% to 40% more expensive than what it is in the home or in one of our infusion suites. We’re helping them manage, situations where they have high complexity from the medical needs and our healthcare professional oversight can provide value there. Those are the things that we’re really working in earnest with. And I think this has come up before, you had asked questions before, Joanna. We felt site of care initiatives were starting to move forward with some level of interest from the payers until COVID.

And then COVID happened and really the world got turned upside down. There were many situations where a lot of the focus was just around the stability of the network and the supply chains and those types of things. I think as we’re emerging out of that and getting back looking at how do we manage the business and how do we drive better clinical outcomes at a more appropriate cost, they’re starting to pursue those types of programs to help support their members and help to reduce that total cost of care. So we feel really good about the position we have. We think that the uniqueness of our platform, especially when you’re in those conversations with the national payers, may have members in Maine and in California and every state in between, that opportunity we have to be licensed in all 50 states to have coverage of 96% of The U.

S. Population and the capacity within our pharmacy and a nursing network really positions us so well-to-do that partner.

Elisa, Analyst, Bank of America: So are you seeing more of an interest from payers coming to you and trying to

John Rademacher, President and CEO, Option Care: those conversations are picking up pace, and they’re trying to think of ways to utilize those types of programs to influence their members to make better choices.

Elisa, Analyst, Bank of America: Right and I guess you mentioned you know, your I guess access points, right? So, you have the the know, each of nursing code that’s available to you but maybe we can talk also about your physical assets, right? Because that’s been part of the growth. So, in terms of this, the infusion suites but then also most specifically the advanced care practitioner model. So maybe you can talk about kind of the trajectory there

John Rademacher, President and CEO, Option Care: and how we should think about how this is aiding the growth, how much capacity there is, and I guess how much is used and what are you looking for and kind of why you’re doing this this evening? We continue to invest. I mean one of the things that we have the flexibility with the balance sheet that we operate as well as with the focus that we have as an organization of making that investment into the business. On a CapEx basis, on an annual basis, we’re anywhere between 30,000,000 and $40,000,000 is what we spend on that. And that’s putting new pharmacies into the infrastructure.

We had highlighted that we have a new state of the art facility in New York, in Tampa, Florida, in Richmond, Virginia. It really allows us to continue to invest in that fleet of pharmacies to ensure that we have the capacity, but also that we’re operating at the highest levels of quality across that. We also invest in our infusion suite capability. We’re now over seven fifty chairs that we operate across The U. S, and those infusion suite and the capabilities that we have there either support patients that are we’re operating under the practice pharmacy, and now we’re building out more capabilities with advanced practitioners.

That allows us to expand the portfolio of products that we’re able to manage and to be able to oversee. It also allows us to tap into a different class of trade as we’re thinking about the way that we’re sourcing the product. And it also gives us an opportunity to manage more medically complex patients, given the fact that those advanced practitioners can help manage and modify the care plans associated with those patients. So we like the duality that that brings to us. We like the optionality that allows us to match the service that we can provide with the needs of the patient.

And we also like that opportunity we have to go based on what we’ve been able to demonstrate with the medically complex to continue to invest in and grow our capabilities to serve more patients where clinical protocols and or the oversight that’s required is more complex than just a pharmacy led infusion event. So on

Elisa, Analyst, Bank of America: this advanced practitioner setting, can you talk about the type of patients that you sort of addressed it because I want to say in the past you talk about Alzheimer’s and even oncology sounds like that’s been your area that maybe something that you guys trying to

John Rademacher, President and CEO, Option Care: expand into? Yeah, it it it opens it up in in a couple dimensions. One is in situations like with Medicare fee for service where there’s limited access because of there’s just not coverage under the home infusion therapy aspects of direct fee for service, It allows us to expand sort of a broader base of patients, given that you can use the advanced practitioner model in order to support them there. On the complex patients, certainly Alzheimer’s in the emerging therapies in that space, more medically complex, certainly those patients require a different level of care and handling and monitoring through that process. So tapping those additional capabilities and competencies of the advanced practitioner model helps there.

And then the other area of emerging interest as well as we think opportunity is really in the oncology area. And starting with a lot of the, I’d say, the more standard products like the PD-1s, the KEYTRUDA, OPDIVO, Yervoy, lot of those have the same characteristics of our chronic inflammatory diseases, require health care professionals to oversee it, have some comorbidities with those patient populations, that ability for us to be able to bring those patients into the advanced practitioner model and really tap into that as well as also tap into some of the site of care initiatives that are happening at the payer level. We think this sets us up very well in order to do that. There historically has always been a bit of a resistance to do oncology in the home. ASCO and other bodies have been resistant to that.

Having the infusion suite infrastructure that we’ve been able to build out allows us to demonstrate our capabilities and do that in a clinic setting, if you want to think of it that way, that allows us to expand and to take on some additional products that may not be really well suited for the home, but we can still serve those patients and serve those referral sources with the patient’s needs. So how many of these advanced care practitioners locations do you have? So the broader strategy that we will be executing is all of our infusion suites will operate in this hybrid model. It takes time. Each state has different aspects of corporate practice of medicine and other things that are the requirements through that process.

But we see that expanding as rapidly as possible and being able to tap into this opportunity. But it’s going to take us, I’d say, a couple of years to get that fully executed given the things that you have to do from a corporate tax kind of thing and then be able to build along. We’re going to continue to be building our infusion suite capabilities along that path with that longer term vision around how to use the facilities. And again, to your earlier question, that just gives us broader, broader capacity and and be able to utilize our nursing resources more efficiently and effectively.

Elisa, Analyst, Bank of America: And you mentioned, excuse me, you mentioned that. I knew that’s going to happen to head. Maybe you can expand a little bit more about, you know, specific therapies that are driving the and kind of pipeline in terms of therapies coming along. Yes. And we’ve highlighted

John Rademacher, President and CEO, Option Care: some of the rare and organ products that have really we’ve been able to tap into the strength of our platform and the clinical competencies as an organization. So products like BIJUVAK, BIEFBI are ones that we have called out before. These are products that, again, expand on the capabilities that we have both in the practice of pharmacy as well as our healthcare professional oversight in our nursing community. Our clinicians, especially with products like BIJUVAK, can set up clinical protocols that are unique to that therapy. Our learning management system helps to deploy any of the training that is required for our nurses to oversee and to execute on that, both in a just in time as well as a reinforcing aspect to that.

And that brings a significant amount of value to our manufacturer partners who are looking for a platform to be able to bring their products into the marketplace. So we always have an eye towards continuing to look for rare norepine limited distribution drugs and be able to continue to push those programs forward and execute around that. We feel like we’re well positioned. And one of the things that we focus on is certainly new product launches and those opportunities to do that. But there’s also existing products that are in the marketplace, and some of the manufacturers are looking for different partners or better partners for their products and channel partners to be able to serve their products.

And so we’re always kind of working through those relationships broadly and looking for the opportunities to select the assets and to really utilize the platform to its fuller.

Elisa, Analyst, Bank of America: Maybe switching gears, Stelara, the topical topic, I should say, recently. The next, so you were able to quantify the headwind for ’25. But how should we think about biosimilars coming online? So, we’re starting to see some of those maybe entering the market right now and how, you know, how we should be preparing thinking about, you know, how this going to play out through this year and into

John Rademacher, President and CEO, Option Care: the next year. Yeah, it it’s still early to tell, Joanna. You know, there has been a lot of talk. I I think most of the focus has been really around the pens and the self injectable aspect of those products. And there are a lot of Stellara patients, again, just defining the world that we operate in.

The patients that we serve is a small cohort of patients that are on Stellara that have letters of medical necessity, they have medical needs in which they cannot do self administration. So it’s a very small subset of the broad patients that participate in Stellara. A lot of the focus has been on those that are self administered and that use the pens to do those self injections through that process. Most of the patients that we have are we use vials, and we are doing it as an intravenous application or administration of that as opposed to a self injectable. So we think that the uptake will be more focused around those self administered patients as it moves forward.

We’re in active conversations with all of the BioSim manufacturers around bringing their products on the formulary, how the economics will work on that. As we reported in the first quarter, the patients that we have, the census that we were operating at the end of the year through first quarter, we’ve retained a vast majority of the Stellaris patients and retained them on service. Again, Stellaris is still a profitable therapy for us. It’s just less profitable given some of the shifting economics from Janssen. But our view is that we’re going to continue to, like with every other biosimilar event, we’re going to manage that as efficiently and effectively.

It gives us some different leverage points in the conversations, both with biosimilar manufacturers as well as the original innovator around the economics that we can participate in, given the value that we bring to those patients and the uniqueness of the patient cohort. We’re going to continue to work on that. Again, we have been given 26 guidance. And one of the things that’s a little bit I’d say I don’t want people to jump to is there are a lot of moving components as we start going through the rest of the year. Part of it’s going to be around the biosimilar, are that are on STELARA, that are on the biosimilar, that are potentially moving to the next generation products like TREMFYA, etcetera.

So that’s why it’s not like a linear, only one variable type of equation and why we’re trying to be really thoughtful around the way that we’re approaching it. We feel good based on the results of the first quarter and how things are trending that the 60,000,000 to $70,000,000 range that we gave for 2025 is in alignment and what we would expect for the remainder of the year through that process. But it’s really early to try to hazard a guess around the implications for ’twenty six, given some of the various variables that will be a part of that overall equation.

Elisa, Analyst, Bank of America: And I guess since you mentioned in the last question, about the there’s some confusion, I guess, around how to think about the headwind, right, from Stellara this year, when it’s at sixty, seventy for the year, but in Q1, was much lower. So I guess, automatically, people kind of assume, hey, that’s going to create additional headwind into next year. So can you walk us through

John Rademacher, President and CEO, Option Care: how we used stop my allotment of still out of

Elisa, Analyst, Bank of America: the answers, so I’m trying

Mike Shapiro, CFO, Option Care: to cut down as well, Joanna. Look, as John said, we would air caution on anchoring on one variable going into ’twenty six. As you know, Joanna, we operate in a very dynamic environment. As John said, there’s a lot of moving pieces around the biosimilar update, what our census looks like, what is the approach of Janssen with you know, the legacy Stellara brand going into ’26. When we laid out the 60 to $70,000,000 range, that was specifically linked to the guidance that we articulated for ’25.

As you know, we don’t provide ’26 guidance at this point And that 60 70 included a consideration that we, like every other year, use our balance sheet at the end of the year to mitigate some of the price adjustments on certain drugs by using our balance sheet to build some inventory. And you know, the 60 to 70 is we see it as our high confidence interval, as John said, around the impact for ’25. At this point, it’s way too early. And I would just caution because there’s so many dynamics, whether it’s in the acute portfolio, whether it’s in the rare orphan portfolio, it’s within our cost structure relationships with payers. To anchor, and I understand the math that, well, I need to adjust my ’26 number by 10 to 15 for this wraparound.

In a bubble where absolutely nothing else changes in our business, which just simply isn’t the case. I think that would be a safe assumption. But again, we’re just not in a position to unpack even our thoughts on how Stellaro will look going into ’26 to ’26.

Elisa, Analyst, Bank of America: So there are a couple of other big topics. I know there’s a lot of uncertainty, but maybe, you know, any initial comments on the executive order yesterday in terms of, you know, trying to influence the how the pharmacy chain works in The US and how this potentially could flow through to you?

John Rademacher, President and CEO, Option Care: Yeah, it’s I think everyone is really trying to understand the executive order. I think in principle, you know, trying to reduce the cost of drugs in The U. S. Or at least have better balance between The U. S.

And other developed nations. I think people understand that aspect. How it actually would be executed as it was laid out would create significant amount of challenges, I think, for everyone. And first and foremost, you know, reimportation, there’s challenges with counterfeit and other aspects that have to be taken into consideration. It’s really hard for us at this point in time to understand how it would actually ripple through to us, given the uncertainties of the way that the executive order kind of outlined on that.

As we’ve said before, we do make a margin on the drug. We do get paid a clinical per diem, and we do get paid a nursing rate. And we have those three levers that we operate. Some of our payer contracts are tied to from a drug price to average selling price, the ASP, and that’s less than 50% of our revenue coming from contracts from that standpoint. There’s other mechanisms, AWP, etcetera, that we’ll use for the majority of our contracts on that.

So how this all patterns out, Joanna, it will be interesting to see. We’re always looking for balance across those three legs in the stool as we move forward, and we know the cost structure that we have and the value that we bring to the patients. And when you’re looking at the total cost of care, the way that we manage from that perspective. So we’re always working with payers around getting that appropriate amount of value across those three dimensions. I think that as this starts to move forward, if we see changes in the drug prices and things associated with that, we’re always going be looking for ways to pull on with the other levers to make certain that we’re being paid fairly through that process.

So a lot to see as it kind of unfolds and develop before that. At this point in time, I just don’t see how this gets applied in the way that it was written and disclosed yesterday.

Elisa, Analyst, Bank of America: But but in, you know, in theory, right, if this is where things are headed and there’s more pressure on costs of drugs. You know, is this something that you can do in response to that? I mean, I understand there’s this, you know, the three legs of the stool in terms of going into maybe, you know, more nursing and and per diem rates to try to, you know. Yeah. I don’t want to

John Rademacher, President and CEO, Option Care: make the margin. Is there something else? I guess from our perspective, it’s always been a challenging market from a pricing standpoint. Just because there’s an ASP or a reference price out there doesn’t mean that the payers doesn’t give us free robe on that. I mean, they’re adjusting our prices as to what’s the ASP plus or the WAC minus that we’re getting.

So like we’ve been operating in a very thin margin business and operating dynamic from that standpoint. So look, we’re always going to be fighting for every basis points. We would look for, as Mike says, pennies and nickels in the cushions, like that’s the orientation of our business and the way that we operate from that standpoint. So we’re always going to be looking for ways for those offsets, Joanna. We’re always going to be pushing around what can we be doing in the investments in our technology to drive efficiency and effectiveness within our operating model?

How do we take costs out of our systems in order to do that? How do we leverage the infrastructure, sweat the asset? Like all of those things are part of the way that we’ve operated the business. But as I said, like we’ve worked through pricing challenges, we’ve worked through changes that have happened within the environment and I think have shown agility and resilience as an enterprise to kind of work through those challenges. So it’s a very good outcome for our shareholders.

Mike Shapiro, CFO, Option Care: The only thing I’d add, Joanne, is when we think about and we’re constantly triaging and analyzing some of these developments that seem to be coming out on a daily basis. As we’ve recently articulated, 75% of our gross profit comes from therapies that are either generic or biosimilar today and those are already very efficiently priced therapeutic areas where you have multiple competitors which are keeping prices relatively competitive. I would say of the 50% of our revenue, which are quote unquote branded drugs, which presumably would be some of the areas that the EO would be targeting, roughly half of those are limited distribution of rare and orphan therapies, are higher cost for very small patient populations. And again, our branded therapies, as we’ve talked about, on a relative basis contribute less at that gross profit line. Not that we’re not monitoring this but as we look at the portfolio of therapies,

John Rademacher, President and CEO, Option Care: you know, we see a lower risk profile. Exactly.

Elisa, Analyst, Bank of America: That’s what I was trying to ask you but you answered the question before I asked it. There was actually exposure to where those prices could show up. On the flip side, right, before this executive order, there was a lot of focus on tariffs, potential tariffs, especially on drugs in particular, and as it relates to how this impact the company. So, can you walk us, you know, through that any updated thoughts and you know, how we should think about it and and you know, same thing in terms of like where it would show up in your portfolio.

Mike Shapiro, CFO, Option Care: Happy to. Yeah and look, you know, we’re in an environment where we navigate and manage through variable drug reference prices on a daily, if not weekly basis. So whether drugs prices increase or decrease, those are dynamics that we’ve reacted and managed proactively quite quite often. I know one of the the prevailing concerns as well. There’s delays in ASP and when it’s calculated, would the company have exposure in an interim basis?

That’s just not that’s just categorically not correct. Less than half of our revenue is anchored to payer contracts that utilize AFP as the reference price. If there are inflationary impacts on drugs, again, we make a spread over the medium term on the drugs, and we have demonstrated that we can very well manage interim disruptions around timing differences with reference prices. AWP and WACC are typically updated more frequently and in more real time, but even with ASP delays because that usually is managed by CMS, we can very well manage those interim the dissonance between the reference price and the drug cost.

Elisa, Analyst, Bank of America: I think we are probably I’ll

John Rademacher, President and CEO, Option Care: just add a last Just because this this had come up before is, look, we we manage med supplies. We’re in a high school in the way that we look at how do we source and drive that forward. As we had called out, it’s not material. I mean, we will, again, find the right ways to do that from the med supply standpoint. So tariffs shouldn’t

Elisa, Analyst, Bank of America: be an impact that’s material for us. Right. Sounds like we have three minutes. Okay. So, my other topic was around free cash flow because company generates very low.

Yeah. Free cash flow. So, maybe walk us through any updated thoughts on the deployment. Obviously, you’ve been buying a lot of stock but there’s also deals there. So kind of, know, look at the targets you’re looking at and how we should think about that.

Mike Shapiro, CFO, Option Care: Yeah, look, think one of the hallmarks of this platform is our ability to convert revenue and earnings into cash flows. We like to say EBITDA doesn’t pay light bills, cash does. And last year we generated more than $0.02 $5,000,000,000 of free cash. As John said, our capital expenditures are quite efficient, around 30,000,000 to $40,000,000 and our guidance this year is we’ll generate at least $320,000,000 of cash flow from op. That implies that we should be this year generating and would expect to clear more than $250,000,000 of free cash flow.

Given the health of the balance sheet and our leverage profile, we’re very comfortable that people should expect us to at least deploy our free cash flow in shareholder friendly manners. I think our balance sheet and our confidence in the cash flow affords us the flexibility and optionality in terms of how to deploy that. We see two primary avenues. First and foremost is through M and A. We were thrilled in the first quarter to deploy $117,000,000 towards Intramed Plus, highly complementary regional provider who we’ve respected for decades that shores up our offerings in the Southeast.

At the same time in the first quarter, we deployed $100,000,000 and bought back more than 3,000,000 shares. So in the first quarter, we deployed over $200,000,000 alone, and yet our leverage profile remains at 2.1 at the end of the first quarter. So I think folks should expect us going forward to continue to be actively deploying capital. M and A isn’t as predictable and smooth as our ability to project timing of share repurchase, but we’ll constantly monitor the forward view of actionable M and A, and if we think we have excess capital at our disposal, we won’t be shy about buying back stock.

Elisa, Analyst, Bank of America: Great, sounds good. This is, I think, the end of our session. Thank you so much.

John Rademacher, President and CEO, Option Care: Thanks, John. Thank you, everyone.

Elisa, Analyst, Bank of America: So this wasn’t working, right? I was like, okay, I have no idea how much time we had.

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