BrightSpring Health Services Inc

Solid Q1 results + strong profitability/momentum (good): - Total company revenue: $3.6B, +26% YoY. Pharmacy Solutions: $3.2B (+25%); Provider Services: $442M (+28%). - Adjusted EBITDA: $190M, +45% YoY; margin 5.3% (+70 bps YoY) driven by mix and operating efficiencies. - Cash flow from operations: $123M (not including Community Living divestiture fees). - Quality metrics across providers and pharmacy remained very strong (e.g., Home Health: >91% 4-star+ branches; timely initiation >99%; Hospice: top-5% program and CAPS 87; Pharmacy dispensing accuracy 99.99%; Infusion satisfaction 94%).

IRA/Medicare headwinds are real but tracked to plan (mixed): - Home & Community Pharmacy revenue declined -9% YoY due to an ~$50M IRA impact in Q1 plus exiting uneconomic customers (both expected). - Company expects IRA revenue impact ~ $45M per quarter remaining in 2026 (~$175M full-year impact). - Management stated IRA-related headwinds in other areas were also tracked to prior expectations (notably Home & Community; plus they reiterated full-year magnitude for Specialty/Infusion IRA and branded-to-generic conversions).

Full-year 2026 guidance reiterated/raised with updated range (key forecast): - Guidance excludes Community Living (divested) and excludes unopened acquisitions. - Revenue: $14.725B–$15.225B (Pharmacy Solutions $12.85B–$13.3B; Provider Services $1.875B–$1.925B), implying ~14.1%–17.9% YoY growth vs 2025 on the same continuing-ops basis. - Adjusted EBITDA: $795M–$825M (implies 28.7%–33.6% growth YoY on same basis), including ~$30M EBITDA contribution from Amedisys + LHC assets integration. - Margin outlook: guided 5.2%–5.6% adjusted EBITDA margin for the year; management expects slight build but largely consistent with Q1. - Operational cash flow outlook: ~$500M annual operating cash flow for the remainder of 2026 (excluding Community Living cash-flow impact).