NASDAQ:AHCO AdaptHealth Q2 2023 Earnings Report $8.60 +0.37 (+4.50%) As of 02:11 PM Eastern Earnings HistoryForecast AdaptHealth EPS ResultsActual EPS$0.16Consensus EPS $0.11Beat/MissBeat by +$0.05One Year Ago EPSN/AAdaptHealth Revenue ResultsActual Revenue$793.29 millionExpected Revenue$765.69 millionBeat/MissBeat by +$27.60 millionYoY Revenue GrowthN/AAdaptHealth Announcement DetailsQuarterQ2 2023Date8/8/2023TimeN/AConference Call DateTuesday, August 8, 2023Conference Call Time8:30AM ETConference Call ResourcesConference Call AudioConference Call TranscriptSlide DeckPress Release (8-K)Quarterly Report (10-Q)Earnings HistoryCompany ProfileSlide DeckFull Screen Slide DeckPowered by AdaptHealth Q2 2023 Earnings Call TranscriptProvided by QuartrAugust 8, 2023 ShareLink copied to clipboard.There are 9 speakers on the call. Operator00:00:00Good day, everyone, and welcome to today's AdaptHealth Second Quarter 2023 Earnings Release. At this time, all participants are on a listen only mode. Later, you will have the opportunity to ask questions during the question and answer session. Today's speakers will be Richard Barish, Chairman and Interim CEO of Adapt Health and Jason Clemens, Chief Financial Officer of Adapt Health. Josh Parnas, President of Adapt Health will join Richard and Jason for the question and answer portion of this call. Operator00:00:40Before 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 2023 and beyond. Actual results could differ materially from those projected in forward looking statements because of a number of risks and factors and uncertainties, which are discussed at length in the company's annual and quarterly SEC filings. AdaptHealth Corp. Should have no obligation to update the information provided on this call to reflect such subsequent events. Operator00:01:24Additionally, on this morning's call, the company will reference certain financial measures such as EBITDA, adjusted EBITDA and free cash flow, all of which are non GAAP financial measures. This morning's call is being recorded and a replay of the call will be available later today. I'm now pleased to introduce the Chairman and Interim CEO of AdaptHealth, Richard Barish. Sir? Speaker 100:01:52Good morning, everyone. Thank you for joining us today to discuss Adapt Health's 2nd quarter performance. To start our call today, I'd like to take a moment to welcome Crispin Teufel, who will be joining Adapt Health on September 1st As our new Chief Executive Officer, Christmann brings many years of industry experience and a deep understanding of the markets in which we operate. His expertise and proven track record will be key to this organization's future success. We're excited to get him on board I look forward to you getting the chance to meet with him in the coming months. Speaker 100:02:32Adapt Health is a full service Nationwide provider of products and services that enable our patients to live their healthiest lives at home and in the community. We have nearly 11,000 employees, including nearly 1,000 healthcare professionals who work to bring these needed products for approximately 4,000,000 patients. We know that we are crucial in the healthcare continuum, especially for post acute care And management of chronic diseases like diabetes, OSA and COPD. Most of our devices are connected and generate lots of useful data to help manage these chronic conditions and reduce downstream costs. We are now in the process of figuring out how best to use that connectivity for the benefit of our patients and our payer partners. Speaker 100:03:27Turning now to the details of the quarter, I'm pleased to report solid second quarter results driven by and successful execution of cost savings initiatives. Most notably, We're also quite pleased with our improved cash flow generation in the first half of the year. The highlight of the quarter was continued growth in our sleep and respiratory product lines, which represent more than half of our total revenue. Building on the robust first quarter, these products grew a combined 15% year over year in the second quarter. Drilling down, the performance in our Sleep business was driven by strong market demand, both new starts and resupply as well as our improved ability to service this demand more efficiently. Speaker 100:04:36The investments we've made in this business line over the past year are now Paying off. We have enough equipment on hand to satisfy demand and we've improved our processes in new starts, especially in resupply, an area of great strength for Adapt Health. Industry data shows that we are the clear leader in sleep and have gained market share over the past year. Our respiratory line of business At its strongest patient acquisition quarter since the Q4 of 2021, we hit our setup expectations And we're starting to see stabilization in the length of time patients are on oxygen events, which had decreased during the pandemic. Now turning to diabetes. Speaker 100:05:25After a very disappointing Q1, we saw a modest rebound in our diabetes business in the 2nd quarter. We acknowledge that we did not react swiftly enough to changing market dynamics and are committed to resuming growth in this crucial market. Over the past 3 months, we've done a deep dive into all aspects of our diabetes business and have emerged with a solid plan To achieve results that reflect a growing market for diabetes supplies, especially CGMs and pumps. This plan Building on our existing patient census, which is the highest in our history gives us a solid foundation upon which to grow. I'm going to highlight 2 specific areas of focus in our plan to regain our momentum. Speaker 100:06:13First, we are going to be even more intentional The focus on our government business with the market for CGMs and pumps is large and growing. We're encouraged by recent decisions by Medicare and other government payers to widen their coverage of CGMs as a result of the emphasis On the medical benefits of compliance, the government market is growing rapidly and we are generally able to achieve pricing It takes into account inflationary pressures. We've emphasized to our vibrant sales force the importance of government business And I've already seen meaningful impact. Government sponsored payers now represent 77% of our CGM census, an increase of 900 basis points compared to last year and up 200 basis points from the Q1. We anticipate this trend will continue over the course of the year. Speaker 100:07:13As to the commercial business, we plan to update contracts to enable us to increase access to our current and new CGM patients, including through the pharmacy channel. We see this as an essential part of the strategy to offer full and creative solutions for our payer partners and patients. Next, we are employing the scale and capability of the entire AdaptHealth team to rapidly improve the operations of our diabetes business. One example is creating synergy Between the HME and diabetes sales forces, take advantage of HME's national reach. Another is to use our world class HME resupply operation to make it easier and more efficient For our diabetes patients to get their supplies including through digital reordering. Speaker 100:08:10The diabetes line of business is crucial to the growth and strategic success of Adapt Health. Sadly, diabetes continues to grow rapidly in our population and we intend to expand our reach and services to help our patients manage this chronic disease. More to come on this important topic in future reports. Subsequent to our earnings call in May, we announced a relationship with Humana to become the value based provider of home medical equipment and supplies to their Medicare Advantage HMO members in 33 states plus the District of Columbia. The program began on July 1, 2023 and we are working hard on the implementation of this transformative arrangement. Speaker 100:09:01Based on our patient focused culture, we've committed to high levels of customer service, which is a sign of the alignment that we've established with Humana. This value based contract marks a significant step toward highlighting our essential role in keeping our patients healthy in their homes. We think this is an important new area of focus for Adapt Health and we intend to pursue other similar arrangements. Like most businesses, we've been affected by increased labor and other costs. We are actively mitigating inflationary factors in several ways. Speaker 100:09:42First, as we have done in the past, We are continuing to add and refine technology that reduces the costly administrative friction between our prescribers, Patients and payers. Among the most important KPIs we review each week is the percentage of e prescribed orders that we process, which has grown meaningfully over the past year. Another tangible result of technology and process improvement is in our RCM function, which as Jason will describe has led to significantly reduced DSOs and better collections. Building on these technology improvements, are also focused on additional cost saving opportunities. As you know, we were an active acquirer in prior years We are now focused on achieving the scale of a much larger business. Speaker 100:10:35As a result of this effort, we are confident That we will achieve the previously announced target of $25,000,000 in cost savings and we're continuing to examine our operations for areas of further improvement. Speaker 200:10:51I'll now turn the call over to Jason Clemens, our CFO, To review the Q2 financials and full year guidance, Jason? Thank you, Richard, and thanks to all for joining our call today. I want to reiterate Richard's sentiment about the strength in our core product lines and the opportunities ahead of us in diabetes. Let me begin by reviewing our 2nd quarter results. Our revenue of $793,300,000 increased 9.0 percent and our non acquired revenue increased 8.7 Our 2nd quarter results were led by strength in our sleep and respiratory product categories, both of which were up double digits. Speaker 200:11:33Taking a closer look at each of these product categories, our total sleep revenue of $303,000,000 increased 16% compared to a year ago, driven by PAP equipment setups and consistent resupply operations. Our PAP equipment patient census grew 41% Year on year and our resupply orders are up 11%. Respiratory delivered another strong quarter with Revenue of $154,000,000 an increase of 13% year over year. As mentioned, this was the strongest quarter of net patient census Since the Q4 of 2021, our diabetes revenue was up 2% over the prior year. The 13% year over year increase in CGM patient census was just enough to offset the expected decline in pump and pump supply orders. Speaker 200:12:25Further, the strength in our government census helped offset the channel mix pressures in our commercial business, which strengthens our foundation for future growth. As we look forward to the second half of the year, we anticipate 3rd quarter year over year growth to be in line with the 2nd quarter and the 4th quarter could be somewhat higher. Our adjusted EBITDA was $171,000,000 in the quarter, an increase of 14% compared to a year ago. This reflects an adjusted EBITDA margin of 21.6%, a full point increase year over year primarily attributed to execution of our cost management program. Cash flow from operations in the Q2 was $86,300,000 As expected, Q2 CapEx was 10.4% of revenue compared to 10.6% a year ago and 12% in Q1. Speaker 200:13:20For the first half, we generated free cash flow of $54,800,000 which gives us confidence in achieving our full year goal of between 3% and 4% of revenue. Now turning to the balance sheet, we ended the 2nd quarter with $45,100,000 in cash. DSOs of 41.2 days are trending in the right direction compared to 45.4 days a year ago and 42.7 days last quarter. We expect DSOs to remain at this level in the second half As we fully realize the benefits of refining our revenue cycle process and investments we've made in our technology and workflow. Our net leverage ratio at the end of the quarter was 3.54 times down from 3.63 times at the end of the first quarter. Speaker 200:14:11We were very pleased with Q2 results, but there is still a gap to make up from Q1 expectations, so we are updating full year revenue and adjusted EBITDA guidance as follows. Revenue of $3,160,000,000 to $3,201,000,000 adjusted EBITDA of 650,000,000 to $680,000,000 We are maintaining our expectations for total CapEx between 10% 12% of revenue and free cash flow between 3% 4% of revenue. I would like to provide a little insight into the assumptions that support our guidance. We expect Q3 revenue to increase just in over 5.0 percent year over year. Keep in mind that Q3 2022 is a tougher comparable period as the TAP equipment supply chain eased considerably in the second half of twenty twenty two. Speaker 200:15:03We expect Q3 adjusted EBITDA margin to be in line with Q2. In terms of free cash flow, We continue to expect the Q3 to contribute modestly and the rest of our projected free cash flow will come in the 4th quarter. We are making steady progress and we're pleased with where we stand today. We look forward to providing updates on our operational improvements and our Humana agreement as it ramps up in the second half of the year. With that, we will open the call for questions. Speaker 200:15:34Operator? Operator00:15:36Thank And our first question will come from Brian Tanquilut with Jefferies. Your line is open. Speaker 300:16:02Hey, good morning guys. Congrats on the quarter. And Jason, thank you for all the color and the guidance. So maybe as we look Past kind of like the normalization trend that we're hopefully seeing through the rest of the year, how are you guys thinking about What the normalized growth rate should be for the diabetes business as all the moving parts click with the shift to government and The what do you call it, the channel shift within commercial as well? Speaker 200:16:31Sure, Brian. Good morning. And operator, a few points of context. So first, if you look back to our Capital Markets Day last September, our view was that by 2025, Our diabetes product line would be delivering mid to upper single digit growth, and we still think that's true. Now the path that we estimated back then versus today is a different one. Speaker 200:16:57We saw growth gliding down From mid teens to low teens to kind of that final resting place, if you will. And in fact, what we're seeing is Trends and headwinds face us just sooner than we expected. I mean, pumps Has been a continued pressure point, also a big opportunity we think going forward, but a big pressure point with the OP5 release With their Tubeless technology, we estimated that this would be a $9,000,000 to $10,000,000 a quarter headwind Over the course of 2023 as compared to prior year, we saw that in Q1. We again saw that in Q2. Spot on at that level, and we believe that will continue for the course of the year. Speaker 200:17:44So what we're guiding is Our view that we will grow through that with modest low single digit Growth on each quarter for the balance of the year. We think we'll add a couple of points in 2024 And then move back to that longer term growth rate as the opportunities in front of us that we capitalize on them. Speaker 300:18:12All right, got it. And then as we think about the likely return of Phillips potentially in the market in the next a few months or so, how are you thinking about what that could do as I think about maybe 2024 in terms of potential margins and just Incremental growth for the industry or even specifically for Adapt? Speaker 200:18:35Sure, Brian. I'll take the second part first. The reentry of Philips to the marketplace, I think, would be welcomed by all market participants, I think, by providers, By distributors, by patients, if when they come back, we believe they will. But we continue to think it's up to 6 months after the estimates that are out there in the street. So we're in other words, we're not counting on it. Speaker 200:19:06In terms of margins or growth, we're at a point today that our supply chain is healthy. I mean, we're getting the We need when we need it to get on our patients with the consistent demand that we've seen in the sleep business. And we don't think that more product really changes that. Now you can get into price and will that drive change within price? I mean, we think it's logical to think so, but we'll have to let that play out once there's more availability on market and we'll enter those negotiations With the PAP manufacturers that we want to enter with. Speaker 300:19:45Got it. Jason, if I may squeeze one last quick question. Just any way we should be thinking The Humana contract, obviously, big headline, big contract, big client, but how should we be thinking about the benefit of that? And I know you said there'll be in the P and L beginning in the back Half the year, but just as a whole, just to put some context around the contract? Thanks. Speaker 200:20:04Sure. Sure. So we're very excited to be Already rolling in our new Humana relationship. Again, it's over a 1000000 patients that have come online that we're managing Their DME needs across the product lines of sleep, respiratory and HME. It excludes the diabetes product line and the supplies to the home product line. Speaker 200:20:30I think there's opportunity there in the future, but this contract excludes So when we report Q3, we should expect to see sequential growth in those three categories. I mean that's where the growth will come for these Humana patients. It's early. We're working through conversions, a heavy lift that we're integrating at the moment. So we're going to be very cautious on specific number expectations the contract, but it is all fully baked inside of our guidance that we refreshed this morning. Speaker 300:21:04Awesome. Thank you. Operator00:21:07Thank you. Our next question will come from Eric Coldwell with Baird. Your line is open. Speaker 400:21:15Thanks very much. Good morning. So on just one quick one on Humana and then I have another Set of questions. On the equipment buy ins, if you will, what is the thought process? You maintained your cash flow, so I'm assuming it's not a big deal, but what is the outlook for needing to go out and acquire equipment for the onboarding of the Humana patients? Speaker 400:21:41And I have a follow-up. Thanks. Speaker 200:21:44Sure. Good question, Eric. So, yes, I'd first note that our CapEx as a percent of revenue quarter was within our expectations. We reported 10.4% of revenue. That's actually down a couple of bps over the Q2 of last year. Speaker 200:22:03And as expected, it's down considerably from Q1, when we had reported Our intention to load up on PAP, on respiratory, on other patient equipment. Some of that was invested to go after what we see as a very large and growing sleep market and to continue winning share. We believe we had, as Richard mentioned. And then secondly, was in preparation for this agreement. We're confident that the revenue that will come online with Humana, that it won't the profile of that terms of the CapEx need, we'll be consistent with the rest of the business. Speaker 200:22:48So, in other words, we believe that our 11% midpoint for CapEx, That we feel very good hitting at or below that number for the year. Speaker 400:22:59Got it. Thank you. My other question was about another initiative that Jason you've had internally, which is as you've gone through System upgrades and consolidation of various activities in the company over the last couple of years. One area that I believe was still a bit behind was the processes, people, paper, manual activities going on in your warehouses. And I know you had an to improve your automation and process. Speaker 400:23:38So, I'm curious if you can give us a status check on where you are with that and what's left to come. Thanks. Speaker 200:23:45Sure, Eric. So, we're happy to report we went live last Tuesday. So, this is a full integration with Oracle Cloud and The hardware and tech and the warehouses that comes with it to create a full warehouse management system. We've had great success. Of course, you're running the daily issues, loans and everything else you'd expect that come with these implementations. Speaker 200:24:06But what's really exciting is the data We've now got at our fingertips on for each warehouse worker the number of picks they're running per hour and per day. We know specifically what they're picking. We know specifically what's patient returns, what's coming back across our entire diabetes platform. So it's only been a week, but it's been good week. We are targeting a handful of important sites Within the H and B portfolio in Texas that we're aiming to go live early Q4 and that work is underway. Speaker 200:24:47The way to think about this from an efficiency standpoint, the AI embedded in Oracle on mins and maxes and ordering thresholds Based on your demand plan, that is all in process of getting turned on, eliminating more than a fair amount of cost there, As well as squeezing the inventory that's on the balance sheet, you'll note a tick down in our inventory. We are charging our teams to continue to Focus on running turns faster and getting cash out of the balance sheet. And so we'll report more to come on that. Finally, The ability to fully integrate and consolidate these sites is now unlocked. We've taken out a lot of locations as part of our management program that I'm sure we'll talk about later over the course of 2023, but this really gives us an ability to unlock That value, now that we've got the technology turned on. Speaker 200:25:44So, in terms of returns or more cash, Changes to our free cash flow estimates. Think of this as 2024 money, if you will. So we're spending the money this year to get the technology installed. But we do believe that our free cash generating power is going to increase as part of these efforts. Speaker 400:26:06Thank you very much. Appreciate the answers. Operator00:26:10Thank you. Our next question will come from Matthew Blackman with Stifel, your line is open. Speaker 500:26:17Good morning, everybody. Thanks for taking my questions. I've got 2 maybe to start on diabetes. Hey, so just hoping for any insight you may have specifically on CGM volume trends in particular with basal coverage now. Have you seen any step Up in patient adoption post reimbursement. Speaker 500:26:36And I guess a follow-up there, I think I heard you say 77% government payer In CGM now, what's the reasonable ceiling for that metric? And then I've got one guidance follow-up. Speaker 200:26:48Sure, Matt. Reasonable ceiling, I don't know, probably halfway from here to 100, could be reasonable. I'd say In terms of CGMs in general, I'd say that we're very happy with the census growth. In this quarter, we hit a record census Volume for diabetes and for CGM. Of course, our government book is growing faster. Speaker 200:27:20That's quite intentional, As Richard described in the opening remarks, harnessing the power of our 700 person strong sales force across the country To sell all products. I mean, that sounds easier than it is in terms of Training, enabling, equipping, it's a different sale, different sales cycle. But our teams are continuing to grow The cross sell. And again, that cross sell is pointed directly at the government business, which we think is for us is Good business. It's strong. Speaker 200:27:54It's healthy. And it's to your Basil comment, it is growing. I think like DexCom, it's early. We won't put the numbers on It's just very, very early. We do think that TAM is somewhere between 3,000,000 and up to 4,000,000 patients Of basal patients, we agree Medicare is open for it and the commercials are well over 50% adoption there. Speaker 200:28:20But it's really early innings and we haven't nor will we include any expectations on Basel in our guide for 2023. Speaker 500:28:30All right. I appreciate that. And then just as we reflect the new revenue guidance in our models, how should we think about which segments Revenues should move lower and is it isolated to any in particular? Or is it sort of broad based? Just any help on so, the segments? Speaker 200:28:46Yes, sure, Matt. So, across the product categories, I'd say firstly in diabetes, so very modest growth in Q2 at 2%. We think that's about in line in Q3. We're hopeful it's up a touch. Could it be a point? Speaker 200:29:02Could it be 2 maybe in Q4? That's what we're thinking. If you look at Supplies to the Home, You'll see that year over year growth has been low to mid teens each quarter now for 4 quarters. The reason for that was the value based arrangements that Josh executed and spoke about Speaker 600:29:23a year Speaker 200:29:23ago. Now as we enter Q3, we are lapping those arrangements and so expect supplies to the home to come back down to very low single digit growth rate. Could it be 2? Could it be 3 in that ballpark? And then thirdly, I'd note on the HME book of business, as we've reported previously, we have changed sales incentive to focus on ePrescribe, ordering that is absolutely working as our ePrescribe is up Pretty considerably in DME. Speaker 200:29:56And with that comes just cleaner orders, cleaner claims, Better margins in terms of processing and servicing. So that will give you a perspective on some of the lower growers, If you will, and then you're rounded out by continued performance, we think, in sleep and respiratory to round out the rest. Speaker 500:30:17Really helpful. Thank you so much. Operator00:30:21Thank you. Our next question will come from Peter Chickering with Deutsche Bank. Your line is open. Speaker 600:30:30Hi there, guys. You've got Kieran Ryan on for PETA. Thanks for taking the question. Another solid quarter on the Sleep side. I was just wondering, are you still seeing any of those issues on kind of the new start Logistics side, that it kind of limited the new starts despite record backlog or is that starting to work itself out at this point. Speaker 200:30:55Yes, good question. It has not just started work itself out, but we're feeling very good about the movement of product. I'd tell you in the summertime, I mean, as usual, Set ups are a bit soft, folks on vacation, providers on vacation, holidays, things like that. So, nothing out of the ordinary obviously, Speaker 300:31:24you came in Speaker 600:31:24nicely ahead of your expectations. Obviously, you came in nicely ahead of your expectations. I think in 1Q when you kind of guided to that just under 20%, You said that, that does that did include the benefits from the cost savings program. So should we just read the upside As being pretty much purely related to the rebound in diabetes there? Speaker 200:31:51I wouldn't say that the margin improvement is due to the pure diabetes rebound. I mean, keep in mind, the diabetes product The lowest margins across the product catalog, as we've reported several times. Really what we're seeing is the strength in sleep and respiratory. I mean those products together represent almost 2 thirds of our business and They're performing well. They're healthy. Speaker 200:32:21It's all systems go and that's really helping the margin improvement with addition of the cost management Operator00:32:36Our next question comes from Joanna Stoyuk with Bank of America. Your line is open. Speaker 700:32:44Good morning. Thanks so much for taking the question here. So I guess first on the Humana contract. So I know it's early, right? It just started A little bit more than a month ago, July 1. Speaker 700:32:56But can you talk about how progress has been in terms of the transitions and Of the 1,000,000 patients you're talking about, are these the vast majority are new? And also with that, do you need additional infrastructure to support this Contract, trying to get a sense of the margin profile of that business versus your Speaker 200:33:26Sure. Investments that we've made, it was important to us upon entering This new arrangement, this new relationship with Humana to really over club it and invest in the customer service aspect, We've done that. We've stood up a dedicated onshore call center Specific for these Humana patients, we have doubled down within our sales force. I mean, the number Referral points that this arrangement opens up is considerable, but Lots of new referral points that frankly we haven't heard a referral from in some cases ever or in other cases in a very long time. And That's taking resource to crack open those doors and to start taking care of in those provider groups. Speaker 200:34:30So that's really on the In terms of the infrastructure side, I'd say, again, on CapEx, we discussed earlier, I think, with Harrick that We're comfortable with our CapEx projections, with our utilization projections in terms of servicing the contract. And then really it's all about, again, that high touch, taking care of patients, Reporting new SLAs to Humana around operational metrics turnaround times and such, patient satisfaction is just paramount here. Of That helps the MA payers as you know with a variety of things including reimbursement to get those patient satisfaction scores Up and that's what we're focused on doing. Speaker 700:35:17And if I may, I guess related question on the diabetes, right? So you're talking about The shift to the government business and it is lower rate in commercial. So I assume a lower margin right there. How should we think about this business going forward in terms of the margin profile? You just said it's traditionally been below Other products in your portfolio? Speaker 700:35:43And then, will you adjust cost structure for the change? Or I guess if that's part of the program that you had already announced in terms of the cost savings and in response to those changes in the diabetes business? Speaker 200:35:59Yes, that's right, Joanna. There are some intermediate term, less than 12 months Cost management focuses that the technology is enabling. Of course, we'll be happy to execute on that and increase margin profile. I'd say in general, the government book of business has been large at Adapt since we started In diabetes. Some of that was just the nature of the businesses we bought and their profiles focused heavily within the Type 2 Diabetes space, I'm sorry, the Type 1, I'm mixing up the Type 1 diabetes space, which we all know It's very heavily concentrated with DexCom products. Speaker 200:36:44The Type 2 space we are growing, Again, through our primary care sales force, the DME sales people that we've retrained and enabled to go We do expect to continue growth of what's already a very large government book of business and we're thrilled to take that We're very pleased with the money and particularly with the free cash flow that those businesses generate for us. And so, margins in very good shape. This is more about growing through the pump headwinds That we've reported as well as growing through the payer mix trends that again we've reported. I mean is our plan to take in growth through these things and if we execute, margin will be just fine. Speaker 700:37:37Thank you. And if I may, just for the last follow-up, since you mentioned the government business and you've been, I guess, exposed to that in other parts of The portfolio, so just quickly outlook for Medicare rates and anticipated competitive bidding and what the expectations are there, I CMS put the program on pause when it comes to competitive bidding. But are you expecting any announcement later this year For 2025 competitive bidding and any kind of views in terms of new categories that will be included in there? Thank you. Speaker 200:38:11Yes. Good question, Joanna. As you said, CMS formally Postpone competitive bidding. We don't believe that competitive bid will go away forever. Frankly, Adapt has benefited from these programs over the year. Speaker 200:38:30We think patients and providers and certainly the taxpayers I have benefited from these programs. So we don't think that it will go away. Timing is very hard to predict on this. I Some context might be just the complexity in running the program. I mean, you've got hundreds and hundreds of MSAs over the country with thousands and thousands of products. Speaker 200:38:55And what we believe is between 5,000 and 6,000 Remaining providers in the space, the DME companies in the space, they'll accept essentially 10 bids, Many more will bid and so it's a big calculator down at CMS, I guess, that runs all the data through. But that administrative side is not a fast or easy process. And so in order to meet a 2025 Go live, if you will, for another competitive bid program. Things need to get rolling In terms of the bidding process and everything else. So that's more context. Speaker 200:39:38I mean, we won't speculate on what will happen next, But we think we position our business well regardless. Operator00:39:50Thank you. And our next question will come from Kevin Caliendo with UBS. Your line is open. Speaker 800:40:03Thanks. Thanks for taking my question. Richard, I want to ask what We're a month away from Crispin coming in and taking over as CEO. Maybe give us a little bit on the process and Chris, Vince's background and sort of what you expect him to bring to the table when he starts in a month? Speaker 100:40:28Kevin, thanks. Obviously, from Christmas background, it brings a great deal of in the businesses that we are in and we felt that it was very important to bring someone in Who could hit the ground running to just help us get to be a better company blocking, tackling, Administrative, we're doing a lot of great things. He can help us further those. He's financially oriented. He came up through finance In his prior organization and we expect that he will tighten down or even greatly improve financial Processes over the next several months, which really it's really a hire to make us a better company. Speaker 800:41:16Do you think there's an opportunity with him in place to take share? Obviously, he was running one of your competitors. Yes. A lot of those relationships are at the personal level. Is that an opportunity set? Speaker 800:41:32Is that something we should The contemplating or is this coming in and this is more about executing Xs and Os and the like? Speaker 100:41:40Yes, it's been executing the Xs and Os In our business, we are very respectful of Crispin's Prior employment and will not do anything to jeopardize anything that he has ever done in that company from a confidentiality perspective. So we have On the greater side of caution there, but what we do expect It's for him to help us be a better company. Speaker 800:42:12Fair enough. That's super helpful. Thank you. Operator00:42:16Thank you. And at this time, there are no further questions in the queue. So I'd like to turn it back over to management for any additional or closing remarks. Speaker 100:42:28Thanks everyone for joining the call this morning. We look forward to Talking to many of you to give you even some more detail on what was a very, very positive and encouraging quarter for Adapt Health. Thank you very much. Operator00:42:42Thank you, ladies and gentlemen. This does conclude today's program and we appreciate your participation. You may disconnect at any time.Read morePowered by Conference Call Audio Live Call not available Earnings Conference CallAdaptHealth Q2 202300:00 / 00:00Speed:1x1.25x1.5x2x Earnings DocumentsSlide DeckPress Release(8-K)Quarterly report(10-Q) AdaptHealth Earnings HeadlinesQ1 Earnings Highs And Lows: AdaptHealth (NASDAQ:AHCO) Vs The Rest Of The Senior Health, Home Health & Hospice StocksMay 8 at 6:53 AM | msn.comEarnings call transcript: Adapthealth Q1 2025 misses EPS forecast, stock risesMay 7 at 8:51 PM | investing.comAltucher: Turn $900 into $108,000 in just 12 months?We are entering the final Trump Bump of our lives. But the biggest returns will not be in the stock market.May 8, 2025 | Paradigm Press (Ad)AdaptHealth Corp. (NASDAQ:AHCO) Q1 2025 Earnings Call TranscriptMay 7 at 3:27 PM | msn.comAdaptHealth Corp. (AHCO) Q1 2025 Earnings Call TranscriptMay 6 at 5:38 PM | seekingalpha.comAdaptHealth (NASDAQ:AHCO) Posts Better-Than-Expected Sales In Q1, Stock Jumps 13.2%May 6 at 5:38 PM | finance.yahoo.comSee More AdaptHealth Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like AdaptHealth? Sign up for Earnings360's daily newsletter to receive timely earnings updates on AdaptHealth and other key companies, straight to your email. Email Address About AdaptHealthAdaptHealth (NASDAQ:AHCO), together with its subsidiaries, sells home medical equipment (HME), medical supplies, and home and related services in the United States. The company provides sleep therapy equipment, supplies, and related services, such as CPAP and bi-PAP services to individuals suffering from obstructive sleep apnea; medical devices and supplies, including continuous glucose monitors and insulin pumps for the treatment of diabetes; HME to patients discharged from acute care and other facilities; oxygen and related chronic therapy services in the home; and other HME devices and supplies on behalf of chronically ill patients with wound care, urological, incontinence, ostomy, and nutritional supply needs. It also offers wheelchairs, hospital beds, oxygen concentrators, CPAP masks and related supplies, wound care supplies, diabetes management supplies, wheelchair cushion accessories, orthopedic bracing, breast pumps and supplies, walkers, commodes and canes, and nutritional and incontinence supplies. The company services beneficiaries of Medicare, Medicaid, and commercial insurance payors. The company is headquartered in Plymouth Meeting, Pennsylvania.View AdaptHealth ProfileRead more More Earnings Resources from MarketBeat Earnings Tools Today's Earnings Tomorrow's Earnings Next Week's Earnings Upcoming Earnings Calls Earnings Newsletter Earnings Call Transcripts Earnings Beats & Misses Corporate Guidance Earnings Screener Earnings By Country U.S. Earnings Reports Canadian Earnings Reports U.K. Earnings Reports Latest Articles Upwork's Earnings Beat Fuels Stock Rally—Is Freelancing Booming?DexCom Stock: Earnings Beat and New Market Access Drive Bull CaseDisney Stock Jumps on Earnings—Is the Magic Sustainable?Uber’s Earnings Offer Clues on the Stock and Broader EconomyArcher Stock Eyes Q1 Earnings After UAE UpdatesFord Motor Stock Rises After Earnings, But Momentum May Not Last Broadcom Stock Gets a Lift on Hyperscaler Earnings & CapEx Boost Upcoming Earnings Enbridge (5/9/2025)Petróleo Brasileiro S.A. - Petrobras (5/12/2025)Simon Property Group (5/12/2025)JD.com (5/13/2025)NU (5/13/2025)Sony Group (5/13/2025)SEA (5/13/2025)Cisco Systems (5/14/2025)Toyota Motor (5/14/2025)NetEase (5/15/2025) Get 30 Days of MarketBeat All Access for Free Sign up for MarketBeat All Access to gain access to MarketBeat's full suite of research tools. 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There are 9 speakers on the call. Operator00:00:00Good day, everyone, and welcome to today's AdaptHealth Second Quarter 2023 Earnings Release. At this time, all participants are on a listen only mode. Later, you will have the opportunity to ask questions during the question and answer session. Today's speakers will be Richard Barish, Chairman and Interim CEO of Adapt Health and Jason Clemens, Chief Financial Officer of Adapt Health. Josh Parnas, President of Adapt Health will join Richard and Jason for the question and answer portion of this call. Operator00:00:40Before 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 2023 and beyond. Actual results could differ materially from those projected in forward looking statements because of a number of risks and factors and uncertainties, which are discussed at length in the company's annual and quarterly SEC filings. AdaptHealth Corp. Should have no obligation to update the information provided on this call to reflect such subsequent events. Operator00:01:24Additionally, on this morning's call, the company will reference certain financial measures such as EBITDA, adjusted EBITDA and free cash flow, all of which are non GAAP financial measures. This morning's call is being recorded and a replay of the call will be available later today. I'm now pleased to introduce the Chairman and Interim CEO of AdaptHealth, Richard Barish. Sir? Speaker 100:01:52Good morning, everyone. Thank you for joining us today to discuss Adapt Health's 2nd quarter performance. To start our call today, I'd like to take a moment to welcome Crispin Teufel, who will be joining Adapt Health on September 1st As our new Chief Executive Officer, Christmann brings many years of industry experience and a deep understanding of the markets in which we operate. His expertise and proven track record will be key to this organization's future success. We're excited to get him on board I look forward to you getting the chance to meet with him in the coming months. Speaker 100:02:32Adapt Health is a full service Nationwide provider of products and services that enable our patients to live their healthiest lives at home and in the community. We have nearly 11,000 employees, including nearly 1,000 healthcare professionals who work to bring these needed products for approximately 4,000,000 patients. We know that we are crucial in the healthcare continuum, especially for post acute care And management of chronic diseases like diabetes, OSA and COPD. Most of our devices are connected and generate lots of useful data to help manage these chronic conditions and reduce downstream costs. We are now in the process of figuring out how best to use that connectivity for the benefit of our patients and our payer partners. Speaker 100:03:27Turning now to the details of the quarter, I'm pleased to report solid second quarter results driven by and successful execution of cost savings initiatives. Most notably, We're also quite pleased with our improved cash flow generation in the first half of the year. The highlight of the quarter was continued growth in our sleep and respiratory product lines, which represent more than half of our total revenue. Building on the robust first quarter, these products grew a combined 15% year over year in the second quarter. Drilling down, the performance in our Sleep business was driven by strong market demand, both new starts and resupply as well as our improved ability to service this demand more efficiently. Speaker 100:04:36The investments we've made in this business line over the past year are now Paying off. We have enough equipment on hand to satisfy demand and we've improved our processes in new starts, especially in resupply, an area of great strength for Adapt Health. Industry data shows that we are the clear leader in sleep and have gained market share over the past year. Our respiratory line of business At its strongest patient acquisition quarter since the Q4 of 2021, we hit our setup expectations And we're starting to see stabilization in the length of time patients are on oxygen events, which had decreased during the pandemic. Now turning to diabetes. Speaker 100:05:25After a very disappointing Q1, we saw a modest rebound in our diabetes business in the 2nd quarter. We acknowledge that we did not react swiftly enough to changing market dynamics and are committed to resuming growth in this crucial market. Over the past 3 months, we've done a deep dive into all aspects of our diabetes business and have emerged with a solid plan To achieve results that reflect a growing market for diabetes supplies, especially CGMs and pumps. This plan Building on our existing patient census, which is the highest in our history gives us a solid foundation upon which to grow. I'm going to highlight 2 specific areas of focus in our plan to regain our momentum. Speaker 100:06:13First, we are going to be even more intentional The focus on our government business with the market for CGMs and pumps is large and growing. We're encouraged by recent decisions by Medicare and other government payers to widen their coverage of CGMs as a result of the emphasis On the medical benefits of compliance, the government market is growing rapidly and we are generally able to achieve pricing It takes into account inflationary pressures. We've emphasized to our vibrant sales force the importance of government business And I've already seen meaningful impact. Government sponsored payers now represent 77% of our CGM census, an increase of 900 basis points compared to last year and up 200 basis points from the Q1. We anticipate this trend will continue over the course of the year. Speaker 100:07:13As to the commercial business, we plan to update contracts to enable us to increase access to our current and new CGM patients, including through the pharmacy channel. We see this as an essential part of the strategy to offer full and creative solutions for our payer partners and patients. Next, we are employing the scale and capability of the entire AdaptHealth team to rapidly improve the operations of our diabetes business. One example is creating synergy Between the HME and diabetes sales forces, take advantage of HME's national reach. Another is to use our world class HME resupply operation to make it easier and more efficient For our diabetes patients to get their supplies including through digital reordering. Speaker 100:08:10The diabetes line of business is crucial to the growth and strategic success of Adapt Health. Sadly, diabetes continues to grow rapidly in our population and we intend to expand our reach and services to help our patients manage this chronic disease. More to come on this important topic in future reports. Subsequent to our earnings call in May, we announced a relationship with Humana to become the value based provider of home medical equipment and supplies to their Medicare Advantage HMO members in 33 states plus the District of Columbia. The program began on July 1, 2023 and we are working hard on the implementation of this transformative arrangement. Speaker 100:09:01Based on our patient focused culture, we've committed to high levels of customer service, which is a sign of the alignment that we've established with Humana. This value based contract marks a significant step toward highlighting our essential role in keeping our patients healthy in their homes. We think this is an important new area of focus for Adapt Health and we intend to pursue other similar arrangements. Like most businesses, we've been affected by increased labor and other costs. We are actively mitigating inflationary factors in several ways. Speaker 100:09:42First, as we have done in the past, We are continuing to add and refine technology that reduces the costly administrative friction between our prescribers, Patients and payers. Among the most important KPIs we review each week is the percentage of e prescribed orders that we process, which has grown meaningfully over the past year. Another tangible result of technology and process improvement is in our RCM function, which as Jason will describe has led to significantly reduced DSOs and better collections. Building on these technology improvements, are also focused on additional cost saving opportunities. As you know, we were an active acquirer in prior years We are now focused on achieving the scale of a much larger business. Speaker 100:10:35As a result of this effort, we are confident That we will achieve the previously announced target of $25,000,000 in cost savings and we're continuing to examine our operations for areas of further improvement. Speaker 200:10:51I'll now turn the call over to Jason Clemens, our CFO, To review the Q2 financials and full year guidance, Jason? Thank you, Richard, and thanks to all for joining our call today. I want to reiterate Richard's sentiment about the strength in our core product lines and the opportunities ahead of us in diabetes. Let me begin by reviewing our 2nd quarter results. Our revenue of $793,300,000 increased 9.0 percent and our non acquired revenue increased 8.7 Our 2nd quarter results were led by strength in our sleep and respiratory product categories, both of which were up double digits. Speaker 200:11:33Taking a closer look at each of these product categories, our total sleep revenue of $303,000,000 increased 16% compared to a year ago, driven by PAP equipment setups and consistent resupply operations. Our PAP equipment patient census grew 41% Year on year and our resupply orders are up 11%. Respiratory delivered another strong quarter with Revenue of $154,000,000 an increase of 13% year over year. As mentioned, this was the strongest quarter of net patient census Since the Q4 of 2021, our diabetes revenue was up 2% over the prior year. The 13% year over year increase in CGM patient census was just enough to offset the expected decline in pump and pump supply orders. Speaker 200:12:25Further, the strength in our government census helped offset the channel mix pressures in our commercial business, which strengthens our foundation for future growth. As we look forward to the second half of the year, we anticipate 3rd quarter year over year growth to be in line with the 2nd quarter and the 4th quarter could be somewhat higher. Our adjusted EBITDA was $171,000,000 in the quarter, an increase of 14% compared to a year ago. This reflects an adjusted EBITDA margin of 21.6%, a full point increase year over year primarily attributed to execution of our cost management program. Cash flow from operations in the Q2 was $86,300,000 As expected, Q2 CapEx was 10.4% of revenue compared to 10.6% a year ago and 12% in Q1. Speaker 200:13:20For the first half, we generated free cash flow of $54,800,000 which gives us confidence in achieving our full year goal of between 3% and 4% of revenue. Now turning to the balance sheet, we ended the 2nd quarter with $45,100,000 in cash. DSOs of 41.2 days are trending in the right direction compared to 45.4 days a year ago and 42.7 days last quarter. We expect DSOs to remain at this level in the second half As we fully realize the benefits of refining our revenue cycle process and investments we've made in our technology and workflow. Our net leverage ratio at the end of the quarter was 3.54 times down from 3.63 times at the end of the first quarter. Speaker 200:14:11We were very pleased with Q2 results, but there is still a gap to make up from Q1 expectations, so we are updating full year revenue and adjusted EBITDA guidance as follows. Revenue of $3,160,000,000 to $3,201,000,000 adjusted EBITDA of 650,000,000 to $680,000,000 We are maintaining our expectations for total CapEx between 10% 12% of revenue and free cash flow between 3% 4% of revenue. I would like to provide a little insight into the assumptions that support our guidance. We expect Q3 revenue to increase just in over 5.0 percent year over year. Keep in mind that Q3 2022 is a tougher comparable period as the TAP equipment supply chain eased considerably in the second half of twenty twenty two. Speaker 200:15:03We expect Q3 adjusted EBITDA margin to be in line with Q2. In terms of free cash flow, We continue to expect the Q3 to contribute modestly and the rest of our projected free cash flow will come in the 4th quarter. We are making steady progress and we're pleased with where we stand today. We look forward to providing updates on our operational improvements and our Humana agreement as it ramps up in the second half of the year. With that, we will open the call for questions. Speaker 200:15:34Operator? Operator00:15:36Thank And our first question will come from Brian Tanquilut with Jefferies. Your line is open. Speaker 300:16:02Hey, good morning guys. Congrats on the quarter. And Jason, thank you for all the color and the guidance. So maybe as we look Past kind of like the normalization trend that we're hopefully seeing through the rest of the year, how are you guys thinking about What the normalized growth rate should be for the diabetes business as all the moving parts click with the shift to government and The what do you call it, the channel shift within commercial as well? Speaker 200:16:31Sure, Brian. Good morning. And operator, a few points of context. So first, if you look back to our Capital Markets Day last September, our view was that by 2025, Our diabetes product line would be delivering mid to upper single digit growth, and we still think that's true. Now the path that we estimated back then versus today is a different one. Speaker 200:16:57We saw growth gliding down From mid teens to low teens to kind of that final resting place, if you will. And in fact, what we're seeing is Trends and headwinds face us just sooner than we expected. I mean, pumps Has been a continued pressure point, also a big opportunity we think going forward, but a big pressure point with the OP5 release With their Tubeless technology, we estimated that this would be a $9,000,000 to $10,000,000 a quarter headwind Over the course of 2023 as compared to prior year, we saw that in Q1. We again saw that in Q2. Spot on at that level, and we believe that will continue for the course of the year. Speaker 200:17:44So what we're guiding is Our view that we will grow through that with modest low single digit Growth on each quarter for the balance of the year. We think we'll add a couple of points in 2024 And then move back to that longer term growth rate as the opportunities in front of us that we capitalize on them. Speaker 300:18:12All right, got it. And then as we think about the likely return of Phillips potentially in the market in the next a few months or so, how are you thinking about what that could do as I think about maybe 2024 in terms of potential margins and just Incremental growth for the industry or even specifically for Adapt? Speaker 200:18:35Sure, Brian. I'll take the second part first. The reentry of Philips to the marketplace, I think, would be welcomed by all market participants, I think, by providers, By distributors, by patients, if when they come back, we believe they will. But we continue to think it's up to 6 months after the estimates that are out there in the street. So we're in other words, we're not counting on it. Speaker 200:19:06In terms of margins or growth, we're at a point today that our supply chain is healthy. I mean, we're getting the We need when we need it to get on our patients with the consistent demand that we've seen in the sleep business. And we don't think that more product really changes that. Now you can get into price and will that drive change within price? I mean, we think it's logical to think so, but we'll have to let that play out once there's more availability on market and we'll enter those negotiations With the PAP manufacturers that we want to enter with. Speaker 300:19:45Got it. Jason, if I may squeeze one last quick question. Just any way we should be thinking The Humana contract, obviously, big headline, big contract, big client, but how should we be thinking about the benefit of that? And I know you said there'll be in the P and L beginning in the back Half the year, but just as a whole, just to put some context around the contract? Thanks. Speaker 200:20:04Sure. Sure. So we're very excited to be Already rolling in our new Humana relationship. Again, it's over a 1000000 patients that have come online that we're managing Their DME needs across the product lines of sleep, respiratory and HME. It excludes the diabetes product line and the supplies to the home product line. Speaker 200:20:30I think there's opportunity there in the future, but this contract excludes So when we report Q3, we should expect to see sequential growth in those three categories. I mean that's where the growth will come for these Humana patients. It's early. We're working through conversions, a heavy lift that we're integrating at the moment. So we're going to be very cautious on specific number expectations the contract, but it is all fully baked inside of our guidance that we refreshed this morning. Speaker 300:21:04Awesome. Thank you. Operator00:21:07Thank you. Our next question will come from Eric Coldwell with Baird. Your line is open. Speaker 400:21:15Thanks very much. Good morning. So on just one quick one on Humana and then I have another Set of questions. On the equipment buy ins, if you will, what is the thought process? You maintained your cash flow, so I'm assuming it's not a big deal, but what is the outlook for needing to go out and acquire equipment for the onboarding of the Humana patients? Speaker 400:21:41And I have a follow-up. Thanks. Speaker 200:21:44Sure. Good question, Eric. So, yes, I'd first note that our CapEx as a percent of revenue quarter was within our expectations. We reported 10.4% of revenue. That's actually down a couple of bps over the Q2 of last year. Speaker 200:22:03And as expected, it's down considerably from Q1, when we had reported Our intention to load up on PAP, on respiratory, on other patient equipment. Some of that was invested to go after what we see as a very large and growing sleep market and to continue winning share. We believe we had, as Richard mentioned. And then secondly, was in preparation for this agreement. We're confident that the revenue that will come online with Humana, that it won't the profile of that terms of the CapEx need, we'll be consistent with the rest of the business. Speaker 200:22:48So, in other words, we believe that our 11% midpoint for CapEx, That we feel very good hitting at or below that number for the year. Speaker 400:22:59Got it. Thank you. My other question was about another initiative that Jason you've had internally, which is as you've gone through System upgrades and consolidation of various activities in the company over the last couple of years. One area that I believe was still a bit behind was the processes, people, paper, manual activities going on in your warehouses. And I know you had an to improve your automation and process. Speaker 400:23:38So, I'm curious if you can give us a status check on where you are with that and what's left to come. Thanks. Speaker 200:23:45Sure, Eric. So, we're happy to report we went live last Tuesday. So, this is a full integration with Oracle Cloud and The hardware and tech and the warehouses that comes with it to create a full warehouse management system. We've had great success. Of course, you're running the daily issues, loans and everything else you'd expect that come with these implementations. Speaker 200:24:06But what's really exciting is the data We've now got at our fingertips on for each warehouse worker the number of picks they're running per hour and per day. We know specifically what they're picking. We know specifically what's patient returns, what's coming back across our entire diabetes platform. So it's only been a week, but it's been good week. We are targeting a handful of important sites Within the H and B portfolio in Texas that we're aiming to go live early Q4 and that work is underway. Speaker 200:24:47The way to think about this from an efficiency standpoint, the AI embedded in Oracle on mins and maxes and ordering thresholds Based on your demand plan, that is all in process of getting turned on, eliminating more than a fair amount of cost there, As well as squeezing the inventory that's on the balance sheet, you'll note a tick down in our inventory. We are charging our teams to continue to Focus on running turns faster and getting cash out of the balance sheet. And so we'll report more to come on that. Finally, The ability to fully integrate and consolidate these sites is now unlocked. We've taken out a lot of locations as part of our management program that I'm sure we'll talk about later over the course of 2023, but this really gives us an ability to unlock That value, now that we've got the technology turned on. Speaker 200:25:44So, in terms of returns or more cash, Changes to our free cash flow estimates. Think of this as 2024 money, if you will. So we're spending the money this year to get the technology installed. But we do believe that our free cash generating power is going to increase as part of these efforts. Speaker 400:26:06Thank you very much. Appreciate the answers. Operator00:26:10Thank you. Our next question will come from Matthew Blackman with Stifel, your line is open. Speaker 500:26:17Good morning, everybody. Thanks for taking my questions. I've got 2 maybe to start on diabetes. Hey, so just hoping for any insight you may have specifically on CGM volume trends in particular with basal coverage now. Have you seen any step Up in patient adoption post reimbursement. Speaker 500:26:36And I guess a follow-up there, I think I heard you say 77% government payer In CGM now, what's the reasonable ceiling for that metric? And then I've got one guidance follow-up. Speaker 200:26:48Sure, Matt. Reasonable ceiling, I don't know, probably halfway from here to 100, could be reasonable. I'd say In terms of CGMs in general, I'd say that we're very happy with the census growth. In this quarter, we hit a record census Volume for diabetes and for CGM. Of course, our government book is growing faster. Speaker 200:27:20That's quite intentional, As Richard described in the opening remarks, harnessing the power of our 700 person strong sales force across the country To sell all products. I mean, that sounds easier than it is in terms of Training, enabling, equipping, it's a different sale, different sales cycle. But our teams are continuing to grow The cross sell. And again, that cross sell is pointed directly at the government business, which we think is for us is Good business. It's strong. Speaker 200:27:54It's healthy. And it's to your Basil comment, it is growing. I think like DexCom, it's early. We won't put the numbers on It's just very, very early. We do think that TAM is somewhere between 3,000,000 and up to 4,000,000 patients Of basal patients, we agree Medicare is open for it and the commercials are well over 50% adoption there. Speaker 200:28:20But it's really early innings and we haven't nor will we include any expectations on Basel in our guide for 2023. Speaker 500:28:30All right. I appreciate that. And then just as we reflect the new revenue guidance in our models, how should we think about which segments Revenues should move lower and is it isolated to any in particular? Or is it sort of broad based? Just any help on so, the segments? Speaker 200:28:46Yes, sure, Matt. So, across the product categories, I'd say firstly in diabetes, so very modest growth in Q2 at 2%. We think that's about in line in Q3. We're hopeful it's up a touch. Could it be a point? Speaker 200:29:02Could it be 2 maybe in Q4? That's what we're thinking. If you look at Supplies to the Home, You'll see that year over year growth has been low to mid teens each quarter now for 4 quarters. The reason for that was the value based arrangements that Josh executed and spoke about Speaker 600:29:23a year Speaker 200:29:23ago. Now as we enter Q3, we are lapping those arrangements and so expect supplies to the home to come back down to very low single digit growth rate. Could it be 2? Could it be 3 in that ballpark? And then thirdly, I'd note on the HME book of business, as we've reported previously, we have changed sales incentive to focus on ePrescribe, ordering that is absolutely working as our ePrescribe is up Pretty considerably in DME. Speaker 200:29:56And with that comes just cleaner orders, cleaner claims, Better margins in terms of processing and servicing. So that will give you a perspective on some of the lower growers, If you will, and then you're rounded out by continued performance, we think, in sleep and respiratory to round out the rest. Speaker 500:30:17Really helpful. Thank you so much. Operator00:30:21Thank you. Our next question will come from Peter Chickering with Deutsche Bank. Your line is open. Speaker 600:30:30Hi there, guys. You've got Kieran Ryan on for PETA. Thanks for taking the question. Another solid quarter on the Sleep side. I was just wondering, are you still seeing any of those issues on kind of the new start Logistics side, that it kind of limited the new starts despite record backlog or is that starting to work itself out at this point. Speaker 200:30:55Yes, good question. It has not just started work itself out, but we're feeling very good about the movement of product. I'd tell you in the summertime, I mean, as usual, Set ups are a bit soft, folks on vacation, providers on vacation, holidays, things like that. So, nothing out of the ordinary obviously, Speaker 300:31:24you came in Speaker 600:31:24nicely ahead of your expectations. Obviously, you came in nicely ahead of your expectations. I think in 1Q when you kind of guided to that just under 20%, You said that, that does that did include the benefits from the cost savings program. So should we just read the upside As being pretty much purely related to the rebound in diabetes there? Speaker 200:31:51I wouldn't say that the margin improvement is due to the pure diabetes rebound. I mean, keep in mind, the diabetes product The lowest margins across the product catalog, as we've reported several times. Really what we're seeing is the strength in sleep and respiratory. I mean those products together represent almost 2 thirds of our business and They're performing well. They're healthy. Speaker 200:32:21It's all systems go and that's really helping the margin improvement with addition of the cost management Operator00:32:36Our next question comes from Joanna Stoyuk with Bank of America. Your line is open. Speaker 700:32:44Good morning. Thanks so much for taking the question here. So I guess first on the Humana contract. So I know it's early, right? It just started A little bit more than a month ago, July 1. Speaker 700:32:56But can you talk about how progress has been in terms of the transitions and Of the 1,000,000 patients you're talking about, are these the vast majority are new? And also with that, do you need additional infrastructure to support this Contract, trying to get a sense of the margin profile of that business versus your Speaker 200:33:26Sure. Investments that we've made, it was important to us upon entering This new arrangement, this new relationship with Humana to really over club it and invest in the customer service aspect, We've done that. We've stood up a dedicated onshore call center Specific for these Humana patients, we have doubled down within our sales force. I mean, the number Referral points that this arrangement opens up is considerable, but Lots of new referral points that frankly we haven't heard a referral from in some cases ever or in other cases in a very long time. And That's taking resource to crack open those doors and to start taking care of in those provider groups. Speaker 200:34:30So that's really on the In terms of the infrastructure side, I'd say, again, on CapEx, we discussed earlier, I think, with Harrick that We're comfortable with our CapEx projections, with our utilization projections in terms of servicing the contract. And then really it's all about, again, that high touch, taking care of patients, Reporting new SLAs to Humana around operational metrics turnaround times and such, patient satisfaction is just paramount here. Of That helps the MA payers as you know with a variety of things including reimbursement to get those patient satisfaction scores Up and that's what we're focused on doing. Speaker 700:35:17And if I may, I guess related question on the diabetes, right? So you're talking about The shift to the government business and it is lower rate in commercial. So I assume a lower margin right there. How should we think about this business going forward in terms of the margin profile? You just said it's traditionally been below Other products in your portfolio? Speaker 700:35:43And then, will you adjust cost structure for the change? Or I guess if that's part of the program that you had already announced in terms of the cost savings and in response to those changes in the diabetes business? Speaker 200:35:59Yes, that's right, Joanna. There are some intermediate term, less than 12 months Cost management focuses that the technology is enabling. Of course, we'll be happy to execute on that and increase margin profile. I'd say in general, the government book of business has been large at Adapt since we started In diabetes. Some of that was just the nature of the businesses we bought and their profiles focused heavily within the Type 2 Diabetes space, I'm sorry, the Type 1, I'm mixing up the Type 1 diabetes space, which we all know It's very heavily concentrated with DexCom products. Speaker 200:36:44The Type 2 space we are growing, Again, through our primary care sales force, the DME sales people that we've retrained and enabled to go We do expect to continue growth of what's already a very large government book of business and we're thrilled to take that We're very pleased with the money and particularly with the free cash flow that those businesses generate for us. And so, margins in very good shape. This is more about growing through the pump headwinds That we've reported as well as growing through the payer mix trends that again we've reported. I mean is our plan to take in growth through these things and if we execute, margin will be just fine. Speaker 700:37:37Thank you. And if I may, just for the last follow-up, since you mentioned the government business and you've been, I guess, exposed to that in other parts of The portfolio, so just quickly outlook for Medicare rates and anticipated competitive bidding and what the expectations are there, I CMS put the program on pause when it comes to competitive bidding. But are you expecting any announcement later this year For 2025 competitive bidding and any kind of views in terms of new categories that will be included in there? Thank you. Speaker 200:38:11Yes. Good question, Joanna. As you said, CMS formally Postpone competitive bidding. We don't believe that competitive bid will go away forever. Frankly, Adapt has benefited from these programs over the year. Speaker 200:38:30We think patients and providers and certainly the taxpayers I have benefited from these programs. So we don't think that it will go away. Timing is very hard to predict on this. I Some context might be just the complexity in running the program. I mean, you've got hundreds and hundreds of MSAs over the country with thousands and thousands of products. Speaker 200:38:55And what we believe is between 5,000 and 6,000 Remaining providers in the space, the DME companies in the space, they'll accept essentially 10 bids, Many more will bid and so it's a big calculator down at CMS, I guess, that runs all the data through. But that administrative side is not a fast or easy process. And so in order to meet a 2025 Go live, if you will, for another competitive bid program. Things need to get rolling In terms of the bidding process and everything else. So that's more context. Speaker 200:39:38I mean, we won't speculate on what will happen next, But we think we position our business well regardless. Operator00:39:50Thank you. And our next question will come from Kevin Caliendo with UBS. Your line is open. Speaker 800:40:03Thanks. Thanks for taking my question. Richard, I want to ask what We're a month away from Crispin coming in and taking over as CEO. Maybe give us a little bit on the process and Chris, Vince's background and sort of what you expect him to bring to the table when he starts in a month? Speaker 100:40:28Kevin, thanks. Obviously, from Christmas background, it brings a great deal of in the businesses that we are in and we felt that it was very important to bring someone in Who could hit the ground running to just help us get to be a better company blocking, tackling, Administrative, we're doing a lot of great things. He can help us further those. He's financially oriented. He came up through finance In his prior organization and we expect that he will tighten down or even greatly improve financial Processes over the next several months, which really it's really a hire to make us a better company. Speaker 800:41:16Do you think there's an opportunity with him in place to take share? Obviously, he was running one of your competitors. Yes. A lot of those relationships are at the personal level. Is that an opportunity set? Speaker 800:41:32Is that something we should The contemplating or is this coming in and this is more about executing Xs and Os and the like? Speaker 100:41:40Yes, it's been executing the Xs and Os In our business, we are very respectful of Crispin's Prior employment and will not do anything to jeopardize anything that he has ever done in that company from a confidentiality perspective. So we have On the greater side of caution there, but what we do expect It's for him to help us be a better company. Speaker 800:42:12Fair enough. That's super helpful. Thank you. Operator00:42:16Thank you. And at this time, there are no further questions in the queue. So I'd like to turn it back over to management for any additional or closing remarks. Speaker 100:42:28Thanks everyone for joining the call this morning. We look forward to Talking to many of you to give you even some more detail on what was a very, very positive and encouraging quarter for Adapt Health. Thank you very much. Operator00:42:42Thank you, ladies and gentlemen. This does conclude today's program and we appreciate your participation. You may disconnect at any time.Read morePowered by