AdaptHealth Q2 2026 Earnings Call Transcript

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Provided by Quartr
August 4, 2026

Key Takeaways

  • Positive Sentiment: Organic revenue growth was strong, with second-quarter continuing-operations revenue up 12.7% year over year, or 15.9% organically; Sleep Health and Respiratory Health grew 15.5% and 14.1%, respectively.
  • Positive Sentiment: AdaptHealth is narrowing its focus to Sleep Health, Respiratory Health and core home medical equipment through the planned $235 million Diabetes Health sale, non-core Wellness at Home exits and an e-commerce joint venture. Management expects these actions to improve long-term growth and margins, while the divestiture proceeds will support debt reduction.
  • Negative Sentiment: Management reduced full-year 2026 Adjusted EBITDA guidance to $490 million-$520 million from $680 million-$730 million. The reset reflects $55 million of pressure from the West Coast capitated contract, a $30 million expected second-half impact from a supplier price increase, stranded corporate costs and portfolio actions.
  • Negative Sentiment: The West Coast capitated contract continues to face higher-than-expected Sleep resupply and enteral volumes, inefficient workflows and elevated labor and logistics costs; management estimates a $40 million second-half profitability impact and expects only gradual improvement toward a 20% margin target next year.
  • Neutral Sentiment: Second-quarter free cash flow was negative $20.9 million after $166.2 million of capital expenditures supporting the capitated rollout, but the company expects $80 million-$120 million for the full year and plans to prioritize debt repayment while working toward 2.5 times net leverage.
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Earnings Conference Call
AdaptHealth Q2 2026
00:00 / 00:00

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Operator

Good day everyone. Welcome to today's AdaptHealth Second Quarter 2026 Earnings Release. Today's speaker will be Suzanne Foster, Chief Executive Officer of AdaptHealth, and Jason Clemens, Chief Financial Officer of AdaptHealth. Before we begin, I'd like to remind everyone that statements included in this conference call and in the press release issued today may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act. These statements include, but are not limited to, comments regarding financial results for 2026 and beyond. Actual results could differ materially from those projected in forward-looking statements. Because of a number of risk factors and uncertainties, which are discussed at length in the company's annual and quarterly SEC filings, AdaptHealth Corp. has no obligation to update the information provided on this call to reflect such subsequent events.

Operator

Additionally, on this morning's call, the company will reference certain financial measures such as EBITDA, Adjusted EBITDA margin, and free cash flow, all of which are non-GAAP financial measures. You can find more information about these non-GAAP measures in the presentation materials accompanying today's call, which are posted on the company's website. This morning's call is being recorded, a replay of the call will be available later today. I am now pleased to introduce the Chief Executive Officer of AdaptHealth, Suzanne Foster.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Good morning, everyone. Thank you for joining our call today. I'm going to cover three topics this morning. First, we delivered 16% organic growth with record volumes gains across the business. Second, we made significant progress sharpening our portfolio and focusing on the core business, announcing the sale of Diabetes Health Business, exiting other non-core products within Wellness at Home, and contributing our e-commerce business into a new joint venture to improve how we serve the direct-to-consumer market. Third, I'll speak to two near-term profitability challenges we're navigating: our West Coast capitated contracts and a material price increase from one of our largest manufacturers. Starting with our financial results. Given the agreement we signed to divest our Diabetes Health Business, I'll walk you through our results on a continuing operations basis, which excludes Diabetes Health included for prior year period comparisons. Revenue remains a bright spot.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Second quarter net revenue from continuing operations was $740.3 million, up 12.7% versus the prior year quarter, and 15.9% on an organic basis. Our West Coast capitated contract contributed 10.7 points of that organic growth, with 5.2 points coming from our base business. Sleep Health net revenue was $386.5 million, up 15.5% versus the prior year. Respiratory Health net revenue was $194.4 million, up 14.1%. Wellness at Home net revenue was $159.4 million, up 4.9%. Total capitated revenue grew to $103.3 million in the quarter and now represents approximately 14% of our continued operations net revenue. This is more than three times the prior year with our West Coast capitated contract driving nearly all of that increase. Second quarter Adjusted EBITDA from continuing operations was $132 million, with an Adjusted EBITDA of 17.8%, driven by elevated West Coast capitated contract costs, which I'll speak to later.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Turning to the work we have done on simplifying and focusing our business. Over the past two years, we have systematically reshaped AdaptHealth around our core Sleep Health, Respiratory Health, and supporting home medical equipment businesses. The parts of the portfolio where we have the strongest value proposition and the clearest path to growth. In July, we took the most significant step yet in that effort. We signed a definitive agreement to sell our Diabetes Health Business for $235 million. A move that we expect will ultimately improve our growth rate, enhance our margin profile, and allow us to sidestep looming industry risks. We also took a further step in focusing our portfolio on the core by discontinuing proactive sales of certain product categories within our Wellness at Home segment. This action removes non-strategic, low-growth, and low-margin product lines from our portfolio.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Last week, we signed an agreement to contribute the CPAP Shop, a direct-to-consumer e-commerce business we've built within our Sleep Health segment, into a newly created joint venture with a leading e-commerce competitor and a telehealth prescriber network. The JV will have an unrivaled set of capabilities to fulfill its strategic ambition to reach the vast undiagnosed OSA population through home sleep testing and a digitally enabled path from diagnosis to treatment. Our growth strategy is focused on improving our service levels in our core business, expanding our capitated relationships where it makes sense, and growing the number of large health systems we serve. This quarter, we made progress on all three fronts. In May, we signed a new capitated agreement with Humana OneHome, successfully transitioning 478,000 new members in South Florida and Texas without disruption.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Our capitated relationship with Humana now spans 33 states plus the District of Columbia and South Florida. We have a proven track record of successfully serving Humana patients under capitation over the past three years, and we're building on that experience as we take on this expansion. Our newly formed enterprise sales team, exclusively focused on large health systems, secured preferred provider agreements with several multi-hospital health systems. These customers recognize the clinical expertise we bring, the value of having our liaisons embedded in their systems to coordinate access to our services and care, and the operational excellence that shapes how their patients experience it. Let me turn to the more difficult part of the quarter, starting with the challenges we are facing with our West Coast capitated agreement.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Having spent the first half of this year executing the largest patient transition in the history of home medical equipment, we spent the second quarter working to stabilize that operation on the West Coast. Standing up a new geography this quickly, new buildings, new routes, new inventory, new people, and a new customer relationship, has posed new challenges, some of which we did not fully anticipate, but which have become clearer as the contract fully scaled. Throughout, we refused to compromise patient care and have remained fully committed to serving patients, whatever it took. With the benefit of a full quarter of operating this contract, here is what we know. Order volumes are running higher than expected, primarily in Sleep Health resupply and enteral products. The outsized Sleep Health resupply volumes largely reflect transition-related pent-up demand and should prove transitory. While enteral volumes will require further intervention.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

As we solve these two items, we believe gross margins will recover toward our original expectations. Second, there are inefficiencies in the inherited workflows, including the non-standard use of urgent orders. These are contributing to unanticipated logistics cost downstream, which in turn have caused labor costs to remain elevated. We have met these elevated demands, but doing so at this level is not a sustainable model. We are working with our partner to align ordering practices with the original assumptions of the contract while rapidly introducing technology to streamline the workflows, shifting more of our fulfillment to drop ship rather than in-person delivery, and right sizing our fleet and labor accordingly. The combination of these items represents $40 million of expected impact on profitability relative to our prior projections for the second half of this year.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

We remain confident that with sustained work and additional time, this contract will be a strong contributor to our profitability. Our long-term profitability outlook for the West Coast contract has always assumed we'd be able to use the footprint we built to serve additional business beyond the current capitated membership. Currently, we are only able to serve our existing patients through our 40 new West Coast locations, and that will remain the case until the government-imposed DME moratorium put in place last February is lifted and we can secure new PTANs, which are the Medicare billing numbers required to serve fee-for-service patients from these locations. Once that happens, we see substantial opportunity to serve patients who use our customer's health system but are insured through other payers, and to sell proactively to other customers located near or within our new footprint.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

That incremental fee-for-service revenue will help absorb the fixed cost infrastructure we've built out on the West Coast. To help offset the cost pressures I just described, we made the difficult decision in the second quarter to restructure our workforce, delivering $19 million in annualized savings while maintaining full operational delivery across every function. This required real sacrifice from our team, who took on more so that we could continue serving patients without interruption. The other lever we're pulling on is technology, using it to fundamentally re-engineer the patient journey from diagnosis to treatment, improving patient experience, and accelerating cost efficiencies along the way. We are already seeing what a digitally enhanced patient experience looks like in practice. Our myAPP platform now connects nearly the entire patient journey. Let me walk you through it. It starts with a digital front door.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Patients can enter our platform before they are even officially a patient. It's as easy as scanning a QR code. From there, AI-powered intake walks them through insurance setup. They receive real-time order status tracking, and they can instantly self-schedule a virtual or in-person PAP setup without a phone call. Order supplies in the app and access live or AI-powered chat support. This quarter, we added our newest feature, an AI-powered mask fitting tool which converted 92% of in-app scans to completed orders in its first two weeks, with early signs that it has reduced mask refittings that delay therapy. These features and the ease of use are driving rapid adoption of myAPP, with users standing at 512,000, up 56% since the end of 2025, and an App Store rating of 4.8 stars. This and similar work to re-engineer the patient and provider experience share a common thread.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

By removing the human intermediary from routine repeatable steps, it frees up our people to focus on higher value, higher touch work, and in return, supports our efforts to improve our cost basis. Addressing the team manufacturer price challenge I mentioned earlier, we were notified on June 30 by the manufacturer of their decision to terminate our contract and impose an immediate price increase effective July 1. As it stands, this results in a $30 million impact in the second half of the year. We are actively working with the manufacturer to secure improved pricing and terms, but at this point, we've reflected the full impact in our outlook. Brings me to guidance. Our underlying base business continues to grow and is performing in line with our expectations.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Between the portfolio actions we've taken, the challenges we currently have with our West Coast capitated contract, as well as the manufacturer's price increase, we must reset our full year outlook. Let me close with how we're thinking about the road ahead. Everything we are doing is to enhance the important role we play within a critical part of the healthcare ecosystem upon which millions of patients depend. The portfolio actions we've completed position us as a more focused company built around Sleep Health and Respiratory Health, where we have the strongest value proposition. Our rapid growth demonstrates that healthcare providers see the clinical and economic value of the services we provide. In addition, with all the realities facing our industry, we are well-positioned to benefit from the industry's ongoing consolidation with the size and scale to take on significant volume.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

We acknowledge that growing this fast over a short period of time has stressed our cost structure. These near-term pains come with a silver lining. Our growth is pushing us to think differently, to leverage technology and innovate in ways we never thought possible. These innovations are benefiting patients and providers today, and over time will lower our cost to serve. Ultimately, these growing pains will make us a stronger, more efficient company. With that, let me turn it over to Jason to review the financials.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

Thank you, Suzanne, and thanks to everyone for joining our call today. I'll cover our second quarter financial results, followed by a review of our balance sheet, capital allocation, and outlook. As Suzanne noted, given our agreement to divest Diabetes Health, all figures I'll discuss are on a continuing operations basis, including prior period comparisons, unless otherwise noted. For the second quarter, net revenue of $740.3 million increased 12.6% versus the prior year quarter, with organic growth of 15.9%. Second quarter Adjusted EBITDA was $132.0 million versus $136.4 million for the prior year quarter. As Suzanne discussed, this reflects continued elevated costs associated with the West Coast capitated contract ramp. Second Adjusted EBITDA margin was 17.8%. Discontinued operations produced approximately $23 million of Adjusted EBITDA, covering $14 million of corporate overhead expenses that remain in continuing operations.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

The West Coast capitated contract missed our expectations by $15 million. We are adjusting for this run rate in full year guidance that I will cover later. Turning to the balance sheet and cash flows. We ended the quarter with a consolidated total leverage ratio of 3.06x. After quarter end, we triggered the $325 million delayed draw term loan secured as part of our April refinancing and used the proceeds to redeem our 6.125% Senior Notes due 2028. This action eliminated our highest cost tranche of debt and extended our overall maturity. We intend to prioritize repayment of our revolving credit facility over the remainder of the year and remain committed to our net leverage target of 2.5x. We intend to direct a significant portion of the proceeds from the Diabetes Health divestiture for further debt reduction.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

Regarding goodwill, the Diabetes Health divestiture required us to reallocate shared corporate costs previously carried by that segment across our remaining reporting segments, and the resulting revision to Respiratory Health and Wellness at Home triggered a $144.2 million non-cash goodwill impairment. Free cash flow was -$20.9 million for the quarter, driven primarily by $166.2 million of capital expenditures to support the capitated contract, including approximately $25 million of one-time equipment and vehicle purchases. I'll note that our Diabetes Health divestiture closes cash flows from that previously reported segment will continue to be presented on a consolidated basis with the cash flows from continuing operations. Our capital allocation priorities remain unchanged, investing to accelerate organic growth, reducing our leverage, and pursuing disciplined smaller tuck-in acquisitions. Turning to guidance.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

On a continuing operations basis, our full year 2026 net revenue projection is $2.85 billion-$2.89 billion, which excludes $630 million of the anticipated full year revenue from Diabetes Health that is moving into discontinued operations. At the midpoint, this represents an increase of roughly $15 million from our prior guidance, reflecting the net impact of second quarter revenue outperformance, the revenue contributed to the e-commerce JV that we'll no longer consolidate, and the revenue disposed with the exit of certain non-core assets in Wellness at Home. On a continuing operations basis, our full year EBITDA guidance is $490 million-$520 million. Let me bridge that to our prior guidance of $680 million-$730 million.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

First, the impact of the Diabetes Health divestiture is $100 million, which includes approximately $40 million of the anticipated full year Adjusted EBITDA moving with that segment into discontinued operations, an additional $60 million of corporate overhead that had previously been allocated to Diabetes Health, but will remain with continuing operations. We expect roughly half of that stranded cost to be removed within 12 months of closing the deal. Second, $55 million of guide down relates to our revised full year 2026 expectations for our largest capitated contract, which includes a miss of $15 million versus our prior expectations for Q2 and $40 million of revised projections for the second half of 2026. We continue to view a margin of 20% as the right long-term target for this contract, though reaching it will take continued work and additional time.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

We expect sequential improvement over the next several quarters, reaching run rate profitability next year. Third, as Suzanne mentioned, we recently received notification that a large supplier has increased prices effective July 1st, which we anticipate will have a $30 million impact in the second half of 2026. Finally, we are reducing our second half projections by $15 million for other intentional actions we took to focus and strengthen our portfolio. As Suzanne described, we recently made the decision to wind down certain non-core wellness products. The company has already started the process of shutting down sales channels for these products, so revenue will quickly decrease. However, the cost of servicing our existing census will continue until we transition patients to other providers over the next few quarters.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

Stepping back from the current year financial expectations, we want to provide perspective on how to think about these areas beyond this year. We believe that we will eliminate roughly half of the stranded corporate overhead within 12 months of closing the Diabetes Health transaction. We expect to achieve our long-term profitability target for our West Coast capitated business next year. We expect to negotiate the recent notification by a large supplier and take actions to otherwise mitigate the impact. Finally, for Wellness at Home, we will reduce our labor and operating expenses as patients transition. For the full year 2026, we expect free cash flow of $80 million-$120 million, which, as noted, includes cash flow from our Diabetes Health segment. For the third quarter of 2026, we expect net revenue of $720 million-$740 million.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

We expect modest sequential growth to offset approximately $20 million of revenue coming out of the second quarter run rate following the JV and portfolio management actions. We expect Adjusted EBITDA margin of approximately 17.9%, and we expect free cash flow to be approximately $50 million. That brings us to the end of our prepared remarks. Operator, please open the call for questions.

Operator

Thank you. At this time, if you would like to ask a question, please press star one now on your telephone keypad. To leave the queue at any time, press star two. Once again, that is star one to ask a question. We'll pause for just a moment to allow everyone a chance to join the queue. We'll take our first question from Ben Hendrix with RBC Capital Markets. Please go ahead, your line is open.

Michael Murray
Michael Murray
Analyst at RBC Capital Markets

Hi, this is Michael Murray on for Ben. Thanks for taking my questions. The revised guidance includes $30 million impact from the manufacturer price increase. I'm sorry if I missed this, but what segment did this impact? Given the magnitude, what levers do you have to offset this, whether through contract renegotiation, passing costs through to the payers, or other operational actions? Over what time frame should we expect those offsets to materialize?

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Sure. At this point, given that we're in active negotiation, I prefer not to say which segment it is hitting, but I can talk about what we're doing now. Obviously, mid-year, we do not, as a company, have the opportunity to pass through price. We are hopeful that we'll be able to resolve this, but in the meantime, the actions we would have to take are things like looking at supplier mix and profitability of those products within the mix would help offset it. We have CPI-U coming. This is kind of a TBD right now with this situation until we really get through the negotiation, which we'll be able to update you at the end of this quarter.

Michael Murray
Michael Murray
Analyst at RBC Capital Markets

Okay, then just another quick one. The revised guidance also includes a $15 million impact from other portfolio actions. Can you walk us through what those entail? Are these additional divestitures, product line exits, restructuring of existing operations? Should we think of this as a one-time headwind or an ongoing drag?

Jason Clemens
Jason Clemens
CFO at AdaptHealth

Yeah, this is Jason. You should think of this as a one-time headwind. The reason for that is we have already started shutting down certain sales channels that produce new patient volumes and the related revenues that come with it. The way to think about this, as a dollar of revenue comes out for these product lines, we drop off about 35%, which is the gross profit of that revenue. Significantly lower margins than the rest of our business from a cost of goods perspective. That work has already happened. However, we're still taking care of the patient census that we've got in the third quarter, as we had in the second quarter. We're actively working to transition those patients to reputable and proper providers.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

That will take us a little time, so we're going to continue to carry the labor and operating expense associated with taking care of those patients. We do believe we'll get through this over the next couple of quarters, which is why, for out years 2027 and beyond, this won't be a repeating expense.

Michael Murray
Michael Murray
Analyst at RBC Capital Markets

That's helpful. Thank you.

Operator

Thank you. We'll move on now to Brian Tanquilut with Jefferies. Your line is open.

Brian Tanquilut
Brian Tanquilut
Analyst at Jefferies

Hey, good morning. Suzanne, maybe as I think about all these moves that you're making, how are you thinking? Is there a strategy direction here to shrink the business, essentially? I get the idea of streamlining, but balancing that with a de-leveraging of the corporate overhead. Just walk us through how you and the board are thinking about all these strategic moves and the direction that you want to take the company to eventually. What is the goal and what is the endpoint?

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Yeah. Thank you, Brian. Let me remind everyone that this company was built through a series of over 150 acquisitions. When we did the portfolio review a couple of years ago, what we found is a whole host of subscale products or channels, dogs and cats that were baked into our different segments. Which was really one of the reasons we ended up going the segment route to get our arms around really what were we offering in the product portfolio. Coupled with those types of acquisitions or the number of acquisitions, you can imagine the different workflows and the different ways of working. Two years ago, we really set out on this path to say, we need to simplify and focus on the portfolios where we have the biggest growth opportunity, highest profitability, which really equates to the best value proposition.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Through that portfolio management, we identified a series of moves we had to make, we've seen in Continence, Custom Rehab, Home Infusion. These were all products that we were subscale at that would require additional investment should we want to bring those to being number one or number two in the market. This quarter is the completion of that strategy. All of them are good businesses. Diabetes is a great business. E-commerce, some of these Urology, Ostomy. With the looming threats out there of competitive bid, of having to invest to grow, we thought it would be better to shrink down to our core and build from there. This very disciplined portfolio pruning has been a journey that we're on that really came to this point in time.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

This is the quarter where we can say we have finished that divestiture path that we've been on, now all of our additional dollars that we generate can be invested back into our sleep and respiratory business, and where it makes sense or in support of our home medical equipment business. It has to be in service to our sleep and respiratory business, where we serve either fee for service, capitated, or more recently, a real focus on our enterprise health systems because we're trying to build density and proximity in the major markets. Yeah, there is, to your point, a shrinking in order to improve the growth outlook and the long-term EBITDA margins of the portfolio, which I believe will make us a stronger company. The last point I'll make is, a couple of years ago, we believed that we knew AI and technology.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

It's great, right? We knew it could improve our business, but the problem we had was nothing was standardized. We had no processes that we could easily put that technology on and deploy it at scale. As we shrink down to sleep respiratory in a simplified, focused business, what we've seen now over the last few quarters is this ability to roll out technology at a much faster pace, deploy AI where it makes sense. We think that we can speed that up under the current portfolio in the way that we're structured.

Brian Tanquilut
Brian Tanquilut
Analyst at Jefferies

Understand. Maybe Jason, just as I think about the West Coast contract, obviously there's some execution there in terms of trying to get the utilizations where it needs to be. Just curious, what exactly operationally needs to be done? Are there opportunities to maybe reprice given the higher than expected utilization? Maybe Suzanne Foster, kind of related to this, just as we think about the Humana contract expansion, are there further opportunities there? How did that work given that I think the other half of that contract was with a different provider. Are you pulling business away from that other provider? Or is Humana kind of piecing that out at this point? Thanks.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Yeah. I'm actually going to take both of those, Jason can assist me after if I've missed anything. Starting with our West Coast contract, what exactly has to happen? There's two buckets that I tried to explain, let me give you a little bit more color. I'm proud of the team, that we really understand now through operating this contract over the last quarter and a half, what is going on. Our relationship with our partner there remains incredibly strong. I want to get that out there. If in an event we can't fix some of the operational issues, I can't promise to any kind of renegotiation, what I can say is in partnership of serving those patients, there is a recognition that both companies have to do so profitably. Back to what we have to do. It's easy. It's two line items.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Order volume and utilization. We have to understand and we have to make sure that it's being utilized and the volumes are appropriate. The example I gave on sleep resupply. We had to send patients at the time of the transition, all of the sleep resupply patients that were being served by the incumbent, we had to send them a letter stating we're your new provider. What we believe happened was people who were maybe not adherent with their therapy but still had the equipment in their house said, You know what? I need to get back on that therapy. We saw an incredible spike happen once we sent that letter. We have seen subsequent to the quarter that that volume is coming down, we believe it was, like all of us, an intention to get healthy, that behavior drops off.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

That's why we call that out as transitory. There are some other types of product lines that we're seeing running outside what we expected, at the same time, a few that are running below is what expected. An ongoing discussion with our partner around that portfolio and the utilization of that portfolio is part one. Part two is there's no data in the world or diligence that we could have done that us and our partner knew about that could have predicted some of these inherited messy workflows. From day one, it kind of sent our operations into a bit of a tailspin because we were not expecting the level of, the example I gave, urgent orders being the biggest one. It's outside the bounds of what we thought.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

You can imagine, it's much easier for a provider to say urgent even though they really don't need that product in four hours, but we were taking that order at face value. Since then, that has been the primary focus of correcting or getting this contract under control on both sides with us and our partner, because that is something we cannot solve alone. It's those two things like I talk about. The rest of it is noise. As we get those two things under control, that'll be much better for us and our partner. Despite all that, at those elevated rates, we are performing under our SLAs. We're hitting targets. I'm super proud of the work we've done to come up to speed. Now that we're effective, we have to make this efficient.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

I have no doubt that we will make that happen. Now on your Humana question, yes. We, like I said, are in 33 states, District of Columbia. South Florida is new for us. Florida was not a state we service. That does not mean we took it from the provider that has Florida. This piece of business was being handled by Humana, and they decided to get out of that business. They RFP'd it. We took it over, purchased the assets, and we are now the new operator in that space. Which is a new geography for us, but with our history with Humana, that's just kind of like a tuck-in for us. We know how to operate these businesses. We've had three years of experience, and that contract performs not only operationally but financially very fair for us. We're thrilled about that new announcement.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Just in perspective, I think you asked a question around just Cap in general. We're up to about 10 or so different contracts, Humana and our West Coast one obviously being the largest. That's the reason I sit here confidently and say that over the next four to five quarters, I have no doubt that we'll figure out how to make our West Coast operations not only strong, but financially sustainable in partnership with our customer there.

Brian Tanquilut
Brian Tanquilut
Analyst at Jefferies

Thank you.

Operator

Thank you. We'll move on now to Pito Chickering with Deutsche Bank. Your line is open. Please go ahead.

Pito Chickering
Pito Chickering
Analyst at Deutsche Bank

Good morning, guys. Thanks for taking my question. Just following up on that line of questioning, just on the Kaiser contract. Can you split out the $55 million sort of between the increase of Sleep demand versus the increase of enteral demand versus the logistics? Does this sort of change your view around capitated contracts in general versus the simplicity of fee for service? Maybe you go and just become the standard fee for service at a lower cost than trying to underwrite these capitated agreements, which take a lot of inherent risk.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Okay. I'll start that discussion, turn it over to Jason for the split out. Pito, this is one of my favorite topics to debate with you, as you know. My view on capitated has not changed. Now, do I wish that we had a different first six months in understanding what this transition would look like? For sure. However, as I mentioned earlier, the strategic value of capitation to get into a footprint and own a majority of those patients exclusively and have those ordering patterns come to AdaptHealth, there is a halo effect as we have talked about previously with the Humana deal, that once you start piling up a few different exclusive deals, you become the provider of choice naturally in the provider's eyes just by ease of it has to go to this supplier anyway.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

We have not been able to capitalize on the halo effect in the West Coast because of the DME moratoria. We always believed we would, one, secure the operations of the capitated membership. We would, two, then secure the 10%-20% that is not capitated within those health systems that are in that territory, and then eventually layer in salespeople to go get additional sales and accounts that that footprint could service. That's been put on hold. Now, we do hope that the moratorium expires in August 24th, but right now we're acting as though that moratorium extends until we know better. I think a mix of capitated and fee for service is our future.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

I don't believe they'll ever be a majority, but I think that having some piece of capitated, much like Humana and the other capitated agreements we have, is a healthy mix for us. Your second question was on-

Jason Clemens
Jason Clemens
CFO at AdaptHealth

On the split out.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

-split out.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

This is Jason, I can handle that. It's roughly two thirds volume, these patient volumes that Suzanne discussed, and the remainder of that is labor. In terms of our outlook, we have planned very modest improvements sequentially from Q2 about $1 million per quarter better into Q3 and then into Q4. We're pretty comfortable with the changes that Suzanne talked about and the impacts that that will drive.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

One last thing I forgot to mention. I think it's important to understand that in a capitated arrangement, those accounts don't require us to fund the sales force. The sales forces go out and ask for the business. In these accounts, you don't have that expense. Of course, you have liaisons and other clinical folks, but you have that savings long term, and you also have reduced administrative cost when they cap directly with us because you're eliminating things like the complexity of Prior Authorization and billing efficiencies, et cetera, and also the real time collections. There is other non-visible benefits to our business of entering into these cap deals. I don't want anyone to think that I'm disingenuous. I do realize that this account specifically has a lot of work to do to fix our cost basis.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

For all the reasons we've stated today and these ongoing savings I just mentioned, that's why I continue to believe that some portion of capitated deals in our portfolio makes sense.

Pito Chickering
Pito Chickering
Analyst at Deutsche Bank

Okay. The follow-up here is just about free cash flow. I think your guidance is $100 million-$120 million for the year. I guess, can you break down the split there between cash flow from ops versus CapEx? I think it implies the back half of the year is a +$175 million of free cash flow versus a $75 million use of cash in the first half of the year. I guess, can you just walk us through sort of the bridge in the back half of the year and how we should think about leverage ratios as you dial less equipment CapEx? Thanks.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

Sure, Pito. In the first half, I think your number is closer to about $47 million-$48 million was the use of cash in the first half. We're saying for Q3, we expect to deliver approximately $50 million of positive free cash flow to offset the first half, and then the remainder will come in the fourth quarter. Cash flow from ops should follow a pretty similar shape as what you've seen in the past from us, and then CapEx will start dialing back as some of the overstock that we've built up to support not just the West Coast capitated agreement, but also national CPAP overstock. That will start working through and dial back the CapEx in the back half.

Pito Chickering
Pito Chickering
Analyst at Deutsche Bank

Great. Thanks so much.

Operator

Thank you. We'll move on now to Richard Close with Canaccord Genuity. Your line is now open. Please go ahead.

Richard Close
Richard Close
Analyst at Canaccord Genuity

Yeah, just maybe back on the capitated and this halo impact. I think maybe remind us what your target margin expectation is for capitated agreements like this, and is that dependent on getting that halo effect? Or is the halo effect separate from that target margin?

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

You got it, Richard. No. We've always said that our capitated target is enterprise margins, which is 20%, which does not include any halo effect. Even with our Humana or any other capitated business, we target that, and that the halo effect has always been upside for us.

Richard Close
Richard Close
Analyst at Canaccord Genuity

Okay, that's helpful. With respect to the overhead on the Diabetes Health, you called out getting half of that out of the business within 12 months. What are you thinking about on the other half? Does that stay with you, or do you get that out over an extended period of time? How are you thinking about that?

Jason Clemens
Jason Clemens
CFO at AdaptHealth

For that remaining $30 million of stranded cost, Richard, we believe through organic growth as well as accretive M&A, we'll bring more revenue onto the rails, that will eat away at some of that $30 million of overhead, as well as we'll continue to be disciplined in our expense structure. I think we demonstrated that in the quarter with a $19 million restructuring program to right size primarily the corporate overhead to the revenue base. That work will continue over time. That first 30, we're quite confident comes out in the first 12 months.

Richard Close
Richard Close
Analyst at Canaccord Genuity

Okay, thanks.

Operator

Thank you. We'll move on now to Kevin Caliendo with UBS. Please go ahead.

Kevin Caliendo
Kevin Caliendo
Analyst at UBS

Good morning. My questions are on the contract and the idea that a contract gets ripped up on June 30th. We work on Wall Street. We know how contracts sometimes work, it just seems like an unusual event to have something like this happen. I guess, how shocking is it that a company can do this? Then more specifically, what was the magnitude of the price increase? Meaning, is this a 5% price increase? Is it a 30% price increase? Was there any visibility going in that this was even a risk to happen?

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

I would agree with you. It's unusual, but it's factual and it's unfortunate. We like to say that we have strong partnerships with our manufacturer, but somehow, whether we're missing each other in communication or what's happening, but it was literally a bit of a surprise to us on June 30th. I mean, we're always in constant discussion with our suppliers on different situations, volumes, supply, recalls, you name it, right? This one did surprise us a bit. Notwithstanding that, the price increase notified to us on the 30th did result in an immediate price, a percentage increase, which, listen, I don't want to say publicly right now what that is because we are working actively to try and get to better price and terms in the spirit of partnership.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Given where we are in the quarter and having to report today, we made the decision that as we sit today, there is no contract. Anything we order today is under those new price terms. We felt it would be disingenuous not to call out that risk. I certainly sincerely hope that it's a different outcome when I'm talking to you next.

Kevin Caliendo
Kevin Caliendo
Analyst at UBS

Isn't normally, please tell me if I'm just completely off base here, but end of quarter, typically there's negotiations around lower price and hitting volume targets and things like that. Just unusual to hear that a company takes a massive price increase at the end of a quarter. Just tell me I'm wrong, but that's always how I understood these kind of vendor contracts. Around the end of quarter, there was always negotiation around price and volume and trying to hit targets and things like that. It was almost never the other way. Those price increases were typically done in advance and were well-defined.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Yeah. I think you understand normal course of business, at this point, I really can't say what the discussions were at that time.

Kevin Caliendo
Kevin Caliendo
Analyst at UBS

Understood. Thank you.

Operator

Thank you. Once again, if you would like to ask a question, please press star and one on your telephone keypad now. We'll move on now to Yujin Park with Baird. Your line is open.

Yujin Park
Yujin Park
Analyst at Baird

Hi. Thanks for taking my question. I just wanted to touch on the cybersecurity incident. Can you explain more on what exactly happened, any disruptions to date, and expected costs to remediate and how you treated out that cost, if you adjusted or was included in adjusted results and next steps for that?

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

Okay. Let me just briefly explain what happened. We issued some information on this, and then I'll have Jason talk about any additional financial implications. We were notified that we had a threat actor that had taken some data, and we have closed that out. It is done. Of the bad situations, it was a good situation. We believe that we've resolved it, and we've moved on. There's nothing left behind. There's no additional risk. It's kind of old news for us right now, unfortunately, like, meaning we've gotten through it and closed that chapter. In terms of ongoing cost, I'll turn that over to Jason.

Jason Clemens
Jason Clemens
CFO at AdaptHealth

Yeah. The settlement expenses to close out the matter are included in our non-recurring expenses, adjusting the EBITDA.

Yujin Park
Yujin Park
Analyst at Baird

All right. Thank you.

Operator

Thank you. It does appear that we have concluded our Q&A. I'd be happy to return the call to our host for any closing comments.

Suzanne Foster
Suzanne Foster
CEO at AdaptHealth

I just want to thank everyone. I recognize a lot of moving pieces this quarter, but I do hope that you can see that the underlying business and the strategic moves that we are making are setting us up for a really successful future. We understand we have a lot of work to do to improve that cost basis, but that's what we're getting after next. Thanks for joining our call.

Operator

Thank you. This brings us to the end of today's meeting. We appreciate your time and participation. You may now disconnect

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