Concentra Group Holdings Parent NYSE: CON reported double-digit revenue and adjusted EBITDA growth for the first quarter of 2026, citing stronger workers' compensation visit volumes, acquisitions and improved cost control as key drivers of the results.
Chief Executive Officer Keith Newton said the company "continued our momentum from 2025" and described the quarter as "a strong start to the year." Total company revenue rose to $569.6 million from $500.8 million in the prior-year quarter, an increase of 13.7%. Excluding contributions from the Nova and Pivot acquisitions where applicable, revenue was $520.3 million, up 6.3% year over year.
Total patient visits increased 6.7% to an average of more than 54,000 visits per day during the quarter. Workers' compensation visits per day increased 9.6%, while employer services visit volume rose 4.8%. Excluding the impact of Nova, total visits per day rose 2.9%, with workers' compensation visits up 6.2% and employer services visits up 0.7%.
Workers' Compensation Leads Growth
Newton said the workers' compensation performance reflected several factors, including improved patient satisfaction, new technologies to support account management and retention, and enhanced prospecting for new employer customers. He said service metrics such as average patient time in centers, Google ratings and patient Net Promoter Scores were "all at or close to historical best."
Weather also played a role in the quarter's results. Newton said the first quarter of 2025 was the easiest comparison of 2026 because last year's winter was relatively mild and dry, while this year included more ice and snow events that contributed to slips, falls and injuries. During the question-and-answer session, he said weather was a "net positive" in the quarter despite some center closures.
Revenue per visit increased 3.1% year over year in the first quarter. Workers' compensation revenue per visit increased 2.0%, while employer services revenue per visit rose 2.7%. Newton said a California workers' compensation rate increase took effect March 1 and that the company anticipates upside to workers' compensation rate growth over the remainder of the year.
President and Chief Financial Officer Matthew DiCanio said Occupational Health segment revenue was $519.9 million, up 9.9% from the prior-year quarter. Workers' compensation revenue increased 11.8% to $337.7 million, while employer services revenue rose 7.6% to $172.4 million.
DiCanio emphasized that workers' compensation generates significantly higher revenue per visit and contribution margin than employer services and accounts for about two-thirds of total center revenue. He said that in the current "low hire, low fire macroeconomic environment," employer services can show muted trends while the company performs well overall.
Adjusted EBITDA Rises, Margins Improve
Adjusted EBITDA increased 17.6% to $120.7 million, compared with $102.7 million in the first quarter of 2025. Adjusted EBITDA margin rose to 21.2% from 20.5% a year earlier. Newton said trailing 12-month adjusted EBITDA reached $450 million, up $85 million, or 23%, from the level at the time of the company's July 2024 initial public offering.
Adjusted net income attributable to the company was $51.5 million, and adjusted earnings per share were $0.40, compared with $42.2 million and $0.33, respectively, in the prior-year quarter.
Cost of services was $399.1 million, or 70.1% of revenue, improving from 71.3% of revenue in the prior-year period. DiCanio said the company continued to realize staffing efficiencies in its centers. General and administrative expenses totaled $55.3 million, or 9.7% of revenue. Excluding items added back for adjusted EBITDA, G&A was $50.2 million, or 8.8% of revenue, up from 8.2% a year earlier, driven mainly by planned additions to staff and IT infrastructure related to the company's separation from Select.
Acquisitions, Onsite Clinics and Expansion
Newton said Concentra has completed integration efforts for its March 2025 acquisition of Nova and has captured all expected synergies. He said the company is ahead of expectations and tracking toward its original objective of reaching a transaction multiple below 7.5 times adjusted EBITDA. He also said the June 2025 acquisition of Pivot has been integrated, is performing strongly and is ahead of the company's original estimate of a transaction multiple below 9 times adjusted EBITDA.
The company added three centers in California through acquisition during the quarter and opened one de novo center outside Atlanta. Newton said Concentra continues to expect eight to 10 de novo openings this year, with planned locations in Arizona, Idaho, Missouri, Illinois, Virginia, South Carolina and Florida. He also said several small bolt-on acquisition opportunities are active.
Onsite Health Clinics revenue rose 125% to $37.2 million, largely due to the Pivot Onsite Innovations acquisition in the second quarter of 2025. Excluding Pivot, onsite clinic revenue grew 20.9% year over year. DiCanio said the segment is nearing a $150 million revenue run rate, up from $64 million in 2024, and cited opportunities in occupational medicine and advanced primary care.
Other businesses, including telemedicine, pharmacy operations and other occupational health-related services, generated $12.5 million in revenue, up 10.4% year over year.
Cash Flow, Capital Returns and Balance Sheet
Concentra generated $21 million in operating cash flow in the first quarter, compared with $11.7 million in the prior-year quarter. Investing activities used $14.8 million, reflecting the California center acquisitions, de novo investments, relocations, renovations, maintenance and IT investments.
Free cash flow, defined as cash flow from operations less investing cash flow excluding business combinations, was $9.9 million, compared with negative $4 million in the prior-year quarter. Financing activities resulted in net cash outflows of $24.4 million, including the repurchase of approximately 661,000 shares for $15 million and $8 million in dividends.
At quarter-end, Concentra had $1.58 billion in total debt and $61.7 million in cash. Its net leverage ratio under its credit agreement was 3.4 times, down slightly from year-end. DiCanio said the company expects the leverage ratio to decline more quickly over the remainder of the year.
The board declared a cash dividend of $0.0625 per share on May 5, payable on or about June 9 to stockholders of record as of May 19.
Guidance Raised After Strong Start
Concentra raised its 2026 outlook following the first-quarter results. The company now expects:
- Revenue of $2.275 billion to $2.375 billion, up $25 million at both ends of the prior range.
- Adjusted EBITDA of $460 million to $480 million, up $10 million at both ends.
- Free cash flow of $215 million to $235 million, with the low end raised by $15 million and the high end raised by $10 million.
- Capital expenditures of $70 million to $80 million, unchanged.
DiCanio said the company expects to end the year "comfortably below 3x" net leverage, given the higher adjusted EBITDA and free cash flow guidance.
During the call, management also discussed the pending retirement of Chief Medical Officer Dr. John Anderson at the end of the year. Newton credited Anderson, known within the company as "Dr. A," with helping shape Concentra's clinical model, training programs and patient-first approach. The company expects to conduct a search for a successor and enter into a consulting agreement with Anderson to support the transition.
About Concentra Group Holdings Parent NYSE: CON
Concentra Group Holdings Parent NYSE: CON is a Canada-based financial services holding company that specializes in serving Canadian credit unions and their members. Through its operating subsidiaries, the group provides wholesale funding, lending solutions and investment management services tailored to the unique needs of cooperative financial institutions. Concentra’s broad suite of offerings includes trust and custody services, mortgage investment products and equipment financing, all designed to support credit-union growth and stability.
In addition to wholesale funding and lending, Concentra Group Holdings Parent distributes life and general insurance products through affiliated insurance brokers and credit-union channels.
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