Welcome to Owens and Minor 2021 Investor Day.
Good morning, everyone. I'm Chandrika Naidam, Director of Investor Relations at Owens and Minor. It's my pleasure to welcome you to our 2021 Investor Day, and we truly appreciate you taking the time to join us. It's an exciting time at Owens and Minor, And today is about a fast forward. But before we get started, I want to provide a Safe Harbor statement.
The information presented today contains forward looking statements that involve known and unknown risks, uncertainties and other factors. These may cause actual results to be materially different from any future results, performance, targets or achievements expressed or implied by such statements. For a description of these factors, please refer to the company's Form 10 ks And its most recent quarterly filing on Form 10 Q filed with the SEC. Additionally, this presentation contains non GAAP financial measures. A reconciliation of GAAP to non GAAP financial measures can be found on our slide presentation online and filed this morning on Form 8 ks with the SEC.
And now I'd like to welcome Ed Sefica, our President and Chief Executive Officer, who will start things up. Ed?
Good morning. Let me start by thanking everyone for joining us today. We have a great day planned for you as we do a deep dive into Owens and Minor and present our plan to ignite long term sustainable growth across our business. As many of you may know, I've been the CEO of Owens and Minor for a little over 2 years. And during the short period of time, we have made a Transformative shift in our business.
Our hard work and strategy have radically repositioned our near and long term opportunities and provided us with numerous levers to drive future value. But the journey has just begun and we believe that the next phase of our strategy can turn us into at least a $12,000,000,000 revenue company and nearly triple our potential profitability from 2020 to 2026. It took a highly functioning team to execute such a successful turnaround at Owens and Minor over the last 2 years. And I'm excited to have a few of these leaders with me today. As you may know, some of these leaders and I share past track record at Dermal Fischer Scientific, While others have deep experience within the Owens and Minor organization, collectively, it's one of the best teams I've ever had the pleasure of working with.
We're excited about the opportunity we have at Owens and Minor to drive long term shareholder value. Let me briefly introduce each of our presenters, Starting with Chris Lowery. Chris is the President of Global Products, which includes all of our proprietary products, Such as our manufactured PPE that have been so vital in helping the United States healthcare system through the pandemic. Next is Jeff Jocums. Jeff is our Chief Operating Officer and President of Medical Distribution and has responsibility for our strategy development.
3rd will be Perry Vernacki. Perry is the CEO of our fast growing home health patient direct business, Byram Healthcare. Next is Mark Zacker. Mark is our Chief Commercial Officer, who leads our growth focused commercial strategy. After that will be Shannon Neal.
Shannon is our Chief Human Resource Officer and has helped us reshape the culture and drive our ideal values over the last And last is Andy Long. Andy is our Chief Financial Officer, who along with his team has helped us dramatically reshape our balance sheets. As you can see, we have a full agenda for you today. One of the key things we'd like our investors and analysts to take away from the conversation is the power of our value chain. We have a collection of assets and businesses that support one of the strongest value chains in the healthcare solutions industry.
And we believe these assets and businesses are strategically positioned to drive robust long term top and bottom line growth for years to come. Therefore, we have structured our agenda today around the walk through of our value chain. I'll begin our presentation with the discussion of the new Owens and Minor And I will walk through who we are today, our journey over the last 2 years and our updated strategic plan to ignite sustainable growth. Then I'll turn it over to Chris to provide insight into our high margin global products business. Next, Jeff will walk us through the backbone of our organization, our medical distribution business.
And then Perry will outline the opportunity we have to extend our reach with Byram, our home health patient direct business. Mark Zacker will then bring those 3 presentations together and discuss our go to market and commercial strategy. We'll then take a quick break after which Shannon will discuss our ESG commitments and critical cultural initiatives that we have been a huge part of our transformation. And finally, Andy will tie everything together with the financial review. And I'll close with a few key strategic reminders before we enter our Q and A session.
Again, we have a very informative and robust day planned for you, so let's get started. Owens and Minor is a growth focused integrated healthcare solution provider. We have nearly 140 years of experience with extensive medical distribution reach. That includes over 95 facilities worldwide, over 15,000 teammates and more than 1,000 plus branded manufacturer partners and over 4,000 healthcare service providers who trust us to support Their critical role in the healthcare industry. That expansive medical distribution platform is complemented by a strong portfolio of proprietary products, many of which we manufacture in the Americas.
This includes one of the most comprehensive suites of PPE products provided by any one company, which has and will continue to be critical in helping the world navigate the rapidly changing healthcare environments. We also have one of the more exciting solutions in home health with our Byram patient direct business. And finally, we offer an array of value added services Technology solutions that create long lasting or sticky relationships with our customer due to these services and technology solutions delivering efficiencies for our customers. Those businesses I just mentioned are aligned into our 2 core segments, Global Solutions and Global Products. Our Global Solutions segment is driven largely, especially on the revenue side Our traditional acute care distribution business, which we often refer to as our medical distribution business.
In addition, our home health business is included in the segment and goes to market as Byram Healthcare, which is also referred to as our patient direct business. This patient direct business provides both revenue and profit growth for the segment. Lastly, the Global Solutions segment also includes our service businesses and Technology Solutions. This includes QSight, SurgiTrak, Handac and MyOM, which are several solutions that help our clients to more effectively and efficiently run their businesses. And thus help us to further ingrain ourselves into our customers given the value that these services and solutions bring.
Our other segment is global products and that's our manufacturing business. It includes well known respected industry brands like Halyard, MediChoice and others. This business has been a critical driver of our financial recovery over the past 2 years, and we believe we have a strong plan to accelerate that growth as we move forward. Now I'd like to remind you of how we got to where we are today. Again, I took over the leadership of this company just 2 years ago We assembled a great team consisting of existing strong leaders within Owens and Minor and combine that with external hires with a track record of success.
What we inherited was a tremendous platform, nearly 140 years of history and a valuable collection of brands, assets and intellectual property. However, we also took over a company heading in the wrong direction. Our culture needed a jump start. We needed to get back to being accountable to our customers as well as to ourselves. We had deteriorating service levels and lost the kind of customer intimacy That is a must have in the healthcare industry.
While we made a few interesting acquisitions, their potential was yet to be fully realized. Worse, we were losing share, losing momentum and had a troubled balance sheet. Change was required, Leadership was needed and it was needed quickly. The new management team got started in early 2019 And knew we couldn't be slowed down by the pandemic when it hit a year later. In fact, the early work we did in the year preceding the pandemic allowed us to not only steer through those tremendously uncertain times, but actually flourish.
As a result, we regained our customers' trust as one of the key partners that helped them navigate one of the truly defining moments in many of our lives, COVID-nineteen. So to understand our path forward, I think it's important to briefly reflect on how we turn the business around. We have some fundamental building blocks to fix in 2019 and those are defined in the business blueprint I previously shared with you. While there are a number of concepts wrapped up in this foundational strategy, it really came down to reprioritizing the importance of the customer, followed by our culture, our process and our investments. We knew that if we took those steps, we drive improved financial performance and begin to harness the power of our synergistic assets.
Moving on to building our culture and living our mission. Shan is going to talk about this later today, but the work we did to rebuild our culture was truly transformational. Again, we have not provided our teammates with the tools and connectivity they needed to help our customers to the best of our abilities. So we created the ideal mantra, our ideal values, which is integral to how we do business today and every day in the future. With each letter of the word ideal representing one of our key values, it includes focus on I, integrity.
It means acting every day with the highest ethical standards and honoring our commitments. And when we're dealing people's lives and the critical role we pay in the continuum of care, it's a must have. Next, D for development. No culture can become stagnant. Growth and evolution in a world that seems to be continually transforming is critical.
And we need our teammates and our customer offerings to continue to evolve. We know we need to push the boundaries to drive the highest quality of service and newest offerings While outworking and outperforming our competition, basically said, we need to get better every day and strive to do so. E for excellence. Again, what we do empowers our customers so they can advance healthcare and save lives. Excellence and integrity are the cost of entry in this business.
And we'll never stop striving to be the best that we can be regardless of the circumstances. This includes delivering best in class service, quality and driving cost efficiencies wherever we can. The A stands for accountability. We own our actions and results. We lost this accountability to ourselves and our customers And that can never happen again.
And finally, the L is for listening. Listening is about customer intimacy. We're not a delivery service, just trying to deliver the cheapest package in the fastest time. We bring a full set of healthcare solutions to customers that provide Truly vital services. Our work has to be right, on time, as expected, value added and consistent.
Being closer to our customers is how we've grown from being just a vendor in 2015 to 2018 to a true business partner today. Lastly, I think it's important to pause here and restate our mission, empowering our customers to advance healthcare. I know a lot of CEOs give lip service to their mission and quickly move on, but we really lived our mission over the last 14 or so months. We have empowered our customers to advance healthcare and we've been humbled to be a significant contributor to the battle against COVID-nineteen throughout this pandemic. And thus, we lived our mission each and every day since it started.
And I'm very proud of the collective work we did to help in this fight. However, the war isn't over yet, and we need to stay true to that mission now and long after the pandemic is behind us. And I'd like to personally offer one last thank you to all the hardworking teammates at Owens and Minor that I have the privilege of working with every day and have lived and exemplified our mission and our values. So we got the leadership and culture right. We got our priorities to be more laser focused on our customers, but we still needed to build a process discipline.
No organization can grow without repeatable processes and standards. As you know, a number of us came from a business that was well known for its business system And thus we attack the problems with a new Owens and Minor Business System Framework. There are 4 key components to the Owens and Minor Business System Framework. 1st, continuous improvement. Aligned with excellence we discussed earlier in our ideal values is the need to support an environment that values Continuous improvement.
By emphasizing daily problem solving throughout the organization and focus everyone on driving efficiency without sacrifice quality We'll be incrementally more successful each and every day, while improving our customer experience and profitability along the way. Next, standard management systems. Standard functional processes and measurable KPIs are critical for a well functioning organization, especially a well functioning organization that needs to grow. Through consistent process and measurement, it becomes more efficient to implement and strategies to grow our business and improve service to our customers. 3rd, program management.
Along the same lines, Managing new programs from start to finish requires repeatable processes, standard tool sets, organizational alignment and flawless execution. Our program management is constantly evolving, but we'll never lose focus on those core elements. And then finally, teammate engagement and leadership. Lastly, the Owens and Minor business system is supported and embraced by the leadership team as well as active teammate participation. Finally, the 4 key components of the Owens and Minor Business System just discussed will be one of the driving forces to provide assurance that the execution of the strategic plan is a success.
With an improved culture and business discipline, we are now in a position to invest in ourselves and in our infrastructure. On this slide, you can see our investments made throughout 2019 2020 and you will hear today about a number of new investment initiatives We'll be making to enhance our long term profitable growth. Through proper investment in our culture, our business discipline and our infrastructure, We drove real fundamental change that took a business that was nearing the crisis and turned it into one that's poised for long term growth and success. This is clearly evident in both our customer service metrics and our financial achievements. For example, Our shipping accuracy jumped to 99.9 percent.
And later in the presentation, you're going to hear today about the success, which was driven by the proper balance between technology and touch across our organization. Our on time delivery stats also rose to over 99 plus percent in 2020 and we achieved 100% KPI achievement in our customer service scores. I can't understate the importance of on time delivery when you're dealing with critical products and solutions that feed the healthcare industry. And obviously there's a direct correlation between happy customers and providing shipping accuracy, consistency and being on time. And last but not least, we drove strong financial achievements.
This can be seen in the stock markets grade of our progress through a strong share price appreciation as we were the number one stock in terms of performance in the S and P 600 in 2020.
Further, Through hard work in
the building of a better business, we've been able to clean up and strengthen our balance sheet, which we believe has turned it from a liability to a real asset that will help us drive future growth and performance as we move forward. Now I'd like to shift gears out of a historical view and into a deeper perspective of Owens and Minor as we look forward. I spoke briefly at the beginning of the presentation about the true differentiation we have within our value chain. But I'd like to take a few minutes to highlight how our businesses work together to drive value.
Owens and Minor traditionally operates as 2 business segments, Global Solutions and Global Products. But what really sets us apart is our ability to control our value chain and seamlessly deliver product and service offerings At Owens and Minor, we are designers, manufacturers, Product distributors, service providers, healthcare partners and patient advocates, Our teammates deliver value at every step in the value chain. Let's discover how. It starts with the design and materials Of our medical grade PPE products. First, we control the design and the materials that go into our products.
Then We develop and adhere to strict quality standards and product specification. And finally, we manufacture these products In our own facilities with our own teammates. In fact, 80% of our self manufactured proprietary branded PPE products Our made in the Americas, which enables Owens and Minor to provide our customers with a secure supply chain. When it comes to distribution and delivery, Owens and Minor operates a vast network of strategically located distribution centers in North America, Combined with a dedicated fleet of healthcare trained and certified transportation experts, our locations are within a 4 hour drive Of 90% of the U. S.
Population and since we self manufacture our proprietary products, our PPE is delivered to our DCs on trucks, Not both, which allows us to rapidly deploy product from our facilities to healthcare customers across the country. As a service provider, Owens and Minor offers technology solutions that drive efficiencies, reduce costs and mitigate risk within the four walls of the hospital. We also employ hundreds of Owens and Minor teammates Who work in the procedural hospital setting, supporting our healthcare systems and their operations so that they can focus on patient care. And when a patient transitions home, our Bylim Healthcare business helps ensure that He or she can live with their chronic condition at home and with the peace of mind that their critical supplies will be delivered. In fact, Approximately 85% of in network insured Americans can be serviced by Byram Healthcare.
And as this market expands, our team is ready to offer convenience, affordability and choice Each and every day, we are laser focused on serving our humble mission of empowering our customers
Each of these businesses are spectacular entities, but the real power is and will continue to be driven by how they support and complement each other. At the center of this diagram is medical distribution business. I like to think of this business as the major interface with our customers with over a century of relationships with some of the leaders in healthcare. Our medical distribution business is within only a few hours of the vast majority of the U. S.
Population. This business is critical to our success And provides logistics backbone, portal and interconnected network that our other businesses can leverage. Think of it as the tip of the spear for our complete suite of products and services. Lastly, it is a revenue driver for us And we believe we can do more to continue to scale it and drive higher long term profitability in the future. Then we have our global products business on the left side of the slide or the beginning of the value chain.
As we look forward, our global products business is both a growth and profitability driver for us. The business houses our manufacturing expertise and provides application expertise and intellectual property that we can use to innovate and expand our proprietary portfolio. We have big plans for this business and we are excited to share those with you later today. Then on the right side of the slide, it's our Patient Direct business, which I like to think of as our amplifier of reach. Myron plays in a growing shift in the delivery of healthcare services that COVID-nineteen has rapidly Home health is here to stay and this business both diversifies and differentiates Owens and Minor.
Further, like Global Products, it also offers solid growth and profit opportunities for us, which is why you'll hear today We plan to focus the future investments in and around these great growth and margin enhancing businesses. Lastly, we have a great collection of service and technology These are high touch solutions that provide the glue that help us solidify our customers' relationships and shift the dynamics from being a vendor to being a partner. We touch on many different parts of health And as you can see, many of the offerings are sold into multiple parts of the care continuum. Everything we bring to the table is bound together by our mission To serve our customers and regardless of what healthcare looks like in the future, we are well positioned to play an active role From ensuring supply chain continuity and resiliency through the strength of our own manufacturing facilities along with our broad supply relationships to helping our customers operate more efficiently with our technology and service offerings to removing the burdens for our at home customers. We are committed to being better every day while bringing positive change to the market and remaining at the forefront of this dynamic healthcare industry.
Now let's move to an update on our go forward strategy. The core elements of which are contained within the business blueprint You've seen me highlight for most of my tenure at Owens and Minor, but I'd like to reframe and update those as we look forward. I think of this in 4 key pieces, all of which build on each other together. They include 1, leveraging the foundation, The foundation that we have spent the last 2 years stabilizing and building. This has been a multi year process and a heavy lift.
Going forward, we will continue to utilize the Owens and Minor Business Blueprint as the foundation with a continued focus on our culture, Business discipline and infrastructure leverage. Next, utilizing our financial strength. 2 years ago, you may have thought I was Crazy though to put those words together, but the hard work we've done has paid off. With the forecasted free cash flow from 2021 to 2026, We are in a great position to leverage that balance sheet and drive growth moving forward. 3rd, ignite sustainable growth.
With a strong foundation and a balance sheet that can support it, the new news today is really around how we're going to turn this into a company that can sustainably grow both its top and bottom lines. And 4th and lastly, by doing these three things, I have the utmost confidence that we'll be able to drive long term stakeholder value. The next few slides outline those strategy in a little more detail. Again, the first two are really about continuing to do what was so successful for us the last 2 years and doubling up on those efforts. To leverage our foundation, we have to maintain an unrelenting focus on the customer.
We also need to continue to focus on our unique and differentiated culture. We also cannot stop driving operational excellence across the organization and we must continue to embed the Owens and Minor Business System into the organization. Lastly, we need to continue to enhance our infrastructure such that it can support the needs of a larger organization. In terms of completing the final steps of repositioning our balance sheet, we know that we're not done. We will continue to prioritize maintaining the leverage target 2 to 3 times.
But we believe we can do that while still investing in the higher growth and higher margin pieces of our business. This will in turn enhance the free cash flow generating capabilities of our business, deliver real operating leverage, which again will help us build and also utilize our new financial strength for long term profitable growth. Steps 34 about shifting out of survival and transformation mode to one that can be more offensive focused and shift to more proactive strategies. As I've said in the first few comments today, We have a very valuable collection of assets that we believe haven't yet delivered the type of performance that they're capable of. Therefore, we have developed a multi pronged strategy to ignite long term sustainable and profitable growth across all of our businesses.
This will include investments in capacity, our proprietary product portfolio and into programs that will help us diversify and expand into new markets. It will also include a renewed focus on complementary M and A as we look to utilize acquisitions to extend our reach, opened up new channels and markets and augment our growth. If we continue to foster and leverage our foundation, Utilize our financial strength, adjust each of our business to be growth focused, I have the utmost confidence that we'll drive long term value to All of our stakeholders, that includes our customers as we become their preferred partner of choice, our teammates who are most critical asset to us And all of you are shareholders. With that, I'd like to quickly outline our long term financial targets, which is likely the slide most of you are waiting for. Again, we have a comprehensive plan to drive growth across our business.
From a top line perspective, we are targeting a growth compounded rate of at least 6% between where we ended in 2020 to 2026. And we have a long term target of revenue exceeding $12,000,000,000 This is all organically focused growth, so any M and A activity will be incremental. Then through focusing our investments on higher margin areas of the business, we plan to drive stronger operating leverage. We believe this will allow us to grow our adjusted EBITDA at higher level than our top line and our adjusted earnings per share at an even higher rate. More specifically, we are targeting 12% compounded growth in our EBITDA that will get us to approximately $650,000,000 by 2026 And 18% compounded growth in our adjusted EPS that would result in at least $6 per share by 2026.
These are aggressive targets, but we believe they are attainable. Again, I look forward to sharing this journey with you. Enjoy the rest of the presentation as we provide more detail around how we're going to deliver on these new commitments. With that, I'll hand it over to Chris Lowery, We'll walk you through a deep dive into global products. Chris?
Thank you, Ed. I look forward to sharing how our Global Products segment fits within O and M's strategic framework.
Let me start by telling
you about our market leading portfolio of products that we design, manufacture and source to support patient care around the world. Our best in class clinician preferred product portfolio includes Halyard, MediChoice and Medical Action branded products that are used across all areas of the hospital and in non hospital market segments as well. Our Halyard products are primarily products that focus on preventing infections In both the patient and the healthcare provider, most of the PPE that we have all become very familiar with Halyard brand. MediChoice is our private label with products that are the staples of everyday use in the hospital. And finally, medical action, which consists primarily of custom kits and trays designed to improve clinical efficiency in the operating room and across many other care settings.
Our brands are widely recognized by health care providers and have a reputation of quality and trust. We have a global manufacturing footprint, But our concentration of manufacturing in the Americas makes us different. We control the design, raw materials, specifications and strict quality standards in our own facilities with our own teammates. We self manufacture most of our proprietary branded products, many in the Americas. We manufacture the nonwoven fabric raw materials for our gowns, our N95 respirators and our surgical masks in our Lexington, North Carolina facility.
This vertical integration, coupled with our strategic American centric footprint And our distribution reach to the customer drives enhanced supply chain assuredness and sustainable margins. This represents a distinct advantage over non vertically integrated competitors. We're unique in that we are the only market leading company that offers this breadth of portfolio of self manufactured PPE type products. Others may have positions in a single category, but our broad offering of self manufactured positions us extremely well to meet the comprehensive needs of our customers and the changing landscape in healthcare. In addition to our broad product offering and shorter America centric supply chain, We have purposely diversified our product category footprint to provide redundancy and reduce single points of failure.
When combined with our vertical raw material production, we believe that we offer the most resilient PPE supply available. A final point of differentiation. Our business has a rich history of market leadership and product innovation. We have a legacy of leadership in these markets where we have been at the forefront of driving change. Like the market introduction of disposable sterilization wrap or driving the replacement of latex exam gloves with nitrile gloves to protect Healthcare Providers.
And we continue to evolve our product offering and lead change to meet our customers' needs. While the PPE market will contract from its pandemic peak, it will likely never return to pre pandemic levels. New protocols and regulations will call for increased precautionary measures and use of PPE in both healthcare and non healthcare settings. As we return to more normal situation, Healthcare professionals will demand medical grade PPE and suboptimal reuse and reprocessing strategies As well as FDA emergency use authorizations for unproven product will end. In the near to midterm, stockpiling efforts at the local, state and federal level will continue to drive demand for high quality, Proven PPE products.
We see a number of avenues to drive growth in global products. First, over the course of 2020 2021, we will invest approximately $100,000,000 to expand capacity our proprietary product portfolio and participate in new product categories with attractive gross margins. And third, we have been and will continue to further diversify into adjacent markets like the industrial clean room and retail. I'll touch on each one of these individually in the next few slides. This slide highlights the market opportunities and gives an overview of our various capacity expansion projects.
From this, you can see a few themes. 1st, due to our vertical integration and America's manufacturing footprint, We were able to respond quickly to the challenges created by the COVID pandemic. We remain uniquely positioned to quickly and reliably to changes in demand for PPE. 2nd, We have and continue to position ourselves to capture market share in gowns, both isolation gowns and non pandemic oriented surgical gowns and drapes. Additionally, we're continuing to enable further penetration of new markets such as clean room and retail gloves, as you'll see on a later slide.
Much of our completed capacity increase is already sold, And we will see the full financial impact going forward. We're encouraged by our recent success and the outlook for our legacy core categories, but we also have a substantial growth opportunity by extending our proprietary products into new categories. Traditional wound care and incontinence care products are examples of categories we plan to enter in the coming months. We believe our products, manufacturing and sourcing expertise, combined with our access to the customer via distribution, Provide us a clear right to play and win. For traditional wound care and incontinence, We see U.
S. Market size of $250,000,000 $370,000,000 respectively. With an addressable market size in the Owens and Minor channel of $150,000,000 We plan to launch traditional wound care this quarter and incontinence care products later in the year. Wound Care, assuming a 20% market share penetration, could generate $40,000,000 to $50,000,000 over the next 3 years. Our custom procedure tray or CPT category transformation is also a form of portfolio expansion in many ways.
We continue to invest in this category and the manufacturing capability to further improve The competitive performance and profitability of the segment. Due to its size and relevance to hospital operating rooms, This is an important anchor category that can fuel growth of both the medical distribution and surgical products businesses. With the U. S. Market size of over $2,000,000,000 we estimate $90,000,000 to $100,000,000 of revenue potential over the next 3 years from potential share gains in the CPT category.
Our third strategy for global product Growth is diversifying into new channels and markets. We expanded into the cleanroom glove market space in the second half of twenty twenty under the Halyard Pure Zero brand. For over 20 years, we've been manufacturing cleanroom gloves for a well known supplier. Our strategy now is to penetrate that segment directly with a new innovative glove formulation And also expand our product offering tailored for the industrial clean room segment. We estimate the market size for Clean room PPE like products is over $1,000,000,000 We intend to further our retail presence in the glove category With the launch of the Safe Skin brand, which comes with an innovative patent protected pop and go packaging design.
We've gotten excellent feedback about this offering from existing private label customers, and we're excited to offer to other retailers and through other channels such as Amazon, for instance. We estimate the market size here is approximately 800,000,000 And we see a revenue opportunity in just the next 12 months of $15,000,000 to $20,000,000 at attractive margins. And finally, adjacent to our surgical gown category, we're commercializing a new personal protection system for orthopedic surgeons that are involved in high risk fluid intensive procedures. This product targets $100,000,000 market Serviced primarily by a single player, we see a $35,000,000 to $40,000,000 revenue opportunity over the next 3 years. In closing, we see a very encouraging outlook for our global product segment, even with expected slowing PPE demand post pandemic.
Our unique supply chain, our investments in new capacity, new product launches and adjacent market opportunities Give us confidence in targeting $3,500,000,000 in total revenue in 2026, which represents A solid double digit growth rate of our 2020 results. Thank you for the opportunity to discuss the outlook for Global Products segment. I'd like to now introduce you to Jeff Jackums, our Executive Vice President, Chief Operating Officer and President of Medical Distribution. Jeff?
Thank you, Chris. Today, I'm privileged and excited to highlight our medical distribution business. We think about our medical distribution business as the backbone of much of what we do across Owens and Minor. The analogy is very real. The business sits at the center of what Owens and Minor is valued for, delivering products to our customers.
At the same time, it is so much more than that. Medical distribution is an enabler unlocking the entire value of our company. The Owens and Minor Medical Distribution business It's managed as 4 distinct components, each running independently, but collectively offering the market a comprehensive and differentiated solution. Let me briefly describe each of these four components. Traditional med surg supply is the long time core of Owens and Minor.
This business buys products from manufacturers and resell those products to customers. Medical distribution though is much more than traditional med surg supply. In outsourced logistics, Owens and Minor brings to market a leading capability to provide logistics services to both suppliers and customers, such as product storage, cross docking, transportation management and logistics services. In our technology and analytics component, O of the miner brings to our customer base and to our supplier community a deep capability to leverage technology and analytics to manage an increasingly complex supply chain. Finally, in our services component, Owens and Minor offers a market leading suite of technology and labor services driving efficiency, quality and productivity across the entire operating room spectrum.
Let's now look at our traditional med surg supply business in more detail. Traditional med surg supply is what most people know us for. This is the long standing core of Owens and Minor that will be 140 years old next year. What makes Owens and Minor different in this space is our dedication to providing choice and flexibility. We are committed to deploying technology and automation, but only up to the point that that would interfere with our flexibility that we need to nimbly adjust to customer requirements.
On this slide, we show a map of our distribution locations and highlight some of the key facts and figures associated with our traditional med surg supply. Suffice to say, the scope of our MedSurg supply operations is huge. We are one of the very few distributors possessing the size and scale necessary to supply the entire United States healthcare industry. Since pictures can illustrate better than words alone, Let's watch a video profiling our traditional medsurg supply business.
When choosing a partner, It's not only the solutions and the technology, but ultimately, it is the people you are doing business with. Aligned to our mission and values, Owens and Minor teammates possess the pride, the passion and the commitment
to serve your needs.
Owens and Minor's medical distribution business delivers a thoughtful combination of technology and touch centered around your needs, With automation in our distribution centers where it makes sense, simple but our technology solutions will never interfere with our ability to serve our customers. We take a thoughtful approach to the operations and we feel like we've got the right blend of tech and touch. Owens and Minor can offer best in class service across the continuum of Our peace of mind comes with knowing that your products are going to show up when you expect them to show up. Our operations strategy enables us To be flexible to deploy changes in customer preferences in hours, not weeks or months, and to scale quickly when Faced with demand increases or supply chain disruption, our LUM module is an example of technology at work. This order based system automates the tote routing using voice pick methodology for speed and accuracy.
Owens and Minor is the only company that offers our customers product returns on surgical kits, which reduces waste. That's the unique blend of technology and touch that provides flexibility, scalability and focuses on the customer's preferences. And it's only from Owens and Minor. We operate strategically
We do embrace continuous improvement here at the DC. We encourage the teammates
At Owens and Minor, we will deliver a unique vision in customized solutions for our customers.
We own the process from start to finish, all the way from raw materials To design a product, to finish goods and then the transportation to our own DCs that ultimately is then delivered to your facilities And to your patients and your staff to provide the right protection for the right procedure.
At our foundation lies the dedicated teammates at Owens and Minor. I've been delivering for Owens and Minor for the last 25 years almost. You become part of the team. Everything we deliver every day, it could be a life or death situation And it has to be there. Our OND Miner teammates are ready to serve our customers.
All promise to you to listen to your needs.
To be a true collaborative partner. To continuously add value
and earn your business
each and every day.
As you saw in the video, Owens and Minor is keenly focused on the appropriate balance Technology and touch. We endorse and adopt technology and automation where it makes sense to enhance quality and the customer experience, but not where it may interfere with our operational flexibility and nimbleness. These images depict just a few examples of technology and automation Across our distribution network, you see here our automated tote destacking and conveyor systems using automation to drive speed and efficiency. Our voice pick technology that provides both audio and scanner confirmation of picks, ensuring the technology is deployed to enhance quality and accuracy. Our in line scales ensure that totes contain exactly what they are supposed to contain, again using automation to enhance quality and accuracy while preserving flexibility.
What does this mean for the customer? You see that in the right handset of images. Product is cart loaded in a customized manner for customers, allowing the immediate deployment of our deliveries to the point of care without decasing or resorting on the customer receiving dock. Our deliveries are tailored to the physician preference items designated by our customers. And finally, we are the only supplier in the industry that accepts the return of unused surgical items, ensuring that our customers pay only for what they use, also reducing waste and our impact on the environment.
In a closed loop manner, we are then able to use data regarding unused surgical kit items To help hospitals revise their physician preference items to ensure that they order exactly what they may need, no more and no less. Now that you have a thorough understanding of our traditional med surg supply business, let's transition to outsourced logistics. You may be surprised to hear that Owens and Minor has offered the market an outsourced logistics offering for more than 10 years, previously known as our manufacturer solutions business. Before 2020, this offering focused on providing 3PL services to manufacturers in the healthcare industry. Over the past year, however, this offering has been widely adopted by hospital customers needing to address pandemic storage requirements and to manage supply streams from multiple sources.
We primarily run this activity from dedicated warehouses in Louisville and Cincinnati with additional space in Dallas, Chicago and Ontario, California. In 2020, however, we expanded this capability across the entire network With more than 25 of our distribution centers now actively delivering outsourced logistics services to the healthcare industry. As you can see, our outsourced logistics business is by no means a side venture. With ISO certified and FDA registered capability, We hold an average of $300,000,000 in 3rd party owned product at any given time, delivering over 26,000,000 cases annually. And we do so to the same standards of our med surg supply business at more than 99% accuracy and 99% on time delivery.
Allow me for a few moments to highlight what outsourced logistics means to our customers. On this slide, you'll see 2 different case studies. 1, a large international healthcare manufacturer and the other, a large multisite healthcare delivery network. While these two customers are dramatically different with diverse needs, both came to Owens and Minor for the same reason. Our unique ability to combine world class logistics support with a deep understanding of healthcare and FDA compliance.
In both instances, we've been able to deliver remarkable scale of support at incredible levels of performance, delighting each of these longstanding and growing customers. Let's now shift to the remaining two components of medical distribution. I'm always excited to talk
about these parts of our business Since they
represent what Owens Miner has become and where we're going, a leader in differentiated technology and services to the healthcare industry. The pandemic and supply chain disruptions last year compelled our industry to think about supply chain management differently. At Owens and Minor, we are committed to leading that thought process. For example, we've invested in a new cloud based inventory management system that will go live this year and provide several industry leading capabilities. We'll use artificial intelligence to ensure that past demand and future trends are assessed together.
And we will expand our leading capability to help customers manage multiple supply sources with single stream delivery through Owens and Minor. As the job of our customers becomes both more urgent and more complex, it is our job to deploy technology in a manner that supports their needs. Through use of our analytical tools, we provide numerous inventory and supply chain reports to our customers, such as spike usage at a particular location, slowing lead times from key suppliers or regional changes in hospital admissions that merit increases in purchasing. This is not the distribution of years past. It is supply chain management for the future based on real time analytics and reporting.
One of our newest innovations is MyOM, a technology solution that just completed beta testing and is now in broad rollout to our customers. With MyOM, we lead monthly look back supply reporting as a vestige of history, instead converting to real time cloud based analytics available to supply chain leaders at their fingertips through desktop or mobile device. Even more broadly, we are deploying a supplier side version of MyLM It enables our suppliers to see real time disruptions in supply chain performance that may impact the customer experience, enabling immediate responsive action to ensure product availability. Let's now transition to the final component of our medical distribution business, services. Within our services business, Owens and Minor offers a full suite of technology and labor services designed to improve quality and efficiency within the operating rooms or of our customers.
Let me take just a moment to highlight a few of the broad capabilities of our services business. Through Pandec, OSAMiner brings to our customers a specialized capability to help manage expensive suture and endo mechanical inventory within the OR setting. Our on-site specialists help to drive standardization, eliminate waste and save 1,000,000 of dollars per year at an average hospital. We are so confident of our capabilities that we guarantee customers savings of 5% on their suture and endo mechanical spend. Through QSight, we offer a point and click scanner based proprietary system that enables real time product checks in the OR or cath lab environment.
By immediately comparing product information against a vast pre scrubbed and maintained product database, we enabled users to ensure that product is unexpired and not on a recall list and then automatically upload product usage data into medical records and invoicing. Finally, QSight Automation facilitates product reorder, ensuring future availability of critical inventory. As you also see here, we provide an enterprise dashboard putting cloud based data analytics at customers fingertips. To bill only management, we enable customers to automate the tediously manual process of requisition of implant products, reducing dramatically the time and effort associated with managing implant procedure invoicing. Finally, SurgiTrak is our kitted offering focused on the surgical setting.
Once again, let me allow a video to bring our SurgiTrak business to life.
One of the unique services Owens and Minor offers is SurgiTrak, a comprehensive program that combines the delivery of custom procedure kits With powerful reporting tools that enable hospitals to maximize supply chain efficiencies, all the while lowering cost. An Owens and Minor Surgery Track Kit combines our proprietary products, Halyard and MetaChoice, we have a portfolio of products from over 1,000 branded manufacturers to give you everything needed for a procedure. This ensures your surgitrac kit is custom built to your exact needs, driving standardization And allowing surgeon preferences with visibility to cost and data. Your surgitrac kit is prepared in one of our Cold access restricted environment or care rooms by our SurviTrak specialist. Once your custom procedure kit is prepared and checked For accuracy, it then leaves our facility and is delivered right to your hospital, typically within 24 hours.
Have unused product after surgery? No problem. At Owens and Minor, you can return your unused unopened product analyze the utilization data generated from SuruTrac and work with you to identify areas for performance improvement, such as cleaning up your doctor preference cards. And the best part is we utilize that information to create visibility And actionable data that you can use to make smarter decisions about your purchases based on facts, ultimately Helping to drive efficiency, reduce waste and lower cost. Every day in every surgical suite In every hospital, patient care is the top priority.
SurgiTrak empowers that patient focus By leveraging the full force of Owens and Minor's product, process and technology to take care of the details So that our healthcare customers can do what they do best, take care of their patients. Owens and Minor,
That's awesome. I love watching those videos. As you may be able to tell, I'm passionate about all that medical distribution offers to our customers and to the broader healthcare industry. So how do we meet this comprehensive offering to ignite growth into the future? In short, we invest.
We leverage our existing portfolio of products and services And we diversify into new markets. Let me walk through each of these paths in more detail. With our strength in financial capability, Owens and Minor is actively investing in our infrastructure to support growth. These investments are being made in several key areas. The experiences of last year have reignited customer interest in dedicated distribution centers offering a multitude of services in one place, frequently referred to as integrated service centers or consolidated service centers.
As customer size warrants, We are investing in expanded distribution centers offering an element of shared facilities that enable Owens and Minor and our customers to jointly make use of space in a manner of benefiting the customer and creating long term account stickiness. With increased needs for product storage, Expanding warehouse capacity is also an area of ongoing investment. And to leverage the exciting things that I described a few minutes ago regarding technology, We are investing in our systems, our applications and our analytics to continue to expand our differentiation in this area. On a final note, and you've heard Ed mentioned this previously, Owens and Minor is making an ongoing investment in the O and M Business System, A comprehensive process approach to driving continuous improvement across our operations. In the context of broadening our products and services portfolios, Our focus follows very closely my earlier description of our services and technology offerings.
For example, in the area of services, We continue to invest in our services and QSight capabilities. Our ambition is to offer full case card management from procedure scheduling all the way through its post treatment analytics. For MyOM, we are focused on the commercialization of this offering to both customers and suppliers. For feedback received to date, MyOM offers a unique and highly differentiated information portal in which the market finds great value. And finally, we continue to invest aggressively in software and programming tailored to our customers' needs.
With respect to new channels and markets, we will continue to exploit our outsourced logistics capabilities. It is a matter of fact that healthcare requires a different level of comprehensive logistics services than it did just 18 months ago. With our unique mix of capabilities, we see this as a continued area of expansion and growth. Finally, Healthcare continues to migrate rapidly from acute care settings into post acute healthcare delivery, particularly the home. In combination, our Byram patient direct and our medical distribution capabilities offer a unique growth platform, largely unmatched in our market.
As you have heard and can see here, we have big plans for the future of our medical distribution segment. We outlined some of the key assumptions and are confident that our offering presents us with the ability to achieve these targets. And now, I'm pleased to hand off to Perry Bernanke, the CEO of Byram Healthcare.
Harry? Thanks, Jeff. I'm excited to tell everyone about the role of Byram within the overall value chain And how our Byram Patient Direct business fits into the strategic framework that Ed laid out to start the day. When you think about our patient journey
from the
hospital to home health and ultimately to the ongoing care at home, what Fyrem brings is that clinical connectivity between the referral source, the payer and the patient. Within the Owens and Minor family of companies and healthcare solutions, Byram Healthcare is the link that completes the continuum of care by providing 3rd party billing and home delivery of prescribed medical supplies directly to the patient's home. While visually it may seem that Byram comes in at the end of the patient journey, initiating and maintaining patient care at home is actually often the start of a new chapter for patients. The population here in the United States continues to age. We are seeing an increase in chronic conditions with the CDC estimating that 3 out of 4 Americans Age 65 and older have multiple chronic conditions and 83,000,000 Americans are expected to have 3 or more conditions Medicare is seeing a 7% growth in patients with even larger growth in managed Medicare enrollments.
The health care spending levels for those 65 plus are 5 times the spending per child and 3 times the spending per working age person. Reality is that patients respond better to treatment at home, and we expect continued growth in this care setting. It is also the patient's preferred care setting. These trends will continue to drive demand for our patient direct business. As noted, there's a growing need for alternate sites of care like mobile health and telehealth.
Recent growth in acceptance of these care alternatives was partly driven by the pandemic. These trends are expected to continue beyond COVID. This alternative care market is characterized by fragmented channels for delivery of products and services. The chronic care market is expected to grow by a CAGR of 6% to 7% Over the next 5 years, Irem's Patient Direct business operates in the soft goods segment of the durable medical equipment market, which is valued at 50,000,000,000 As of 2020, Byram also competes in the home health agency market, which is valued at another $750,000,000 B2B spending in the soft goods. Byram has been growing at approximately 2x the underlying market growth rate.
To give you a sense of the scale of Byram's business, We handle on average 35,000 new patients per month and ship approximately 3,000,000 orders per year. Through our vast insurance contract portfolio, Byram has access to over 260,000,000 or 80 percent of the insured lives in the United States. This means we can service most people with in network coverage rates, Meaning most patients will have better financial experience with Byram. It also means that Byram is well positioned as the partner of choice for manufacturer and other referral sources. As you can see, Byram has national presence across 7 key markets.
We invest resources where the covered lives are. Healthcare is local. However, we maintain a strong local presence in these key markets. We rely on our robust delivery network, Specialized center of excellence and experienced sales teams to ensure quality service for home health agencies, managed care organizations and health care professionals nationwide. These capabilities support our growth outlook and help cement Byrum's leading market position.
Our strong national presence and scale offer new opportunities. For example, we are the exclusive soft grid provider for the largest staff model HMO in the United States. Of our key differentiators is our product and reimbursement expertise through our specialized center of excellence. We serve members of national and regional managed care organizations over 650 contracts and over 2,000 plan designs, our constant focus on customer satisfaction continues to be rewarded. Iron's main customer stakeholder is the patient.
We ship them the products that they need directly to their home and build third party insurance on their behalf, Putting them at ease by managing the complexities of insurance reimbursement. We do this across a broad range of chronic conditions covering thousands of products. While primarily B2C, we partner with home health agencies across the country with B2B support for patient direct supplies by one agency service. This provides a seamless transition of care from home health to chronic care at home, meaning no interruption in patient supplies for continued optimal care at home upon discharge. We deliver the right product at the right time in the right place.
Furthermore, we provide best in class customer service. Our culture and business process represents our mantra that the customer is at the center of all we do. Perhaps the best way to demonstrate this commitment is to hear from some of our teammates on the front lines.
Byram offers a wide variety of services, especially to our diabetes customers. Education, I think, is important. Education about the products and services that we are selling to them. We also educate them on the processes that they need to go through. And I think that that's extremely helpful for these patients that have a terrible disease that nobody wants.
And We help them from beginning to end through the process, the ordering and the receiving of their products. And I think that makes a huge difference.
I think one of the best things that we do is advocate for the patients, helping them navigate their insurance. Their insurances are constantly changing And updating them and making them informed and also being able to make an educated decision. It's more than just placing a simple order. And we also offer a lot of different So we're not just focused on diabetic supplies, there's wound, ostomy, incontinence, breast pumps, so
a lot of choices as well.
We're all very passionate. We're direct to customer and they have chronic diseases. And so we, in my day, it's ensuring that our teams are prepared and have all those tools to ensure that they can best provide the top notch
Typical day for me is I make outreach calls to our customers To coordinate services to receive diabetic equipment and supplies. I collaborate with doctors' offices and insurances. A typical day in our pharmacy definitely starts off with us just being ready at 7 am to answer those phone calls and to help any patient that calls us. Having Accreditation in our pharmacy demonstrates our quality and accountability in the pharmacy. So this is just such a huge thing for
us to have and for
us Being the only pharmacy in Utah to have that, we just take great pride
in that. An informed patient makes good decisions. I think it's any one of The more one form, the better decision we can make. So I think being honest, I think being upfront, I think is the best way to empower the patient. I have a grandmother that's diabetic and we go through this company because I trust this company, not because I work for the company, but I see the process and I trust
An example that really sticks out to me is a couple of years ago, we had a patient that was recently diagnosed, she's a child, Recently diagnosed with diabetes around the holidays and we walked them through the process, got them on boarded and got their supplies out to them in time for Christmas. And we actually got a picture from the mom with the daughter under the Christmas tree with all of her supplies, with a nice letter of how it's going to impact her life and allow her to go to school and all the things she's able to do, because she's on the therapy now, and knowing that that's behind all the interactions we have day in and day out, Give a sense of pride at the end of the day that what you're doing really does make an impact. I have a family member that was recently diagnosed with gestational diabetes And the phone calls she made to me when she got it and the fear in her voice really put it to me
Reality to me is what
we do every day. So I share that with my team. And I think things like that are what separates us is that passion bringing every day to really It's not just a customer, but it's a life.
Our promise to our customers
Through our service and interaction, our goal is to help you forget
that you have a chronic condition, to take away from worry
We offer convenience, affordability and choice through the self care model. We accept all forms of order intake from e orders, referrals via the web To fax, to phone or text, we handle all the documentation, authorization and prescription validation requirements. We then provide timely and reliable delivery of a broad range of medical supplies and communicating for the patients along the way. Byram is the preferred partner of choice for delivering optimal patient care at home. As you can see, Byram has received top accolades for its service offerings.
We were rated the best diabetic supply company of 20202021 by Very Well Health through an independent study among diabetic educators. We are the leading CGM provider in our space and are consistently the top choice among wound centers. We are the preferred provider for the 2 largest wound management companies, Logix and Restorics. Our consistent number one ranking in Ostomy is a testament to Byron's strong history in that specialty. Our patient direct business serves people with chronic conditions or long term needs by delivering medical supplies across a broad range of product categories directly to patients' home.
Each program is designed and positioned to win in the market through a unique marketing and sales approach. Our care and touch at home patient support programs are designed to help improve clinical outcomes across all these therapies through educational resources and tools for patients to self manage their conditions. What drives and motivates us is the difference our service and our teammates make in people's lives, which we are reminded on a regular basis by our customers themselves.
My name is Melissa Valentin. I've been a parent of a patient at Byram Healthcare
for about 7 years now.
My daughter is right now 11 years old, but she was diagnosed at the age of 2 years 9 months. No one wants their child to have Type 1 diabetes, especially when they're nearly 3 years old. Like how do you to nearly 3 year old that they have a chronic disease that they will have to live with for the rest of their lives because at this point, there really are no cures, right? I would recommend Byron to my friends and family. I feel that they are truly trying to do the best they can within the limitations that the policy And the health insurance companies imposed.
An example of a time when Virem was very helpful with a specific change was We had changes of coverage from one company to another. At a specific time, we did not realize, my daughter and I, that the Change of the company also made changes in policy and the employees at Byram really, really become Became really good partners in helping us navigate the changes to make sure that we were still able to get the coverage that we needed, but upfront let us know That would be our responsibility and how those changes in coverage would impact our specific needs When we were in that need, Byron pulled through for us. She's now 11 years old. She is very healthy. She is engaged in everything and anything she wants to.
She has a normal life. I tell my daughter all the time that diabetes is her superpower. It's what makes her strong. It's what makes her resilient. It is what helps her to have a different perspective that most kids her age not have
Wow, what a great story. This slide gives some insight into the size and growth outlook for the different segments of the patient direct assessable market. Byram is well positioned across the largest, fastest growing categories. We expect Byram to outpace the market and continue to take share across our major product categories. It's also worth noting that 85% of our revenue is reoccurring revenue.
Once we acquire a patient, they often stay with us for years to come. Our patient customer retention and experience initiatives are key drivers of our success. Across the 3 strategic pillars, expanding capacity, Broadening our products and service offerings and diversifying into new markets and channels, Byron will play a significant role in igniting sustainable growth for the organization. We are committed to investing in technology to help make sure our customers have the best experience possible and start and stay with Byron. Our B2B interaction with referral sources, we are looking at technology to improve the ordering and data capture process.
In this and other areas, I'd like to underscore how Owens and Minor is integral to Byram's success. As part of the O and M family of solutions, We are better positioned to leverage new relationships and resources to capture large chunks of business across larger healthcare systems. We are uniquely positioned to meet the needs of the fast growing home health market. Hyram plans to expand into adjacent markets in new therapy verticals. Furthermore, we will continue to leverage the extensive Owens and Minor distribution pipeline.
Irem is poised to remain the partner of choice in the patient direct care market. We plan to expand our capacity in 3 key ways. 1st, by investing in technology to make the order process easier for patients, Healthcare Professionals and Agencies. This includes the launch of the new mobile application and enhanced reorder website, Expansion into our texting program and a new web ordering portal for home health. 2nd, we will leverage technology focus on prescribers, payers and patients to streamline the order to delivery And third, we will continue to improve the customer experience and patient satisfaction through a more CRM based personalized communication.
In terms of products and service expansion, Byron will focus on home health agency business growth and IDN affiliated agencies and pull through Leveraging Owens and Minor relationships. Kyron will pursue new global products through areas such as traditional wound care dressings and incontinence, Leveraging Owens and Minor Distribution footprint for expanded presence and efficiency and securing preferred and exclusive agreements with payers through service differentiation. Entering new and adjacent markets will also be a significant focus for Byram as we look to grow beyond our organic growth trajectory. This includes an entry into mobile health with a digital product designed specifically for diabetes population management, We focus on maximizing our large preferred partnerships in lien care as well as establishing a cash and e commerce business as an expanded offering within our categories. In addition, we will launch new category verticals with attractive growth and reimbursement profiles Such as respiratory and continued investments in sales personnel and digital marketing in our priority markets to solidify our organic growth.
As you can see, Iram's growth has been well above market rates and again 85% is reoccurring revenue We expect strong above market growth and a bright future as we build upon our core strengths and explore opportunities and partnerships. We are excited for what's ahead in the Patient Direct business. Now I'll turn it over to Mark Zacker, our Executive Vice President and Chief Commercial Officer.
Mark? Thanks, Perry. I'm excited to tell you more about how our commercial approach complements the strategic Framework that described earlier. Over the last 2 years, we've done an excellent job of renewing and expanding relationships with existing and prospective customers. We've accomplished this by having our executive team lead from the front by reorganizing our commercial team to streamline connectivity with the customer.
Our new structure, which has been in place since start of 2020 has enabled us to capture an increased portion of the customer share of wallet between our products, Distribution and Services Businesses. In addition, the enterprise team has been effective at identifying and advancing leads for our patient direct business. Previously, there was a complex and siloed structure with multiple owners and a lack of clear internal accountability. The new enterprise structure streamlines support and provides a single commercial point of contact for each account. As an example, instead of having separate representatives for the products, distribution and services businesses, We are now organized to work together to gain new wins and ensure customer success every single day.
By having a single point of contact for the customer who is responsible for bringing in product, distribution and service experts when needed, We give our team the ability to showcase the breadth of our total company offering. This approach has dramatically improved our ability to retain existing customers and Excellence in service to our customers is the hallmark of the Owens and Minor brand. Operational excellence is not optional and is absolutely required so the clinicians can focus on care for the patients Without worrying about having the supplies they need. Every interaction with the customer is a moment of truth as it can create a lasting impression And impact their perception throughout the customer lifecycle. At O&M, key ingredients for operational excellence and customer care include: Getting the right product at the right time at the right price to the customer 100% of the time.
Streamlining resources and reducing waste to provide the best overall value for our customers. Capturing and utilizing actionable data to optimize product utilization, selection and inventory levels, while maximizing our mutual operating efficiencies. With exceptional operating performance, we are earning the right for deeper And more strategic partnerships with our customers. As a result, we can elevate the level of discussions we are having. For example, How do we grow together?
How can we strengthen the supply chain? How can we work together to ensure supply resilience? Earlier, you heard Jeff Jocums talk about our capabilities in medical distribution. Medical distribution enables access to the key decision makers The customer acting as a catalyst for revenue and profitability growth. With our proprietary products, the ultimate decision is up for the commission And this plays to our strength as we are incredibly confident in our products given our vertical integration, manufacturing expertise and intense Focus on product quality.
In addition, we are continuously enhancing our 3rd party branded product Service portfolios increase customer efficiencies. Our value added services with inventory management solutions like Hughesight Bring exceptional value to our customers, providing O and M with a competitive edge. Here's a look at how the commercial team approaches new proprietary product introductions. We start with detailed product training for our team, then dive into pricing strategies and top target identification. We then provide the sales force with the tools they need, like marketing collateral, product samples and sales talk tracks to support their efforts.
Following extensive customer interactions and follow-up, we deliver product and drive sales. We ensure by utilizing disciplined processes to drive sales team accountability and execution throughout the entire sales cycle. In summary, we simplified our commercial structure with one point of contact. We listened to our customers and we have provided More proprietary products to them. But don't take it from me, let's hear from a few of our customers.
To ensure the safety of our staff and patients in the face of this pandemic. I wanted to
be sure you knew how much you were appreciated And that your work has contributed significantly to the safety
of our clinical staff. To date, we have no indication that any COVID transmission has occurred when Staff were wearing available PPE and
of course your work and that of your organization has helped to ensure adequate supplies.
We had some tough days and great days,
All to be expected in
a situation like COVID has brought, but I'm most proud of the relationships we've built and the way we work together to solve problems. Of course, the COVID pandemic has challenged all aspects
of the global supply chain.
As a provider of long term acute and intense rehabilitative services, we
have certainly felt the impact of PPE allocations, increased patient census And acuity beyond the
sickest of the sick when we typically treat
and having to source alternative products to meet heightened demand. Throughout these challenges, it has
I'm Tom Lobasky, the Vice President, Supply Chain at Allina Health up in Minneapolis, Minnesota. So Allina Health in terms of its makeup is about 12 hospitals. 3 large metro based hospitals really 80% of the revenue base. The supply chain spend is about $800,000,000 Our relationship has been almost 20 years. So it's a long standing relationship.
Our past and the many years that we've had worked with Owens and Minor, our needs, of course, change. And so we really have a partnership that's been highly responsive. The partnership though expands into strategy and that is Really, Sam, where do we want to be for the future and continuing to look at their strategies as well and then align them accordingly so that we Can really begin to address what are the best path for a win win situation and to advance that work at hand. Responsiveness is really the first thing I think of when I think of Owens and Minor. As I mentioned earlier, They're not only the people on-site that are located regionally, but nationally, if there are issues Of the day that really need to be attended to, they are most successful and most responsive and really working through the challenges that we have.
So The demand to act fast and efficiently is really important, especially when we're talking about patients that require the supplies in order to be treated correctly. So With all the new demands, without question, we know that we can rely on Owens and Minor to be at the table with us
As you can see, they've responded positively to our efforts and this level of execution will remain our focus moving forward. Everything we do is centered around the customer. Our value proposition enhanced and driven by our teammates And combined with our best in industry execution enables our mission to empower our customers to advance healthcare. Thank you for the opportunity to tell you more about our commercial structure here at Owens and Minor and some of the key structural changes we've made. Let's take a 10 minute break and then you'll hear from Shannon Neal, our Chief Human Resources Officer.
Welcome back. As Mark said, I'm Shannon Neal. And today, I'm going to talk about our Owens and Minor team, our culture and key initiatives to support these efforts going forward. The world has changed since Owens and Minor's founding in 18/82, but one constant over the years is our commitment to taking care of our teammates, our customers And the communities in which we operate. Our more than 15,000 teammates spread across 70 countries worked tirelessly to uphold our mission.
I am continuously impressed by the caliber of our team and their loyalty, dedication and passion around serving our customers. While we are proud to say that 38% of our female identifying teammates are in management roles, I'm even more excited to tell you that 42% of our new hires at the VP level in 2020 were also female and 57% were ethnically diverse. I'll further address our diversity initiative shortly, but the strength and heart of our organization lies within our teammates. Earlier today, you heard Ed talk about our ideal values, which represent the core of Owens and Minor. As the CHRO of this great organization, My mission is to ensure our culture is consistently exhibiting these values each and every day across the entire company, Acting with integrity, aspiring to develop and improve, performing with excellence, being accountable And listening to our customers and to one another.
The teammates we have at Owens and Minor are the best yet and I'm excited to be part of such a great team. As my colleagues discussed in their presentation, while the COVID-nineteen pandemic had a significant impact on our operational and financial performance, We like all essential businesses implemented strict protocols to ensure the safety of our teammates and their families And to ensure that there were minimal to no disruptions to our business. Very early in the pandemic, when the first cases began to occur in our communities, We immediately pivoted to remote work for office based teammates. And for those in our manufacturing and distribution centers who were required to be on-site To ensure we continue to provide critically needed products, we immediately implemented strict health and safety protocols for their protection. These included things such as training on how to properly use the PPE that we produce in a manner that kept them safe and allowed them to perform their duties.
Installed temperature scanners, staggered work schedules to provide the ability to social distance, contact tracing and strict quarantine rules, Providing free telehealth access and offering time off to care for loved ones or to recover themselves. As you heard the team mention, automation and technology enhancements also kept our teammates safer and improved our operations and our delivery methods. I'm incredibly happy to report that we have had a much lower than typical incident rate of positive COVID-nineteen cases since the beginning of the pandemic, Allowing us to continue to serve our customers each and every day. I'm proud of our team and their unwavering commitment to their own health and safety and that Their colleagues and our customers. I'd now like to spend some time discussing our efforts around ESG, a concept we've been hard at work on for years.
In 2020, we took the appropriate steps to begin formalizing our ESG program. And the output of these efforts is our first ever corporate sustainability report, which will be published in a few weeks on our website. This assessment helps us identify the critical ESG topics that are aligned with our mission, our values and our strategy. For 140 years, Owens and Minor's core mission has been to empower our customers to advance healthcare and by extension protect our communities. We believe this is one of our core responsibilities, but it does not end with just providing medical supplies.
We understand that doing business the right way operating in a sustainable way from raw materials to finished products to distribution. That truly means everything from recycling to reducing our energy demand, to lowering our carbon footprint and how we get products to customers. These efforts across our full geographic footprint are yielding positive results. Our commitment to empowering our customers begins with the safety and well-being of our teammates. And as I mentioned earlier, our views on safety have always been at our core and not just during the pandemic.
Owens and Minor has long been focused on healthcare protocols at our manufacturing sites, distribution centers and offices. Across all of our operations, our Safety Management System or SMS standardizes safety procedures and improves performance. The foundation of our system is leadership commitment and the support that empowers the organization to make safety a top priority. Over the last 2 years, this has resulted in a 62% decline in recordable incident rates at our manufacturing and distribution sites And significantly lowered workers' compensation claims, a noteworthy reduction of 37%. In fact, We've awarded our prestigious Crystal Eagle, which signifies more than 365 days without a recordable injury to 7 of our 9 manufacturing sites.
We believe that diverse and inclusive teams are essential to broaden perspective and ignite creativity and innovation in our business. And as such, Our teammates are empowered to help lead us on this journey to create a culture where everyone can be their authentic self at Owens and Minor every day. Fostering a culture that promotes diversity has been a long standing goal at Owens and Minor. But in 2019, we felt we needed to accelerate our work in this area Inform a more comprehensive D and I strategy. In 2020, we began building the foundation of a program and that centered around supporting our teammates.
In particular, we found significant value in the creation of our teammate resource groups In which members of specific social, racial, ethnic, sexual orientations and other unique backgrounds Collaborate with us to help shape our policies and our practices to be more supportive and inclusive. Despite the great work in 2020, We know we have much more to do as we continue with training, awareness and education and recognition of our amazing teammates. We are seeing higher levels of teammate engagement, satisfaction and retention since we started this initiative. And we recently completed a global engagement survey where more than 90% of our teammates responded. My focus is to foster an environment where every teammate feels valued and that they belong at Owens and Minor.
I'd like to add that our D and I efforts are not solely limited to our teammates and we actively strive to acknowledge the need for inclusion in our suppliers as well. We work to support qualified small, women, minority, LGBTQ plus disabled And veteran owned businesses to advance a superior supply chain and to support the economic development of small and underrepresented businesses in the communities That we serve. With only 3% of revenue of all U. S. Corporations spent with diverse suppliers, there is considerable opportunity here.
In 2020, we sourced 7% of
our total sales and a strong 32% of our MediChoice brand from diverse suppliers. The team is committed to increasing that number every year and I look forward to updating you on our progress in the coming years in our sustainability reports. Earlier, I outlined a few of the efforts our team has taken to support our local communities, particularly in times of crisis. Notably, our teams across the U. S.
Proactively sought ways to support our customers and first responders by giving them the critical supplies they needed to save In one such example, our customer PeaceHealth, which is a non profit healthcare system in the Pacific Northwest, Work closely with our Owens and Minor account managers to send double orders of all supplies in the face of devastating wildfires last summer To ensure that first responders had the supplies they needed. Additionally, our team took extraordinary measures to support our customers in the Florida Keys in advance of And following Hurricane Irma making landfall, our quick thinking team rented duck boats that would normally carry tourists To bring essential supplies to hospitals and field clinics that were isolated by impassable roads. These are just 2 of the many examples of incredible measures our team takes to serve our communities during their greatest need. As further proof of our commitment, I am extremely pleased to announce the launch of the Owens and Minor Foundation. Through this foundation, we will make impactful investments in the communities we serve in the areas of environmental, healthcare and diversity and inclusion.
Let's now turn to how we think about governance and leadership at Owens and Minor. Our 5 guiding principles with respect to leadership, integrity, development, Excellence, accountability and listening are what drive us every day. We started at the top with our Board of Directors, Following our most recent proxy vote now includes 7 independent directors. 25% of our directors are ethnically diverse And 25% are female and all of whom bring tremendous expertise that will help us achieve the next level of success. Having diverse and inclusive leadership that embodies the highest ethical standards is critical to fostering a culture that supports the best talent throughout our organization.
You now heard over the course of the day, our senior team outlined the necessary steps to achieve the next level of our potential. And at the heart of it all are our teammates. Teammates whose commitment to our mission and values allows us to empower our customers Advanced healthcare in the markets we serve. With that, I'd like to turn it over to Andy Long, our Chief Financial Officer.
Thanks, Shanna, and hello, everyone.
It's great to be
with you here today as we lay out our strategy And conclude what has been a full day with a financial update and outlook. Let me begin by talking about how our strategic framework has impacted our financial performance and positions us for ongoing profitable growth. In order to appreciate the road we've traveled to get where we are today, I think it's important to understand where we were financially back in 2016. Here you can see a snapshot of where the company was during the 2016 to 2018 timeframe. We were experiencing margin compression, deteriorating free cash flow and a rapid increase in leverage following the acquisitions of Halyard and Viarm.
As you've heard throughout the course of the day today from Ed and the rest of our leadership team, the groundwork that was laid beginning in 2019, Which includes our operational improvements as well as a renewed focus on our customers positioned us very well to respond to the challenges the entire healthcare industry faced As we entered 2020, with a renewed intense focus on the customer, our teammates rallied to respond to the needs of the healthcare providers we serve In the face of unprecedented demand and volatility during the COVID-nineteen outbreak. As you can see, our business performed incredibly well. The resulting improvement in the bottom line drove increased cash flow, which we deployed to reinvest in the business in the many ways in which you've heard during today's presentations. In Global Products, we added the laminator in Lexington, North Carolina, installed new N95 capacity in North Carolina and Texas And expanded our gown production. In Global Solutions, we expanded our low unit of measure capabilities, improved our inventory planning algorithms And enhanced customer experiences through QSight and MyOM, our data management offerings.
And with our disciplined capital allocation process, We also utilize this cash flow to reduce debt and overall leverage leading to improved credit ratings and ultimately to a total restructuring of our balance sheet With longer maturities, favorable rates and ample liquidity to fund the day to day operations while providing capacity to invest Inorganically, should the opportunity present itself. The power of our operating model is clearly apparent on this slide. Improved margins have translated directly into higher free cash flow, a portion of which has been used to drive debt reduction. This combination of increased EBITDA and lower debt has drastically improved our leverage metrics. The credit rating agencies have in turn responded with multiple upgrades over the last four quarters and we expect to be at or below the low end of our target leverage range of 2 to 3 times by the end of 2021.
With a significantly cleaner balance sheet, we will continue to invest to drive organic growth And have the optionality to use bolt on M and A to supplement via inorganic growth. The next slide illustrates our consistent quarterly margin progression Since the Q1 of 2019, our focus on operational excellence as well as our strategic investments in new capacity, Patient Direct Growth and Infrastructure are the main drivers of this improvement. As you've seen today, our future organic growth opportunities and potential M and A are expected to be margin accretive. Execution of our strategy is resulting in higher quality, higher margin revenue across the company. Our investments in expanding capacity have utilized our existing footprint and infrastructure, driving operating leverage and margin expansion in the short term.
Long term, our investment in new proprietary products should not only drive revenue growth in new and existing markets, but target attractive margins as well. The COVID-nineteen pandemic has forever changed the landscape of the healthcare industry that we serve. While we're all looking forward to the day when we as individuals We'll no longer need to wear PPE to go to the store, to go out for dinner or even to travel. This eventual fall off in demand in the retail space Should not have a major impact on us as it's not our primary market. We primarily focus on healthcare providers And long term, while we expect demand for PPE in this market to eventually settle in at levels below what we saw in the peak of the COVID outbreak, We believe that demand will be well in excess of pre pandemic levels as a result of new protocols, new regulations and new requirements for stockpiling.
We also have opportunities to expand beyond the domestic acute healthcare customers that we focus on today to other channels portfolio of America's based medical grade PPE coupled with our direct channel to market, we believe we are well positioned for the future. Earlier in the presentation, Ed shared with you our 2026 revenue targets. Here's what we believe are the key drivers of this growth Building from 2020 is the base. 1st,
we expect the overall market
to grow in the low to mid single digits. Partially offsetting this is the resetting of PPE demand from the peak pandemic levels, which we saw in 2020, as I just described. Next, as you've heard today, we expect our investment to expand our proprietary product portfolio as well as our patient direct categories We'll continue to contribute to not only top line growth, but improved profitability as well. Furthermore, we have an opportunity to drive growth by Expanding into adjacent markets like industrial clean room, retail and international. The combination of these actions Allows us to target annual revenue in excess of $12,000,000,000 by 2026, representing a 6% organic compound average growth rate.
Any M and A activity that we may choose to pursue will be incremental to these projections. With the strengthening of our balance sheet, M and A activity has now become another option for our capital allocation strategy moving forward. We'll maintain a disciplined approach and our evaluation of M and A opportunities. Our focus will be on reasonably sized deals that are quickly accretive. We'll look for opportunities with key market positions that are complementary to our strategy and support our growth platform.
We're in a great position to use M and A as a lever to drive both revenue growth and margin expansion. We're targeting over $1,000,000,000 of Cumulative free cash flow being generated through 2026 as we execute the plans we've described today. We'll continue to be disciplined in our capital allocation approach and we'll utilize our Owens and Minor business system as the framework to maximize value to meet the needs of our stakeholders. This will be achieved as we invest organically in our infrastructure, our technology, our teammates, our products and our processes. Debt reductions will remain a priority, keeping the company in a position of financial strength.
As just highlighted, where it makes sense, We'll target strategic M and A transactions to drive growth and expand margins. And finally, we'll return cash to shareholders through dividends and Strong earnings growth. As I close out my section of the presentation today, I want to summarize the key drivers of our expected long term financial performance. We're targeting in excess of $12,000,000,000 in annual revenue by 2026 through winning new business, broadening our portfolio And expanding into new markets. As compared to our 2020 actual results, this annual revenue level allows target a 2x increase in adjusted EBITDA to over $650,000,000 as a result of selling a portfolio of higher margin products, Generating efficiencies and driving operational leverage.
Our revenue and adjusted EBITDA targets will translate into Target adjusted average annual EPS growth rate of at least 18% and are targeting to exceed $6 per share by 2026. We're excited to have a strong platform for future growth. Thank you for the opportunity to discuss our financial strategy and outlook with you today.
Now I would like to turn it back
to Ed for his closing remarks. Ed? Thank you, Andy. The team we've assembled here at Owens and Minor is passionate about our business, our culture, our values and our commitment to delivering critical products everywhere. As you've heard today across all of our presentations, Each of our business lines complement each other and we firmly believe that creates a unique value chain that is a key differentiator.
And most importantly, it provides true value for our customers. From design to delivery, We are fully invested in the entire process to ensure the right product reaches the patient at their most critical moment. We take that commitment very seriously every single day. You likely recognize this slide by now. But most importantly, these four steps represent where Owens and Minor is headed.
I spoke earlier about the necessity to rebuild our foundation. We have some of the best and brightest in the industry on the Owens and Minor team, and it shows every day with how much we have accomplished in such a short period of time. With step 2, Andy and his team's ability to fortify our balance sheet has allowed us the financial flexibility to achieve our long term goals. These two areas combined provide the stability we need to ignite both our top and bottom line growth. I'm looking forward to sharing updates on these efforts in the coming quarters.
And finally, and why I'm so excited to be speaking with all of you today Is that Owens and Minor is going to generate the long term value it is capable of generating. I'm honored to have your trust to do exactly that over the next 5 years. In our time together, I hope you've not only gained a greater understanding of how Owens and Minor operates today, but also our true potential. While we are a leading healthcare solution provider with over 140 years of history of helping providers give the critical care to their patients' needs, We are also humbled to take such an important role in combating the global pandemic with our trusted made in the Americas products that are designed to help keep our community safe. As the team spoke to you about today, we serve those that care for thousands of patients every day.
And through our Byram Patient Direct business, we serve patients' needs right in their home, where we believe more and more care will be delivered in the years ahead. And finally, as I mentioned before, Andy and I are intensely focused on our strategic plan to prioritize on high margin and growth focused areas, while simultaneously building our improved financial footing, expanding our cash generation and funding our growth. I hope you recognize why we're so excited about the future. I look forward to updating you on our progress over the coming years And thank you for your support of Owens and Minor and our mission of empowering our customers to advance health care. Thank you.
The team and I are ready to take questions now.
As we turn our attention to Q and A, please feel free to join the queue to ask your question. Our first question comes via chat from Daniel Crossley Can you provide more details around your proprietary product portfolio expansion? How many products will you be manufacturing in your owned North American facility? Will you need to invest in additional capacity?
Sure. Well, thank you for the question. I'll start and then I'll allow Chris and maybe Andy to provide some color on it afterwards. So as you heard today, the amount of Excitement we have around that proprietary expansion is immense. Chris talked about it today.
We have those identified categories right out of the gate that we're going to continue start to And that manufacturing and that product of our proprietary products. In addition to that, the CPT business. The way we're thinking about that is obviously getting ready to launch it this year and then continue to grow going forward. I think one of the advantages we didn't talk about today Is the amount of data and information we have about understanding what products customers need both from a scale standpoint or uniqueness. And that's going to help us guide this repeatable process to continue to add and expand that product portfolio as we go forward.
As Andy talked a little bit earlier about our investment strategy, we will do a make buy analysis on that and look at it both organically and or inorganically To expand that footprint. And then you're going to see the sustained growth. So once you build that product in the portfolio, That stays there. The next year, you continue to sell that same product. You can expand it to more customers.
And then I don't want to miss another factor that also ties into this. And that is the fact of the adjacencies in other markets where we can take that broadening product portfolio and move those brands into it. And then lastly, beyond just that portfolio expansion, Chris talked about it today, some of the unique products, unique packaging that we're going to use to continue to drive more of our proprietary products. So with that, maybe I can turn it over to Chris and he can add a little more commentary around Some of the specifics in the category that we're expanding into. Well, thanks, Ed.
I think just what I would add is that We believe that we can do multiple categories per year, much like the traditional wound care and incontinence that I described in the presentation. And as you said, really each category is its own independent make versus buy decision. And of course, over the long term, Neither one is precluded. We could buy initially and then invest to in source down the road. So we see a lot of growth headroom associated with leveraging our reach to the customer and expanding the portfolio.
The other thing I'll add is I'll ask Andy to talk about a little bit about our capital deployment and the amount of ability to now invest into that growth For that capital deployment associated with portfolio expansion. So let me turn it over to Andy for that. Yes. Thanks, Ed. So as we look at the decision to And our proprietary product portfolio and as that fits into our overall capital allocation process, given the strength of our balance sheet and given the cash flow that we expect to be able to generate over the long term, it really comes down to 2 step decision.
As we talked about, 1 is getting the product right And then 2, it becomes, as Ed said, a make buy decision. And given the strength that we have financially, where it is a buy decision, I feel very confident that we'll be able to fund that And grow the business with those investments. And I'll just close out on this question and go to the next question. But the other thing I don't want to miss is We've got great commercial teams, both in our classic medical distribution as well as in our home health that can continue to help support those products once we bring those products into our
As a follow-up from Daniel Goofly, can you comment on the RFP season this year? Can you quantify new wins or competitive retention? And how your ability to deliver on PPE during the pandemic has impacted your competitive positioning?
Sure. So I'll start and then maybe I can have Mark Zacker add a little bit of commentary on this. So here's what we know is The team has done an incredible job during the pandemic. We serviced our customers as best as we possibly could. You put the whole value chain together.
Chris and his team produced more and more products at rates we've never produced before. We expanded capacity to greatly serve our customers. But I think you have to be honest, there were points in time during the pandemic where that supply demand imbalance was there. And from that standpoint, There were times when we could have sold more products, but we were producing at full capacity to our customer base. But that goodwill we gained and that credibility plus The significant improvements we've made in our medical distribution business, as Jeff talked about earlier, that great balance of touch and technology, The ability where we were able to scale quickly and had the flexibility to adjust, that also added to that tremendous amount of goodwill with our customer base.
So what we've seen from that and translate into that, we have more and more of our customers, we are in the process of renewing agreements because of the relationships that we've built. What I've talked about in previous earnings calls as well as in the past is our pipeline is for opportunity is bigger than it's ever And that's what gives us tremendous sight into the future and encouragement of that growth trajectory that we're on. And all of that stems back from And it sounds because we've talked about it so much today is our mission and our values. Our mission is around serving our customers. Our values are the guidelines of how we do it.
And that's what we did during the pandemic. We've leaned on that heavily to make sure that we could best serve our customers and we did gain goodwill from that. So with that standpoint, let me turn it over to Mark and maybe he can talk a little bit more about how excited he is around the trajectory of where we are from those types of bidding processes.
Thank you, Ed. It's been quite a journey, right? It's no secret that in 'seventeen, 'eighteen and into 'nineteen, we had problems with medical distribution business, That business was eroding. We stabilized that in 2020. Into 2021, we're poised to have a high degree of net wins.
And the footprint of our business, the retentions that we're gaining, we've really stabilized that business in the position to grow. And we're growing with products, but also with medical distribution, which you heard is a backbone for growth for a large portion of our businesses. So we feel really good about it. Our teams are working together. Our commercial teams are more integrated than ever before.
Representing 1 Owens and Minor wherever we go and that's paying dividends as well. So we're incredibly excited about 2021, But also 2022 and well into the future.
Let me add this too. I'm going to ask Jeff to make a couple of comments because he spent the last week or so Out on the road visiting our customers face to face, which is great because now we've got opportunity to go and see them in person. But maybe let Jeff Talk a little bit about what he heard in the last couple of weeks when he's been on the road.
Sounds great. Thanks, Ed. We did have a chance to get out and see a variety of customers. It was great to get back out on the road, Losing a room key here and there, being out of travel shape. It was great to get out and chat with them a little bit about where they see things going.
One of the things that we hear from customers and we heard a lot of in meeting with 5, 6 customers over the course of a week was they were Thrilled with what Owens and Minor did for them as customers, but we also met with some that are interested in becoming customers. And they were thrilled with Owens and Minor's ability to support them during COVID with our self manufactured product. And the feedback that we're getting is, If you were that good for us when we weren't your primary customer, then what can we get from you as a primary customer? And so we're able to talk about The full spectrum of what Owens and Minor can bring to the table. So there's a building momentum based on the way that we were able to serve customers last year that I think will continue well into the future.
Our next question comes from Michael Cherny from Bank of America. Please go ahead with your question.
Good afternoon and thank you for all the color so far. So I'm particularly intrigued by some of the opportunities you had around these new Channels and seems like you have potential for market expansion, product expansion across all lines of business. As you think about expanding into Those various different areas. When do
you think you'll feel comfortable about having the
right amount of visibility to show that those solutions, whether it's And so healthcare channels, non healthcare channels, some of your other products as specific examples are hitting the metrics, hitting the growth targets that you've laid out.
Sure. So I'll start with that and then I'll maybe turn it over to Andy to add a few comments and then Chris would like to also. So here's what we see. We already have the road map planned out. We already know where our tack points are, where we're going to go after And frankly, part of it is taking existing products that we're already selling today and moving those in other channels.
So we understand the value of those. So as we start to think out later into this year and early into next year, that continues to give us that path. I think it's all critical and contingent on is what Chris talked about today. You already see when those products are going out into the market and when we're going to start to launch them. But it's not just about the launch, it's about the preparation on that.
We have to make sure, 1, we have the product in place, we have it to the right locations, we have the collateral material, we have the reps trained on it, we've had the conversations with the customers, We work with value added with the value added committees from the customers. We're talking about the adjacent markets. We have the unique packaging set in place. And all of that work Started last year. We planted those seeds and we started to see them we're starting to see them grow now.
But it's really going to be later this year, early next year when you start to see that get on a rhythm and To move forward with it. With that, let me turn it over to Andy to see if he wants to add a little more color around that on the timing. Yes. No, that's exactly right, Ed. And just to Stress in the overall financial planning for the expansion of the portfolio.
As I've said exactly, we've generated a significant amount Over the last 15 months to 18 months and we've talked a lot about organic growth investments. And what you've heard about today are not just investments that are planned for the future. These are investments that As Ed said, those seeds have been planted. They've been ongoing and expect to bear fruit as early as the end of this year. And then we've got that roadmap out throughout Out to 2026.
So I think it's exciting to be talking about those expansion plans as we look towards achieving our growth of over 6% compound growth rate out to over $12,000,000,000 in revenue out to 2026.
That's very helpful. And maybe this is a great day for The team as a whole to take stock of the work that you've done basically since you came in and the operational improvements that you made and the pathways that owns a minor up on. As you think about the pure operational side, so thinking about how you can make Owens and Minor a better run company, I hate to use the analogy, but what inning do you think You're in right now in terms of where Owens and Minor has gone so far on all the optimization, IT investments versus what is still left?
Yes. So let me first start. The reason for the turnaround is really the leadership team And that's why today was so important to me and to our company. It's where you get the opportunity to meet and see the rest of the leaders. We had a great blend of leadership.
We had several leaders that were incredible that were already here and then brought in leaders that understood the industry, understood the space and had a clear focus on how to turn things around. So, 1st and foremost, it's that. And then beyond the leadership team, it's You don't hear this, but a lot of the work that Shannon and her team did with the HR organization were doing talent assessment last year, identifying high potential Teammates, identifying promotable teammates, identifying succession planning and building that and the countless hours that we've added in training. That's everything inclusively that's helped it. Then you talk about our changing of our culture.
So I think about our culture and I think about our business That continuous improvement, all of that's still really early stages and it's something that you still have to do. We're not in the 7th, 8th inning. We're really still in the early innings on that because having looked at this and done this in the past, Your continuous improvement in that mentality, it's everyday work that you have to do and it takes time to further get it ingrained in the fabric. We're getting there. We still have a ways to go and there's always opportunity to improve.
You saw one of the slides today too that talked about the changing environment of healthcare And we can't sit stagnant. So if you're sitting here mentally saying your 7th, 8th, 9th inning, that's a mistake because the market is moving. So we have to constantly keep advancing. So short answer to the question is we're very early still in the game. Long answer to the question, it's we got I believe we've got an incredible team that understands the market, adjust as necessary, We'll continue to engrain the Owens and Minor blueprint of our culture, our discipline into our company as a whole.
Perfect. Thanks so much. Really nice job with today as well as the work over the last couple of years.
Our next question comes via chat from Eric Coldwell from Baird. We thought we heard a comment about global products capacity additions or new lines being sold out for some period ahead. Can you clarify this comment?
Sure. I'll start and I'll let Chris add some additional commentary. So really on twofold. One is, we work with our customers To have long term relationships with them. So that way, as pandemic continue to move on, as pandemic continues to That multi year agreement on to be able to sell to them or the production coming off of the line, I should say, being dedicated to those customers Into the future.
I think the other part of the question was also on expansion as we did talk about that today also is the expansion we still have in And Chris showed it on a slide is really our glove expansion in our factory, continuing to produce significant number of incremental gloves Every year in our factory. So those are really the 2 things you have, I think, in that question. The first one being, yes, absolutely. We do have long term contracts with customers on products and And yes, we're continuing to expand based on those needs. The biggest example of that is gloves.
Chris, let me hand it over to you if you want to add a little additional commentary and color on the success of that program in the past and the customers' willingness to think differently And just buying as needed, as well as a combination of stockpiling, as well as a combination of having capacity going forward. And I'd just add that our customers really did see the essence of our value proposition with our unique Americas based supply chain. And as a result, in some of the categories where we did capacity expansion, we've locked up large material portions of that capacity with long term contracts. Yes. The other thing that I would add is relative to our large glove expansion that's really underway as we speak.
The nature of our model in the nitrile example of business where we both manufacture and source gives us a lot of confidence that we'll be able to fully
As a follow-up from Eric Coldwell, most of Biome product categories are growing well ahead of market With the exception of incontinence and astronauts, why are these lines below market? Is this purposeful Focus elsewhere or something else?
So that maybe, Perry, I'll let you talk about it. I know Perry and his team have done really an incredible job And majority of the categories where they're at and you saw the tremendous growth rates. But maybe Perry add a little bit color around the whole thing.
Sure. Thanks, Ed. Our team and our sales unit is focused on the higher growing categories. And really, as I mentioned earlier this morning, we're Position me number 1, so diabetes, ostomy, wound care. It's not that we're ignoring Control nutrition or incontinence, it's part of our total portfolio, but we're really continuing to dominate the space where we're number 1 in those categories.
So the other thing I'll add is a question earlier around what inning are we in. That's a great example to say we're not in the later innings of the game because there's still opportunity Even in the areas that we're providing service for today. So in patient direct, those two categories are areas of Frankly, you go back to where we really are in the very early innings on those. So that's why there's we see that continued growth trajectory
Our next question comes from Jayendra Singh
Thanks for the presentation and taking questions. Really helpful. So you are laying out some really impressive long term growth targets. I understand the value you have with customers with the U. S.
Manufacturing footprint. As we think about PPE market growth beyond COVID within the context of 2026 forecast, I'm curious what are you assuming from a comparative landscape standpoint and what kind of impact that might have on either pricing or demand?
So I'll start and then have Andy, add a little more color on So specifically related to that, so I think Andy showed you the bridge where we showed the different revenue drivers and corresponding obviously The profit drivers that lift a little bit of a downward tick on the PPE. Here's the other thing you got to remember here is, again, we heard about it today. RPP, the reality is we're not selling that to the person walking down the street who's walking into the grocery store. RPP is medical grade PPE that's being sold into health In addition to that, it's being sold into healthcare. It's brands and scale that a customer wants.
So the smaller one offs We're going to have more of a struggle time versus us continuing to be strong. So I met with a customer yesterday in the Mid Atlantic and this is exactly what we talked about. He was talking to me about the demand for PPE is going to continue to be strong because the protocols are staying in place. He said in addition to that, he believes that even if he has product in stock that was bought during the pandemic that may not be medical grade Or may not be the traditional brands they use. He knows that his clinicians want traditional medical grade PP like our Halyard brand.
And that's what they're going to want when the protocols stay in place. So that creates that opportunity of that much elevated demand for PPE than what we saw pre pandemic. Julindra, I think the other thing that you really have is, we talked about this in the past. We've in essence squeezed our PPE to primarily be domestic or the We have markets outside of the U. S.
That also have put those protocols in place that also are going to want that health grade PPE. They're also going to want to be able to buy it on scale. We had an existing customer base there. We continue to remain in contact with them. So there's opportunity to continue to Drive that long into the future.
And then last, Chris showed some unique stuff. You take the gloves. You think that pop and go retail market glove, you have patented technology on it. That's another example of taking a PP into adjacent or a simple example of taking it into adjacent, that being the retail market, which gives us tremendous upside. It's All opportunity and all gain.
So as you can see from that, that's why that 2026 number, the combination of the entire value proposition that we have, The combination of what we still believe is PP market that's going to be well above pre pandemic levels, the combination of that portfolio expansion, The combination of taking the portfolio and moving it under adjacencies, the combination of our medical distribution with that technology and touch balance that can Scale and being flexible for our customers. All the stuff that we've done for them, the services within the four walls that create that that can turn around and also drive operating efficiencies and continuous improvement within the four walls. And then Perry's business that patient direct for when the patient goes home. That's why that 2026 numbers out there, we have tremendous focus on that and the ability to track And continue to grow our business. And again, that's really from an organic standpoint, too.
So with that, I can turn it over to Andy if you want to add if Andy wants to add a little Color around that. Yes. Thanks, Ed. So just 1 or 2 more sound bites on that and how this affects the financials. So I did have 2 slides in my presentation that addressed this.
And one of them was exactly where the long term where we see the long term PPE market is below those peak pandemic levels, It's significantly above pre pandemic levels. And then on one of the later slides where we showed the 2020 to 2026 drivers of that long term growth, Those drivers included a softening of the PPE market over that time period. But again, as Ed said, that softening has been muted or mitigated Because of all the things that we've talked about, whether it's the changes in regulations, protocols or even the long term contracts that we've been able to enter into to help offer that. And that's certainly one step. And then the other bar in that growth from 2020 to 2026, that's an upward trajectory It's taking that PPE portfolio and then expanding into adjacent for other markets.
So as I said, that's kind of the financial impact of where you'll see that in our 2026 projections. Okay.
That makes sense. Just one more follow-up here. Trying to understand the margin trends in longer term. How should we think about more sustainable or steady state margins for each segment? I think what I'm understanding here, it is fair to say that new steady state margin trends are likely to be higher than what was reported pre COVID across both the segments.
Maybe if you can if you're willing to put some numbers around those, how should we think about long term margins in each segment? And what could be the potential up drivers to what is already reflected in your long term outlook from margin point of view?
So let me Andy, you want to take this one? Yes, absolutely. So to help understand margin and margin progression over the long term. So I'm going to start actually at the total company level. Again, you think of the business Holistically, all of our businesses, products, medical distribution, services, patient direct, they're highly integrated, highly synergistic businesses.
And so we look at this In the aggregate, in the aggregate, there's a number of drivers that will drive margin. And we're looking at the portfolio expansion that Chris talked about, Whether that's in global products or even category expansion that we have in our patient direct business that Perry talked about, those are It's expected to be additional revenue that's coming on at accretive margins. And then we talked about the expansion into new markets, whether that's We today primarily service the acute care market. It's going beyond acute care into the non healthcare markets potentially like retail, Clean room in other areas. And then also in the expanding on our global footprint and taking advantage of the scale that we have internationally to drive volume there.
And then also another key driver of margin is going to be the continued investment that we're making in our patient direct business. Again, that business participates In one of our higher growth areas of healthcare and those margins are accretive to the overall business. And then the final set of drivers that I'll kind of highlight here is that Through our Owens and Minor business system, the continuous improvement efforts that we will employ to drive efficiencies to improve margins that way, net of the continuous ongoing reinvestment in the business. So those are kind of the macro drivers for the total company. Then spending a little bit of time, Jalendra, getting back to your specifics on how this will affect each of the segments.
I'll start with Global Solutions. So Global Solutions is So dominated by the medical distribution business and that business is largely a fixed cost leverage business, right? So it's got fixed costs and as we drive volume through that business, We would expect to see margins improve in that area. And within Global Solutions, that's where our patient direct business lies as well. And that, as I talked about, is our High growth, high margin accretive business.
And then of course across both segments, you'll see the benefits of our continuous improvement and reinvestment efforts. But what you won't see in our Global Solutions business in the margin impact going forward is our expansion of our portfolio, right? So that is Primarily focused in global products. Those margins again, as I said being accretive, those will largely stay in our global products Our reporting segment, again, as we sell through medical distribution, again, leverage the synergies that we have between our businesses, those transactions will largely take place at an arm's length basis. So we'll treat global products like we do any other suppliers.
Those margins will stay with global products. So those are the key drivers for margins in the aggregate And a little bit of color on how you
can see that playing out by segment. That's helpful. Just quick one housekeeping question. Does your 2022 EBITDA and EPS outlook Include any spillover drag related to the gloves tossed pass through, which you have said wash this year that skew us to take anything dry you're expecting next year?
Can you repeat that? You broke up a little bit.
So I was saying that your 2022 EBITDA and EPS outlook, does that include any spillover drag Related to the gloves cost pass through, which you talked about is going to be probably washed this year, but are you seeing any drag spills over next year or not really?
Yes. So as we look at our 2022 EPS assumptions, between our 2021 guidance and our 2022 guidance, As we exit 2022, we assume that the glove pricing dynamics that, that will reach an equilibrium and stability. And then as we exit 2022, We won't be hopefully talking about that dynamic going forward. And I think you said it. The first one is as we exit 2021, we think we'll be at the equilibrium.
I know you said 'twenty two, I want to make sure Clarifying that. Thank you.
Okay. Thank you. Thanks guys.
Our next question comes From Michael Minchek, we are Chad from J. D. Morgan. With respect to capital deployment, you talked about reasonably sized M and A. Maybe if you could provide some incremental color on that.
Given that you are already at the lower end of your longer term leverage target, Would you potentially be willing to lever up to the right opportunity? And then with respect to returning cash to shareholders, Does that also assume opportunistic share repurchase?
Yes. So I'll start at a high level of Andy and both Jeff Jocums talk about So let me take the second part of that question first. As of right now, we believe we have tremendous amount of investment opportunities both Organically and then when it's appropriate inorganically that can provide tremendous long term positive returns. So that's kind of where that's where we're leaning towards right now, less on that share repurchase or dividend, more focused right now on long term profitable growth with investments both Organically and more appropriately inorganically. Let me ask Andy to add a little color and commentary around our M and A process and strategy as well as Jeff Jocums We'll leave that for the company.
Yes. Thank you, Ed. So again, it's an element of our capital deployment Strategy and as we look at the strengthening of the balance sheet that we've achieved over the last 15 months, it's actually great to be able Talk about M and A activity, right? So just 15, 18 months ago, it was not prominent in our discussions. And today, it is a real opportunity.
And as we look at our very structured capital allocation and deployment process, as Ed said, we are looking at organic investments, Debt reduction, but as part of that M and A category is looking at M and A cash deployment. First, we're looking at the strategic fit Of that M and A project, does it align with our strategic long term goals? Does it contribute to where we want the company to be in 5 to 6 years from now? We're also looking at the potential synergies that that acquisition can drive. Does it drive cost synergies?
Does it drive cash flow? And is it accretive? So that's a key criteria. And then we also look at it through the lens of make versus buy. Is this an acquisition?
Can we achieve the outcome of this acquisition We're doing it ourselves organically, right. And we look at that trade off between maybe potential savings and cash flow versus The time impact, we're winning that balance between cash and time. But overall, in terms of what size would we be looking at, I would probably say that we would want to keep our leverage. Where we're at today is a really good range for our leverage. But if the right acquisition came along, I think we could be up in I'd like to Keep that leverage under 4 times for the right for the perfect acquisition.
Could we go a little bit above that? Absolutely. But what we're looking for in return is, again, back to that Cash generation, that ability of that asset we're acquiring to drive cash flow, be accretive and take that cash flow and be able to get levels back down Into that 2 to 3 times range as quickly as possible.
I think what I would add is this. We've got very robust inbound deal flow. We've been looking at a lot of deals recently. We've gone fairly deep on a couple of deals. We'll use the same methodology for each of those.
Number 1, we want to make sure it's a business that fits our values. We operate in a highly regulated environment. We want to make sure that the potential acquisitions that we would make are things that fit with our values and match our Standards of performance. Secondly, as Andy said, we want to make sure that it's got the right strategic fit with the company. And then third is where does it sit in valuation.
We'll probably avoid the deals that are small and reasonably immaterial to the company. We've got ambitions to grow and evolve Owens and Minor. We'll have a bit of a floor there in the size of deals that we would look at. Andy described sort of the high end of the process. We're now at the point to where we're starting to pivot and more proactively look at where are the places that we want to go, what are the frontiers that we want to explore by way of acquisition, Who are the high quality targets that are out there and how do we start making steps toward those kinds of proactive moves in the M and A field.
So I expect this will be something that we'll continue to work on very aggressively over the next couple of years.
As a follow-up to an earlier question, beyond what you are seeing with respect to gloves, Can you talk about some of the other underlying assumptions that are factored into the 2022 guidance, Including around the recovery of elective procedures, global solution wins, CPE sales, margin trends and capital deployment.
Sure. Sheldon, Andy. Yes. Yes, absolutely. So as we look through the key assumptions that went into driving our 2022 Earnings guidance, so a number of factors.
So as you pointed out, starting with elective procedure. So we do assume that 2022 will be at For the entire year, we'll be at kind of pre pandemic elective procedure levels. In terms of PPE, as I said in one of the previous We do assume that there would be an easing of the PPE volumes. But again, that would be buffered by the impact of long term contracts And again, changes in protocols in the industry that would support our sales into the healthcare industry. Regarding N95, so as you know, we've talked a lot about in 2020 and in 2021 that we've been supporting the HHS strategic national stockpile and supplying N95s into that program.
That program wraps up formally at the end of 2021. We assume it does not roll into or get renewed in 2022. If it were to get renewed, that would certainly be upside to our projections. I talked about the glove price normalization. I've also talked about another key driver being the impact of Chris Lawrie's portfolio expansion, proprietary portfolio expansion.
So again, that will take root and start to bear dividends in 2022. And also we talked about the glove expansion. So just a reminder that that big investment that we've made in 2021 is expected to come online. That capacity expects to be we expect that capacity to be productive In the Q1 of 2022, looking at the Byram, our patient direct business, the investments that we've made in 2021 We'll enable that business to grow at attractive top line growth rates and also at accretive margins as well. And then in medical distribution, I think the Final element was what are our assumptions around customer expansion.
So again, you've heard a lot today about how we've been able to Improved service levels, improved how we've been servicing our customers, how that's translated into improved retention rates. And again, enabling us to go out and be more aggressive in terms of net wins in the industry. So those would be the key assumptions That momentum would continue into 20
Our next question comes via chat from Eric Coldwell from Baird. Credit rating agencies are often 6 plus months behind in their ratings. Based on your conversations with the credit analysts, Where might you expect ratings to gravitate through the end of 2021? What is your stretch goal for credit ratings from where you are today?
So that one, Andy, why don't you? Yes. Thanks for the question, Eric. So as we stand here today, we're very excited with what we've been able to do with our leverage, right? So For those of you that have not maybe been following the Owens and Minor story and are new to the Owens and Minor story, just 15 months to 18 months ago, we were at $1,700,000,000 of debt.
We were at leverage ratios that were over 6 times. We were facing multiple maturities every year for a number of years. So our debt maturity was pretty significant. And we were in credit agreements that had very restrictive debt covenants. And so as we stand here today, our debt has been reduced by over 40%.
At the end of the Q1, we actually brought that down to below $1,000,000,000 for the first time since 2018. Our leverage ratio has dropped from over 6x to about 2x. And we've really made improvements in our debt maturities, right? So our next maturity now is not until 2023. And we've now exited that restrictive Credit agreement that gives us much greater financial flexibility, which is why now we're entertaining discussions about being able to have more financial flexibility and how we use our Capital deployment strategy going forward.
At this point, Eric, I think that based on our credit quality, the credit rating agencies maybe, as you said, haven't Caught up yet. There's that lag that I think you mentioned as you position the question rightly so. So I think that we are positioned well for credit upgrades. And I think if we can demonstrate, we work with the credit rating agencies very closely. And as we continue to demonstrate our growth, Our cash generation and our continued commitment to managing debt, I would expect those credit ratings to continue to improve as we exit 2021.
There are no other questions in
the queue. I will now turn it over to Ed Sefica for closing comments.
So first of all, thank you everyone for joining us today. What we wanted to accomplish today was 1st and foremost to see the strength of this leadership team. Look, I put this leadership team against any other leadership team in the industry. I would put our organization in the same in that same sense. The other thing we want to let you know is here's where we see the future.
We are excited. The opportunities that we have in front of us to continue to grow this business, To leverage the foundation we've built, focused on our vision and our mission or our culture, our ideal values along with our mission, Focused on our continuous improvement, NorthStar Business Discipline, the investments we've made over the last 2 years and that we continue to make this year That continue to plant the seeds for long term future profitable growth. In addition to that, the results that we've delivered over the last several years. So again, we are excited about what the future holds. We're looking forward to having to be providing updates on this in the quarterly earnings calls.