BrightSpring Health Services, Inc. (BTSG)
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Bernstein Insights: Healthcare Leaders and Disruptors – 3rd Annual Healthcare Forum

Sep 24, 2026

Summary

The forum highlighted integrated growth strategies across pharmacy and provider services, driven by operational synergies, targeted M&A, and technology investments. Specialty pharmacy and home health are key growth areas, with AI initiatives enhancing efficiency and future commercial potential.

Jen Phipps
CFO, BrightSpring

Yeah.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Sounds like that is how you know things started, like the sound has begun. Okay. We will get started here because we only have 40 minutes. I know you guys have a packed agenda for the day. Lance Wilkes, Healthcare Service Analyst for Bernstein. Appreciate everybody attending today, and really excited to be hosting BrightSpring. I think the easiest way to do it, let me just start off with letting each of you give an introduction of yourselves, and then we can shift over to a broad introduction of BrightSpring and start talking a little about the underlying business.

Jen Phipps
CFO, BrightSpring

Great. Thanks for having us. My name is Jen Phipps. I am the CFO at BrightSpring. Very happy to be here today. It is our first time participating in this conference, and we are excited to be here today.

David Deuchler
Head of Investor Relations, BrightSpring

I am David Deuchler, Head of Investor Relations at BrightSpring.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Great. For our audience, I know so many of the people who are here for you guys in particular are either investors or folks who are potentially that, but for some of the folks who are not and the people out there, maybe you can just frame a little bit of the elevator, not pitch, but the elevator description of BrightSpring, and then we can start talking maybe at a corporate level about why things are together, and we will walk through some of those questions and then get into the underlying units. But maybe just framing what BrightSpring is would be helpful in the beginning.

Jen Phipps
CFO, BrightSpring

Yeah. BrightSpring is a leading home and community provider, providing services to specialty and senior populations in high ROI and patient-preferred settings. As we think about that, we operate several different business lines. We segment into pharmacy and provider services. What's unique about the patients that we're serving is that pretty much everyone needs multiple services. All of the patients we serve have a polypharmacy need typically, and many of those also have a multi-service need. Whether that is primary care, home health, hospice, rehab services. We're able to provide more of the services that are necessary for the patients that we're serving. We think ultimately that provides better outcomes from a disease state. But we're very focused as an organization in a few different areas.

As you'll hear Jon or I or David talk about it, each of our business lines focus from a core growth perspective and our ability to grow each of those business lines with market-leading teams, operational initiatives, lean efficiency programs, working to grow volumes underpinned by our high-quality services above market rates. From a strategic growth perspective, how do we unlock more of those operational synergies, have the best top side support, whether that's HR, IT, finance leadership, in each of our different business lines done better as an organization. How do we better unlock procurement synergies and ultimately be able to have more integrated care of multiple patients? There's a few different other areas that are interesting. How do we get leading technologies and differentiated payment models because of the support and outcomes that we're able to provide to our patients?

We think about that in terms of the strategic growth areas, and then highly accretive M&A, which we've done about 80 deals over the last 10 years. Almost 100% of those deals have improved their results from the time that we acquired them. Almost a 100% hit rate there. We just feel like those things have been part of our strategy to be able to grow really outsized to the markets that we're in, even though we're in very highly attractive markets that continue to grow.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah. That's fascinating. It's a fascinating company. Let me maybe just start off with some questions. Actually, I think you hit a little bit of, well, why do these businesses fit together? The other aspect of that got into a little bit of, as you're looking forward, where do you see growing further? Are there other capabilities you'd see naturally wanting to fit or needing to fit into what you have?

Jen Phipps
CFO, BrightSpring

Yeah. As we think about our organization, again, we're serving similar patients in similar settings, and we really see just more opportunity to continue to grow. We serve over 450,000 patients every single day, and how can we serve more of their needs across our organization? Not just continuing to grow, again, from a core standpoint in each different business line, whether that's specialty pharmacy, infusion pharmacy, home and community pharmacy, or home health hospice, primary care, rehab. How do we continue to do that? I would say our benefits of scale have provided a lot of different things. Complementary diversification has been very helpful. We've gotten real benefits of scale in terms of our ability to negotiate better on the payer side, our ability to negotiate much better on the procurement side, and how do we leverage our purchasing synergies across the entire organization.

As we think about our ability to then drive best practices throughout our organization. How can we be better as a home infusion company? We should be better. We expect to be better as a home infusion company that has, for example, home health capabilities and skill sets and the ability to recruit nurses. How do we bring that over to our infusion business? We're focused. That's just one example. We're focused across all of that. How do we, again, develop and deploy best practices across our organization? We're able to look across our organization and see two, three, four, five years out. How do we want to deploy capital? How do we want to think about investments? You'll hear us talk a lot about investments that we've continued to make to drive growth.

Our specialty pharmacy has been able to capitalize on a lot of growth drivers we were able to see three, four, five years ago. Our specialty pharmacy business was able to take advantage of those things because of investments that we made in that business five years ago, as an example. How can we look out across opportunities we might see in infusion or home health or other specialty pharmacy areas to drive growth into the future? Then again, our ability to use our balance sheet is in a really strong position and how can we use that balance sheet to look across all of our different target areas to get the most attractive opportunities as we're consolidating in a number of different areas.

Lance Wilkes
Healthcare Service Analyst, Bernstein

That's really interesting. Makes a lot of sense. We haven't done things before. My background is like 20 years in industry, head of M&A and strategy at Aetna, head of business development at Cigna. Some of the things that you guys do are so interesting to me. That obviously is an interesting company. I want to talk a little bit about kind of M&A—

Jen Phipps
CFO, BrightSpring

Yeah

Lance Wilkes
Healthcare Service Analyst, Bernstein

—priorities and maybe if you could broaden it just a little bit or add to it a little bit and just talk about from you sitting at corporate on top of these businesses, in addition to M&A, because you're just hitting upon some of these, are there a few other things that you kind of view as like, "Oh, this is where we're really adding value amongst the businesses?" Later we were going to talk about AI anyway, but—

Jen Phipps
CFO, BrightSpring

Yeah

Lance Wilkes
Healthcare Service Analyst, Bernstein

—that might be interesting. We could kind of frame because M&A is clearly an area of strength and capability for you, and I want to talk through that. But if there are other things you want to highlight as, "Oh, these are areas you guys really kind of create more value.

Jen Phipps
CFO, BrightSpring

Yeah. From an organizational standpoint, I think it goes back probably now about 13, 14 months. We had really been doing a lot of things with AI since you were asking.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah

Jen Phipps
CFO, BrightSpring

We were really looking into what sort of opportunities would we have across our organization. We brought in someone that came from, she's our Chief Technology Officer, came from Google and CoreWeave and had been at a payer prior to her time at both of those organizations, very familiar with healthcare. She's developed an almost 30-person team now at this point that is developing solutions that we're utilizing in our organization. That's really exciting to us. How do we be very innovative in terms. We're not going to be Microsoft, we're not going to be Google, but how can we be one of the most innovative in health services, maybe even in healthcare. That's very interesting to us.

As we think about a lot of the areas of service and pharmacy that we're in have a lot of manual processes associated with that, and how can we better enhance the experiences of our workforce, our pharmacists, our nurses, utilizing technology. How can we streamline processes? I'll give you an example of one project that we've been working on. In our home and community pharmacy business, we have over 200 consultant pharmacists that have to do a medication reconciliation every month for every single one of our customers. We deployed that AI team to build some technology that helped streamline that medication reconciliation process for the consultant pharmacists that are to make it simpler to bring together multiple pieces of information that they can review.

Instead of having to look at what might be 15- 20 screens and processes, how do we highlight and provide a much easier process to streamline that, to make that go faster. That ultimately is allowing our consultant pharmacists to do more value-added activities, potentially allowing for them to take on even more customers with the same number of staff that we would have. Those are examples of things that we are working on deploying. It is an interest that we've expressed potentially to the extent we build tools that would be beneficial to the industry. Maybe it's interesting in the future that we are able to commercialize those things. But that's obviously a little bit further—

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah

Jen Phipps
CFO, BrightSpring

—off. But these are things that we see real value in reducing cost, improving efficiency, or improving quality and outcomes for our patients and that we're serving every day.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Got you. Last question at kind of this overall level would be earnings split today and maybe how you perceive that evolving over the next three to five years, and obviously that's enhanced by M&A or whatnot. But how do you guys look at the company from that sort of perspective?

Jen Phipps
CFO, BrightSpring

Yeah, really good question. We have had really strong growth, broad-based growth across all of our businesses, and certainly above-market rates. We continue to see opportunities for pharmacy to really underpinned in many respects by specialty pharmacy, but a lot of opportunities in infusion that we're going after and then certainly improvements in profitability and margin expansion in home and community pharmacy. We see continued strong growth there. From a provider standpoint, we had over 30% growth. It was almost 20% that we posted in the second quarter year-over-year, really strong performance from a provider standpoint. We see a lot of that continuing. We've had historically mid-teens growth in that business, which is above market levels, and we see a lot of opportunity because of market density, the ability to continue for geographic expansion, to be able to continue growth in that segment as well.

Certainly, we are able to better leverage our corporate infrastructure with everything that we're doing. We've done that, though, while making significant investments, for example, in the AI team and technology projects that I've talked about. We continue to still, despite that, make significant investments, whether it's in our business lines, or in corporate for what we think are future growth.

Lance Wilkes
Healthcare Service Analyst, Bernstein

That's great. Well, let's dive into one half of the business—

Jen Phipps
CFO, BrightSpring

Yeah

Lance Wilkes
Healthcare Service Analyst, Bernstein

—in pharmacy. Could you talk a little, and frame for everybody maybe, the major subsegments there in pharmacy, and talk just a little to the growth algorithm associated with them and then maybe the margin characteristics of each of those.

Jen Phipps
CFO, BrightSpring

Yeah. From a subsegment perspective in our pharmacy, we operate really in three subsegments. The first is our specialty pharmacy. That is oral and injectable drugs that are largely our oncology and rare and orphan disease states, so the majority of the drugs would be in those disease states. We focus largely on drugs that are in limited distribution drugs, or LDDs, that we've talked about. We think that's important in terms of the competitive moat and area that we're focused on. How do we provide-- We have very differentiated, we think, quality and service capabilities within that specialty pharmacy business, and we think that is best served for those particular markets versus highly commoditized specialty pharmacy drugs. Again, focused there. Then we have our home infusion business.

That is doing acute and chronic infusion in the home or in a clinic setting, primarily the home. Then our home and community pharmacy is a closed-door pharmacy that is a local pharmacy that needs to get to our customers and patients very quickly. We're serving end markets like senior nursing facilities, senior living communities, IDD, PACE, hospice, and probably a couple other communities. But those are—

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah, yeah.

Jen Phipps
CFO, BrightSpring

—those are the primary ones.

David Deuchler
Head of Investor Relations, BrightSpring

One thing to just note is in our infusion business, it's all non-oncology. Our oncology exposure is in the oral and injectable specialty business, and in infusion, we're doing all non-oncology business.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah. Let's dive a little deeper into those collections of businesses. One question I've got, and you just hit on, I think, the answer to it, but just to kind of amplify it for everybody. One of the questions I'll get about you folks is, "Oh, how do you compete against Accredo or a Caremark specialty or whatnot?" I know I have my answers, but would love to just hear how you see yourselves as being differentiated, the key elements of that, and the value prop that you're delivering to, whether it's the patients or pharma.

Jen Phipps
CFO, BrightSpring

Yeah. Our focus area, again, are primarily on these drugs that go through a limited distribution network. We work to win access to these drugs. We believe our high quality and differentiated service model allows us the ability to win preferential access to these. Typically, when we talk about an LDD, what we mean is a network of one or two. Occasionally, that network is wider or older drugs. But over the last three years, I think there's only one drug that maybe has been in a network greater than two of these drugs that we're focusing on. Why are we winning these LDDs? Again, it is our high-quality services that we're providing to the patients, which we believe provide differentiated outcomes, which is important to pharma. We are able to service the entirety of the United States.

We have a large sales force that is in oncology practices every single day, helping us to pull through those scripts. Then we have really leading quality measures. Examples of that would be our time to first fill, is about 50% of the industry average. We're typically less than four days or right around four days. That means from the time a patient is prescribed a medication to the time that they have it in their hands to be able to take, we are able to get through benefits verification, all of the, whatever the REMS or other testing requirements would be necessary, and then ultimately get the drug delivered to their home for them to take very quickly. Medication possession ratio is typically in the mid-90% . That's an adherence measure.

As I am sure you can imagine, for these life-sustaining, life-enhancing drugs, life-extending drugs, it is really critical that patients are adhering to their medication regimen. Our process and high touch nature of the services performed by our specialty pharmacy business has produced that really significant medication possession ratio that is leading quality. We have really high patient satisfaction scores, typically above 90% NPS scores, very high physician satisfaction scores. We are trying to really, during this very important, difficult time in a patient's journey, trying to make sure that our pharmacy is doing everything that they can to make at least the pharmacy component easy for them or better. Those are examples of why we have won.

Lance Wilkes
Healthcare Service Analyst, Bernstein

That is perfect. I will combine a couple of questions, so we will be able to make sure we spend the time on provider as well. Could you talk just a little bit about maybe the growth that you perceive in LDD or exclusive newly introduced specialty pharmacy, and maybe contrast or complement that with the growth in biosimilars. Are there different margin opportunities? Are each of those tailwinds, headwinds for you? Obviously, you have had a lot of growth in the LDD over the prior years, so that presents, obviously, some interesting opportunities.

Jen Phipps
CFO, BrightSpring

Yes. We think about LDDs certainly as tailwinds to the business. We have launched about 16 - 20 LDDs each of the last several years. Our view is that we will launch 16 - 20 again this year. Those are definitely, we are proud to serve those manufacturers in support of those drugs, but definitely has been very helpful from a growth trajectory standpoint. Oftentimes, the launch curve of a new drug takes two to three years or four years to ramp in the market. So drugs that we launched in 2025 or 2024 or even 2023 are providing growth in 2026. The drugs that we launch in 2026 typically will provide more meaningful growth in 2027 or 2028 or 2029. So gives us a lot of visibility into the growth rate. We are oftentimes working with manufacturers, what can be up to 12 months in advance of the launch.

We have visibility into networks that we are likely going to be supporting also into the future. I think that gives us definitely some visibility, but certainly the things that we have won provide us a lot of visibility into that. As we think about biosimilars, that is more relevant in the infusion market space. We have very limited exposure to biosimilars, primarily because we are mostly acute-focused in our pharmacy. There are some target chronic infusion disease states that we are very interested in expanding and growing, and we have active strategies to do that. From a biosimilar perspective, that is really not relevant to many of the drugs that we are serving today and potentially is an opportunity in the future for us as we continue to grow and expand our infusion business. From a risk standpoint, really, we do not anticipate that being a headwind.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Got you. Last question, again, combining a couple here would be, for the infusion, for the home and community subsegments there, how do you perceive those growing relative to the specialty pharmacy growth? Is the composition of the business similar five years plus from now compared to what it is today?

Jen Phipps
CFO, BrightSpring

I think our view is that specialty pharmacy is going to continue to have strong growth and potentially is greater than the whole of pharmacy. But we do see really significant opportunities, especially within infusion. We seek for that business to be significantly larger than it is. It's really a small piece of what we do today in our pharmacy segment. We see opportunities for that to be multiples larger. From a home and community standpoint, that market grows low to mid single digits, but we obviously seek to be in advance of that. There are some end markets like senior living, IDD hospice pharmacy that we see stronger growth in that. So we're really targeting our investments and our initiatives in a lot of those areas.

We do think that there is a number of operational improvements as well, via AI technology, as we're really seeking to better optimize our operational costs in that particular business. We see the most opportunity there.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah, that's great. Last question is, with PBM reform that's been taking place, then there's obviously potential other reforms like the breakup of vertical integration a little bit amongst PBMs or things like that. How's PBM reform impacting you today, if at all, and how do you see that impacting you going forward, that environment?

Jen Phipps
CFO, BrightSpring

We obviously continue to monitor that environment very closely. We seek to be a partner to everyone that we're working with, a partner to the PBMs that we're serving their patients, they're our patients as well, a partner to pharma in the service of their drugs and as well as to our patients. We are doing work that is driving outcomes and lower costs to the system, and certainly, that is an important area. Again, we continue to be very focused on what that would look like, but really don't see anything that would meaningfully change what we need to do in that environment.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Perfect. Well, let's pivot over to the provider side of the business, and maybe you could give us a similar sort of framing of the subsegments, kind of what's in them, but also the growth characteristics, the margin characteristics of each of those segments.

Jen Phipps
CFO, BrightSpring

Yeah. As I mentioned earlier, our provider business is made up of three subsegments. We've got our Home Health Care subsegment, which is home health hospice primary care. We have rehab, which is largely very neuro-focused, Traumatic Brain Injury, other acquired brain injury, outpatient, or short stay services that are necessary, really changing the cost trajectory and the outcomes for individuals with these. It's really intensive neurorehabilitation that really can dramatically change outcomes for individuals. And then our personal care business. As we think about our Home Health Care business, that certainly is an area that has strong market growth, and we have a lot of opportunity, we believe, to grow outsize to the market. Those include deepening and penetrating further the markets that we're in, but significant expansion opportunities.

As we think about those particular areas, we're very interested in being an attractive market certainly, but also areas where we can provide more density of the types of services that we have, so that we can have more holistic care and more geographies, so we can layer on pharmacy and more of those provider services in one particular geography. As we think about the growth trajectory, we have consistently grown the Home Health Care segment, mid-teens to what is sometimes higher. We really see a lot of opportunity. We're really focused, obviously, home health and hospice. You probably know what those services are. We think there's a lot of opportunity there. Primary care is really interesting to us. That's definitely a much smaller piece of that subsegment, but as we think about primary care, we think about that as being the quarterback of care oftentimes for patients.

As we are very interested in differentiated payment models and our ability to get that with payers or potentially participate in ACOs, we do think primary care is an important piece of that. We are working to get more density in certain geographies there. Then, I would say growth trajectory, certainly, mid-teens from a rehab. Our personal care business, we do really think of that as being, from a revenue standpoint, kind of a lower single digits at growth business.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Got you.

David Deuchler
Head of Investor Relations, BrightSpring

Oh.

Lance Wilkes
Healthcare Service Analyst, Bernstein

I thought you were going to say something as well.

David Deuchler
Head of Investor Relations, BrightSpring

No. Sorry.

Lance Wilkes
Healthcare Service Analyst, Bernstein

That's okay. Let me ask a little further on home health, and in particular, maybe a little bit of what's been driving such good growth. One of the things that's so interesting, like in the rehab business, you have such a specific focus that when I initially was looking at you all, it's like, "Oh, rehab. Well, there's lots of challenges in that business." Then when you see exactly what you're doing, like, "Oh, that makes a ton of sense to me." For home health, maybe as you talk a little bit about kind of the growth drivers and M&A and consolidation versus organic growth and things like that, if there are any areas where you're particularly focused, whether that's geographies, conditions, or things like that, to give us a little more texture on it, that'd be great.

Jen Phipps
CFO, BrightSpring

Yeah. In our home health business, we did, at the end of December, an acquisition. Amedisys and LHC divested some of their assets as part of their sale to United. We were able to pick up the majority of those assets that were divested, other than Tennessee, where we had more overlap. That one was a really interesting acquisition for a lot of different reasons. For us, certainly price. It was largely CON states, areas that we did not have significant overlap that would provide us density in really high target markets for us. We were really excited about that opportunity. It effectively doubled our home health component of Home Health Care business line. The team has been working to integrate those new branches into our operations, has been performing ahead of schedule. That was the largest acquisition we've done in the home health space.

From a price standpoint, and geographical footprint, really made all of the sense in the world. We had gotten more confidence in regarding our view of rates as it related to home health, and so we leaned into that acquisition, and that's been performing really well for us. Separately, home health, the preliminary rate was the first time in a couple of years that the temporary rate decrease stayed stable, effectively allowing for the COLA component of the rate that has come every year to be a net positive rate increase. That was consistent with our views, and certainly we have a very active government relations team that is advocating and oftentimes carries the water for a lot of industries that we're in. Certainly, has leaned in home health standpoint. But really great business that is performing, and driving outcomes.

Home health is a service that has shown to reduce hospitalizations pretty significantly for individuals that need it. We also know that over 40% of people that are prescribed for home health do not receive those services. That is something that we're working to obviously solve.

David Deuchler
Head of Investor Relations, BrightSpring

Great. The home health market in general is quite diversified and highly fragmented. There is a lot of geographies where we are not currently today and where we are smaller density than we could be. As we think about the growth algorithm for home health, there is a lot of opportunity to penetrate into the existing markets as well as expand into new markets. As Jen said, there is a significant number of prescribed home health services that are actually not executed.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah. One question that broadens out to the whole provider segment would be around labor and talent acquisition and talent management. Obviously, that is person-intensive sets of businesses there. Could you just talk a little bit about how you are performing in that, but how you go about doing it?

Jen Phipps
CFO, BrightSpring

Yeah. You are right. It is definitely a person-intensive business in certain areas like nursing that have tended over time to be difficult areas from a recruiting. We have focused on many different things that I think have worked really well for us. Our turnover has improved every quarter since COVID time. Our stability, we look at stability, which is individuals that have been with us for a year or more. As you can imagine, in a lot of these businesses, even if you have some turnover, what does the stability look like in the workforce that you have in each of the areas? We have seen significant improvement there. Those things have been helpful also in terms of what we need to do to drive growth and that everybody that we are able to recruit is able to help participate in that growth. How have we done that?

I think this goes back to one of the earlier comments that I talked a little bit about earlier, which is the strength of our platform and the scaled investments that we have been able to make. As we think about our ability to invest in leading talent recruitment, targeted teams, and programs to do that, career ladders. We have invested in a number of programs and culture initiatives in the business lines to help people be more excited to stay and see a career at BrightSpring and within their business lines and growth and development opportunities. Those, I think, have all been very beneficial. We have a leading HR team that has done a really fantastic job across a bunch of different areas, that have really supported and driven that alongside the operations team.

Lance Wilkes
Healthcare Service Analyst, Bernstein

That's perfect. The last question I wanted to ask you specific to provider was going to be on rehab care. Maybe if you can, obviously, you're really clear in the specific component of that that you're focused on, but if you could talk a little bit about how you deliver that and what's involved and maybe a little of the characteristics of maybe the revenue that you're able to achieve in something like that, because obviously it can be very intense.

Jen Phipps
CFO, BrightSpring

Yeah. The majority of our rehab business is this highly skilled neurorehabilitation that is focused on TBI and ABI diagnoses. Think of a 26-year-old that's in a devastating car accident, could be, and they are able to go to outpatient therapies or have inpatient or in-your-home therapies come to you that are able to do really intensive rehabilitation. This is not home health. This is very intensive, like neurorehab skill sets, and ultimately able to really significantly change the trajectory of the injury that you had and speed up what could be you're not able to participate in everyday life to you're done with rehabilitation and you have significantly improved outcomes. This work is really interesting.

It's probably one of the highest ROIs that we actually have in each of our service lines as you think about what it does in terms of the cost curve perspective. Separately, in addition to that, from a rehab perspective, we've been building out over the last year, Part B rehab, which is for seniors. That is highly synergistic with home health and pharmacy and senior living as we go. When you think about a senior living community, and we serve that across many different business lines, what are the services that they need? They need pharmacy partner, they need a home health partner, a Part B rehab partner, oftentimes a hospice partner, and many of those communities also have personal care activity of daily living partners to bring in and offer to their communities. We service all of those.

How can we, again, get better outcomes for individuals and be able to go to senior living communities and offer more services that they need? Those are, for example, some specific targeted activities that we have going on across our sales team and sales initiatives.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Makes a ton of sense. Actually, it is a perfect lead-in to a question I wanted to ask. It is really a follow-up to one of the interesting things you brought up at the beginning, which had to do with synergies and integration. Maybe if you could just talk a little bit about where you are on a journey of extracting or achieving synergies and integration, because I know as I had looked at your business initially, they are all good standalone businesses, and I could see how one might just look at these and say, "Oh, I just want to be in these." As you have talked about it seems to me that there is more focus there on the integration and those opportunities.

Just interested if that is a focus that is yet to be achieved or if there are things that you are already achieving with that, and what might be the opportunity there?

Jen Phipps
CFO, BrightSpring

Yeah. As it relates to synergies across our enterprise, I would say we are very early in—

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah

Jen Phipps
CFO, BrightSpring

—what we think we can accomplish. Whether that is the first inning or the second inning, I do not know. But we do have examples. For example, every single one of our hospice patients receives their medication from our home and community pharmacy. We have a lot of interplay between home health to hospice referrals, or how do we make sure where we have the physician practice, they are typically serving customers of, whether it could be pharmacy customers or home health customers. We have a number of different areas where those are examples. But I think our ability to unlock the cross-referral opportunity is really early. For example, on senior living. We recently, as part of some of our investments in 2026, have a fully dedicated team that is now going after senior living opportunities across the enterprise.

That's not to say we didn't go after senior living opportunities in home health or in home and community pharmacy or in hospice. We absolutely did. And those teams are still doing that. But we put dedicated resources in terms of having that broader conversation as an example. I think we're really early in our ability to unlock differentiated payment models. We have examples where we've done that. For example, in home health, we've had a couple of large payers come to us and say they would like us to take more of their patients. We said, "We need a better rate if we're going to take more of your patients." Ultimately, because they came to us and they said, "You're one of our highest quality providers. We see the best outcomes.

How can you take more of our patients?" We came up with a model that ultimately gave us a differentiated case rate construct that was based on quality and outcomes that we're already producing. Those are examples of things that we've done. We have worked as a partner with another ACO, part of an ACO, where we've worked to now get access to our own ACO. That will start in 2027. 2028 will be a more meaningful year, as we'll spend the first year really developing that. But how can we service? We're servicing these patients, and we know these patients well. We already are achieving the outcomes or the cost constructs. How can we better serve in those models where we might get differentiated payment for the services and outcomes we're already producing? We'll do that, obviously, in a careful and very constructive way.

But those are things that we're very interested in. I would say we're in really early innings in terms of what we think the opportunity set is for that. As it relates to M&A and synergies, I think we're very quick to get those. Related to M&A, which might have been the first part—

Lance Wilkes
Healthcare Service Analyst, Bernstein

Yeah

Jen Phipps
CFO, BrightSpring

—of your question. We oftentimes are getting very quick synergies. We're trying to get them into our platform pretty quickly. Our payor contracts, our purchasing contracts, our processes. We're also very careful to make sure we don't disrupt what is special about that acquisition and what's interesting to us in the first place. But we think, with our integration and our M&A team, that we've been able to develop really significant strategies that have worked really well to drive growth and opportunity in those businesses.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Great. We're at 3:00 P.M., so if we were in Michigan, we could have one more question. But we're not. I did want to give you the last word, though, as far as anything you'd like to leave the audience with as far as how to think about BrightSpring or anything that you think maybe investors aren't understanding well enough?

Jen Phipps
CFO, BrightSpring

Yeah, no. Really appreciate the time today. Excited to be here with you guys today. We again are a leading home and community provider, really seeking to provide high-quality outcomes to our patients that we're serving. And we think that ultimately, because underpinned by those high-quality services, that gives us an opportunity to have outsized volume and growth opportunities as an organization, so.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Okay. Well, thank you so much. Thank you, everybody. And I think the next session will be here starting in a minute.

Jen Phipps
CFO, BrightSpring

Thank you.

David Deuchler
Head of Investor Relations, BrightSpring

Thank you.

Lance Wilkes
Healthcare Service Analyst, Bernstein

Thank you, guys. Really—