Great. Thanks everyone for being here with us. We're really pleased to have Concentra joining us for a fireside chat. Concentra is the largest provider of occupational health services in the U.S. With us from the company are Keith Newton, CEO, Matthew DiCanio, incoming CEO, and Tanner Newton, incoming CFO. We're really pleased to have you with us today. Maybe just most topical has obviously been probably the leadership announcements that we've seen over the past few weeks. Maybe speak a little bit about the transition process and obviously the business. We'll talk more about this seemingly. Is it a very healthy point coming out of the second quarter? What about that makes this the right time for all the transitions to occur?
Yeah, I'll take that. We have had a pretty robust planning as far as succession over the years, and we've got a tremendous amount of talent within our company and had planned for this for quite some time to transition just the way we did, whether it was the individuals here or other executives that we've had in the past. It's gone just as we anticipated. Well-received. We've got very qualified people that are moving into the positions, that have been with the company, know the business, have been very engaged in conferences like this. They're not unknown, and I think have proven themselves well over time, both Matt and Tanner. We're excited about the change. Me personally, I'll still be very involved with this group. I will transition to Executive Chairman.
Bob Ortenzio, who is currently Chairman and founder of Select Medical, but Chairman of Concentra, will transition into just a director role. Effective November 1st, Matt will move into the President CEO role, Tanner will move into the CFO role. We have very similar type of succession planning going on with other key leaders that we have when they should come up to make up whatever decisions they're going to make relative to their careers in the years coming. We've prided ourselves on the talent we've built. We've talked about it in many discussions around the years of service and the experience we have, not only in the executive team, but that next level down. We've got quite a few people that are very capable of stepping up as the company continues to execute on its strategies.
Yeah. Okay. No, it's great to hear. I appreciate the perspective. Maybe just to take a step back, I think in the past, you've talked about having really great access to real-time data, just as part of running your business day- to- day. I think you often characterize that as obviously much more helpful than some of the broader BLS type data that's out there. I guess when you look at the data that you have and the key metrics for the industries that you're most tied to, how would you describe the backdrop on employment and hiring in the first half for your key industries?
Yeah, I can take that, and Tanner jump in, add any comments. We've had a very strong start to the year from a visit standpoint, both our workers' comp business and our employer services business. One thing about our business is we're incredibly diversified. We have real-time data across pretty much every industry on the pre-employment side to hiring events and then also employment levels as well. All across the country, we're in 45, 46 states. Most of the patients that walk in our doors every single day are blue collar industry workers, so we've got great insight into that. What we've seen the first couple of quarters is some strong growth. Employer services is stable, but workers' comp is above our long-term algorithm. We noted in our second quarter results that we are seeing some green shoots in manufacturing, construction.
We referenced data centers, reshoring, things like that, some of the trends that we've talked about for the last year or so, and we've seen some of those pick up more recently. That's a sign of some optimism for our business.
Yeah, I was going to ask, maybe you could expand a little there. I guess any particular sectors you'd call out, maybe parts of your geographic footprint that you'd call out as really leading the improvement in volumes that you've seen, and again, I guess how you're thinking about the durability of some of that improvement going into, I guess, the next couple of quarters or into next year.
Yeah. I'd say really it's pretty diverse from a geographic standpoint in terms of the strength that we've seen in the first part of the year, and by sector. We pride ourselves in having a really diversified end market grouping, and that there's really been no change from our long-term algorithm from that standpoint. As Matt said, manufacturing, construction recently we've seen an uptick there, which is consistent with a lot of the macro data that's out there from PMI, and then also just with some of the BLS data that's come out specific to construction and manufacturing. That's really encouraging with respect to some of the reshoring tailwinds that we hope to see over the long term. More to come over the next 12 months or so. But it's been a nice little tailwind for us recently.
I would just add one comment to both Matt and Tanner. We've had a really strong year relative-
Yeah
to what we've been experiencing with our business, and that's in a year when I wouldn't call it a strong, robust job growth year. We feel very good about what we've seen, what we've been able to accomplish, and the things that we're doing. That if the economy really starts picking up steam, it's just going to add fuel to the fire.
Yeah. No, that's interesting. I guess to that point, obviously you're focused on, obviously the headline numbers are what they are, and the blue collar trends underneath that are better. I guess as you look at the data that's available, I guess how much do you feel like maybe you're seeing organic sort of market share gains as well that are contributing to growth above and beyond sort of what the market level growth and sort of incidents and sort of employer screening type visits are?
Yeah, we track all the publicly available data, the jobs reports, BLS, all the government data, ADP, everything. We are also seeing our own data every single day from the prior day.
Yeah.
We can track it very closely, and we have 55,000 patients walk in our doors every single day, so it is a pretty large data set that goes back 40- 45 years. So it is a great data set, and we are watching it closely and monitoring the trends as we go.
Okay.
I would add to that, 55,000 patients a day representing 250,000 employers on a nationwide basis, so we feel we have got some pretty good data that gives us real time information as to what is happening out there.
Steve, I was just going to add that specific to market share versus macro, it is really difficult to tell. We get the number of injuries basically a year in arrears, so we will get 2025 total injuries data in November of this year. At which point, we can kind of go and then back into our market share back in 2025. But based on our best estimates, it is really a combination of both that we are seeing strong top side volume as well as gains for the market share relative to what we are doing from a value proposition and investing in technologies and the like.
Okay. Got it. It may be helpful to contrast the growth that you are seeing in the employer services business, I guess how that compares to the workers' comp business and how you think about employer services potentially as a leading indicator for the rest of the business?
Yeah, it is definitely a leading indicator. We look back 40+ years, and it is definitely an indicator of any downturn or any pickup in the economy. What we are seeing right now in the first couple of quarters and even into last year, is a lot of stability with employer services. It is in that 1%-2% range. We always track the quits rate, and our employer services is highly correlated to the quits rate, which has been pretty flat over the last one to two years. The quits rate is still well below its long term average. So what we are seeing is that 1%-2% employer services growth rate in a low churn marketplace. To Keith's point, if the quits rate goes back to long term historical averages, we would expect to see employer services pick up from where it is today.
That 1%-2% growth is a nice departure from where we were a couple of years ago coming off of COVID, where you had a lot of churn in the economy back in 2022, 2023. There was a lot of hiring, a lot of firing going on, a lot of job changes. We had really elevated employer services. Saw a number of quarters in a row where we had a decline in employer services coming off that high water mark, then over the last two years, we have flipped that positive and really have a lot of momentum there over the last 18 or so months.
Yeah. Definitely. I guess there has been a couple, I know your own internal data is obviously very strong, but if we are looking at the past couple maybe job prints that we have had, that have come out since you reported results, anything meaningful you are observing in the data that you want to call out or discuss at this point in time?
I think just what we have seen with some of the blue collar numbers, where some of the job creation has taken place. Just the recent ones, manufacturing, construction, healthcare, that is always a big one for us.
Yeah
As far as the individuals working in hospitals and healthcare facilities as far as needing our services. But I think that is probably one of the bigger things we have seen, just where some of that job growth is happening. It is right in our breadbasket.
Got it. Okay. Just remind us, obviously you have had a very strong first half result. How have you approached building up to volumes that are embedded into guidance, and I guess how do you think about the potential for out-performance if maybe you see volume trends remaining closer to where they were in the first half of the year?
Yeah, so we have raised our guidance a couple of times so far this year with strong Q1 and Q2. Our philosophy for the remainder of the year is pretty much in line with our long term growth algorithm. So low single digit visit growth rate, 3% rate growth rate, and we have got some de novo in M&A that are ramping and new launches later this year. So we updated our guidance slightly higher than what we beat for Q2, so we built in a little bit of continued out-performance. But overall, I think our team's philosophy is to be conservative. So there is no reason for us to project any slowdown in visits from what we saw in Q1 and Q2. But I think we just kind of point towards our long term visit and rate trends for our best educated guess for the remainder of the year.
Okay. I think being a new public company that-
Sure
was somewhat unknown. We had been private, not out in the visible world, so to speak, since-
Yeah
really 1999. As we rolled out our IPO in July of 2024, wanted to make sure that what we said was going to happen over the next year or so did happen, and that's the way it's transpired. I guess nine quarters going on now of basically hitting the numbers we said we were going to hit.
Yep.
Just proving that we were able to execute on what we are able to articulate.
Yeah. Okay. Makes perfect sense. I think this most recent quarter, I think you probably had the most outperformance, relative to maybe where we were at or where the Street was at in terms of numbers, and a lot of that translated through to really strong margin performance in the quarter. I guess, help us think about the drivers of outperformance on the margin line. You mentioned that you raised for a bit more than the beat that you put up in the quarter, but just help us think about if you were to break the Q2 outperformance into factors that you think there's a better chance of proving durable to things that maybe are a bit more of a watch area when it comes to things like visit mix and things like that.
Yeah
That you called out.
I'll start. Tanner, jump in as well, but Q2 was pretty much across the board. Visits were slightly above our expectation, the rate was very strong, and the cost control, specifically at the center level, the teams did an unbelievable job of managing costs. Cost of services as a percentage of revenue has come down every quarter since we went public a couple of years ago. The teams just did a great job managing staffing efficiencies while delivering great turnaround times, patient satisfaction scores, things like that. When we look forward, back to what I was saying a minute ago, we're back in line with our long-term growth algorithm. We expect there will be some slight improvement in cost of services, but maybe not as much as we had in Q2.
But again, just want to make sure we're conservative and provide the right outlook for the Street.
Okay.
The gain in cost of services, or improvement relative to revenue, largely driven by efficiencies within the centers. We also had some one-time items back in Q2 of last year, related to the Nova transition, where we had some Nova costs still embedded in our P&L. We had some one-time synergy or dissynergies embedded into our P&L at that point, those were obviously synergized out at this point. So that helped us to some extent. I think there was a 240 basis points improvement over Q2 of 2025, and the large majority of that was related to the efficiencies within the center. I would just say, as we look at margin on the whole from a guidance standpoint, we are projecting basically 100 basis points increase over prior years. A lot of solid improvement.
Great job by our operators and our medical leaders this year, that is something that we expect that we can continue going forward.
Steve, back to some of Keith's comments about the performance since we went public and then margin expansion that Tanner just mentioned. This is exactly what we described to everyone right before the IPO and the nine quarters since. We needed to digest the public company costs. We needed to separate from our parent company. We did all of that while keeping our margins at 20%. We digested all these costs. Our margin would have expanded if we were still part of Select.
Sure.
But we kept it flat, and now we expect the margin to start to increase, which we saw here in Q2.
Okay, great. Tanner, just maybe update us a little bit. Obviously, the Select separation process has been pretty substantial. It sounds like you are substantially complete. TSA spend, I believe, is largely immaterial. What loose ends, to the extent there are loose ends, are kind of still out there? To the extent that that frees up organizational capacity to focus on maybe some other priorities, I guess, what are some of those key priorities?
Yeah, we are at the really crossing the finish line right now with the Select separation. There is just some small details we are cleaning up here. We had till November of this year to get that done. So we are ahead of schedule, and very happy with our execution on that.
Okay.
And certainly, probably one of the biggest areas that had their attention diverted to some extent during this process was our technology group.
Okay.
Just with all the systems and stand up of the enterprise system and those type things. We have certainly started to redirect their attention back on some more business-related needs within the company, and pretty excited about some of the technology things that we're evaluating that potentially not only drive revenue, but really create efficiencies within the center, create a better customer experience, and just as of importance is creating a better colleague experience with the technologies that they're using in the centers.
Got it. So I guess is the right way to think about it, you essentially had to stand up systems that were very analogous to the system Select was already using, and you've kind of been frozen in place a little bit as you've done that, and now you have a chance to actually innovate to some degree. Is that kind of the right way to think about what's in front of you?
Yeah, I'd say the only thing, that's the way I would have said it.
Yeah.
Oh, it's just a lift and shift, stand up, and you move on.
Yeah.
I don't think the technology guys would have said it was quite that simple.
Sure. Yeah.
It was a big effort. It was a humongous effort to do that. I think through this process, whether it was back in the test the waters or road show, as we talked about we were going to have to do this. There were several instances where individuals will look at us and say, I've never seen one go well. It's typically everybody undersells what the costs are going to be. I think we did it. We executed it. The costs came in where we thought they were going to be, and we've improved margins as we've come out of it.
But Steve, to your point, I think our teams, as they've gone through the process, have looked at some of the processes that we've inherited and said, there's ways to do this much better.
Yeah.
That's going to be the next phase, which is going in and making improvements. Not wholesale changes, but-
Yeah
efficiencies around the margin.
One more comment. It is important to note that all of this was back office related.
Yeah.
None of the systems at our centers, none of the processes at our centers. That was our own technology already. It was really around IT infrastructure, security, payroll, benefits, things like that. It was a big effort and it took a lot of our support resources, and now they are freed up to work on the business, which is great.
That was a good point as far as it was not just taking Select and standing it up.
Yeah.
We actually feel like we are in a better position because we learned some things and were able to set something up that was an improvement over what historically we might have had.
Got it. Maybe to pivot a little bit, when you talk to employers, I know a big part of the value proposition is obviously the cost of care is quite strong. Satisfaction is quite strong. Getting people back to work very quickly, obviously the metrics there are really strong and differentiated. I guess, just broadly, how would you characterize the tenor of the discussions you are having with employers? I guess how is what they are looking from you different than maybe it looked like five or 10 years ago? How do you get them to do more business with you? Because it seems like the value proposition is there for that to happen.
Yeah. I would say the general tone of all those conversations with employers is very positive. If you think about all the challenges in healthcare today in the U.S., Concentra is providing great access. We are in pretty much every state, in every major metropolitan area. We need to add more, but we have a presence pretty much everywhere. We are delivering lower costs of care, 25% lower total claim cost versus our competition, and that goes all back to our value prop and our medical philosophy. Return to work, having the therapist and the specialist in-house with the primary care doc. And we are doing all that while delivering a great patient experience. So our patient satisfaction scores, NPS, Google, things like that, all across the country are at or near all-time highs.
I always talk about it in terms of if you are an employer and you have an injured worker and you need to send them somewhere, would you send them to Concentra, that has been doing this for 45 years, has the medical approach that we have with everything within the four walls, at a lower cost per claim, with technology and all these solutions that we have invested in over years? Or would you send them to the urgent care that might have to refer to physical therapy a week later, two weeks later, might not have a specialist referral to make, et cetera. Or would you send them to a family medicine or an ED? I think the choice is very clear.
To us, it is just about getting in front of the employer. We have 200,000 employer relationships, but how do we get in more discussions like that so we can present our value prop? Then when there is a changeover in our customer contact, how do we make sure we have the new contact person so we can tell that story and keep the market share?
Okay.
We talked about technology. Probably one of the most positive things, feedback that we have gotten from employers is with a technology that we have invested pretty heavily in over the last five or six years, which we call HUB. It is basically a customer portal. It really is a differentiator between utilizing other providers and ourselves because in workers' comp, time is money. They need access to information. They need to know what is happening. They need to feel like they are involved in it so they can get those employees back to work and fully functional as quickly as possible. Employers say if they go somewhere else, like an urgent care, ED, or something like that, they are flying blind. They are not getting information.
Yeah, of course.
They are having to chase it down to try to figure it out. They are getting it days later. With Concentra, it is like they are in the cockpit. They know where the plane is going. They are in there. They have got all the information they need to make the appropriate decisions relative to getting their workforce healthy and functional and fully back to work.
How should we think about the way that you work with some of the largest logo companies that are out there versus working with maybe the small and middle-sized companies? Do you think there is more of a penetration opportunity as you start to move down the spectrum a little bit in terms of employer size? If that is the case, how do you go about better accessing that opportunity?
We work with employers of all sizes, all industries, all geographies. We might have somebody that has an injury once every two years, and we have the Amazons and UPSs and Walmarts of the world. The way that we are set up as a company is to provide service to all different sizes of customers. We have local sales individuals all the way up to national sales individuals. We have center relationships with our center operations director or our medical director or our therapy director. We are set up nicely to deal with employers of all different sizes. Concentra HUB is a great example, but we also have digital connectivity with large employers and large payers, where we can deliver results electronically into their systems. We can do it at even greater scale. Hopefully that answers that question.
Yeah. That is great. Let me shift a little bit maybe to the reimbursement side. I am sure you are starting to get greater insight into 2027 rates across the portfolio. Maybe it is still a touch early, but I think you maybe said with Q2 they are generally kind of constructive based on what you know. Maybe just an update on that front for workers' comp, and just remind us, I know you are a bit more of a price setter on the employer services part of the business. But any reason to expect anything unusual there?
Yeah.
Yeah.
You want to take it?
Yeah. So right now, it is still a little bit early. We typically start finding out what states are going to do, finding out the inflationary indices that they are indexing to in Q4. By the time we are issuing guidance in the first part of the year, we have a really good idea. Obviously, most of the states take effect January 1st. From what we do know right now, it is looking like it is going to be a relatively normal year next year, which we always talk about long term 3% growth rate on rate. No reason to think that there is going to be a significant departure from that at this point.
Okay. When do you think we might hear about New York? I guess the context there for those that do not know is just historically New York has had very low reimbursement and potentially in the process of changing, which could make it potentially somewhere you could operate and invest in. Any change in the status of what you know about New York at this point?
Yeah. So New York came out in the last 10 days or so, and basically reiterated what they initially published. They did not put a date on it, but we expect on or around January 1st of 2027. There were no changes. They took all the public comments that were shared, including a lot from Concentra. There was some optimistic language that although they did not incorporate the comments in this initial release, that they plan on making subsequent releases that will incorporate some of the comments. We think that our comments were obviously important to what they are trying to do in that state. So the fee schedule will increase significantly for initial injuries, rechecks, specialty visits, but it is not increasing for physical therapy, which is important for us.
It does improve the environment significantly for us, and we are looking at ways to start to dip our toe in the water in the state of New York, and get back to operating there. We had centers there in the past. This will make the margin a decent bit better than what it was before this change. We will continue to lobby to get the physical therapy rates increased.
Okay. T hat is great. It has been a full year now, I guess, for Nova. Maybe update us on the performance there. How would you characterize both where margins are at in the centers and then as you think about the growth profile that you are seeing there, how does that compare to maybe the rest of the portfolio?
Nova, we are a little bit more than a year in. We closed that deal on March 1st of last year. We are ahead of schedule, in terms of our initial underwriting. All the synergies have been captured. The teams are starting to grow. The visits at the centers, the margins have grown nicely. We put out some investment multiples for year one and for year three, or run rate, I think, as we called it, and we are ahead of the run rate contribution from Nova. Again, the teams do an unbelievable job with these acquisitions. We have completed hundreds of them over the course of our history. They know exactly what to do, and they did it very nicely here with 67 centers across five states. From here forward, we will just continue to leverage our customer relationships and continue to grow the volume.
We have got a great track record as far as being able to execute on transactions like that and integrate it where really the largest two we have done in the last 10 years is the U.S. HealthWorks transaction, which was 200+ centers around 2020, and then this Nova deal. Both of them low double digit purchase multiples based on their earnings. But we knew once we brought them on, got them on our contracts, our systems, eliminated duplicative corporate overhead, they would, in these instances, be mid purchase multiples, and that is what has transacted. Even on the single site ones that we do out there, same thing happens where after they get on and we have been able to grow them a little bit, you have got a two or three times multiple at most within a year or two on things like that.
Okay. Yeah. Maybe if you could provide a bit of an update on the onsite business. How are you thinking about the growth potential of this business for really the next couple of years, especially given some of the cost pressures that employers are under with regards to healthcare. How do you contrast the economics of this part of the business versus kind of everything else you are doing in the centers?
Yeah. Onsite has been a great growth driver for us. I think the last couple of quarters, we have been north of 20% organic growth on that front. Not to mention, we acquired Pivot Onsite last year in summer of 2025. Like Nova, that deal is well ahead of schedule in terms of its performance. Really firing on all cylinders on the onsite on both organic and inorganic. We think it is upwards of a $20 billion total addressable market, a fraction of which is currently vended. We are a, let us call it, a top five player in that space right now in terms of size and number of onsites. There is a lot more room and opportunity to continue to grow. Whereas there is obviously a lot of opportunity to continue to grow on the brick-and-mortar side of the house, but we are the largest player over there.
From a pure percentage growth standpoint, onsite represents probably the highest growth driver. Steve, what was the last part of your question?
Margins.
Oh, margins. Yeah. From a margin standpoint, slightly lower than our overall, if you aggregate all the overhead and everything related to the onsite business, slightly lower than our overall company margin. But every site that we add is accretive to the margin, and we really made an investment in onsite when we acquired Pivot and kept a lot of the overhead and infrastructure in place to make sure that we could grow accretively going forward. That margin is continuing to go up. I would also point out from an EBIT margin standpoint that it is definitely accretive because there is zero CapEx involved in that segment of the business.
Yeah. A few years ago, we were $50 million in revenue, and we'll do north of $150 this year. So basically tripled in size through the organic growth, but also the acquisition. As we continue to penetrate that market, I think the margin's going to continue to trend up in line or maybe even slightly above our all-in company average.
Okay, great. Then maybe last one, just be on capital deployment priorities. Obviously, the leverage has now reached a point where it's no longer the constraint that maybe it was for the past couple of years. I guess, how do you think about the landscape for capital deployment? I guess, what's the M&A pipeline look like, especially now that you've done one of the larger deals that was potentially going to be out there for you? Anything else you plan to be focused on you think is worth-
Yeah
calling out?
Yeah. Priority 1A for us is always going to be growth, and that encompasses both M&A and de novo. We've really accelerated de novo over the last couple of years. We'll do 8- 10 this year, looking at north of 10 next year. Those are really accretive 25%-30% cash-on-cash type returns for us. Same with, as Keith was talking about earlier, the small bolt-on M&A, also in the 20%-30% cash-on-cash type of returns, sub three times entry multiple. So we're going to do as many of those as we possibly can, adding, call it 15- 20 centers a year through those channels. As we think about the rest of the capital allocation spectrum, over the last year and a half or so, we've been really focused on de-leveraging.
We came out of the gate at the IPO at 3.9, got down to 3.5, did the Nova deal, popped back up to 3.9, then have been consistently messaging that we'd be below 3x to the market by the end of this year. We hit that mark two quarters early at the end of Q2 that we're at 2.99x and still trending lower. I think as we go along, our long-term target is closer to 2.5. We think that's where the capital stack is optimized. Now that we're below 3x and heading towards 2.5x , that unlocks some other opportunities with capital, including enhanced share repurchases and things like that. As I said earlier, growth is always going to be the priority. Share repurchases is elevated into a priority, then we're going to continue to pay down debt.
Okay, fantastic. I think that's all we're going to have time for. Thanks for your time today.
Thank you.
Congrats again to all of you on the transitions.
Appreciate it. Thank you.