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UBS Global Healthcare Conference 2025

Nov 11, 2025

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

All right. I think we're good to get started here. Thanks, everyone. We next have up, Enhabit. We're very happy to have them participate in the conference this year. Bob Jacobsmeyer, President and Chief Executive Officer; Ryan Solomon, Chief Financial Officer. Great. We're 10 months into the year. Why don't you just spend a minute sort of assessing the performance here today? What have been the upside positives? What have been any challenges that you would highlight?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Sure. I would say 2025 has been a good example of some success on our strategies we've had in place over the last few years. Obviously, hospice has continued to outperform, so it really reinforces the work that we've put in over the last few years. Home health, that payer strategy, really starting to pay off, particularly with our negotiations with the various payers. When we look at that, and I'm sure we'll get more into it, we've done a lot with lowering that leverage. That's really been a focus of that free cash flow. Really pleased with the performance for 2025, pleased with how we're starting this fourth quarter. Yeah. Brian, anything to add to that?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

No, outside of the gregarious proposed rule, I think everything's been—we've been really, really happy with the strategic execution and performance.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

I'm going to ask you about the rule in a minute, but can you remind us a little bit about how you think about long-term growth algorithm, how she would think about the company achieving that over the next few years?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Sure. For home health, we think about low to mid-single-digit growth. For hospice, kind of that mid to high single digits. We have obviously outperformed that this year. What we think about that right now, that has really been on organic and de novo strategies.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

When you think about—so that's the top line. Where are you at on margin versus where you think you could be in the next few years?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. I think as we think about hospice, starting there, the margin trajectory has really benefited from the volume on fixed cost. And so I think we've seen some really good execution and consistent performance there. When you look at that margin profile that we've seen both Q3 and kind of throughout the full year, we think that's very durable. As we think about the home health margins and what that really looks like, I think it's heavily dependent upon where the final proposed rule would go. I think once we have clarity there, we'll be able to give a little bit better sense of where that home health margin trajectory would look like.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

When you think—let's just talk about the proposed rule. Do you have a sense of where that is at this point? Any thoughts about it?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We think we'll see it before the end of the month. There's an administrative procedural act which really says that the rule has to be published 30 days in advance of it going into effect. We think really by the end of November, probably latest December 2nd, is what we're thinking at this point. I think the scenarios this year of the outcome are more scenarios than what we would have thought of in the past. When we think about the final rule, we do think it will be better than the proposed rule. How much better? Hard to say. We think about scenarios. If CMS really listens to the industry and the feedback that we've been providing and the alliance has been providing, CMS does have the authority to stop these permanent and temporary adjustments.

They have the authority to really go back to giving us a regular market basket update. Whether or not they listen to that feedback, I think, is yet to be seen. We do think that the final will be better than the proposed.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Yeah. It just seems like there's two things. Are we going to have to absorb the full rate cut, 6.4%, whatever? Also, do we get clarity on where we go from here? Some have said, "We get the 6.4% rate cut, and then you're growing off a lower base." That is clarity. Is that your view, or what are you guys thinking about that?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. I think that's right. I think we feel two elements. We feel really good about the building blocks, and we've talked a little bit on some of our previous calls around how we think about our positioning relative to the proposed rule if it were to go final. We feel a combination of—we think about BPE, our overall cost discipline, and then growth will position us well if the final rule were to look like the proposed. Setting that aside, the clarity component, I think, is critical. Just as we think about wherever the proposed rule goes as it turns final, having clarity there if the final rule looks like the proposed, we can offset that and at least have a clarity of kind of what the path looks like from a rate perspective.

The CMS rule, as it was structured, that temporary rule would recover their perceived view of over-reimbursement over a seven-year period. If the final creates some clarity in that regard of what that would look like, those are the two elements we'll be looking for: what is the hurdle that we need to overcome from any sort of proposed rule should it be negative? The second is the clarity that we need from a management and from an investor perspective to really move forward.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Right. Right. What is your thought about how much you can mitigate? I know it's a little tricky because you want to wait and see, but you've had a big chunk of the year to work on mitigation strategies. Where are we at here?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

I think as we think about—we started to talk a little bit about this in our Q2 call, and we feel far more confident as we think about Q3 and some of the tests and the pilot that we launched around our VPE. As we discussed, for every half visit, that's worth about $5 million to $8 million. Some of the elements that Bob disclosed in our last call, in our test sites, we saw visits per episode decrease from roughly 15 to 13. You can start to do some math there around kind of what each half visit of reduction is worth. What we're seeing early in the test sites is building some confidence there without impacting quality, something that we'll want to really continue to look at. We've also then taken that pilot and rolled it out to 80-plus sites over the last through October.

We feel really good about that. The cost side, we did deliver some in-quarter cost savings, so we were early and often in that regard. We built some confidence there. The growth, as you saw within hospice, continued momentum on the home health side. If you look at some of the KPIs there, we did see some ADC growth in the quarter. We had some disruption from some of the payer negotiation early in the quarter that, absent that, we would have expected year-over-year revenue growth there. When you add all three of those elements together, we feel like we can meaningfully offset the proposed rule as it's structured. We'll see exactly where that final goes. I think the general expectation is it'll likely be better, but we're prepared should the.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Did you size, in the worst-case scenario, what that headwind would be?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

It would be $35 million-$40 million. That would take into account your fee-for-service business as well as the payers that pay us episodically.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. Okay. I think with the third quarter, you updated your outlook a little bit lower home health expectations, offset with some higher hospice. Anything to say what the trend was that drove that decision to moderate?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. When you look at the outlook, I mean, it's really a function of the disruption early in Q3 and then the exit point. As we think about, as we touched on in the call just last week, we had sequential improvement in ADC throughout the quarter. If we feel good about the exit trajectory and the recovery post the disruption early in the quarter, and then if you think about the outlook, it's just a function of that baseline being a little bit lower as we enter Q4. The progression and the momentum being relatively strong, it's just the ability to recover that in year was reflected in our full-year outlook revenue guidance.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Are the hospice improvement trends just a little stronger across the board, or is there anything to call out specifically there?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

No. I mean, I think we've continued to see strong performance there. So nothing specifically to call out there other than just what we're seeing in current trends and kind of how we're thinking about the business.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

On the payer disruption, it seems to now be resolved. Did you walk away with what are the rate implications for the fourth quarter and beyond? Anything you can say on that?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

On the payer disruption, it really was at the end of the second quarter, early third quarter, where we were in negotiations with a national payer that was not considered a payer innovation contract. We did ultimately give notice. They had to give notice to their members. That ended up being a pretty significant, about 600 drop in our census in a short period of time. That disruption, though, did pay off because ultimately we did get to resolution. We ended up with a low double-digit increase, moving this payer into a payer innovation. While we would prefer not to have the disruption, it did end up turning out positively. I would say during the third quarter, we did have another national agreement come up for renewal. We did not have to create any disruption to get to a price update for that one. That worked.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. So you've got these preferred arrangements when you're—and obviously, it's important to do the first deal to get the flexibility to do the things you need to do to get hopefully better rates. As those are coming up for renewal, are they materially changing, or is it just what is the nature of how those work?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. Most of them are three-year agreements. We do try to, if it's not currently an episodic, our preference is an episodic arrangement because then we can manage those visits based on the patient's profile and how the patient's comorbidities look. The preference is episodic. I would say that one of the things that we're seeing in these renegotiations is that as we have built census with these payers, two things we're finding are really important at the time of renegotiation are high-quality outcomes and the fact that they have to ask themselves, "Can they meaningfully find ways to cover that member access if we end up going away with the same high quality?" Building census of that payer and delivering the high quality really is something meaningful to walk away with a better deal at the renegotiation time.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

How are they measuring high quality?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Most of it is on that readmission rate and timely initiation of care, knowing that you really can help get that patient, particularly if they're coming from a facility setting, getting them out in a timely manner, and then really helping to make sure we're managing those readmission rates.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

We're hearing on the labor side, things are getting a little back to normal after some challenging times right around the pandemic and the first year or so out of the pandemic. Has that turned around also on the supply? Is the supply-demand dynamic still pretty tight when they go to find discharge places, or has there been some easing of that as there's been easing on the rate?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. I would say the clinical workforce certainly is in a better place than where we were several years ago. I would say the supply-demand has more to do with how have plans negotiated. So what anyone, particularly maybe a smaller agency, has to really determine is, "Can I really give access to a plan that is not willing to pay me for the services that I deserve?" Because my costs have gone up. While costs continue to—they are not rising like they were back in 2021 and 2022, you are still seeing kind of that 3% increase. Well, if you do not have payers that are willing to pay you, commensurate with that, you have to decide, "Even if I have the ability to provide it, can I provide it for that reimbursement level?

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Yeah. Has there been any change? I mean, obviously, we've got Humana with their Kindred at Home. We're several years into that. We've got UnitedHealth with LHC and now Amedisys. Has that changed the dynamics in any of your markets to say significantly?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We have not felt the change of the dynamic. We certainly would welcome the dynamic if it meant that they were going to care for more of their members. That would obviously free up maybe some fee-for-service business for the rest of them. At this point, we really haven't felt any sort of change in any market dynamics.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

What is happening just in traditional fee-for-service? Because we had a couple of years where it was actually declining. It seems like the MA penetration rate is moderating a little bit now. Is that turning around and creating more fee-for-service volume for you?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

I would say we are very anxious to see what happens with this current open enrollment period. While it kind of had lowered a little bit, the continued move to Medicare Advantage continued to be strong even over these last several years. We are hearing a little bit about potentially that really stabilizing and potentially even some electing to go back to fee-for-service. I think we'll know after this open enrollment period and come January on how does that affect. In all the previous years, we've had patients on census that have moved from traditional to an MA plan or one MA plan to the other. We never really saw it go the other way. We're anxious to see what January brings.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Right. When you think about your payer innovation contracts, where are we at in that move? Do most of the major payers at this point on board with some kind of a payer innovation contract, or is there still big national players that are not there yet and a lot of regionals? I know you got a lot of Blue plans out there.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. We have one large national that's still not at a payer innovation level. Just a handful of small ones that more we need to do to really be seen as that full-service provider in a market. Some of our smaller ones that were not paying us at payer innovation, we've been able to term over this year really because we have enough access and availability to the other plans to not need those.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. When you think about Medicare fee-for-service versus MA, you got the discharge planners there trying to make the decision. Are you taking everything at this point pretty much, or?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. So come January 1 of 2025 was really our first time that our business development teams could go out there and say, "We are a full-service provider. We have the majority of all the large, medium, small plans out there." That came with really language around, "We want to earn that healthy payer mix of patients," because we wanted to make sure that our discharge planners understood, "We spent this time and energy to get contracted so that we could better serve you." That means better serve you so that we can earn that healthy payer mix.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. Do you feel like most of your competitors are doing that, or do you see that as still guys that are just chasing the fee-for-service business?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

I think there's a handful of still. Those tend to be some of the smaller ones that are kind of still chasing that. I think it is very difficult to do that if you're any sort of sized provider because the referral sources are saying, "Everybody would want that. I need providers that can be full-service." I think the demand for full-service is much more in place now with referral sources.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. Okay. I know hospice revenues were up 20% in the quarter, mainly ADC and revenue per patient day, and you had one extra calendar day. Same story. Admissions were down or basically flat, down 0.3%. What would you attribute the strong growth with? Is that mainly share gains, or what would you say?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We definitely had—we really started this strong growth in Q3 and Q4 of last year. We knew we had some high comps that we were facing. We had about 10 of our locations that did have capacity constraints due to significant growth. Those are being prioritized from a talent acquisition to make sure that we can hire the additional staff we need to kind of grow to that next level, if you will. As we mentioned on our call, we did hire some additional business development individuals so that we can reach even further and more referral sources to grow that admission volume.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

When you think about where we're at with hospice overall, or is there just still an underlying growth and penetration? More people that could qualify for hospice getting it, or are we sort of at a plateau on that, you think?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

No. I think there's still ability to grow. I think it's from two: one, from more individuals even knowing that it's a benefit that they can access, but also from those that are accessing it to know that they can get it earlier. You do still have some of the patients that are finding out about hospice and only being 7-10 days on service. That's really a disservice to the patient and their family. There's two opportunities: one, to get to them earlier and get to more of the patients that do qualify.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Do you see a big difference when you look at that geographically across the country, or?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Not usually by geography, more by maybe physicians, referral sources, kind of their own thoughts around it, but not really geographically.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. That market had been pretty competitive from an acquisition standpoint. Pricing was pretty high. Have you seen any change in that or moderation in that?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

No. If anything, I think we've seen that actually continue to increase. It's why we've really put a focus on our de novo strategy and more kind of leaning towards hospice, putting hospice where we have home health, where we can, because it is a cost-effective way for us to get into markets, considering particularly where multiples are today for hospice.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

What is the overlap between your home health and hospice at this point in footprint?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We have 109 hospice locations and 256 home health locations. We do not have hospice in Florida with it being a CON state. As we sit and prioritize our de novo, we really do look at what markets, what areas do we have where we cannot cover home health and really prioritize that from a hospice de novo standpoint.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Where are you at on the penetration versus where the opportunity would be?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. I mean, when we look at overall from a home health perspective. If you look at 25%-30% of the overall referrals in those markets would come from our home health in those markets where we have that overlap. We still think, one, there's opportunity in improving the overlap, as Barb just touched on. As well, when we think about penetration, we have relatively good penetration rates with those 25%-30% of hospice referrals. We think there's still a little bit of opportunity there. It's not something that we've disclosed publicly, but we think we do a relatively good job today. There's always a little bit of opportunity to continue to improve there. We feel really good about the overlap strategy, the ability to grow there, continue to fine-tune that overall strategy.

Between de novo and some of the overlap strategy, a fair amount of growth that's still to come there.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Is there a target of de novos into new markets where you already have, I mean, home health that you've got in mind?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We still have the goal of 10 de novos each year, leaning more towards hospice, so 6- 7 hospice of the 10. At this point, those are all in markets that we would have home health.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. Okay. Talk a little bit more about the—and this goes back to home health—the visit-per-episode pilot program. You're saying it sounds like you're farther along than I realized, actually. You started out earlier in the year with a few locations, but now you've got a pretty significant outlay.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Right. We started with 11 locations in the pilot. It takes about 60 days to really touch every patient on census because you do it at the start of care. About mid-October, we had those 11 branches fully on the pilot. Saw them go from about 15 down to 13. It has really put a structured program in place on following the metallurgics recommendation, complemented by virtual clinicians. When and if we feel a patient is trending at a higher risk, can we support them through some virtual visits so that we can maintain our high quality while managing the visits per episode? We rolled out another 83 locations during the month of October. By the end of November, we will have all locations in this new process.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Is there any risk in rolling them out at that pace, or you feel like, "Well, these 11 were great, so we know we're in good shape"?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. We feel like we have the support in place for our off team and our virtual clinicians to really be able to do this in the cadence so that we are not impacting that quality of care. Right now, the biggest thing we watch is the TIF rate, which is that transfer to inpatient facility. We're also going to have to watch the claims-based measures as they come through to make sure that we didn't see any significant increase in readmissions. Those will be things that we'll be monitoring as we get more patients on it. You can always make the decision, "Do I need to let up a little bit based on how the quality metrics are trending?" At this stage, we feel really good about it.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

The 15 to 13, how much is metallurgics versus how much is the incremental stuff you're doing on top of that?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

The 15- 13 is this new pilot put in place because these branches through metrics had declined in the past episode.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

You've gotten down to 15?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. Okay. Interesting. Is there one thing that you can call out that says, "This is what's causing how we can get down from 15- 13"? What is?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

It's really been about putting in that extra layer on top that actually says to the clinicians, "Okay, this is what's being recommended. And unless you can really justify why you believe your plan of care should be more than this, this is what we're going to actually put in that you can schedule." We have put really another layer to enforce following the recommendations unless—now we will not always follow the recommendations. For example, if a physician has ordered more or if there are specific things like a wound care patient that needs more dressing changes, those types of things then mean we will allow them to schedule more than the recommendation. We have this—and again, the virtual clinicians to help complement is the other piece that has been a really added support.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Yeah. So how should we see that flowing through? You went to the 80, and now you're at the 40.

Ryan Solomon
CFO, Enhabit Home Health & Hospice

It's a good question. I mean, when we think about it, there's really three components here, and we've touched on two of them in the context of freeing the capacity up. As we talk through, we have been building that confidence over the last 30- 60 days as we deploy the pilot. Maintain quality is the second component. We'll continue to monitor and evaluate if there's any sort of impact there, which we haven't seen at this stage. The third is then making sure we utilize that capacity. As we think about caseload and overall caseload, now that we're freeing up the capacity, how do we make sure that we're seeing additional patients to make sure they receive our high-quality care?

We are seeing as well in the early tests the ability to free up the capacity and redeploy or increase caseloads on whether it be RN or PT-related skilled sets. Once you put all three of those together, that ultimately improves revenue on existing kind of salaried, mostly salaried clinician base, which ultimately results in kind of that margin expansion of that $5 million-$8 million for each half a visit. It is really about freeing it up, carrying additional patient load with that similar cost base that creates that kind of margin expansion that helps offset any sort of rate risk.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

The incremental volume is there for them? If you free them up to take on the incremental volume, they're able to do it?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

That's right. Because when you look at our conversion today, for our non-Medicare, our conversion is only about 50%. And so there is the ability to have the referrals there to fill the capacity.

Ryan Solomon
CFO, Enhabit Home Health & Hospice

That is the beauty of when you think about our strategy with the payer innovation and being a full-service provider, we can augment that and kind of pull that volume in at relatively reasonable rates. As we free up that capacity, that volume is there. We really feel like it is putting it all together, payer strategy, balancing or optimizing the overall payer mix, and then having that volume when you need to be able to kind of drive additional utilization as we free up some of the capacity.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

How do the clinicians respond to that? Do they feel like you're looking over their shoulder a little more when you tell them they're only going to do 13? Do they really care whether they've got an incremental patient because they've freed up capacity?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We've been very transparent with our clinicians about the proposed rule. Our clinicians have heard talk within the markets about other home health providers starting to look at how they're paying them from a salary to a per visit or changing benefits because some of our peers already have really low visits per episode, and that is not a lever for them on mitigating these rate reductions. We've been very transparent with our clinicians that we need their help. This is why we're doing it. We've kind of been forced to do this and that we need to do it in a way that we do not harm our clinical quality. I really think that our clinicians are in a place where they understand the reasons behind why we're doing it.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. This has been couched around the idea of this is preparation for this rate cut that's being—so it's the government's fault.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

That's right. It really comes down to them understanding we know that we need to be competitive in how we pay them. There are some industries out there that may say, "Well, we're just not going to give merit increases," right? That's how we're going to offset it. We know we need to be competitive for our highly skilled workforce, so we have to think of something different.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

What is sort of the baseline trend on wages at this point? Where are we going to end up for this year, and what are you seeing for next year?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

We're kind of back to that more normal 2.5-3%.

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. Yeah. I think, and you combine that with the ability to build clinical capacity in that type of environment. So you've got normalized rate environment or predictable, if you will. We've continued to build clinical capacity both on home health and hospice. You have some regional or kind of targeted areas where we have some challenges, and that's not abnormal. You're going to see that. But we feel really good about broader rate clarity in the clinician front, the ability to build capacity. From an MA perspective, the penetration has slowed, and we'll see where the open enrollment goes. And so really, you think about putting those three items of kind of question mark two or three years ago across the industry, clearing those out, and then we'll see with this final rule, whatever that looks like, we've got a clear strategy to overcome that.

We feel like then it's a very different model as we think about growth and predictability within our business.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. On labor, your turnover rates and all of that are back to pre-pandemic levels pretty much?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. We're pretty much where we were before the pandemic.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. Okay. I think leverage-wise, you were down to 3.9 in the third quarter debt EBITDA. What is your target at this point? Do you have a target for where you'd like to be?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

We have not put out any sort of leverage target. I think we have done a great job. When you look at we have reduced over one and a half turns of leverage post-spin from Q4 of 2023 to current. As we think about where we are at today, we think that provides more balance sheet flexibility to start to look at whether it be investments in technology and innovation, potentially accelerating our de novo strategy because there is some investment from just the losses that you would put in initially. As we think about very strategic type of M&A and how we might think about that going forward.

While we do not have a targeted leverage that we put out there, we do believe that the current range and really continued path of 2025 into 2026 puts us in a position where we have more flexibility to explore some of those areas than we have in the past.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

I mean, presumably, we need some clarity on the home health rule before you would do it. Do you see that opening up opportunities significantly? Would you say, "Okay, we've gotten whatever the rate is, 6.4%, hopefully something less than that, and that's it? We're going to go and we think there'll be opportunities to"?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

I think it will create some clarity on the home health front. There's been kind of this seller-buyer mismatch over the last several years, and I think it would create some clarity around what does this look like. I do think there's maybe some small players that if the final comes out anywhere close to the proposed, could actually almost just close, and then you just look at getting the market share by bringing on those clinicians. I do think it would create a little bit more clarity.

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. I think there, I mean, just the clarity on the home health side and kind of what the clearing price may look like for some of the assets that may be in market. On the hospice side, you made the point earlier, AJ, I mean, multiples continue to be a bit frothy on the hospice side. Those tend to be more platform-type assets. We clearly do not have a need for a platform-type asset, but we may look at some of the smaller, medium-sized assets that maybe do not have that type of multiple attached to them that could be strategic in certain markets, a land and expand type of approach or something along those lines. We will be very selective.

I think we're really confident in the operational execution, the free cash flow, the delevering that gives us optionality and flexibility, but we want to continue to be disciplined and strategic as to how we approach that. The final rate rule will be informative, hopefully, as far as kind of clarity around the home health and kind of potential M&A there.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

I mean, you get the rate rule. Do you automatically know, "Okay, this is what these guys look like, and it happens," or does it have six months where we got to have everything shake out, and then you're sort of, "Okay, this is how these guys are going to look going forward," and we can think about tucking deals? Do you think it takes some time even once the rate notice is finalized?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

I think there is how definitive is CMS around whatever that rate rule looks like. As we touched on earlier, I think just the clarity in how definitive that looks, I think will potentially solve for some of the buyer-seller mismatch. Ultimately, it probably will take some time for that to, for those that maybe are not as well prepared as we are, to overcome some sort of a rate decrease for that to kind of manifest itself in those assets coming to market. I think realistically, it comes down to how much clarity is there in that rule, and then likely a bit of time for prospective sellers to really kind of fully understand what their strategy is, play through or go to market.

At that point, the clearing price in the instance where CMS is very clear, that selling price is hopefully a bit more aligned with what buyers are prospectively looking to acquire at.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

The difference is mainly on what the operating income level is as opposed to what the right price to pay for the asset is?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

I think it's both. I think it's both. What do you think that prospective margin looks like and what levers they either do or don't have similar to what we've talked about? At the same time, I think you've got some sellers that have multiples in mind that are not reflective of current market. I think it potentially is both.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Is there any way to put a parameter around what the going price for a home health agency is?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

I think that's part of the challenge that we're talking about here. I mean, I think you probably line five people up on a wall, and you get probably five what could be very different answers around kind of home health valuations dependent upon the asset and some of the rate considerations that we've talked about. I think that's why you haven't seen in some ways, the industry's talked about home health consolidation for many years. I think some of the outcome of CMS and the rate approach has been the lack of clarity and this buyer-seller mismatch around valuations that hasn't allowed some of the consolidation to occur that I think we all agree needs to.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

I mean, I think we hear about tugging deals. Traditionally, we're sort of mid-single digit EBITDA multiples, maybe a bigger platform deal was 10 or 12 or something like that. You think that's changed in any way in the discussion, or?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

I don't.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

If you can agree on what the earnings power is, I'm trying to, not trying to, I guess I'm trying to pin you down a little bit.

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Barb, I don't know if you have any thoughts.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

No. I mean, I think I do not think you are far off. I think it really comes down to not only this rate rule, but I think what we have seen over the years, right, is really that move to Medicare Advantage too, right? I mean, you have to take that into consideration. You cannot look at what their mix was two years ago. You have to look at what does that current look like in that market today. I think that really is kind of what is going to inform it going forward.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Hospice valuations, they're sort of in the mid-teens EBITDA. Is that still?

Ryan Solomon
CFO, Enhabit Home Health & Hospice

That's what you've seen as far as some of the more platform-type assets and where they're trading at. Again, I think there's some opportunities maybe at a little bit lower multiples where you don't have that platform aspect to it. Yeah, I generally agree with your comments.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Okay. You may say we can't say anything, but I'm going to still ask you about it anyway. The former founder and CEO, you've got the litigation. The judge made the ruling that you would share in the earnings.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Constructive trust, yes.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Yeah. I mean, are you getting anything of that? Are you likely to get anything out of that anytime soon? I know you're supposed to split that 50/50 with Encompass, I believe, is the way it's set up.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Right. We're still awaiting final orders from the judge. So there was a trustee appointed, but there are still final orders yet to be entered, including the attorney's fee. So it's still ongoing and still await for some final orders.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Is it clear who would be, if they were? I mean, if I'm on the other side of that, I want to negotiate a settlement and just be done with it. Is it clear whether that's you would negotiate the settlement or Encompass would negotiate the settlement, or you have to do that jointly? Is there any?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. With it still being really considered ongoing litigation, we can't comment on that.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

Can't comment. All right. Just to summarize, what would you say a summary comment here about where the company's at looking ahead to next year? What should we keep in mind?

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Yeah. I think my summary comment would be really proud of the team and really showing the results of all the strategies that have been put in place, the case management model for hospice, payer strategy, all of that, creating the free cash flow generation that has paid down the debt. I think in a really good place to end 2025 and a good place to start 2026.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

All right.

Ryan Solomon
CFO, Enhabit Home Health & Hospice

Yeah. I think just to build on that, I mean, I think the execution, I mean, I think we've got a really good story building here in the context of continued hospice momentum. Home health starting to kind of see that growth on the KPI side, which we believe revenue will shortly follow thereafter. Deleveraging will give us the flexibility. I think we feel more confident than we did 60 days ago around our ability to overcome quickly any sort of proposed rule. We think that we're well positioned, whatever that environment looks like, and our consistent execution throughout the year has hopefully built confidence not only across our team but within the investor community as well. We're really looking forward to 2026, whatever that might bring, and executing at a high level.

Brian Tanquilut
Senior Equity Analyst, Jefferies Financial Group Inc.

All right. All right. You got some scarcity value in home health these days. There aren't really many plays left. Most people ask that you're the one that people are focused on. Thanks for participating in the conference again this year, and thanks everyone, and have a great rest of your day.

Barbara Jacobsmeyer
CEO, Enhabit Home Health & Hospice

Thank you.

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