AdaptHealth Corp. Common Stock 2026 Q2 Earnings Call

Good morning, everyone. Thank you for joining our call today. I'm going to cover three topics this morning. First, we delivered 16% organic growth with record volumes gains across the business. Second, we made significant progress sharpening our portfolio and focusing on the core business, announcing the sale of our Diabetes Health business, exiting other non-core products within Wellness at Home, and contributing our e-commerce business into a new joint venture to improve how we serve the direct-to-consumer market. Third, I'll speak to two near-term profitability challenges we're navigating: our West Coast capitated contracts and a material price increase from one of our largest manufacturers. Starting with our financial results. Given the agreement we signed to divest our Diabetes Health business, I'll walk you through our results on a continuing operations basis, which excludes Diabetes Health included for prior year period comparisons. Revenue remains a bright spot.

Second quarter net revenue from continuing operations was $740.3 million, up 12.7% versus the prior year quarter, and 15.9% on an organic basis. Our West Coast capitated contract contributed 10.7 points of that organic growth, with 5.2 points coming from our base business. Sleep Health net revenue was $386.5 million, up 15.5% versus the prior year. Respiratory Health net revenue was $194.4 million, up 14.1%. Wellness at Home net revenue was $159.4 million, up 4.9%. Total capitated revenue grew to $103.3 million in the quarter and now represents approximately 14% of our continued operations net revenue. This is more than three times the prior year with our West Coast capitated contract driving nearly all of that increase. Second quarter Adjusted EBITDA from continuing operations was $132 million, with an Adjusted EBITDA of 17.8%, driven by elevated West Coast capitated contract costs, which I'll speak to later.

Turning to the work we have done on simplifying and focusing our business. Over the past 2 years, we have systematically reshaped AdaptHealth around our core Sleep Health, Respiratory Health, and supporting home medical equipment businesses. The parts of the portfolio where we have the strongest value proposition and the clearest path to growth. In July, we took the most significant step yet in that effort. We signed a definitive agreement to sell our Diabetes Health business for $235 million. A move that we expect will ultimately improve our growth rate, enhance our margin profile, and allow us to sidestep looming industry risks. We also took a further step in focusing our portfolio on the core by discontinuing proactive sales of certain product categories within our Wellness at Home segment. This action removes non-strategic, low-growth, and low-margin product lines from our portfolio.

Last week, we signed an agreement to contribute the CPAP Shop, a direct-to-consumer e-commerce business we've built within our Sleep Health segment, into a newly created joint venture with a leading e-commerce competitor and a telehealth prescriber network. The JV will have an unrivaled set of capabilities to fulfill its strategic ambition to reach the vast undiagnosed OSA population through home sleep testing and a digitally enabled path from diagnosis to treatment. Our growth strategy is focused on improving our service levels in our core business, expanding our capitated relationships where it makes sense, and growing the number of large health systems we serve. This quarter, we made progress on all three fronts. In May, we signed a new capitated agreement with Humana OneHome, successfully transitioning 478,000 new members in South Florida and Texas without disruption.

Our capitated relationship with Humana now spans 33 states plus the District of Columbia and South Florida. We have a proven track record of successfully serving Humana patients under capitation over the past three years, and we're building on that experience as we take on this expansion. Our newly formed enterprise sales team, exclusively focused on large health systems, secured preferred provider agreements with several multi-hospital health systems. These customers recognize the clinical expertise we bring, the value of having our liaisons embedded in their systems to coordinate access to our services and care, and the operational excellence that shapes how their patients experience it. Let me turn to the more difficult part of the quarter, starting with the challenges we are facing with our West Coast capitated agreement.

Having spent the first half of this year executing the largest patient transition in the history of home medical equipment, we spent the second quarter working to stabilize that operation on the West Coast. Standing up a new geography this quickly, new buildings, new routes, new inventory, new people, and a new customer relationship, has posed new challenges, some of which we did not fully anticipate, but which have become clearer as the contract fully scaled. Throughout, we refused to compromise patient care and have remained fully committed to serving patients, whatever it took. With the benefit of a full quarter of operating this contract, here is what we know. Order volumes are running higher than expected, primarily in Sleep Health resupply and enteral products. The outsized Sleep Health resupply volumes largely reflect transition-related pent-up demand and should prove transitory. While enteral volumes will require further intervention.

As we solve these two items, we believe gross margins will recover toward our original expectations. Second, there are inefficiencies in the inherited workflows, including the non-standard use of urgent orders. These are contributing to unanticipated logistics cost downstream, which in turn have caused labor costs to remain elevated. We have met these elevated demands, but doing so at this level is not a sustainable model. We are working with our partner to align ordering practices with the original assumptions of the contract while rapidly introducing technology to streamline the workflows, shifting more of our fulfillment to drop ship rather than in-person delivery, and right sizing our fleet and labor accordingly. The combination of these items represents $40 million of expected impact on profitability relative to our prior projections for the second half of this year.

We remain confident that with sustained work and additional time, this contract will be a strong contributor to our profitability. Our long-term profitability outlook for the West Coast contract has always assumed we'd be able to use the footprint we built to serve additional business beyond the current capitated membership. Currently, we are only able to serve our existing patients through our 40 new West Coast locations, and that will remain the case until the government-imposed DME moratorium put in place last February is lifted and we can secure new PTANs, which are the Medicare billing numbers required to serve fee-for-service patients from these locations. Once that happens, we see substantial opportunity to serve patients who use our customer's health system but are insured through other payers, and to sell proactively to other customers located near or within our new footprint.

That incremental fee-for-service revenue will help absorb the fixed cost infrastructure we've built out on the West Coast. To help offset the cost pressures I just described, we made the difficult decision in the second quarter to restructure our workforce, delivering $19 million in annualized savings while maintaining full operational delivery across every function. This required real sacrifice from our team, who took on more so that we could continue serving patients without interruption. The other lever we're pulling on is technology, using it to fundamentally re-engineer the patient journey from diagnosis to treatment, improving patient experience, and accelerating cost efficiencies along the way. We are already seeing what a digitally enhanced patient experience looks like in practice. Our myAPP platform now connects nearly the entire patient journey. Let me walk you through it. It starts with a digital front door.

Patients can enter our platform before they are even officially a patient. It's as easy as scanning a QR code. From there, AI-powered intake walks them through insurance setup. They receive real-time order status tracking, and they can instantly self-schedule a virtual or in-person PAP setup without a phone call. Order supplies in the app and access live or AI-powered chat support. This quarter, we added our newest feature, an AI-powered mask fitting tool which converted 92% of in-app scans to completed orders in its first two weeks, with early signs that it has reduced mask refittings that delay therapy. These features and the ease of use are driving rapid adoption of myAPP, with users standing at 512,000, up 56% since the end of 2025, and an App Store rating of 4.8 stars. This and similar work to re-engineer the patient and provider experience share a common thread.

By removing the human intermediary from routine repeatable steps, it frees up our people to focus on higher value, higher touch work, and in return, supports our efforts to improve our cost basis. Addressing the team manufacturer price challenge I mentioned earlier, we were notified on June 30 by the manufacturer of their decision to terminate our contract and impose an immediate price increase effective July 1. As it stands, this results in a $30 million impact in the second half of the year. We are actively working with the manufacturer to secure improved pricing and terms, but at this point, we've reflected the full impact in our outlook. Brings me to guidance. Our underlying base business continues to grow and is performing in line with our expectations.

Between the portfolio actions we've taken, the challenges we currently have with our West Coast capitated contract, as well as the manufacturer's price increase, we must reset our full year outlook. Let me close with how we're thinking about the road ahead. Everything we are doing is to enhance the important role we play within a critical part of the healthcare ecosystem upon which millions of patients depend. The portfolio actions we've completed position us as a more focused company built around Sleep Health and Respiratory Health, where we have the strongest value proposition. Our rapid growth demonstrates that healthcare providers see the clinical and economic value of the services we provide. In addition, with all the realities facing our industry, we are well-positioned to benefit from the industry's ongoing consolidation with the size and scale to take on significant volume.