Accendra Health (ACH) Q4 2024 earnings summary

Executive summary

• Achieved mid-single-digit top-line growth and 13% growth in adjusted EPS for 2024, with continued reinvestment in operational efficiencies and technology.

• Achieved $244 million debt reduction in 2024, totaling $647 million over two years.

• Patient-direct segment outpaced market growth, delivering over $13 million incremental operating income year-over-year and strong performance in diabetes and sleep supplies.

• Initiated active sale process for Products & Healthcare Services (P&HS) segment; Citi engaged as exclusive advisor.

• Board authorized up to $100 million share repurchase program over 24 months.

Financial highlights

• 2024 revenue: $10.70 billion, up from $10.33 billion in 2023; Q4 2024 revenue was $2.7 billion, up 1.5% year-over-year.

• 2024 GAAP net loss: $(362.7) million, driven by $307 million goodwill impairment; Q4 2024 GAAP net loss: $(296.1) million.

• Adjusted EBITDA for 2024: $523 million, nearly flat year-over-year; Q4 adjusted EBITDA was $138 million vs. $170 million in Q4 2023.

• Adjusted net income for Q4 was $43 million ($0.55/share) vs. $54 million ($0.69/share) last year.

• Cash flow from operations: $161.5 million in 2024; Q4 operating cash flow was $71 million.

Outlook and guidance

• 2025 revenue guidance: $10.85–$11.15 billion (midpoint $11.0 billion), with most growth from patient-direct.

• 2025 adjusted EBITDA guidance: $560–$590 million (midpoint $575 million, ~10% growth); adjusted EPS: $1.60–$1.85 (midpoint $1.73, ~13% growth).

• Gross margin expected at 20.75%–21.25%; interest expense $138–$142 million; capital expenditures projected at $250–$270 million.

• Guidance excludes impact from Rotech acquisition, P&HS sale, and share repurchases.

• 70%+ of earnings and cash flow expected in the last two quarters of 2025.