BrightSpring Health Services (BTSG) Q4 2025 earnings summary

Executive summary

• Achieved strong revenue and adjusted EBITDA growth in Q4 and FY 2025, exceeding guidance and driven by operational efficiencies, strategic acquisitions, and strong performance in Pharmacy Solutions and Provider Services.

• Divestiture of the Community Living business approved, expected to close by end of Q1 2026, with $715M net after-tax proceeds earmarked for debt reduction.

• Closed acquisition of Amedisys and LHC Home Health Assets, adding 107 branches and $345M pro forma revenue; integration underway.

• Continued focus on high-quality, patient-centric care, with industry-leading satisfaction and quality metrics across service lines.

• Leveraged scale, technology, and complementary services for sustainable differentiation and efficiency.

Financial highlights

• FY 2025 revenue reached $12,911M, up 28% year-over-year; adjusted EBITDA was $618M, up 34%.

• Q4 2025 revenue was $3,551M (+29% YoY); adjusted EBITDA was $184M (+41% YoY).

• Pharmacy Solutions FY revenue was $11,446M (+31% YoY); Provider Services FY revenue was $1,465M (+11% YoY).

• Cash flow from operations was $490M for 2025; leverage ratio improved to 2.99x from 4.16x.

• Gross profit for FY 2025 was $1,518M, up 19.8% year-over-year.

Outlook and guidance

• 2026 revenue guidance: $14,450M–$15,000M (11.9%–16.2% growth); adjusted EBITDA: $760M–$790M (23.1%–27.9% growth).

• Pharmacy revenue expected at $12,600M–$13,100M; Provider revenue at $1,850M–$1,900M.

• Amedisys and LHC expected to contribute ~$30M to 2026 adjusted EBITDA.

• Sequential quarterly growth and margin expansion expected in 2026, driven by operational improvements and product mix.

• Guidance excludes Community Living and any not-yet-closed acquisitions.