BrightSpring Health Services, Inc. (BTSG) March 2026 Capital Markets Day Transcript

for the I guess the video is coming back over here yeah yeah so if you want zoom to hear anything that it's got to be on okay so on and on 830 that's just on yeah on and on and then your inputs it's Wallace one two three four it's like they're labeled over here channel nine and ten are those and then you've got your PowerPoint, your Pro-P, which I don't think we need PowerPoint audio, but Pro-P looks like it's set. So anyway, he's already got it on. So like that. And it looks like he's got music. Yeah, we'll figure that out.

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let me hear you test test perfect for Q&A if we were yes great thank you test one

two hello hello at bright spring health services we believe the future of

healthcare demands more more connection more coordination more accountability across the country we deliver high quality integrated services for seniors and individuals with complex high acuity needs meeting them where they are in their homes and communities from primary care and rehabilitation to advanced pharmacy services we provide patients with the clinical expertise and support they deserve but innovation isn't just about expanding services touch one

two, test one, two. We have you coming up after Rich, so...

You gotta have both here, right? Yes, exactly. Or you may have no version. You just stand up and wave, you know?

And so I will have you potted down until you are actually up on the stage. Let me know if that feels comfortable. May I test you real quick?

And go for it. Happy, happy.

At Bright Spring Health Services, we believe the future of healthcare demands more. more connection, more coordination, more accountability. Across the country we deliver high quality integrated services for seniors and individuals with complex high acuity needs, meeting them where they are in their homes and communities. From primary care and rehabilitation to advanced pharmacy services we provide patients with the clinical expertise and support they deserve. But innovation isn't just about expanding services, it's about delivering results. Bright Spring consistently achieve strong industry leading quality metrics across its service lines we remain focused on delivering superior timely lower cost coordinated patient care that provides significant value to the health care system the individuals we serve and our organization by integrating provider pharmacy and supportive services into one coordinated model we are transforming fragmented care into a seamless experience for patients families, and partners alike. As the needs of our aging population grow more complex, the solution must be smarter, older, built for the future. At Bright Spring Health Services, we are not adapting to the future of health care. We're defining it.

Good morning everyone. Thank you all for joining us here at Bright Springs headquarters in Louisville and welcome to those of you who are on the webcast. Today's agenda will start with a company overview from John Rousseau, Chief Executive Officer, followed by detailed reviews of the pharmacy businesses from the leaders of Specialty, Infusion, and Home and Community Pharmacy. Following the pharmacy overview, we'll bring up the leaders for questions and answers before taking a break. After the break, we'll go through the provider businesses, starting with home health, hospice, and rehab and personal care, followed by a Q&A session with the provider leaders before breaking for lunch. After lunch, we'll hear from the leaders of government relations and business development teams, followed by a discussion on the company's financials, with a wrap-up discussion and Q&A with John and the other leaders. Our goal is to end the day around 2 p.m. Eastern. Before we begin, I'm going to read the company's forward-looking statement. Today's discussion will include certain forward-looking statements that reflect our current assumptions and expectations, including those related to our future financial performance and industry and market conditions such forward-looking statements are not a guarantee of future performance these forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially from our expectations we encourage you to review the information in today's presentation as well as in our annual report in form 10k that is filed with the sec including the specific risk factors and uncertainties discussed in our form 10k such Such factors may be updated from time to time in our periodic filings with the SEC, and we do not undertake any duty to update any forward-looking statements except as required During today's presentation, we will use non-GAAP financial measures when talking about the company's financial performance and financial condition. You can find additional information on these non-GAAP measures and reconciliations of our non-GAAP financial measures to the most directly comparable GAAP financial measures to the extent available without unreasonable effort in the company's 10K. This presentation is being recorded and will be available for replay on our investor relations website. And with that, I will now turn the day over to John Rousseau, Chief Executive Officer.

Thanks, David.

Good morning, everybody. Is this thing working good? You guys can hear me? Oh my gosh, the spotlights. Good thing I can't see so well. Well, good morning, and thank you for being here. I appreciate everybody traveling. And for those that were able to get the walkthrough last night over at Onco and CareMed and I'm gonna hit just an overview for about 20 minutes then we'll hit pharmacy then the provider side and then we'll wrap up with some corp dev and in finance if that sounds good if I can figure out okay well look I think a lot of you are very familiar with the story at a high level but but I'll reiterate it you know we are a leading home and community health services company full stop whether it's pharmacy services in a closed-door manner directly to the patient or whether it's provider services going where the patient are you know we are a solution for the future of health care where we deliver very high quality product place to be aligned with long long-term health care trends and we want to ride that out as far as we can and continue to be an innovator and a solution provider within health care so again we primarily take care of seniors and specialty populations providing them with very needed solutions which are also lower cost in doing so we really focus on the platform and our quality and operational capabilities that's really been a hallmark now for nine and a half years that we've invested in process people operational excellence wherever we can and that drives our growth the quality reputation and our ability to get services out the door quickly drives our growth. Ultimately, we also have a lot of scale advantages with this platform, which I'll talk about more. Sometimes I think that's a little bit underappreciated. Yes, we have a lot of service lines that are doing well, and we are defined by broad-based growth with a few superstars in our portfolio from a growth perspective. But I also believe that the reason why we've been so successful, we're in the top 5, 6% of public companies in the last three years on EBITDA. You know, in the Russell 3000 for companies over $5 or $10 billion in profitable, we're second on revenue growth over the last three years, right? I think the reason why we've been able to do that is because we have the one enterprise platform. So a little bit on our history, ResCare, our predecessor company and brand, goes back almost 50 years, founded here in Louisville, taking care of individuals with intellectual and developmental disabilities in group homes, just an unbelievable mission. You know, that company has grown its revenue for about 30 or 40 years in a row consecutively, an incredible quality that leads that industry. When I got here about a little over nine years ago now, we started more heavily investing on the clinical side. We also had a pharmacy business taking care of those individuals in the home very smartly. We had a rehab business, personal care, but we really started building out more of the clinical side with some of my background in particular in those areas. That went really, really well. Onyx had been in the company for about 15 years, taking it private. We recapitalized to KKR about two and a half years into that, a little bit sooner than we wanted to, but Onyx literally had to exit. KKR has been incredible and wonderful partners throughout. I mean, their focus on quality, their focus on mission was just ideal for this company. So that happened in early 2019, and it's just been an incredible run. You know, our thesis then was to combine a large pharmacy company of scale for America which they had bought about a year earlier with our provider scale and create a very unique platform within healthcare a very unique scaled pharmacy and provider platform that could more comprehensively serve patients and that has gone extremely well fortunately that headquarters was about four miles down the road on the for America side and very seamless for us to all come together so after that you know it's really been about seven years at this point of just execution and building out the platform you know we had the service lines we largely wanted to be in and it's been growing in those service lines on the back of our quality and operational skill set which has been the focus for the last six or seven years and has resulted in those growth rates that I that I spoke about before you know keggers of around 20% at this point on both the top and bottom line you know we've had some events now in the past couple years we went public in January of 2024 so it's been about 26 months now and in that community living business which we started with about 50 years ago we decided late January of last year to divest that business to have a strategic focus on more clinical services in the organization also helpful from a deleveraging perspective and a cash flow perspective so again we expect that to close here in the next few weeks you know we've also selectively done some acquisitions with these home health assets here more recently which we think that'll be very favorable for the company so you know our model today you know the circle the top half is pharmacy the bottom half is provider and we think those fit together extremely well it is a comprehensive in what we believe to be a very differentiated model for home and community health care services that better addresses required patient needs for improved outcomes it creates market and integrated care opportunities and it leverages our scale so i think everybody's probably pretty familiar with some of the challenges and opportunities in health care i think the left side of this slide is is very self-evident but there's a smaller percentage of the individuals in our society that make up a larger proportion of the spend it's individuals on with chronic conditions seniors and specialty indications, you know, one of the markers of these populations is that most people is typically on six or eight or more medications. You know, when you look into healthcare and you see an individual who's on six or more medications in particular, that's referred to as polypharmacy. I mean, that is a pretty clear indicator of where your biggest risk is going to be and where your most complex patients are. A lot of these individuals could be served in lower cost settings very logically and a lot of ER visits and hospitalizations could be curtailed with more proactive and more proximal care for these patients where they are. So our solution to that has been the integrated care model. These services are delivered in lower cost settings. We've been able to deliver to deliver very strong quality results. The comprehensive model does give us a lot of integrated care opportunities whether it's cross referrals across our service lines or ultimately managing patients in more value-based care models. This model we believe again is the future of healthcare in many ways and what we need to keep driving. So what constitutes that model more specifically from a product perspective on the pharmacy side we have three key service lines on the provider side we more or less have three key service lines. So I always keep it straight in my head with kind of a three by three framework if you will on pharmacy. This is closed-door pharmacy, okay, and that is the big difference. This is not you and me walking into a retail pharmacy. It is the polar opposite of that. There are a myriad of settings and locations in our society and neighborhoods every day where people need their medications, where they are more chronic, more acute, where they can't walk into a Walgreens for one script. That doesn't work for a large chunk of our population. So we go to them. That's what closed door means. You cannot go in. We go to our customers. We go to our patients, wherever they are. The first patient population that we do that for are individuals with cancer and individuals with rare and orphan diseases. That's our specialty pharmacy business under two brands, Onco360 and CareMed. Onco360, as the name might indicate, is our focus on oncology. Care Med is our focus on LDDs and rare and orphan therapies outside of oncology, and that continues to grow. That is a leading quality business in the United States with excellent service metrics, net promoter scores of above almost 95. And on the backs of that, the team has developed incredibly deep and trusted partner relationships with pharma over the years. And our sales team really pulls through as a partner in the offices every day prescriptions working with patients and families. Our infusion business, this is going to the home or sometimes in a suite or in a clinic and providing needed infusible therapies. We really do everything there. It can do everything in infusion except oncology. The specialty business I talked about before is oral and injectable. This is infusion, and we do most things except oncology, which is primarily done by the hospitals and the doctors in the buy-and-build model. So in infusion, there's two key areas in patient population types that we focus on. It's our acute patients, antibiotics, nutritional therapies, etc. Then the chronic specialty population, IVIG, a lot of neuro and gastro indications, etc. Wonderful business, large market, growing. Our home and community pharmacy business. This was more or less the biggest legacy business of PharmaRica. This is where we are getting drugs and medications to hundreds of thousands of people every day, wherever they may be. These are individuals, again, that are more acute with chronic conditions in skilled nursing facilities, in assisted living facilities, at home on hospice, at home on home health, in behavioral group homes. This is a good example of where we have integrated care in our company. All of our hospice patients, all of our behavioral IDD patients also receive all of their pharmacy services from us. But collectively, across these pharmacy businesses, we dispense over 40 million scripts a year. I think that puts us in about the top 10 of the country as a pharmacy after the big retailers and after the big PBM mail order houses. Scale is very important in a lot of industries. It is absolutely vital, as Scott will talk about, in the pharmacy industry for purchasing, for payer contracting, for leveraging your OpEx, for driving automation. Pharmacy is just critical. We can be anywhere in the United States on the ground within three hours. That's our coverage, and that's our footprint that's been built up over the past 40 years, and it's a huge advantage. On the provider side, home health care, rehab care, and personal care. You know, home health care, that's home health and hospice, and we're building out our home-based primary care business. We'll talk more about that. We're integrating presently the home health assets that we acquired in the United Divestiture of Emeticis. that's going very well. But we love those businesses. You know, huge ROI of home health reduces hospitalization rates by 20, 30 percent, reduces costs. The same for hospice. These are wonderful services with very mission-driven clinicians who are out there every day taking care of people in their home so that they don't go to the ER unnecessarily or they don't go to hospital more than they have to it seems incredibly intuitive that the more you get to somebody proactively in their home see their setting and make sure they have a customized care plan like that works i remember like 15 years ago somebody told me there's not a lot of new ideas in healthcare it's just the implementation and the execution of it and a lot of these things are very clear in terms of what you should do it's the ability to actually do it and it's making sure that you have a reimbursement model that supports it. On the rehab care side, wonderful business with incredible clinical quality. Here is where historically we have taken care of individuals with severe neuro conditions, either a brain injury or a spinal cord injury. It's mostly a workers' comp and a commercial funded business where we have a footprint across about 30 states, very predictable nice double-digit growth business it's about a 7% growth market we are more recently leveraging that rehab and therapy expertise to also move into the senior setting adjacent to our home health hospice primary care and pharmacy and be the rehab provider in conjunction with home health in places like assisted living in the home for seniors under the Part B benefit personal Personal care, very, very steady business for us, 2% to 4% grower, but operationally very consistent, very steady. It is not the easiest thing in the world to hire caregivers to go deliver personal care. The lesser clinical home instead type services in the home, our team does that very predictively and in a very consistent manner with really good quality results. I really think that personal care and med management are the two ways, if you look at the data, that keep people out of the hospital the most. You know, if you just think about it, when somebody's in the home, you don't have to necessarily be a doctor or a nurse or a therapist to do common sense things at the home. What are you eating? Are you able to get around? Are there fall hazards in your home? Are you getting companionship? Are you taking your right meds? Any of us can do that. That's personal care, and it has an incredible impact on also keeping people out of the hospital. Our markets are large and growing, and they're also incredibly fragmented. So we think that creates a lot of runway for us in the future, both organically and from an acquisition standpoint. If you look at our markets, they all have favorable demographic trends. Everybody, I think, knows the growth in the seniors population. I think people over 85, that population is supposed to triple in the next 10 to 15 years. people over 65 that's supposed to double in the next 30 years so a lot of long-term growth trends here especially indications are generally growing at about five to seven or eight percent in the country you know on the pharmacy side a lot of these specialty therapies have been growing more in the 10 to 12 range ultimately these markets we believe are very attractive they're also very fragmented we believe scale is going to only be more and more important in the future you need scale in these industries to invest in HR to invest in technology I mean Charlie and VG are going to talk for a second about how we're investing in AI you know to drive operational efficiency through the organization you know our ability to deliver really good operational services and sound practices should be so much better than a home health company in three states than an infusion company in two states you know we try to leverage our expertise we think scale will only be more important in these large and fragmented markets while we also try to partner with the government and with payers on needed solutions. The prevalence of chronic conditions unfortunately continues to escalate as well. These are all factors that are fueling the growth in these markets where we want to continue to be a standout provider. We want to not only benefit from addressing the demand needs in these markets but also through a differentiated model and better operations take market share as well. You know, there's just some growth stats here for you. I won't go through all of these. It's going to be in your deck. But on the pharmacy side, we see infusion in specialty pharmacy generally growing in the 8% to 12% range. There's some therapies and indications there that are growing higher than that. There's some that are growing lower than that. Acute tends to grow at 3% to 4%. Other chronic conditions in infusion tend to grow in the double digits. You know, within specialty pharmacy, oncology is not only one of the biggest segments of specialty pharmacy, it's one of the segments growing the most quickly because of all the innovation and the new therapies coming out of the pipeline that are literally extending life and saving people's lives. And obviously, we have the largest position as the independent pharmacy in that very interesting growth market. You know, on the provider side, personal care tends to grow at the population growth rate. But home health, hospice, and rehab are growing in that 5% to 7% range, depending on which number one you look at. Very healthy growth rates. And the way we think about that is, look, if the market's growing at 5% to 7% and we need to try to double that, we're taking market share. And that's our approach to try to get to double-digit growth in all those businesses on the clinical side of provider, rehab, home health, hospice. Everything's based on quality, as I talked about before. I think one of the things that collectively our management team is most proud of is what we're doing from a service perspective and from a quality perspective. Again, a lot of pretty obvious comments today, but you literally can't almost do anything if your operations aren't very stable and predictable and if you're not getting good quality outcomes. For us, really importantly, we try to benchmark everything and we try to track everything so we know how we're doing. We try to do that in real time as much as we can with investments for the past seven or eight years in all of our data warehouses and reporting suites so we can see in real time how we're performing and then also how do we go get benchmark data in the industry to really hold ourselves accountable. On the pharmacy side, you know, I could pick any one of about 20 metrics, really, that would show, you know, really strong and consistent performance, whether it's the predictability of getting our meds out on time, the accuracy of those meds, or net promoter scores that literally can be world class in the mid to upper 90s. You know, on the provider side and hospice, we've been ranked the top 5% hospice provider or home health branches. I think about 94% right now are over four star or hospice branches are well above the industry average on four star and hospice. We see our patients a lot more, right? If your mom or dad or somebody you knew was on hospice, would you want somebody coming once every two weeks? Or would you want somebody coming four or five times? It makes a massive difference. We invest in quality, and we invest in service levels, and we think that's ultimately manifested in our ability to reach more patients and make a bigger impact and grow the organization. We've had over 30 articles and abstracts written about our outcomes in leading journals and publications. I would be surprised if I knew of another company with one or two or three of those. It's just really shows, and I think a tangible demonstration of how focused we are on wanting to drive quality and service through the organization. Slide here on some of our advantages as a one enterprise scaled platform. You know, I think some of these things do go underappreciated oftentimes, but there are real reasons why these businesses collectively and why our company together as one does better. You know, first and foremost, probably, you know, stating, you know, stating the self-evident here from a procurement and contracting perspective, we're able to be much more effective in terms of how we buy across the company. You know, we are able to leverage IT spend and drive best practices and technology and data and analytics throughout the organizations. It's not only the ability to buy that more effectively and save money, you know, as a bigger company. It's to make sure that's being deployed through the organization the right way so each one of the businesses has the right technology profile. Clinical quality and compliance. We invest heavily. We've got some 250 people that sit topside at corporate, even above the quality personnel in the businesses that are constantly auditing. They are constantly out there teaching and educating across all of our branches and locations. You know, we have a greater ability to invest and deliver those results on the prior slide because we leverage the organization. Sales and marketing. You know, we try to drive best practices in sales and marketing across every one of our businesses. How are we hiring sales reps? How are we onboarding and training them? You know, what are what is our sales analytics for how we target our referral sources? You know, what kind of compensation plans do we have in place, rewards and recognition? Just down the list of Sales 101, we try to make sure that that's very consistent across our businesses. You know, HR is an area we have been focused on along with IT, along with sales and marketing at the corporate level. You know, we always aspire to be an HR, quote unquote, academy company. You know, what is your experience like when you're recruited? How are you onboarded? How are you trained? You know, what is the intranet, what is the internal systems that you're able to use? You know, what systems do you use every day for your EHR? Is that an easier system to use? Are there career pathways here? What can I do? And these are all reasons why our retention and our turnover has improved every single year for the last nine or ten years. And if you look across our businesses, we are typically in the top 10 to 20 percent of retention as you benchmark us across our industries. The PMO, you know, that's something that I was very familiar with going back to my Medtronic days. That is a program management office. You know, the way that I like to describe the PMO is they just help make sure stuff gets done. And, you know, you have people that are in charge of everything in a business. There is always the need for follow-up no matter what, and things can always fall through the cracks when you're executing on cross-functional initiatives. The PMO team, we've got about 20 people on that team right now. They are working on over 100 initiatives at a time in this company, helping to make sure those projects are on time and getting moved forward. We have evolved that to take probably some informal process around smart lean process over the years. And in the last one or two years in particular, make that much formal in our company. So we now have individuals and leaders in this company who drive Lean Sigma training, whether it's a white belt, a green belt, or a black belt, you can get that here at our company, just like you're at Medtronic, or just like you're a GE in the old days, you can get that here. And we have something like 300 projects going on right now in this company, initiated by people on their own in their business, working on how to do something smarter. So we want people to organically think about what we're doing every day. I've been taught about, you know, what lean and smart process looks like. Now, how can I go execute that as part of this training? Because I need a live project to get through graduation of this training, and I have to demonstrate the execution of a project. So, you know, really, really cool stuff that we get excited about, you know, that's in the bowels of the organization every day, but it's literally how things get done. Really last from an acquisition perspective. We are able to leverage a lot of our size in terms of being able to be selective about our acquisitions, right? Like we don't have to just pick from home health assets. We don't just have to pick from any infusion assets. We can look at infusion, hospice, rehab, home health, LTC pharmacy, and we have the luxury of being able to sit back at any point in time and say, which one of those do we like the most, right? And think about what makes the most sense right now in our company for an acquisition to do. Most of them have been small tuck-ins, but we have the ability to execute on really almost any deal out there with our team and with the synergies that we bring to bear. You know, in some of the pharmacy deals, day one, day two, after close, boom, you know, that financial profile looks very different because of the contracts that we have and the revenue and the cost synergies that we can bring to bear. These are all strengths of the organization that we believe we have advantages of scale, driving best practice through the organization that I just am not sure, you know, a local or regional provider of one business alone would have. And so we want to continue to push the pedal down on this as we move forward in the future and just drive more and more scale and more and more advantages of scale with really high quality services. Just a slide here, a little bit more on the lean process. I mentioned it before. There are over 700 projects in the last three or four years that our PMO team has completed in procurement or process or technology implementation, separate now from all of the organic, you know, on the ground Lean Sigma projects going on as a result of the Lean Sigma academy training in the company. You know, this is in our DNA, and this is what drives operational service levels and the quality results that you saw. Charlie and VG, did you just want to take one or two minutes to talk about, we can't talk about all the things we're doing AI for a few reasons, but we're excited about it, right? And we feel like with a company of our size, a $15 billion company with our resources and our people, you know, sure, there's going to be some things we go by, right? There's already some projects we've partnered with, paid for with outside AI vendors to get going. Home health intake is a good example of that. But we feel like we should have the sophistication and the ability to get these AI projects done. And if we can do that, we're the ones with the workflows and the businesses that the vendors want to get their hands on. So we're doing this every day. We know what the problems are. We know what the opportunities If we can develop and leverage all the great work we're doing in tech on the AI side, we think that's probably an advantage for us going forward, probably saves us a lot of money, ultimately is more predictable if we have the team to be able to do it. And so that's what we've been building out.

Thanks, John. My name is Charlie Wardrop. I'm the chief information officer here at Bright Spring. And thank you all for coming. Like John said, we've invested a lot in technology over the last couple of years. we've been able to establish a very sophisticated integrated data and technology platform that not only supports the needs of each individual line of business but also supports the needs across the entire enterprise it gives us the ability to provide integration where we need to and share data across the organization as we as we feel fit in order to do that we've done a few things we really focused on establishing a very operationally focused platform we work closely with our operators to make sure we can identify things and solutions they need and that we can provide outcomes that they need to operate their business also we focus on hiring the

best people you know and as john said you know ai is a big focus that we have in place right now so we went out and found vg evers i let her introduce herself she's our chief technology officer who joined the company about seven months ago now so vg why don't you just introduce yourself good morning everyone um i'm my um i've been here for about six months and my remit is all things technology advancement including ai ml and intelligent automation my background is before joining bhs i was with core weave which is a gen ai hyperscaler and prior to that i was leading the machine learning fleet for alphabet working with 23 internal stakeholders including deep mind search, research, and ads. My passion is driving innovation to drive better quality outcomes for our patients while improving revenue and reducing cost and simultaneously improving employee productivity. And we have several AI initiatives across the care continuum that will drive that scale that John was talking about. Thank you.

Yeah, and you know, Fiji's been able to actually bring a lot of people from the industry into the organization so we focus on a couple key areas hire the best people to fill the gap so we have the ability to service these things internally at the same time in order to accommodate scale and time to market partner with key strategic partners so we've engaged like with several partners now that will allow us to drive these ai projects in the organization we focus on like john said on about three areas uh we try to keep it simple i didn't realize we were all going to get to threes today but we get we did get to threes today you know and one is we got to provide clinical outcomes great clinical care we got to support our clinicians and how they provide the services through technology we focus on revenue generation and how can we support the company and revenue growth through referral management through effective m a integration capabilities and other strategies and at the same time we focus on like john was alluding to how can we get rid of overhead burden so how can we automate processes and that's where we think AI has a tremendous amount of opportunity in the organization to automate those functions for us. So thank you all. Thanks, guys.

Charlie basically hit on it, but these are the fundamentals and the building blocks for IT that we've been very focused on. I would call out cyber as well. You know, it's a tricky world out there. And, you know, Charlie's background in particular, deep on the infrastructure and cyber side, it's a huge focus, but really excited about how technology, really excited about how technology can help us drive forward from not only an operational perspective but quality and growth as well you know look these are our growth drivers at a high level as as we go forward you know each one of the businesses obviously has their top five or ten growth drivers but when you look in broad strokes number one you know as i mentioned before we're fortunate to be in in markets that are growing where we can provide more needed solutions in participating in that market growth rate number two in those markets driving market share through a differentiated capability set and focus on quality and growth. You know, number three, we continue to try to expand geographically. You know, that is a big opportunity we have in this company. You know, I would say more on the provider side and in infusion, and especially in LTC pharmacy, you know, we're pretty much everywhere. You know, there's some markets we can be deeper in home and community pharmacy, but on infusion, home health and hospice and rehab. I mean, there is still a good ways to go. I mean, I don't even think we're 50% of the way there in terms of where we could be geographically in the next 10 years. And one of the ways you do that is through just opening up new locations on a regular basis, which we've done continuing to expand your geographic footprint. Continued platform efficiencies, that's a form of core growth for us as well. You know, continuing to drive the organization as efficiently as we can reinvesting in IT and in our people and process. So that's core growth. And that's, these are literally words we use in the company, core growth and strategic growth. Core growth is how do we take the service lines that we have today and just continue to scale them as best we can. Strategic growth would then be getting into more and more investments, some of the newer AI initiatives that we've talked about before to hopefully continue to transform the company and support scale. Adjacent provider and pharmacy patient and payer markets, you know, there are numerous patient types and payer types that we could address with what we are doing today. You know, a good example of that is in rehab, where we took our rehab platform and workers comp and commercial, and now we're growing into the Medicare side and the ALS. You know, there's quite a few more examples where we could continue to extend our services into certain patient, customer, and payer partners. Driving additional integrated care opportunities. I'll talk about that on the next slide, but how does the business work together as effectively as possible to provide more integrated care? And then ultimately from an M&A perspective, continuing to drive really accretive M&A. So integrated care, we're sort of getting to the end here of my section. You know, again, our focus every day is on core growth and how do we continue to provide great services in these attractive markets and scale our core service lines but there are a lot of other interesting opportunities available to us because of our platform you know some examples i talked about before is on the provider side where we provide a lot most of those provider patients with our own pharmacy services that's just an obvious example of where we are a bigger company from a financial perspective because we are able to offer multiple services to that patient and individual instead of just one. But we think about integrated care in two buckets. On the top of the page, above the dotted line, is really how do we better integrate care for patients within our service lines, right? And so as we look forward, some areas that we're most focused on, more and more integration of home health with palliative and hospice, more integration of hospital and SNF discharges into our other service lines. Our skilled nursing customers in our home and community pharmacy business, we're not the SNF, the customer where we are the pharmacy in that building, they will discharge about 250,000 people a year into the home from those buildings that we service on pharmacy. Some of those buildings we're getting into with primary care. Those are all individuals 30 to 40 percent that will need home health rehab and hospice. That's a huge opportunity from a care coordination and continuation standpoint. One-stop service solutions into ALFs. ALFs need home health, hospice, rehab, primary care and pharmacy. ALFs have to have that. We do all of those. So our ability to be that service provider instead of saying hey we're just the hospice over here or hey we're just the pharmacy in these buildings over there. We have the ability to go in as a one-stop shop, and we are really starting to do that more, really led by our home health and rehab business going in and offering one combined rehab solution to that building. And then really last, home-based primary care integration and patient management. We have been building out a house calls model. You know, Wilford Brimley, this is old school, going back to the 20s. Doctors, largely NPs, going into the home or a SNF or an ALF, and they are your doctor, 50% reductions in hospitalizations in that model by the doctor coming to you, right? And so the doctor is the holder of the pen. They are the ultimate care coordinator and they can prescribe for the patient what they need. And if we're better integrated with that doctor, and if that doctor exists under our organization, that's a nice opportunity to provide services for the physician and for the patient in a better way. And then there is integrated care from the perspective of value-based care. You know, for us, this would be managing patients in a quality-focused manner under a different payment model where you are compensated for the incredible work that we do in quality and the cost savings that we drive in the organization. So we think there's three fundamental things you need in order to treat a complex, high cost, high risk patient who's out in the home on their own. How do you do that? Well, we think number one is home-based primary care. You need to go to them in their home as the doctor, as the NP, see their environment and proactively care for them on a regular basis. Number two, you have to put the meds on lockdown with a medication therapy management program that works. One of the top two leading causes of unnecessary hospitalizations and ER visits is medication issues. So our continued care program is a customized program where we can do this for anybody in the United States where they have a 30-day cycle fill with compliance packaging. They get phone call check-ins. Where we provide this service in conjunction with home health, a JAMDA study two and a half years ago showed a 70% reduction in hospitalization. Like that's just a staggering number. But it's because we really focus on the medication issue, which so often goes unnoticed and underappreciated. And number three, what do you do with the in-between time? It's great if a doctor's starting to go into the home, but you can't be there all the time. So you need a clinical nursing hub or a way to monitor and be in touch with that patient in all of the in-between time. And so we're building out that hub with eight specific use cases as well. If we can deliver those services in that comprehensive model to patients, you can have the confidence to be able to go and get paid in a different way or at least be able to appreciate the savings you're generating in an ACO model. So we have an ACO today that's been productive. It's been an EBITDA driver. It hasn't been overly significant. We've got a couple thousand patients in it, but that's a huge opportunity to scale in the future. That is a shared savings model with no risk whatsoever. It's literally getting the savings, a piece of the savings that you're driving with your better clinical model. And then what we're trying to do is be an effective partner with the payers. Hey, payer, you have 5 to 10% of your members that are 70 to 80% of your cost. We will deploy this model for you with those individuals and get them a much better quality of life, better experience, and get you better outcomes. Let's please partner together. That's what we're trying to build out. Wrapping up here from a financial perspective, you know, Jen will hit these numbers in a bit later. But on the revenue side, you know, we have a three-year kegger of about 20% now. It's almost the same from an adjusted EBITDA perspective. You know, we were up to $13 billion of revenue at the end of 25, $618 million of adjusted EBITDA. I think one of the things Jen and I are most happy about or pleased with, in addition to a lot of the quality stuff of the organization over the years is, you know, we went public at about 4.6 times leverage, and that number is now down below three times. It'll be about two points, 2.6 times now pro forma, you know, should that community living transaction close. In addition to that, you know, we generated about $500 million of operating cash flow last year. You know, you take community living out this year, you put in growth for this year. We expect that OCF number to be about the same in 2026. But we just feel like that gives us a lot more optionality and flexibility as we move forward into the future. So, you know, that's been something that's been really pleasing for us. You know, Jen will talk about how we're thinking about the next this year and the next couple years, you know, later in the presentation. But as we look out to 2028, you know, on our range that we see today, with what we know today, you know, we think this company can grow off of 25 anywhere between 70 to 85 percent in terms of EBITDA as we go from the end of 25 to the end of 28. You know that's what we're really excited about and that would be from an organic perspective and so you look at the balance sheet and you look from a leverage perspective you know that would be additive and you know just very pleased that we've been able to grow into our leverage level and cash flow continues to perform with continued increases in working capital in the capex light nature of our business. You know, that's really it for me. If I were to sit here and just and just talk to you for one minute about what I think makes us different. It's this slide. I'm going to spare you the details. But I'm sure you'll rush to pull this out after the day and read it for yourself. But really, this is why we think Bright Spring is the difference. And it goes back to what I said before, you know, we are a home and community health services provider, full stop. We think that is a very good place to be, and we think doing that at scale with the operational quality and sales focus that we have is hopefully going to continue to allow us to grow and move forward in the future, importantly, so that we can continue making a bigger and bigger impact for so many patients that need these services in the U.S. So with that, that's it for me for now, And I think we're going to go right into the Onco360 and CareMed team. So, Chris, Ben, and Robert, you guys come on up. I probably ate into your time by five or ten minutes. So, Robert Thompson is our chief commercial officer for the business. Ben Fernandez runs trade. Chris Urban runs all things operations. That is forward. These guys do a tremendous job with the business. and the focus on our patients is always evident and the creativity and the ingenuity in this business the partnership mentality with everybody in the system has been phenomenal and we're excited to continue scale this business not only in oncology but in a lot of other areas that are defined by rare and orphan disease and ldd so guys take it away of you yesterday ben fernandez chief commercial officer uh been in healthcare over 20 years here with uh onco 360 for about 14 really with a focus on driving access to therapies and our limited distribution portfolio morning everyone robert thompson chief growth officer i'm in charge of everything sales and business

development included in that is payer sales physician sales which is an outside and inside sales team hospital sales and then also sales operations and i've been with the company 13 years now.

Nice to see everybody again. Chris Urban, Chief Operating Officer. I've been with ONCA 360 for just over 10 years. So for those that participated in the tour yesterday, thank you. Hopefully you found that just as valuable as we did. So for those that were not there, we are going to start this meeting like we start all external meetings and that's to really talk about our mission, vision, and values. Mission, vision, and values are not just words on the screen, but they are what we truly live day in and day out with our employees and extended to our patients. So our focus is to improve the lives of patients living with cancer, rare, and orphan disease. How we do that through our vision, we will clearly demonstrate that in our presentation today. The values, values are truly embedded in the DNA of each of our employees. Now one of the really neat things that we do on a quarterly basis, we encourage our employees to nominate each other when they see our mission vision and values being demonstrated. We review hundreds of nominations a year and then every quarter we choose a winner or multiple winners in some cases when you're reviewing a hundred and we put publications out both internally and externally celebrating that and then that winner gets to choose a charity of their choice and we make a donation to that charity in their name it's something that we truly believe is awesome and we really celebrate it as an organization I think most of you that were there yesterday saw that so we have had the unique ability to grow both organically with onco 360 but then also capitalize on operative opportunistic adjacent markets in rare and orphan. Back in 2014, we had 12 sales reps. We had 39 limited distribution drugs. Today, 275 sales reps strong, and now over 149 limited distribution drugs. We also took our accreditations from two up to four, with the key being designations in some of those accreditations for rare and cancer. This execution has really allowed us both Onco360 and CareMed to become the largest independent oncology rare orphan pharmacy platform in the United States.

Thanks Chris. As you all can see we've been very intentional and purpose-driven with with really an unbelievable focus on driving clinical and operating superiority across specialty with the focus on cancer, rare and orphan disease. All of our focus has historically been around driving an optimal therapeutic experience for patients. Sounds simple in its message, pretty complex in its delivery. How have we done that? It's been through really investment in infrastructure and technology. Today we have the benefit of going to market to support manufacturers across, you know, new pipeline innovation through three really defined businesses. In our specialty pharmacy, we have Onco360, which is really our largest, most mature business within the rare cancer in northern space. We have CareMed, which has been a solution to partners looking to get that same service, quality, performance, innovation, ingenuity that they saw in oncology at CareMed. But in addition to specialty pharmacy, separate from the pharmacy business, we have Connect Met 360 that looks to partner with manufacturers and really provide support and services. And all of the programs coming out of Connect Met 360 are really fee-for-service driven through clinical programs, innovation, really providing a lot of path, bridge, free drug support as an extension of the manufacturer partners we support. Let's go to the next slide. We're going to talk, you know, you've heard the theme of quality today. Throughout every interaction, empathy, compassion really drives all that we do across our care coordinators internally, our account management teams, our sales organization. From a manufacturer perspective, we built a reputation and credibility based off consistency. You know, when we partner with manufacturers. We're consistently first to market. That's because Robert's team is driving pull through. We leverage those 250, 275 sales reps in the market to create awareness of access whenever we launch the limited distribution. Chris's team is operationally ready to launch on day one. Consistently, once a product gets after the approval, that product's not generally in the channel for a period of time that could be 48 hours sometimes that can be two weeks a number of our programs partners product arrives on the shelf that same day we're sharing the success getting patients on therapy you know that speak to market really means a lot to a patient a caregiver could be a pediatric neurology oncology patient that we're servicing we saw that success with our partners that continued focus and support um really is what fuels our pipeline we're going to talk a little bit about you know pipeline and our ld access in a little bit our people are an extreme differentiator for us right we have seasoned leaders within the business that have really positioned us for continued growth whether it's through new access you know our sales organization and our operational leaders so guys this is how we view the business in simple terms.

Ben acquires the drugs, thereby creating a differential advantage in the marketplace for Onco360 and CareMed. In doing that, he turns over the opportunity to us, my leading sales force around the country, 200 plus. And what they try to do is create awareness of access with the physicians, educate the physicians, create a first mover opportunity, and then also just in simple terms garner referrals. In doing this, one key aspect of Onco360 and what we've built by design is that our sales force is built into Chris's operational workflow. This literally means that they can see the prescriptions as they come in minute by minute by minute and start educating the physicians as it relates to prescription status. Of course, inclusive of this is the the ability to troubleshoot, should there be any prior authorization issues, medical issues, or just more information needed. And then lastly, upon final dispensing of the prescription, they educate the physicians to ensure that the patients who need this therapy in an urgent manner, go on therapy and start their... The last part of this is, of course, they have payer access. So we've got a team of fully dedicated sales folks dedicated to relationships with payers so we can service and have broad network access for all the referrals that the hospitals send to us and the physicians send to us because a high percent to fill is absolutely critical in this industry.

And it all comes back down to the patients. Our high-touch, white-glove service model is truly delivering. A few call-outs here. Obviously, Onco360, John mentioned it, always in the high to mid-90s. I do not want to steal any thunder, John, from one of your upcoming calls. Well, in Q4 2025, CareMed, our rare and orphan pharmacy, received a 100 net promoter score. Okay?

That's absolutely phenomenal. that is their third perfect 100 in the past five quarters so we are so proud of that team and we're so proud of the service that they're delivering for our patients we're going to expand a little bit about what you see on this page here is really the diversity of our manufacturer partnerships right you can see a mix of emerging biopharm as well as big pharma you know some manufacturers that are solely focused on oncology but also others that have a healthy mix of of oncology rare and orphan pipeline as we look at the market we still feel very excited about the growth and the pipeline in oncology but these partnerships really set us up for success not only from launching a manufacturer's new drug but oftentimes when we launch the first new drug we're getting the next two three four drugs from the manufacturer's portfolio as you know there's you know a lot of consolidation of the marketplace, you'll see, you know, pharma acquire different organizations consistently. Our platform is the go-to from a partnership standpoint. We're coming off our most successful year in company history with the 2025 new product launches. And what we're seeing in, you know, the delivery and network selection of new drugs is, you know, compared to 2019, 97% of the products we're launching today are an exclusive or ultra-nour network. The value for that from our team and our program is in those networks, we're driving larger market share. Robert's team has an extensive portfolio of products that they have as an availability for the offices. Some of the reasons why manufacturers want to select Onco360, CareMed, and also partner with ConnectMed in that platform is really driven by the consistency in the operating model. The ability to know near real time the status of all of our prescriptions not only empowers them with access and visibility, but ensures we're driving speed to market and confidence in the model. The volume of new products we're launching on an annual basis also fuels new patient start growth and volume growth, right? So, you know, compared to the earlier part of the decade, you know, we're launching over one new drug a month. In 25, it was 24. We expect that to be very exciting again this year. Not only are they new molecular entities coming to market, but you also have examples of manufacturers that have broad limited distribution networks or open access drugs that consolidate that. And we had a number of examples of that in 2025. So ultimately creates a more captive market share and audience. As I look at 2026 and beyond, we're already working the pipeline 12 to 16 months out, 20 months out, in terms of near-term opportunities, a lot of those decisions are already made. We feel very excited about the future and the pipeline of the portfolio, and Robert's going to talk a little bit more about that.

So as you can see, over the past couple of years, the momentum is increasing with Ben's ability to garner drugs. Well, we believe the future bodes extremely well for us. Over the next seven years, you can see on the left, about $100 billion of new product is expected to come to market, And our leadership team feels very, very confident that we'll be within network, if not preferred or exclusive, with all of these products. In addition, there's a unique opportunity in the market. On the right, a significant amount of brand drugs are going generic over the next seven years. Approximately $20 million or $20 billion of drug is going to go generic. And, of course, our physicians rely on us and our hospitals rely on us due to our capabilities and access. they rely us on us for brand drugs, LDDs, but also generics due to our capabilities. So we're really excited over the next several years of that conversion cycle. Next slide. So this is a really important slide to understand how the sales force is configured. Our sales force is configured of approximately 60 teams across the country. Think field sellers and inside sellers combined in a partnership model where we use data and information both both external and internal, to focus on the biggest opportunities in the biggest markets and make sure that we're targeting the right physicians. Although Onco360 has a significant sales force, we pride ourselves in speed to market. If you think about it, we try to get to the marketplace when Ben wins a drug over the first 24 to 48 hours. What that allows for is first mover advantage, where we're educating the physicians on these needed drugs in the marketplace, but equally as important, it establishes that we can garner any pent-up market demand because these physicians are waiting for these unique therapies in the market. Lastly, on the right-hand side, we can never forget our existing patients. So our sellers truly are a seller sales and service model, so we focus a significant amount of time working with our physicians on their current patients to ensure that they stay on therapy, talking about new patients that they've referred to us. And so it's really a white glove service model for the physicians in our hospital partners. Next slide. One aspect of this due to our unique market positioning with Onco360 and CareMed, we formed deep and longstanding direct relationships with PBMs around the country. This allows us to ensure broad network access in both their commercial networks, but also their medicare networks at the appropriate rates in addition to the pbms we're focused on we have a team focused on smaller payers around the country who want to establish a direct relationship due to our product access but also our operating model and in many instances we'll carve an exclusive out or a preferred relationship where we get to manage all of their patients inclusive of LDDs brand and generics due to our capabilities okay so just one more time just want to summarize our value proposition for you know for our

patients in the industry so for our patients it's the reassurance that they're receiving the best quality a the best care based off of the protocols that we are we have built with our board certified oncology pharmacists and also our certified specialty pharmacist. Access, I think that pretty much speaks for itself. 149 key products, key LDD products and growing. You know, Compassion and Care, mentioned it yesterday, we have 30 what we call Onco advocates that are dedicated solely to helping bring down that copay and help with funding for our patients. And last year alone, they serviced 27,000 patients And help them get their medication. So if you really think about that, if they were not able to do something to help bring down that copay, they may have to cut another expense. It could be, you know, a utility bill or maybe, you know, their food bill. So it's really something that we're, we're, we're very proud of time to first fail the North star of metrics and specialty pharmacy. We're really proud of our four days, approximate four days for 2025. And then that is all wrapped together with our IT and enterprise data services team so that we can provide, one, the highest quality data to our pharma partners. We can also provide to our sales and to our physician partners the most actionable updates. And at the end of the day, deliver the highest quality care and customer service to our patients. Thank you very much. And I think we are going to hand it on over to Rich and infusion.

Thanks, guys. Great job. Yeah, thanks. All right. Rich, thanks for being here today. So Rich Dennis is the president of our infusion business. business you know rich and i connected um you know pretty quickly with our uh shared pharma background and you don't see that a lot in health services um but rich has been a seasoned leader uh of a lot of pharma organizations in the past and rich had been the chief commercial officer at option care as well um and just has a passion for infusion and bringing these products to as many people as possible so rich thanks for being here today thank you green button That would help the big one.

Well, thank you all for being here. Welcome to Louisville. I don't live here. So I hope your journey here was as eventful as mine. That said, you know, John raised something. It's we we we did share our farm award stories back in the day. But when I look at infusion and when I look at Amerita, I think of of the opportunity to truly build a brand and to build a brand within an industry that is truly evolving every day as the pipeline comes out and Chris and team referred to it. The amount of infused drugs in this pipeline, the amount of drugs that have to be administered by a health care professional just continues to grow. You know, it's evolving, it's changing, but I go back to the pharma days when I'll age myself. I was at the Claret and launch meeting, which was about 1937, I think somewhere back then, and we became the official allergy medication of Major League Baseball and I didn't know that Major League Baseball really needed an official allergy medication but apparently they did and over time you saw the pharma industry get more and more heavily regulated because of things like becoming the official allergy medication Major League Baseball we have the ability to build our brand here super exciting and I would argue all of infusion has that ability to do it together so let me get into a little bit there we go about who we are excuse me emerita i would call us a super regional infusion provider we're not fully national at this point and i'll get to our footprint in just a minute but a super regional infusion provider focused on both the acute and the chronic business i'll probably use the term chronic and specialty interchangeably throughout the course of the presentation, but at the end of the day we are involved heavily in both. That is significant because for those of you that, excuse me, follow the infusion business, you know that over the last three four years a couple of large providers have backed away from the acute business. Last year a regional provider do the same and we are still heavily involved in in both so we we take both of those patient responsibilities very seriously and at the end of the day we are committed to the the the acute and the the chronic or the specialty pieces of our core business i don't need to probably explain to you you know who we serve in both of those markets but i always liken the acute business excuse me, two, riding the Tour de France in first gear. You have to be present to win. Your feet are moving, your legs are moving a million miles an hour. You get home, you rest, you come back the next day, and you do it all over again. That's kind of the acute market. If you're not present to win, if you're not providing world-class service, if you're not, you know, timely with great nursing in the home that day upon discharge, you're probably not going to be nearly as competitive. Chronic, a little bit different. You have fewer patients, high revenue, and basically an annuity business, you know, month after month moving forward. We focused, John mentioned it earlier, on the neurology and the gastro-neurology markets. We're not, you know, unique in that section. And frankly, it's our ability to provide world-class service best in industry service that makes us competitive in this market excuse me when we look at the overall size of the business you can see the markets growing you know quite quite well the 9% really includes the HOPD the hospital infusion pharmacy department books of business and then And the 11% is the home and the alternate site infusion business. Pardon me. When you look at the acute business, the TAM is going to be less than your chronic business. That should be no surprise to anybody. And then the alternate site, where we are actively engaged and have a full-scale expansion strategy set up, is also growing at $9 billion on a TAM scale. Pardon me, where is our footprint? I mentioned we're a super regional, we're not everywhere in the country, but we are strategically located in many key markets around the country. We have a plan to, as John said, organically grow where we currently exist and then expand our footprint into new markets. So this footprint I think you can see will evolve over time and we are actively engaged pardon me, in M&A. Now let's talk about the acute opportunity. This middle section I think is the most important on this slide. We currently have the ability to cover a third of the geography in the United States. So 33% is where we have the ability to compete. So clearly growing our geographic footprint in the acute business is a significant opportunity and we are currently active looking in markets throughout the United States where we can grow our, excuse me, our acute footprint. The one thing that I will say when we look at the acute business, we are currently number two or three in most markets where we compete in the acute business. Our market share in acute is growing every day. Our market growth is a very healthy double-digit growth, so we're very pleased with that. And again, two out of three in 16 of the 18 major markets where we currently compete. On the chronic side, we focus on about half of the market, the geography in the U.S. The differences in chronic, as you guys know, you can actually service into other states from pharmacies that are not necessarily located within the state that the patient resides. so we cover or have the opportunity to compete in half of that geography on a national basis. In pharmacy our growth strategy is to basically be the fastest most efficient in terms of getting benefits through the system and getting patients on service. You know Chris and team talked about a white glove service we are doing the same with IG. IG is the holy grail of the chronic specialty business. So we are treating that with with kid gloves, white glove, no pun intended. And we expect to be excuse me, market leaders within the chronic business. Reasons to expand. I mentioned the underserved population, the pipeline, our scalable strategy. We have excellent payer access. We continue to work with payers on what we can do to further differentiate ourselves. But the opportunity for us to provide service above and beyond with payers is extremely significant. You think about it. We spend 40 to 60 hours a year with patients. How many other providers do that? How do we create value and extract value out of that? When we look at where the clinical innovation opportunities are. Emerita, our infusion services business, is very heavily involved in Alzheimer's. We are one of the key providers of Lakembi in the country, and Emerita has been selected by ASI to participate in the Alzheimer's Advisory Board. We're certainly collaborating excuse me, with both Asai and Lilly on opportunities to expand our Alzheimer's franchise. When we look at IG, I talked about our clinical focus on IG, our concierge services on IG, excuse me, and that that is underway right now. Our growth in IG has been quite significant and certainly proud of where we see our franchise going, excuse me, moving forward. And then other limited distribution drug opportunities. We currently have access to around 20 that we are working with manufacturers on in the pipeline. So I am very very encouraged by where we're going to go with our LDDs moving forward and we've got, excuse me, new leadership that is heavily involved in the the LDD franchise for us. Now, if you look at, pardon me, operational excellence, we're really focused on our turnaround times with both the acute and the specialty business. The acute turnaround times are running 30 to 45 minutes, specialty 12 to 14 days, and Chris mentioned a heck of a of a patient center NPS score. Ours are running at 94% right now. Very proud of that. So, if you look at, pardon me, where we have the ability to invest, people, process, technology, Charlie and VG spoke about our technology opportunities earlier, but we have put in an entirely new executive leadership team with an infusion, and, excuse me, I'm very, very pleased with where, pardon me, where we're taking the business. The last thing I'd say, excuse me, is basically our overall growth drivers. I mentioned several of them, but we're excited about where this business is going to go. Between the current growth we're seeing in the acute market, where we're going to be taking the chronic business, what we're doing with LDDs, where we're taking technology, and what our new leadership team is doing. The ability to build the Emerita brand within Bright Spring is massive. We look forward to it. And with that, excuse me, with that, I'll turn it over to Scott Greenwell.

Thanks, Rich. Yeah, the acute business. And, Rich, thanks. I know you're coming off of a case of pneumonia. Thank you. Most people would not have been able to do that with your last week or two. But thank you. Scott, thanks for being here. So Scott joins us most recently from Humana. Scott ran all the pharmacy operations at the PBM there. I think among many, many things over the years, you know, really building that pharmacy operation out over there in a highly, highly automated way, driving something like $5 cost per script reduction over a period of years that is very hard to do, also with exceptional quality. So Scott, we're thrilled you're here. And, you know, just like Rich, I wanted to say Rich has done an incredible job in the last year at Infusion, really building out a broad team. If you look at the top 10 leaders in our Infusion business, everybody is essentially new in the last year and just, you know, A caliber individuals, whether it's sales or operations or rev cycle or specialty and LDDs, et cetera. So Scott has done the same really across the business, I would say, just building on a lot of the strength we have, but going out and getting the people and the resources to build this out into the biggest and most efficient home and community pharmacy in the country. So take it away, Scott. Thank you.

Thanks, John, and appreciate all your time today. And by the way, happy St. Patrick's Day. I can't wait for you said that, you know, I think it's St. Patrick's Day. I don't think of snow and sleet in the Kentucky market. But unfortunately, here we are. and I understand some people had some travel issues getting here. But again, Scott Greenwell, I'm a pharmacist by training. I've been with the company now for about nine months. It's certainly been an exciting time to join the organization around the home and community segment, and we're going to get into what that looks like here over the next couple slides. I am going to try to save us some time. I'm used to batting clean up, so hopefully I'll get us back on schedule. As you can see you know uh BrightSpring and Pharma America has really built a really really powerful pharmacy platform to serve really all kinds of transitions of care as people navigate through the course of their life between the work that we do in the group home setting and servicing our IDD members to assisted living under the senior living brand and then one point patient care our hospice pharmacy and PBM provider business and ultimately into the traditional skilled nursing business under the PharmaRica brand. What I hope you gather from today is really around how this business has evolved over the last couple years, how we're thinking about it going forward and kind of pivoting from a SNF focused long-term care pharmacy business to really tackling each one of these individual business segments in a unique way. To do that, it takes scale, right? We have 4,700 heartbeats every single day working to take care of over 4 million patients across 120 pharmacies servicing 6,500 facilities across the U.S. Those 4,700 heartbeats every single day waking up to take care of the nation's most vulnerable patients is our bread and butter. It is what makes us different it's what makes us unique and I'm really proud to be part of an organization driven by such an incredible purpose. My father passed in 2020 of frontal temporal dementia so I personally know all too well what our patients and their loved ones and caregivers have to navigate as they navigate through the long-term care setting and one of the reasons why I'm here today is to to help make this a meaningfully better process and to offer a different level of care and focus that comes along with that. As we think about our quality deliverables and metrics, John has been incredibly passionate around this, but for me, it's simplified around the right patient, the right drug at the right time. We have to get those things right every single time. It is not something that it's ever allowed to be off. And as you can see, by delivering across all three of those right patient right drug right time you ultimately get your attention with your customers and we have an incredibly strong retention across each for each of our four business segments within home and community and continue to grow and expand that clicker all right so this is the footprint John's reference scale scale scale frankly this map speaks for itself. 120 pharmacy locations spread across the country. We most recently entered into the Alaska market with a pharmacy there and we are we are capable of servicing coast to coast any patients need within three hours delivery to door. So I think that is a competitive advantage for us especially in this market right now with the disruption that we'll speak about here in a little bit that has been the long-term care pharmacy space. Next, strategy. And one of the things I really want you to take away from this slide in our conversation is that this is not the Farmerica of old. This is a new Farmerica. This is a Farmerica that is not trying to, you know, stick a round peg in a square hole of skilled nursing facilities and capabilities into the IDD and senior living slash assisted living marketplace. We are focused now around core general managers for each one of these businesses, focused on the unique sets of needs and skills for their respective businesses, and aggressively targeting growth across each of those. We have a leading sales team across each of those four business segments, aggressively targeting, leveraging our scale collectively to figure out how can we can continue to grow double-digit growth across each of those four segments. This is a new for America that's you know backed by a tech stack that VG and Charlie referenced earlier that it gives us the ability to leverage our national scale and footprint but to deliver a local unique customer service model that makes it feel again very local by leveraging our account management teams and capabilities powered by the analytics and data that come along with that. Ultimately to get to a 24 billion dollar addressable marketplace, you know we are trying to rethink how we service these customers again unique to each individual business segment. Part of that comes to also rethinking our clinical capabilities through formulary management, utilization management, particularly in the skilled setting trying to think through how do you take traditional PBM tools to leverage total cost of care and optimizing clinical outcomes at the most appropriate cost. This is not something that you know as an outsider coming into the space that we've seen with the collective industry and one that we believe that's a very real opportunity to differentiate strategically for Far America against everyone else and to power the growth that we've that we've been referencing. One of the keys, again, around our focus and kind of the new way of how we're thinking about long-term care pharmacy and in the home and community segment is really standardization of processes. How do we take and create a consistent standard process and onboarding experience for each and every one of our customers within their respective segment that allows us to partner with large regional players and national chains to make sure that whether it's in a skilled facility, whether it's an assisted community, or whether it's an IEDD, that they experience a consistent onboarding experience again and again and again. And we have done that through leveraging technology in a way, specifically things like robotic process automation and machine learning, to make the onboarding process as smooth and streamlined as humanly possible. We have a lot of investments today trying to automate a lot of the historic legacy clerical tasks that pharmacies have to deal with, whether it be member load, prior authorization requirements, billing capabilities, and order entry within the pharmacy proper. Pharmacies, you know, candidly benefits from having a lot of structured data as a way for us to feed off of, which is highly adaptable to a lot of these new tech capabilities that we're partnering again with Charlie and VG to deploy, which is going to create a differential experience for each one of our customers that we've not yet seen across the industry. So incredibly excited about that. And by leveraging those things, we can get to a different operating model in terms of how we think about our operating cost and cost to fill, as John referenced, which is something that I'm incredibly focused on right now, is how do we get to a differential to drive truly a world-class experience and operating model.

Okay, we're getting close here.

Okay, investments can clearly be kind of summed into two different parts. One, again, I've been referencing it, automation, automation, automation. how do we leverage automation in a way to streamline and take advantage of the scale that this business offers across our 120 pharmacies and then ultimately to our customer in clinical experiences for for our customers. Way too often our clinical counterparts within our facilities are dealing with being historians of a patient's care, navigating through a very bureaucratic process on ordering meds, getting meds, where's my meds, etc. You know, I think everyone today is very familiar with the pizza tracker analogy of trying to figure out how do we leverage technology in a way to improve our partner experiences so they know exactly where the meds are, when they should expect them, and ultimately giving them back time to spend it where they should be spending it most, which is caring for the patients that they ultimately are are tasked to do and not trying to figure out where their medications are. So we're spending a ton of time specifically in that realm in terms of improving those experiences again with Charlie and VG's help and then ultimately I think we'll probably spend some time at a future meeting talking about the outcomes of the deploying of these lot of these machine learning and robotic process automation tools and how they're evolving our cost structure and how we're thinking about the advantages that we'll create. And then last, it's all about growth. I mentioned earlier, you know, we are expecting and trying to drive to double-digit growth across each of these four segments. Again, backed by the national scale that we have, backed by the clinical capabilities that we have, backed by the technology and deployment enabling these things, and ultimately related to a best-in-class sales force that can go back and articulate this value prop, the differential that we're offering to each and every one of our customers. We are now seeing over the last several quarters meaningful growth across each one of these business segments, and we expect to continue to see that. It's an exciting time. All right, five keys to our success really is around this high-touch, reliable and dependable partnerships with each one of our customers. It's a best-in-class clinical capabilities that we have built in the LTC model. It's operating at scale and driving efficiencies both for our pharmacy operations but as well as our clinical counterparts and how do we return again back operational efficiency time to them in nursing especially when they're dealing with you know high turnover a nursing environment as well as constant training needs. And then ultimately bringing stability to a very disrupted market that currently is the long-term care pharmacy space. As we look across the market and see some of the large players and the legacy players having filed bankruptcy in the last year have been very public, we believe that that disruption creates a very real tailwind for us given our stability market position and scaled footprint to really take advantage of all of that disruption. And coupled that with some of the things we'll see with the IRA, particularly focused on the small regional independent pharmacies who are going to have to navigate some of the complexities with the IRA that do not have the strength of BrightSpring or Farm America's balance sheets is going to create another very real tailwind for this business as we think about growth going forward. John referenced this earlier you know this this organization has curated a leadership team over the last 24 months that takes advantage of the 40 plus years of traditional long term care pharmacy expertise but has now coupled that with PBM clinical and cost containment excellence. Modern pharmacy practice at very large scale and highly efficient coupled with providers and partners that have historically been on the provider side and operators that have a very unique perspective and point of view into the real very real pain points that our customers and providers deal with every single day that can help re-inform our products and suites and services and how we're showing up to the market. And really, again, this has been a very real change over the last 24 months and I'm really excited about what this team is starting to produce and how we're starting to think differently about this as a product and a service offering within this suite.

Okay.

At the end of the day, it's about winning. We are here to win. We love to win. We are focused on winning. That winning comes because we have 4,700 heartbeats showing up every single day, taking care of the patients, the over 4 million patients that we serve, and doing so as if they're caring for their own loved ones and family members. That is the differential. Every single day, every single meeting that we kick off, kicks off with a patient story and a patient persona so we can continuously remind ourselves why we are showing up, what is our purpose every single day. We're here to win to help our customers manage their overall drug costs. We're here to help them win related to making them more efficient and operationally effective. And ultimately we want to win so we can win for our shareholders and the investor community at large, which is why we're here. And that strategic differentiators that I referenced earlier, I think position is incredibly well to do that here over the coming quarters and years. So I think John wraps me up. Yep, and yeah, Q&A.

So I think everybody comes up for Q&A? Hey, while they're coming up, I'm just going to just sort of, you know, there's a lot of slides there. So I'm just going to recap, you know, some of the growth drivers for the businesses. You know, Onco, again, this is helpful. Everything starts with quality, deep relationships with pharma. There's a very deep innovation pipeline that still exists today coming to market. the opportunity to partner and bring these new brand LDDs to market, they ramp up over a period of years. So you have this LDD growth that kind of stacks upon itself with launches every year as prior launches are still growing. Those drugs are pulled through by a sales force that we've heavily invested in. And then over time, in addition to the brand side, you have some brands going generic. And then the team has built out a really strong and rapidly scaling fee-for-service business of data and service agreements with pharma and hub programs so multi-factorial growth model there and specialty on infusion really got to run those businesses from an acute and chronic specialty perspective you know we are investing in the sales force on both sides of those we're investing in turnaround time and service metrics to build those businesses out we have a lot of geographical expansion opportunity and we're building out suites over time to give patients in prescribers more alternatives on where their patients could be seen in addition to just the home, which should also drive labor efficiencies as well. You look at home and community pharmacy building on 40 years there in the scale that we have today. You know, it is all about scale and continuing to scale that business as efficiently as we can. There's a lot of attractive end markets in that space with ALF, with behavioral, with hospice. PACE is emerging for us. And then you've the historical skilled nursing channel which is very healthy today you know look at some of the skilled nursing pharmacy companies out there today and they are very healthy so a lot of very attractive growth markets for home and community health care and how do we further penetrate those with leading services in a very efficient model you know with automation at its bedrock so that's our pharmacy business again we go to where people are hundreds and thousands and millions of acute chronic individuals every day helping to take care of them better and to try to keep them out of the ear on the hospital and give them a better quality of life so with that happy to take any questions on the pharmacy side brian maybe you want to go first

i saw your hand quickly uh brianton keeler from jefferies ben just for you so when i think about the successes you've had with ldds and bringing those in how do we think about translating that to the opportunity in generics or maybe ask differently how do you drive market share with these new generic introductions coming up?

I'll take the first part of that and Robert will probably expand that in through the Salesforce so our focus really is you know multifactor right so we want to launch be a part of the pharma when we're launching new therapeutic products coming to market when we do that and we're one of one one of two multiple SPs we're consistently driving larger market share than our competitors that creates really you know an advantage for us as we think about the pipeline you know as organizations manufacturers are looking at getting in the space you know on go 360 is embedded in a lot of those relationships Robert seems focused on pull through want to drive new patient starts and then retain them over the lifecycle of that brand when that product brand goes generic the larger

the market share we have when that products brand the bigger the opportunity is in that respect anything about farm I would just add you think about when a drug is generic you know the pharma sales force and the detailing just completely goes away so you know that's where robert and his team becomes very effective working with prescribers and patients to still be there as a supportive educational resource for the offices at that point in time um with the ipo there was that significant opportunity to also kind of better integrate the businesses in terms of pharmacy provider you talked a lot about that in terms of

that one-stop shop but what has surprised you where does that stand relative to a couple years ago and I guess for an analogy like what inning are we in on that front in terms of that sort of overlap and then one more pharmacy specific question just on the 100 billion and new products that are coming to market that you mentioned um I think that was just oncology if if I read that slide correctly you know what about rare and orphan can you talk a little bit about that size and then also the relative growth rates across, you know, your rare and orphan and then versus your tradition or your Onco 360 business.

Yeah, so maybe I'll go first and then, you know, Ben or Robert, you can speak to the rare and orphan and the LDD or Rich Chimon if you want on that and maybe just characterize some of the rare and orphan growth in the portfolio. But as it relates to integrated care opportunities and care coordination opportunities, that continues to be a really big opportunity for us it continues to evolve and you know new opportunities present themselves seemingly on a regular basis you know we have tried to be careful um not to let that distract from the strength of the growth and the core service lines as well because i think you know aaron is as you're saying and it was a question that we got repeatedly in the ipo I think people look at the uniqueness of the platform and the integrated care services that we have and they immediately say, well, that's different and that's unique. And that seems like a really obvious opportunity to combine all these services. That's a good idea. You know, we wanted to make sure that we also didn't lose the attention on, well, hey, the core services themselves are in great markets. They're executing really well. So we view the integrated care opportunity, what I referred to here today as strategic growth, as just really additive to the core growth. And hopefully, it's a lot of really interesting upside in the future, you know, which would be great for patients and the system. So, you know, I gave a few examples of those today. I mean, I do think we are in the second inning. And what we have found is that you really do need to, and like, this is not rocket science, you really do need to resource things in an organization for them to move, particularly when they're sort of in the gaps in between service lines, right? You know, Ben, Robert, Chris, Rich, Scott, I mean, they have a day job. Elizabeth, Rhonda, Jay, and Hospice and Home Health, they have a day job to grow their business as much as we can. Now, they're also thinking from an enterprise perspective, but what we've done in the last really six months or so, we're starting to build out a team. We hired gentlemen, Scott Hawkins, who's terrific. We're starting to build out a team that just focuses on these integrated care opportunities more. You know, we're also continuing to resource that primary care team. There's a new leader there in the last year. We hired a CMO there in the last seven months. We just hired somebody to drive payer contracting. We're continuing to resource the payer, the private, the primary care team. So with that focus from a resource perspective on integrated care and growth in primary care, we expect to see these opportunities continue to present more growth and then more revenue and EBITDA as we go forward as well. So a ton of opportunities. And, you know, frankly, you know, I think sometimes it's a situation for us where, you know, there's a lot of good stuff going on. And, you know, we don't want to shortchange growth and infusion, growth in home health and get distracted too much. So what we've tried to do for these strategic growth areas which i think are really unique to our organization we've tried to resource them appropriately in the last year and be really sober and thoughtful about needing to do that so that hopefully in five to ten years you're getting nine figures of ebitda from these areas and and that's what we're focused on now so maybe maybe ben you can start with the second and third parts of that question absolutely yeah so as we think about the pipeline uh from our perspective oncology silver kind of over the next you know five years still remains you know probably 70% of where the innovation and biggest opportunities are going to be from a growth opportunity perspective.

You know, we're out there 16, 20 months in advance. If you think about the life cycle of when they start to make pharmacy network decisions, distribution decisions, you know, sometimes, you know, that doesn't start until about 16 months when they're really thinking about access. And so we're typically right there. A lot of those same manufacturers that are launching products in oncology, there's a segment of the portfolio of very targeted therapies with like rare cancer patient populations. That's in that number that we described. And then we think rare provides really a lot of opportunity as well. You know, probably 30% of the other segment of the market comes from a rare orphan disease. A lot of the activity today that we have around, you know, non-oncology products, it reminds me of where Onco360 was maybe in 2018, 2019, right? There's a lot of conversations around, you know, our support system and transferability from oncology to rare. If you think about the programs that we've developed with pharma to support cancer medications, they're not only product-specific, they're product-indication-specific, but then implemented, we talked about the infrastructure, the technology that overlays, you know, our operating model. You know, these are really patient-dedicated programs that the business is managing at scale. That transferability into rare disease, which is a more fragmented market from a physician perspective, from a product perspective, a lot of the work that we're doing there early on is whiteboarding with pharma to create and develop solutions for those patients and caregivers across the pharmacy space, but also as you think about the Ameriton team medical benefit and being able to provide support and services in the home.

AJ? just maybe a couple questions about for america um there's been a lot of disruption on the competitive landscape of the last few years is that mostly done or are there still chunky opportunities for you to gain share vis-a-vis players that are struggling additionally i guess when we talk about ai opportunities it seems like to me ambient listening with consulting pharmacist is there going around doing charting uh are you are you doing that and how big an opportunity might that be and then i'm going to throw one more in there um in terms of um your other businesses is there leverage because you have access to a unique population

in the far america is that a selling point for you and these uh specialty pharmacy businesses that you're able to use Scott yeah so great questions AJ so so first for America and opportunities there we do believe that there are very real opportunities in the traditional for America sniff space for us to continue to take advantage of given the disruption that you referenced I'd love to have a crystal ball to try to figure out within the IRA for you know other pharmacies that do not have the same size and scale and frankly ability to contract with PBMs to offset that, that they'll be continued offset of that, but I think we're all kind of in a watching waiting lens of let's see where that ball ultimately drops. But we do expect to be opportunity there for us from that lens as well as we're also trying to think through a repositioning of SNF almost this lens of like a Part A PBM and how do we really think about drug cost management in a different way for the SNFs during that Medicare Part A stay and help them inform their budgets and spending projections for months and quarters out like a traditional PBM model would in the commercial market space so I do think there's a very real opportunity for us to continue to deepen our penetration in the sniff side on the I think AI maybe was the next piece of it so incredibly excited about that space especially using AI as an enhancement to our clinicians and to really you know touch a do a couple things one help us operate at scale and to think differently about how we can solve complex medication problems and challenges in a more efficient way by leveraging ai capabilities to help offset just the traditional reading of charts finding medication opportunities classifying those types of things so those are all things that we are actively working on today uh to help enhance our model um and we'll get into more details around that as that comes to to fruition but But I do think that's a space across, frankly, all the medical landscape that's really going to be a powerful tool for clinicians to take advantage of in an appropriate, safe manner, truly as an enhancement tool. And I'm sorry, AJ, the third piece, maybe talk about Blake, you know, how we're- So on the specialty piece, so we do have, we picked up an acquisition a couple of years ago called Blake RX. Blake is really focused today in a couple of states, literally a handful of states. But it's trying to solve for this unmet need of specialty within a institutional care setting. It's an interesting space. We do think there's a lot of opportunity leveraging the CareMed and Onco special capabilities within that, within the Far America customer base already as well as expanding beyond the Far America customer base because it's a bit of an unmet need across the industry that no one seems to have taken advantage of just yet.

Yeah, I didn't even mention that before.

We actually currently have a process built out amongst all three businesses where, you know, if Scott's team gets a referral, has some questions, we have it all worked out where it would come over to Onco360 or to CareMed to service that patient where we can. Based off of the the payer associated with it. And then it's the same thing. We get an IVIG or hemophilia patient You know from that is also on an oncology medication That is automatically going over to to rich in the emerita team and then both of those products are delivered to the patient Within the Alzheimer's space just giving where that product is likely going in terms of the impact of that across all three of these platforms is a really really an interesting opportunity we're going to continue to take advantage of.

We really didn't even touch on that before. I mentioned ALF, behavioral, hospice, skilled nursing as the end markets in home and community. The specialty part of that business is really growing. You know, the team's doing a nice job of focusing on the specialty drug needs of individuals in those institutional long-term care settings. And, you know, it's interesting. I mean, you look at behavioral, hospice, specialty, ALF, pharmacy within that home community business, skilled nursing compared to those four is much smaller um it's been a really interesting and that was a business that 10 years ago was all skilled nursing it's not it's a good market it's just that the business has continued to evolve in really interesting ways but all of those markets present an opportunity to be much much much bigger uh thanks uh charles with td count um two questions maybe first follow up to brian's question on on generic opportunity um obviously it's a bigger everyone's kind of

focused on it, but maybe talk about how you are, you talked a little bit about how you are working to gain share as these drugs go generic, but particularly, can you talk a little bit how you work with or, you know, around, you know, big PPM-owned specialty pharmacies that obviously would also want to capture some of this generic conversion opportunity? And then secondly, you know, John, in one of your slides earlier, you're showing sort of the ramp of the LDDs, and it looked like in particular, the 23 and 24 cohorts were ramping very nicely, and then it looks like the 2019 cohort is now starting to ramp up. Anything particular about those years of LDDs that you'd call out, or what's interesting about those, and why are they ramping so much better maybe than some of the others?

Robert and Ben, go ahead.

I can take the generic question. If you think about cancer, which we showed the pipeline of the cancer drugs going generic generally it's a disease of the elderly and if you think about the the network configuration and the way the industry works there's any willing provider regulations so long story short as long as you can meet the pbm criterias for access and participation and agree upon rates which we've got into a good place it's then about service it's service and support and And your physicians, by choice, have the ability to use whoever they believe services the patients in a better manner, whether it's assisting with funding, like Chris said, turnaround time, communication, because this is a crisis diagnosis. So absolutely, we compete against the PBMs, but we compete on service, we compete on relationships and support for the patients.

Ben, on the LDDs, like different cohorts, different growth rates, all depends, what's the drug what's the market yeah so on that side you're you know we're seeing just an acceleration of new products coming to market from an innovation standpoint right so but it's not only new molecular entities as existing products that may be of open access or you know call it we call it broader limited distribution networks and you know it's called 2013 through 2020 most of the limited distribution networks may have been comprised of you know over seven pharmacies Today, we are seeing 97% of those be three or less, right? But 30% of our launches in 2025 having been exclusive. So that creates, obviously, that opportunity from a growth brand perspective. The products that are coming to market oftentimes have longer durations of therapy. You know, because we're one of one, one of two, we have greater market share in those limited distribution networks. The longer durations of therapy also benefit us from a patient retention standpoint. There's a number of examples. In 25, there was two significant products that were open access, and now we're one of two SPs.

And Charles, I mean, we really try to partner with everybody out there as productively as we can. We've had really longstanding and positive relationships with all of our PBM partners, you know, just really aspiring to serve their members in as high-quality a way as we can and again you know we've invested in a clinical liaison team over the past 15 years that's you know close to 300 folks every day right now you know you know aside from the hundreds of individuals we have internally interacting with patients every day but really invested in a field force in team over the last 10 years that we've been growing every single year you know to be there in prescriber accounts with patients every day you know just helping them through their decisions hi thank you this is joanna gadget good bank america so which actually i want to switch

to home infusion um so a couple of things there's first on the 20 or over 20 ldds in home infusion that doesn't sound like you were involved in those so can you give us a little bit more color in terms of what exactly you need to do to make it you know uh i guess your presence shown in those all these doesn't require investment in pharmacies people technology or anything else and the second question on that map on the regions are there some markets where you have like your eyes on set and why like is there some priority where you're looking at this and like okay we gotta get that market mix thank you first off um thanks for all of you putting up with me with my flare

on slide five i appreciate that very much i wasn't expecting that um two very good questions i'll answer the last one first, if I may. We have a two-pronged growth strategy that we know is real in infusion. The team is absolutely excited about it. I mentioned earlier, my entire leadership team has turned over. So nobody's been here for more than a year outside of my HR person and our finance person. Everybody else that touches the outside world is new. The markets that we want to compete in where we don't currently have a footprint while i i won't get into specific markets think of the states that are highly populated that aren't on our map full of health systems and i know that you are very familiar with the infusion business where we will be able to take our competitive strategy and compete against other players. That said too, there is the chronic and the acute side of it. I mentioned earlier, we are the number two market share now nationally in acute. We are absolutely convinced we can compete with anybody in that book of business in any state, whether we're in it now or not. On the chronic side, on the specialty side, same thing. So the best answer i can give you without giving you specific locations a we are very very active in looking for acquisition opportunities we are focusing on high population states we are focusing on states where our combined experience john mentioned where i came from we have our operations leader is from quorum our sales leader is from option care we have a trade leader which i'll get to the other part of your question who has experience from Orsini, Cava Fusion, and Soleil. So we know where the opportunities lie and that's where we're going. On the first question that you asked, we have access now to 20 plus LDDs per se by definition. Access is one thing, having a relationship with the manufacturer where you're actually working with them is another thing. That's where we need to be. So part of the strategy moving forward is to get heavily involved using some of that experience that I just mentioned from past companies where my leadership team has evolved, getting strategically involved with manufacturers. In some cases where we have access to drugs, we are rekindling those relationships because for whatever reason, historically, Emerita did not take advantage of that. So that's a lost opportunity in the past. But moving forward, I think it's a big opportunity for us because, as you know, with LDDs, there is an opportunity for us not only to successfully service patients, but there are data monetization opportunities. there are outcomes opportunities and there are ways for us to help build our brand which is our overall strategy so there's the existing portfolio that we're pursuing my head of that business my head the gentleman that works for me that's responsible for that comes from a specialty pharmacy background uh where basically the lifeblood of what his business did he came from morcini so he has had a very very good track record historically and he is he has been very successful in his early tenure here he's been here about four months now four and a half months where he has re-established I think our image our brand our experience our approach with manufacturers and there are a number of I think novel very interesting molecules where blas are filed and we expect approvals coming and and you guys probably know a lot of these drugs i won't get into the details but they're for cardiovascular disease they're for diabetes they're for other things that we are going to have to become involved in as is every infusion provider because the specialty landscape has changed so much on the gi front which used to

be a huge piece of the business so i hope i've answered your question but two-pronged approach on that the company was just so focused on acute with its history historically and you know what we're doing today is trying to focus on both you know acute and chronic and specialty and you know you just you need to operationalize those two markets you know very independently within your organization and I think that's what the team is doing a good job now trying to focus on Dave Larson with BTIG can you talk a bit about a day in the life of your sales rep like you got specialty you've got infusion you've got home and community pharmacy what is this sales rep doing all day is that person representing all of these different business lines how are how is their commission determined are they calling on doc offices or hospitals or um sniffs or all of the above or health plans can you just describe that please can i hit that just up front real quick to set the table and then we'll just go one two three so so dave interest i would just say two things up front number one um i've been at multiple organizations you know leading health care companies over the past 15 years it is always a question as to whether or not you have a sales rep sell the whole bag or a suite of services or just their own service line or product let's say we have four reps in Boston and we have you know each selling you know and we have four products at the company should we have four reps they're selling each product or should we have one rep they're selling for our experience time and time again has been you need focus you know You are always going to have something that's left out if somebody's selling multiple pieces. And so we have made the decision again, which I think is the right one, is to have focus sales reps, focus sales reps in our businesses to be much more productive. Now, if we can share relationships, if we're swinging by another doctor's office when we're at that hospital, if we're passing along referrals that come up, that's fantastic. But number one, you know, principally, we want focus. I would say number two at our company, as you look at the call point, it's either B2B or more of a call it pharma medical device sales point where it's a hospital, you know, case manager, physician or a doctor's office. So home and community would be a good example where it's all B2B. You know, we are working with the assisted living facility CEO management team to win that contract for the chain. that's the way it works largely across home and community. In most other parts of our company, you have an individual clinical liaison going out there every day, whether it's home health, hospice, infusion or oncology, and they are individually meeting with a case manager, a physician in the hospital or in an office to pull that individual referral through. And it's more of a quote unquote retail model.

So, you know, Robert and Rich and Scott, maybe you can just, you know, hit anything more about what the sales reps are doing, who they're calling on. so i can i can go through this specialty side of the house onco 360 and care med we have two different types of sales salespeople a field seller which think about traditional pharma they're going in into doctor's offices educating the doctors the nurses the oncology coordinators of our drug access capabilities giving potential patient updates and they're going to see in certain metro areas various hospitals around the country or actually around their region and then they move on and they do that all week long to go interact with the physicians the inside sellers which are which are partnered at a regional level with the field sellers so the strategy is aligned the message is aligned the targeting they're behind a computer they start the day with data and information literally the night before they have information on what referrals came in the day before so they start the follow-up they start the education they start the troubleshooting if necessary and then they're working in conjunction with the field sellers to make sure that they're on one page as it relates to physician offices next steps strategies opportunities and long story short over the past couple of years we've shrunk territories Chris showed that we've gone from 12 reps to 275 in shrinking territories you can service more accounts you can touch more accounts more frequently you can provide better service updates so in in the past we might have had very expansive regions right now they're smaller regions so we can see the doctors and the offices more frequently and generally with the relationships the sellers that are there most often providing real value to the doctor's offices win as it relates to where the doctors choose to send referrals. And then as far as the comp plan, we have a comp plan that rewards mix, making sure that there's a healthy mix of both brand and generic drugs. But then also you're comping as it relates to growth, new patient acquisition, because that turns into prescriptions and those who have the highest success rate as it relates to growth and mix are rewarded accordingly.

Okay, so in infusion, we have two sales forces. We have an acute sales team and a specialty sales team. We have data that allows us to segment our customers and quintile them, quintile one through five, based on where we see the potential. So the data is heavily utilized in terms of call planning and things of that nature. We go with a four-week call plan. That doesn't mean we just see somebody every four weeks. We may double down. I may see you every week if you're a quintile five. I may be there so much that if you repeat back to me what I want to say to you, I feel like I've done my job. So that's the way that we operate with the acute and the specialty team. The acute team is focused on health systems, hospitals, and getting referrals for those patients that are discharged from hospitals on a daily basis. I mentioned earlier, it's like riding the Tour de France in first gear. You have to be present to win because if you're not, the case manager needs to get that patient serviced by somebody, and you've got to be there. Now, the better job we do at providing service, the more we are front of mind, and that case manager knowing and building a relationship with our seller will reach out to them and say, I've got a patient who we want to discharge today. They need daptomycin, blah, blah, blah, right? So that's the way we operate on the acute side. There are two roles in the acute business. There's the account executive whose job is, we just use the analogy of the hunter and the farmer. The account executive is the hunter. They're building business in health systems or in hospitals. We may already exist, and they're expanding that business, but their job is to grow the business. We have clinical liaisons that we refer to as the farmers who are there to maintain the relationships, to put out any fires if there are any. But they really are the liaison between the patient, the referral source, and our pharmacy. So that's how the acute business works. And I'll get to how they're paid in just a second. On the specialty side of the business, our folks there are calling typically on large neurology and gastro-neurology practices. In some cases, there are other specialties that are involved. Rheumatology, if you're dealing with gout or crostexa or some of the chronic inflammatory diseases. Ophthalmology, if there's an opportunity with Tepeza and our partnership with Amgen, which goes back to your question earlier. So the specialty team has a very, very clearly defined target audience that they call on as well. Again, four-week call cycle. Their job is to be the frontline representation of the Emerita brand and to get referrals from those physicians for basically, you know, the target opportunities that we showed on the slide earlier. So in neurology, it'd be IG, it would be multiple sclerosis, it would be drugs that have to be administered by a healthcare professional. A lot of those are for the emerging market in generalized myasthenia gravis. You see the TV ads all the time on TV. So we're involved in neurology in a heavy way and in gastroenterology, you know, with all of the drugs that you all know. The Remicades, the Biosimilars, the Sky Rizzies, no longer the Stellaras, but at the end of the day, there's plenty of opportunity there as well. We are seeing a shift, and our focus is becoming more neurology-focused than gastro-focused, quite frankly. How they get paid? Everybody has goals and quotas. And on the acute side, you get paid based on the referral or the admit, not the referral, but the admit, the start, whatever terminology we want to use where a patient's actually put on service. Our focus is on antibiotics and TPN, as is pretty much every other acute provider's focus. So they get paid on their ability to attain goal or exceed goal there. Same thing on the specialty side. it's a starts based uh compensation plan we don't make money on referrals right so that's the other the last thing i'll say on that is the sales team's ability to partner with our pharmacies to make sure that referrals are as as complete or clean as possible so we don't have to keep going back and forth to the referral source that is critical the far those criteria that we put on the slide earlier. We show 12 to 14 days to get benefits through on a specialty patient. That's pretty darn good. We want to get it below 10. We show 30 to 45 minutes on the acute business. We'd like to get that way lower as well, but it's progress and it keeps us competitive. Our ability to partner between the sales team and the pharmacy is what keeps the service levels good. And frankly, referral sources don't want you to keep coming back to them. They want you to take this case and go get the patient service so the better we do that you know we always say good service begets more referrals you know good service with more referrals begets growth and and that's where we want to be so i hope i've answered your question on infusion uh and then lastly in the home community space john references for us it's mostly b2b as we think about it uh i would say and this goes back to my reference related to kind of the the new way of America's kind of approached this.

Again, we think specificity is a differentiator in how we should think about growing the home and community space. I think historically we had more of a sniff lead-in and we got sold against by some of the other larger assisted living companies and say, well, they're a skilled company. Why would you bother? Well, that's not the case anymore. And we were showing up in a very specific and unique way in how we're servicing the assisted buildings as well as IDD with a specific sales team focused on that. And we're investing in the assisted side, you know, in the retirement belt, right, where a lot of these assisted living communities are growing and expanding exponentially. That is where we are doubling down our efforts to focus our growth in those populations. We do have, as you can imagine, some large vertically integrated customers, right, that have skilled assisted living and some IDD communities. We have very clear ways to hand off those referrals as they may hurl across multiple different settings for an institutional-based customer and client. In terms of pay, it's, again, we're very focused on profitable business, growing profitable business, and making sure that we have customers that can pay us, pay us on time, and are good partners for the business, and their comp plans are structured.

So even within a home and community, we have dedicated individuals' resources by those end markets that are focused on those. And I would say, you know, Rich, with what Rich said about think about, you know, the hunter versus the gardener, the hunter being more of an account manager per se, the gardener being more of a clinician per se, who's kind of settled maybe in one location versus hitting many, many different referral sources. that's a model that we employ broadly, you know, in home health and hospice as well. And I mean, as you step back and look at our company, I mean, we're probably in over 10,000 different offices today across the country with our liaisons. And so that's where, you know, thinking about the benefits of our organization, we do try to drive best practice consistency of sales methodologies and techniques throughout all of our businesses. But a lot of folks out there educating a lot of accounts and patients every day.

Can I say one more thing?

Sure.

One of the really unique things about our service providing business is the interaction that our sales team will often have with patients, caregivers and the ecosystem that is treated. If you're in pharma, you're not dealing with a patient if they get prescribed your drug. You're not. I mean, I am blown away at how professional our sales team is as they interact with patients and caregivers on a regular basis to make sure that everybody understands what's happening next. You know, you get discharged from a hospital and you get told, oh, you're going to be on TPN for an indefinite period of time for your nutritional needs. Or, you know, you're going to need this chronic drug possibly for the rest of your life. People need professional, I think, compassionate but very knowledgeable folks to support them because our company shows up at their door. And I think that's one of the cool, unique things that makes, you know, our business very, very special and very, very different from other sales jobs, if you will, that are out there in health care.

Yeah, I say this a lot. You know, in pharmacy, you know, I think a lot of people just think about I grab my script and go. In closed-door pharmacy like we do, serving these populations where they are, there are easily over 30 things we are doing on an ongoing basis interacting with the patient and with the family. And, you know, that is a huge part of why you can differentiate yourself from a service quality perspective and from a loyalty perspective, because you are very involved with so many things along that patient journey. And, you know, we are who they call. Break time? Well, thank you guys for that flu. About three hours already. Two hours. But thank you guys for your attention this morning and I think we've got a little bit of a 20 minute break or so right now. Five minutes?

What?

Dang. We got to do some work in these breaks. But yeah, it looks like we got about five or 10 minutes and we'll continue the agenda after that. So thank you guys.