Concentra Group Holdings Parent, Inc. (CON) Q3 2026 Earnings Call Transcript

Thank you.

Thank you for joining us today for the Consensure Group Holdings Parent, Inc. earnings conference call to discuss the third quarter 2026 results. Speaking today are the company's executive chairman, Keith Newton, the company's president and chief executive officer, Matt DeCaneo, and the company's executive vice president and chief financial officer, Tanner Newton. Management will give you an overview and then open the call for questions. Before we get started, we would like to remind you that this conference call may contain forward-looking statements regarding future events or the future financial performance of the company, including without limitation, statements regarding operating results, growth opportunities, and other statements that refer to Concentra's curtain plans, expectations, strategies, intentions, and beliefs. You are hereby cautioned that these forward-looking statements may be affected by the important factors, among others, set forth in Concentra's earnings release and that reports that are filed are furnished to the SEC. Consequently, actual operations and results may differ materially from those discussed in the forward-looking statements. These forward-looking statements are based on the information available to management of Concentra today, and the company assumes no obligation to update these statements as circumstances change. Additionally, during today's call, we may reference measures such as adjusted EBITDA, adjusted EBITDA margin, and free cash flow, which are non-GAAP financial measures. The definitions of adjusted EBITDA, adjusted EBITDA margin, and free cash flow, and the tables reconciling those metrics to the corresponding gap measures are provided in the earnings release. At this time, I will turn the conference over to Mr. Keith Newton, Mr. Matt Decanio, and Mr. Tanner Newton.

Thank you, and good morning. This is our first earnings call following our leadership transition, and I'd like to begin by congratulating Matt on his assumption of the chief executive officer role, and Tanner on his assumption of the chief financial officer role, effective as of November 1st. These appointments reflect a thoughtful succession process and the strength of the leadership team we have built over many years. Concentra enters in this next chapter from a position of considerable strength. We have a differentiated market position, a proven strategy, strong operational execution, and a talented, very experienced team serving our patients, employer customers, and partners every day. I am confident that Matt, Tanner, and the broader leadership team are exceptionally well-positioned to build on the momentum we've established and continue to create long-term value for our stakeholders. While my role has changed, my commitment to Consentra remains the same. As Executive Chairman, I'll continue to partner very closely with Matt, the board, and the leadership team to support our strategic priorities and ensure a seamless and successful transition. I'm very excited about the opportunities ahead and the future of the company. With that, I'll turn the call over to Matt. Thank you, Keith, and good morning.

I appreciate your leadership and look forward to continuing our partnership in your role as Executive Chairman. I also want to welcome Tanner to his first earnings call as Chief Financial Officer. We had a great third quarter with strong visit volume, higher revenue per visit, and disciplined cost management driving significant earnings growth. Let's jump into some of the highlights. Total revenue increased 8.6% year-over-year to $622.1 million. Net income was $67.8 million, up 36% from a year ago, and adjusted EBITDA was $140.2 million, up 17.9% from a year ago. Tanner will walk through the financial details, but I want to spend a few minutes on what we saw across the business and where we are focused. Total occupational health center patient visits increased 4.9% to an average of more than 58,000 visits per day in the third quarter. Our workers' compensation visits per day increased 4.2%, and employer services visits per day increased 5.8% relative to prior year. We believe this performance reflects a combination of favorable labor market conditions in many of the blue-collar sectors we serve and continued market share gains. Growth was broad-based across all six of our regions and most end markets. Recent activity in our employer services business remains particularly encouraging with strong increases in hiring-related services such as drug screens and physicals across transportation and logistics, manufacturing, construction-oriented customers, and other industries as well. The activity we are seeing among customers in these sectors continues to indicate healthy workforce demand. We believe our ongoing investments in sales execution, account management, and technology continue to strengthen our competitive position and support market share gains. Customer retention remains at multi-year highs, while year-to-date new business activity is tracking ahead of 2025 levels. Turning to our occupational health center rate, revenue per visit increased 3.3% year-over-year in the third quarter. This growth was driven by a 3.5% increase in workers' compensation and a 4.0% increase in employer services revenue per visit. Employer services revenue per visit was slightly elevated this quarter, in part due to a shift in the mix with services comprising a larger percentage of higher revenue per visit physicals relative to drug screens. During the third quarter, we acquired four medical centers in Minnesota. We also opened three DeNovo centers in Kansas City, Missouri, Boise, Idaho, and Daytona Beach, Florida, with the latter two representing new markets for Concentra. Following quarter end, we opened two additional centers near Pensacola, Florida, and Washington, D.C. We expect to open one more center before the end of this year. In total, completed acquisitions and de novo development are expected to add 15 new centers during 2026. We are currently anticipating low double-digit de novo openings in 2027. Our M&A pipeline remains strong, with multiple bolt-on transactions progressing well. We see attractive opportunities to continue expanding the business through both acquisitions and de novo development, and we will remain disciplined. in evaluating returns and executing on those opportunities. Within the on-site business, fundamentals remain strong, supported by employers' continued focus on managing their rising health care costs, a growing sales pipeline, and strong operational execution as we capture the benefits of the pivot integration. I'll now turn the call over to Tanner to review our financial results in more detail.

Thank you, Matt, and good morning. I'm pleased to join you in my new role and look forward to continuing to work with our leadership team and the investment community. I'll begin with our consolidated results, then review operating segment performance, expenses, cash flow, and the balance sheet. Total company revenue is $622.1 million in Q3 2026, compared to $572.8 million in Q3 of the prior year, representing 8.6% growth year over year. We saw a slight acceleration in year-over-year organic revenue growth compared to Q2, which grew at 8%. Net income attributable to the company in Q3 2026 was $65.9 million, or $0.52 per share, compared to $48.3 million and $0.38 per share, respectively, in Q3 2025. Adjusted net income attributable to the company in Q3 2026 was $66.1 million, and adjusted earnings per share was $0.52, compared with $49.9 million and $0.39 per share, respectively, in Q3 2025, reflecting growth of 33.3% in adjusted earnings per share year-over-year. Adjusted EBITDA increased 17.9% to $140.2 million. An adjusted EBITDA margin expanded 178 basis points to 22.5%. Sequentially, relative to Q2, margin was affected by one additional expense day in Q3 compared with the second quarter. More broadly, the year-over-year improvement reflects strong volume and rate growth, disciplined execution, and operating efficiencies across the business. Next, breaking down revenue by segment. Total occupational health center revenue increased 8.3% year-over-year to $569.7 million. Workers' compensation revenue increased 7.9% to $370.5 million, while employer services revenue increased 10% to $190.5 million. On-site revenue increased 10% year-over-year to $38.4 million. Organic growth moderated versus Q2 as Pivot entered the organic calculation following the acquisition anniversary, with Pivot's relatively modest year-over-year growth diluting stronger growth in the core business. Finally, other businesses, which include telemedicine, pharmacy operations, and other occupational health-related services, generated revenue of $14.1 million, an increase of 18.4% year-over-year. Moving on to expenses. Cost of services was $426.7 million, or 68.6% of revenue, in Q3-2026, an improvement from 70.8% of revenue for the same quarter of the prior year. The drivers were consistent with the first half of the year, with strong flow-through from visit and rate growth, together with favorable staffing efficiencies across our centers. Our total general and administrative expenses were $60.9 million, or 9.8% of revenue, in Q3-2026, compared to 9.2% of revenue in the same quarter of the prior year. Excluding items that are added back for the purposes of calculating adjusted EBITDA, including equity compensation expense, one-time select separation costs, and M&A transaction costs, G&A expense was $56.4 million for the quarter, or 9.1% of revenue, compared to 8.5% of revenue in the same quarter of the prior year. Turning to cash flow. In Q3, we generated $51.9 million of operating cash flow, compared to $60.6 million in the third quarter of 2025. The year-over-year decrease was driven primarily by working capital timing and higher cash tax payments, following the roll-off of certain tax benefits associated with the OBBBA that we received in the prior year period. Excluding these factors, the underlying cash-generating capacity of the business remains strong and consistent with our expectations. Investing activities use the net $25.9 million of cash in the third quarter, which includes both acquisition capital related to our Minnesota deal that closed in the quarter and net inflows from the sale of a previously owned building. Free cash flow or cash flow from operations less cash flow used in investing activity, excluding business combinations, total $32.2 million, a decrease from prior year third quarter free cash flow of $40.2 million. The year-over-year decrease was primarily due to the aforementioned lower cash flow from operations in Q3, 2026. Finally, financing activities used $98.2 million of cash during the quarter. We repurchased 1 million shares for $34.65 million and returned an additional $8 million to shareholders through dividends. At September 30, 2026, approximately $19 million remained under the Board's original $100 million repurchase authorization. Subsequent to quarter end, the Board authorized a new $250 million share repurchase program with no expiration date. The authorization provides additional flexibility to return capital while continuing to invest in organic growth, acquisitions and de novos, and debt reduction. The Board also declared a quarterly cash dividend of $0.625 per share, payable on or about December 4, 2026, to shareholders of record as of November 19, 2026. During the quarter, we repaid $52.4 million on our Terminal B, comprised of both mandatory amortization and a $50 million discretionary prepayment. We ended the quarter with a total debt balance of $1.52 billion and a cash balance of $85.8 million. Our net leverage ratio per our credit agreement at the end of September was 2.90 times. We were also pleased to receive a ratings upgrade from S&P Global in August, with our corporate rating improving from double B minus to double B. In mid-October, Moody's also revised its outlook from stable to positive. Now, I'll turn it back over to Matt to close us out with some comments on separation activity, as well as our updated guidance.

Thanks, Tanner. As discussed last quarter, separation activities are substantially complete and will conclude with the expiration of the TSA with Select Medical at the end of this month. This marks the successful completion of a multi-year separation process. I'd like to recognize and thank both our Concentra team and the Select Medical team for their tremendous efforts and partnership throughout this entire process. Their work has been instrumental in achieving a smooth and successful transition, and we are pleased to have this milestone behind us. Now, with respect to our updated guidance, we are raising our 2026 outlook as follows. We are increasing the low end of our revenue range by $35 million and the high end of our revenue range by $5 million, resulting in a revised range of $2.36 billion to $2.38 billion. We are increasing the low end of our adjusted EBITDA range by $20 million and the high end of our adjusted EBITDA range by $15 million, resulting in a revised range of $505 million to $510 million. Our free cash flow range of $220 million to $240 million and our capital expenditure range of $70 to $80 million remains unchanged. The business continues to perform well, and we expect to close out the year on strong footing. As in prior years, we expect to provide formal 2027 guidance early next year when we have greater visibility into the economic and reimbursement environment. At this stage, we expect employer services rate growth to remain generally consistent with our long-term expectation of approximately 3%. It is too early to provide a definitive outlook for workers' compensation rates because most states have not yet announced changes to their fee schedules. Based on the information currently available, however, we have no reason to expect aggregate workers' compensation rate growth to differ materially from our long-term expectations. That concludes our prepared remarks. We thank everyone for the time today. We'll turn it back to the operator to open the call for questions.

Certainly. Everyone at this time will be conducting a question-and-answer session. If you have any questions or comments, please press star 1 on your phone at this time. We do ask that while posing your question, please pick up your handset if you're listening on speakerphone to provide optimum sound quality. And once again, if you have any questions or comments, please press star 1 on your phone. Your first question is coming from Anne Hines from Mizzouho. Your line is live.

Great. Thank you so much. So, I just want to break down the strength just in the visits. So, I know you give visits per day. What is the trend with visits per patient? What is that typically average, and is that growing per patient, or are you seeing absolutely new patients? Thanks.

Hey, good morning, Anne. It's Matt D'Canio. Thanks for the question. So... We don't really break down our visits beyond what we disclose publicly, but I'll add some comments on your question. We've talked about complexity of cases, severity, things like that that have been trending higher over recent years. We saw a little bit of that in Q3, but Q3 visits were really driven primarily by stronger initial injury visit volumes, which is the start of the patient cycle within Concentra.

Okay, great. Oh, and I meant to say congratulations to everyone before my question on your new positions. And then when I head into 2027, can you remind us how much MA EBITDA contribution that was in 2026? And when we do our models, should we put kind of some unannounced M&A in our models, or would you prefer just like organic models?

Yeah, hey, Ann, this is Tanner. I'd say the way we think about it is until we've got deals definitively done, we don't bake that into our internal projection, so I would expect our analyst community to follow along or follow in suit from that standpoint.

All right. Great. Thank you.

Thank you. Your next question is coming from Justin Bowers from Deutsche Bank. Your line is live.

Hey, good morning, everyone. Matt, we've continued to get constructive feedback from your customers, and you talked about new business development trending very well this year as well. So, longer term, how should we think about market share gains relative to, you know, the historical algo of volume plus price? And then... Part two would be, again, for Matt and or Tanner, any updates on New York and some of the developments there?

Yeah, sure. Good morning. I'll take the first one, Tanner. You can hit the second one on New York. As far as market share gains, similar to what we've said in prior quarters, our teams out there managing the centers and the visit volumes are doing a tremendous job. Retention is up across the board. Our KPIs are at or near all-time highs in anything we measure, whether it's turnaround times, patient satisfaction scores, things like that. So our job on a go-for basis will be to continue that. And we've got some technology enhancements that we'll look to continue to roll out to help support the center colleagues so we can continue to drive that great experience. And as we continue to add dots on the map and do what we're doing at our existing centers, that is our goal to continue our market share gains across the board.

Yeah, and hey, Justin, with respect to New York, there's not a substantive update at this time. We got through the public comment period. The regulator basically said, hey, take your comments, understand them, but we're going to stick with our existing proposal for now. We're not exactly sure when that's going to go into effect. They haven't. Provided guidance around that. We're still thinking sometime early 2027, hopefully. That being said, you know, we do think that the level that they have increased the E&M codes within the state have made it attractive enough for us to at least explore entry either via de novo or, you know, small bolt-on acquisitions. So, we're going to be looking at that in pretty heavy detail.

Got it. Thanks so much. Thank you. Your next question is coming from Ben Rossi from J.P. Morgan. Your line is live.

Hey. Good morning, Nate. I appreciate you taking my questions. I guess across segments, rates held up pretty steadily from 2Q despite the sequential step-up in value and growth. To what extent did rates reflect this underlying fee schedule and contract pricing versus some of the service line visit mix and market share gains? Then looking ahead to 2027, you mentioned consistency with rate trends in your 3% long-term guide. Are there any specific states to call out regarding fee schedule refreshes for next year?

Sure. Good morning, Ben. Thanks for the question. So, from a rate standpoint, three and a half percent work comp rate year over year in the quarter, four percent from employer services. We did call out there was some visit mix that drove the employer services rate slightly higher than our long-term average of three percent. So, a little bit of visit mix, but from a work comp standpoint, most of that is just straight fee schedule gains year over year. As far as 27 rates, I think that was the second half of your question. We are about to find out a number of states. I think in the next 45 to 60 days, there's about 20 to 25 states that release their fee schedules for next year. So we'll have a lot more information. Most of those states release in December. Most are effective January 1. We have some pretty good insight, but obviously we'd like to wait, you know, the next 30, 45 days and get the full data set.

Great. Hey, Matt. This is Keith. I'd say the only thing to add what Matt just said, specific more to employer services than work comp, is that pretty much in the finalization stages of sticking a stake in the ground on that, communicating it to the employers relative to our Jan 1 price increases that we typically do every year. As we've talked to you guys in the past, We will evaluate that typically October-November timeframe, communicate to the employers what we're doing in a generic letter, and put that into play on January 1st for everybody, and that has historically gone very well for us, and we anticipate that to do the same and be basically in line with what we've been seeing.

Great. Appreciate the added details there. I just, as a follow-up, on some of the initial contributions you've described from things like onshoring and the data center build-out, can you just refresh us on how these trends are showing up across your footprint and maybe some of the specific indicators from either your customers or screening data that can help us get a feel for whether this is a sustained demand driver? Thanks.

Yeah, hey, Ben. Tanner here. Yeah, it's a great question, and it's something that we're spending a lot of time trying to dive into our internal data on and parse out some, derive some responses from. So, what I would say there is with respect to... With respect to data centers, it's a really small, it's growing part of our business, but it's still a relatively small and immaterial part of the overall Boca business. We're tracking all 300-plus projects across our sales team, both on-site and our core brick-and-mortar sales teams. I think there is going to be more opportunity going forward on the on-sites, just given the nature of the construction projects there that are in the size of those construction projects that we're going to be tracking. But I wouldn't say that it's a huge contributor right now. On the overall reshoring trend, just given the data that we're seeing with respect to things like manufacturing and construction growth, and particularly within the employer services book of business, which, as we always talk about, is kind of a leading indicator, we are optimistic and hopeful that that is a sign of a growing reshoring trend. But again, I think we've talked about this in the past. It's still a little bit too early to definitively say that one way or the other.

Thanks again for the details, and congrats again on the new rules to Matt and Tanner.

Thanks, Ben. Thank you. Your next question is coming from Ben Hendricks from RBC. Your line is live.

Hey, this is Michael Marion for Ben. Thanks for taking my questions. Just kind of building on the last question, just

wanted to hear your initial results on the election results. Or your initial thoughts on the election results, and if that has changed your long-term perspective on the tailwinds from the data center build-outs and the manufacturing reshoring.

Yeah, it's Matt. Hey, Michael, thanks for the question. Here's what I'd say, just to add on to Tanner's comments, too, about reshoring and the data center build-out. If you look at our results and what's driving the visit volumes... It is very broad-based, and we are very diversified across the country, across industries, across geographies, across employer sizes, and what we have been seeing. It's strength across pretty much every industry and every geography. So, you know, we don't really have a view on the election results and the potential impact on our business. We're continuing to monitor the day-to-day visit volumes, and it's not one industry that's driving what we're seeing right now. That's really my main point. Okay, that's helpful. And then just a quick follow-up, looks like adjusted G&A ratio is up a bit year-over-year, even with the strong revenue growth. So, is this the right run rate moving forward? Thank you.

Yeah, I would say in Q3, we had a few additional expenses that I would characterize as more one-time in nature. And so we had a slight uptick relative to Q2 GNA. I think the run rate's probably somewhere in between Q2 and Q3 GNA is how I would look at it on a go-forward basis. All right. Thank you.

Thank you. Your next question is coming from Jack Slevin from Jefferies. Your line is live.

Hey, good morning, guys. This is Brett on for Jack. I just wanted to touch on the margin progress you guys have made and kind of get a look into, once you lap these separation costs moving forward into 27, how we should be thinking about the margin expansion and maybe the levers you can pull upon.

Yeah, so we've had really strong margin expansion in 2026. I think that we feel pretty confident that we're going to be able to sustain that level of margin going forward. Staffing efficiencies in our centers have been great. We're starting to get more leverage off of Our G&A as we start to run rate the separation costs. So I think that, you know, over a long period of time or a medium period of time, there's still opportunity for margin expansion, particularly as we continue to invest in centers and efficiencies within the centers. But, you know, would I expect to see the same level of margin expansion year over year that we saw in 2026 relative to 2025? Probably not, but I do think that we can sustain the current level of margin going forward. Yeah, I would just add to that.

It's really a combination of strong rate, strong visits. We've done a nice job with cost control, and we've obviously been very active from a growth standpoint. So, you know, that's our strategy. We're going to continue that into 2027. And, you know, what you're seeing now from a margin expansion standpoint is very much in line with How we've talked about the business for the last two, three years since the IPO. As soon as we get through the separation costs, digest some of the M&A, we expected margin expansion, and that's pretty much exactly what we're seeing right now.

Great. That's super helpful. Maybe just for a quick follow-up on the capital allocation front, I know you have the new buyback authorization, and obviously with leverage coming down below three times now, how should we be thinking about moving forward capital allocation and appetite for further M&A and Vinovo growth as well?

So, the new authorization is really a product of the fact that we are almost through the original authorization that we got put in place in the latter part of 2025. So, we sized this appropriately relative to our market cap and really think it just provides a tremendous amount of flexibility as we go forward. From an overall capital allocation standpoint, our first priority is always going to be good accreted growth opportunities, both organic capital being spent and inorganic capital being spent. We think that's our highest returning use of capital. Beyond that, we have a long-term debt target, leverage target of two and a half times, which we think we're going to continue to work down towards over the course of the next 12 months. And that has historically been priority call at 1B. I think now that we are below three times leverage and working down towards two and a half, we are able to elevate share repurchases into the category of You know, one B, one C alongside debt pay down. So, I think given the nature of our free cash flow and the strength of that, we're able to do all three of those things simultaneously.

Thanks.

Thank you. Your next question's coming from Chote Fidel from Goldman Sachs. Your line is live.

Hey, good morning. You've got Sarah Conrad on for Scott. Keith, last quarter you described employer services as a leading indicator that ultimately yields future workers' comp visits. With the acceleration in employer services visit growth in the third quarter, does that give you greater confidence into continued workers' comp strength into 2027? And can you also help us think about the typical lag between the strength in employer services and then the workers' comp volumes?

Yeah, hey, Sarah, it's Matt. I could take that, and Keith or Tanner jump in as well. Yes, we have historically seen when there's a pickup in employer services, there is a subsequent pickup in Work Calm. What I would say here is it's one quarter of data. We've got to continue to monitor employer services. We've been trending in the 1% to 2% growth rate range for employer services. Obviously, saw a nice pickup to 5.8% here. But, you know, when you look at our 40-, 45-year history of visit data, it is an early indicator of economic activity. But, obviously, we need to see, you know, more than one quarter worth of that activity.

Yeah, I'd say it is definitely positive when we're seeing this, and again, as Matt said, it's early, but historically, that's what it tended to reflect is that workers' comp follows it, but, you know, so that's really what I would add to it.

Great. Thank you. And then can you update us on wage inflation, turnover, and clinician availability? Just given all of the volume strength you've been seeing, how are you thinking about the incremental hiring needs and labor unit costs as you move into 2027?

Sure. Yeah. What we're seeing right now is pretty consistent with what we've seen over a long period of time. Right around 3% wage inflation. Turnover is stable. And in certain areas is improving slightly. So, obviously, the visit volumes are strong. Our efficiencies at the center level are improving. But we've been able to do a nice job from a recruiting standpoint and retention standpoint. But something we're focused on heavily and we're reinvesting in our colleagues and we'll continue to monitor that as we go forward.

Thank you.

Your next question's coming from Jared Haas from William Blair. Your line is live.

Hey, good morning. Thanks for taking the questions. You know, you've had a little bit of favorability on MIX supporting your revenue per visit, both in workers' comp and then this quarter in employer services, it sounds like. I'm wondering, is that something that you would say is becoming more in your control structurally such that, you know, MIX could be a little bit of a rate tailwind on a more durable basis going forward, you know, above and beyond what you get from a fee schedule perspective? Or do you still feel like that's sort of more just the reality of what's going on in the market?

Jared, what I would say on that is the visit mix, that bounces around a decent bit. There's been no real consistent theme. So some quarters will have physicals slightly higher than drug screens. Some quarters will be slightly the reverse of that. So there really has been no consistent theme in employer services or work comp.

Okay, that's helpful. And then you mentioned a couple of the de-novos. That you opened up recently, a couple of them in new markets. Could you just kind of remind us what the motion looks like for opening a center in a new market? So some of the, you know, startup or ramp up activities involved with that? And then, you know, really, how do you go about building relationships in the community, building brand awareness for Concentra with employers and, you know, ultimately with employees?

Sure, yeah, so just as we think about opening and developing the NOAA's NA Center, it starts with looking at injury Density in any given market. It involves looking at the fee schedules in any given market, and it involves looking at real estate in any given market. You really need all three of those things, those factors playing together to have a successful de novo. And when we go into a market, particularly a new market, we lead with our sales and marketing team months and months in advance. We're doing open houses. We're visiting different workplace sites. We're doing marketing blitzes in the community such that they're getting familiarity with Concentra. And so by the time the De Novo actually opens, we're driving solid visits, you know, day one. You know, in some cases, that could be 25 visits a day in the first week. In some cases, that's upwards of 50 visits a day, just depending on the market. But in terms of the overall economics of a de novo, we still look at that and view the payback and the overall payback inclusive of capital spend in the two to three year range.

Yeah, I'm just going to add to that. You know, we've got a large footprint now. We've gotten so much more sophisticated and better at these de novos, and our sales force is typically segregated for certain sized employers out there. So when we open up in Jacksonville, our first center, we've got a national sales force that is handling the UPSs and the Amazons and the large national employers that use us elsewhere. So the first thing they're doing is communicating to their corporate contacts about this new center. And the local UPS or Amazon or FedEx terminals, wherever they may be, finding out who they're using and just making them aware that we're opening up. And pretty quickly, we've gotten really good at making those switches. So those anchor accounts pretty quickly go in there. And then we've got the ground-level folks that are knocking on the doors within a five- to ten-minute drive time of those particular clinics and meeting with the local municipalities, which, again, those local municipalities, the cities, the schools, and all that, that are in a... A short area timeframe from those centers. There's been a real need in a lot of these smaller municipalities that we've opened up and just communicating way ahead of time, doing, as Tanner had mentioned, the open houses and inviting them in for tours. And it's really, I think the recipe book has really progressed dramatically over the last few years. We're very successful at ramping them up very quickly.

Hey, Jared, the only thing just quickly that I would add to that, definitely sales and marketing, but just a shout out to our medical therapy and operations team that obviously play a big role in those center openings as well. And it's truly a team effort that all those teams come together to help drive the success.

Thank you.

Your next question is coming from Stephen Baxter from Wells Fargo. Your line is live.

Hi, thanks. I was curious if you have a perspective on what industry-level workers' comp volumes are doing. I'm trying to put your volume out performance this year into that context, maybe how much you think is driven by maybe the better industry overall, maybe has to do with your market selection, or maybe it's better than expected sharegains. I guess how are you thinking about that at this point based on what you know?

Thanks for the question, Steve. So, there is some publicly available data through the BLS on injuries, but it's typically almost a year in arrears, so we don't have that data yet, but we do monthly financial calls with all the regions. We know that our retention is higher than previous years. We've got a decent bit of anecdotes of us picking up market share. So it's hard to know exactly the split between market share gains and new customers and how that compares to the overall growth in the marketplace. We definitely think there's macro trends that are helping, but everything I talked about earlier on the call is helping us drive market share gains as well.

Yeah, and total blue collar, which is a big driver of the injuries, employment has continued to increase.

Got it. And then, you know, I think when we went back to, you know, some of the education process, I think historically you guys have spoken about something like 60% of injuries in the workplace, you know, or dealt with in places like, you know, ER, urgent care, primary care, and then more like 40% ultimately land in the workers' comp arena. I guess I'm curious if you think there's been any change to that or if you, you know, potentially look back to periods where, you know, you've seen some economic pressure, whether there tends to be maybe more migration out of settings where people are going to have, you know, exposure to their cost sharing and things like that from their health benefits and into the workers' comp or in wondering if that's something you've seen in the past or something that you feel like you might be seeing now.

No, I don't think we're seeing any shifts there. Obviously, you have Concentra. With our market share, you have hundreds of smaller occupational medicine practices that make up the number you talked about, and then you have a wide range of urgent cares, health systems, family medicine offices. So, we have not seen a shift in where the occupational health visits are going. There's a lot of players. that see occupational health across the entire country.

Thank you. And once again, everyone, if you have any questions or comments, please press star, then one on your phone. Your next question is coming from Joanna Gajuk from Bank of America. Your line is live.

Oh, hi. Good morning. Thanks so much for taking the question. I don't know, maybe I missed it, but did you talk about the acceleration of all this in the context of, you know, variation by maybe geography or industry, or is it kind of roadway?

Yeah. Hey, Joanna. We did comment on that and basically said that the acceleration is pretty broad-based across all of our regions, across most of our industries. And so that's what gives us comfort that, you know, we're really seeing, you know, solid – we're on solid footing really across the country, and I think we can hopefully sustain that for a, you know, decent period of time.

And I guess that was my actual question in terms of, yeah, when I look at these volume growth numbers, you know, workers come up four and employer services almost 6%, and historically kind of talk about the length, you know, like the long-term framework more in the, you know, low single digits range. So is that going to change how we should think about, you know, the growth going forward, especially, you know, you might not be prepared to talk about 27, but just, you know, as you exit this year, it sounds like you're having like a, you know, a higher level of growth versus where, you know, where you started the year.

Yeah, I'll add some comments to that. We always point over a long period of time back to our long-term growth algorithm, which is low single-digit visit growth volumes, 3% rate, and then low single digits on core semi-organic growth rate. We've obviously had five, six quarters here where our visits are above that long-term algorithm, and looking back over 40, 45 years, there are periods of time where we'll see growth rates in excess of that long-term average. We're right in the middle of that right now. We can't really predict how long the cycle will last, but it's a combination of all the things we've talked about, our operating metrics, our retention stats, our sales technologies. We acquired a competitor. We've got a growing blue-collar labor force. We've got the reshoring trends we've talked about. So... There's a combination of things that we believe are all adding up to these growth rates that are above long-term averages.

And if I may, on the outlook into next year in terms of pricing, so I think last quarter you said, you know, you should know more about the fee schedules for 27. Anything to call out that you know right now and that we should think about when it comes to 2027 workers' comp pricing environment?

The only thing I'd add there, we'll give formal guidance in the first couple of months of next year. As I mentioned earlier, we're going to wait the next 30, 45 days and get the full data set on work comp fee schedules. As Keith mentioned, our employer services price increase will be in the same range as it's historically been. And so more information to come, but, you know, no, we don't expect any material differences from our long-term algorithm.

Great. Thank you so much.

All right. Thank you, Joanna.

Thank you. Your next question is coming from Raj Kumar from Stevens. Your line is live.

Hi, good morning. Maybe just on the on-site clinic business, I know overall smaller portion of the business, but just kind of given the expansion there, just want to know if you guys have been seeing any maybe incremental referrals to your occupational health centers for some of the more higher severity cases from the on-site clinic business and whether there's a kind of meaningful opportunity on that front longer term.

Yeah, this is Keith. You know, historically, it all depends on where the on-site clinics are relative to the bricks and mortar clinic, and in many instances, they're not really convenient for that, a lot of our on-site clinics, but where they are, certainly there is a collaboration between the two. I wouldn't say we've seen more, you know, relative to what we've seen in the past when we do have the opportunity to do that, but I think as we continue to expand our footprint. From across the United States with our on-site group, and as we have more on-sites that are closer in proximity to allow that, certainly I think our bricks and mortar will benefit it at some point in time, but at this point in time, no real fluctuation.

Great. Thank you.

Thank you. That completes our Q&A session. Everyone, this concludes today's event. You may disconnect at this time and have a wonderful day. Thank you for your participation.