AdaptHealth Corp. Announces First Quarter 2024 Results

Rhea-AI Summary

AdaptHealth Corp. announced financial results for the first quarter ended March 31, 2024. Net revenue increased by 6.4% to $792.5 million. However, net loss was $2.1 million compared to net income of $15.7 million in the same period last year. Adjusted EBITDA increased by 18.3% to $158.5 million. Cash flow from operations decreased to $49.0 million, and Free Cash Flow decreased to $(38.9) million due to delayed payments from the Change Healthcare data breach.

Positive

• AdaptHealth saw a 6.4% increase in net revenue to $792.5 million for the first quarter of 2024.

• Adjusted EBITDA rose by 18.3% to $158.5 million, with an Adjusted EBITDA Margin of 20.0%.

• The Company continued to reduce debt and expects to be below 3x leverage in 2024.

Negative

• Net loss attributable to AdaptHealth Corp. was $2.1 million compared to net income of $15.7 million in the same period last year.

• Cash flow from operations decreased to $49.0 million, and Free Cash Flow decreased to $(38.9) million primarily due to delayed payments from the Change Healthcare data breach.

Insights

Financial Analyst

AdaptHealth Corp.'s financial results for the first quarter of 2024 indicate a mixed financial performance, with a notable increase in net revenue of 6.4%, rising from $744.6 million to $792.5 million. This growth suggests resilience in their healthcare-at-home solutions segment, particularly in Sleep and Respiratory product lines, as highlighted by the management. Nonetheless, the reported net loss of $2.1 million, in contrast to the previous year's net income of $15.7 million, raises questions about the company's profitability. Adjusted EBITDA increased by 18.3% to $158.5 million, underscoring improved operational efficiency and margin expansion. However, investors should be cautious about the reported decrease in cash flow from operations, which fell drastically from $140.2 million to $49.0 million and a shift to negative Free Cash Flow of $(38.9) million. The management attributes these cash flow issues to the Change Healthcare data breach, claiming recovery in payments post-quarter. Moreover, the commitment to reduce debt below 3x leverage by 2024 could improve the company's financial stability. The operational metrics are promising but the net loss and cash flow concerns warrant a careful assessment of the company's financial health.

Market Research Analyst

Despite AdaptHealth's dip into net loss territory this quarter, the market for healthcare-at-home solutions remains robust, driven by an aging population and a growing preference for in-home care. The company's expansion in non-acquired revenue by 6.2% and continued investment in the Sleep, Respiratory and Diabetes product lines suggest a strategic focus on high-demand areas. The sector is benefiting from technological advancements and various initiatives to reduce hospital readmission rates, which could open further growth avenues for AdaptHealth. The mentioned Change Healthcare data breach, however, presents a warning for potential disruptions that can affect operations and financials. It's essential for investors to consider the broader industry trends, including regulatory changes and reimbursement challenges that could influence AdaptHealth's performance moving forward.

Debt Analyst

From a credit perspective, AdaptHealth's aim to reduce leverage below 3x by 2024 is an ambitious target that could significantly enhance the company's credit profile. Leverage ratios are a critical parameter for assessing the risk profile of a company, especially in industries like healthcare, which are capital intensive and can have variable cash flows. The reduction in debt would also potentially lower interest expenses and improve net income margins. Investors need to monitor the company's ability to manage its debt obligations, particularly in light of the temporary financial setbacks like cash flow disruptions caused by external events such as the Change Healthcare data breach. Still, the proactive debt management strategy communicated by AdaptHealth can be perceived as a positive signal for the company's long-term financial health.

PLYMOUTH MEETING, Pa.--(BUSINESS WIRE)-- AdaptHealth Corp. (NASDAQ: AHCO) (“AdaptHealth” or the “Company”), a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment, medical supplies, and related services, announced today financial results for the first quarter ended March 31, 2024.

First Quarter Results and Highlights

All comparisons are to the quarter ended March 31, 2023.

• Net revenue was $792.5 million compared to $744.6 million, an increase of 6.4%.
• Net loss attributable to AdaptHealth Corp. was $2.1 million compared to net income of $15.7 million.
• Adjusted EBITDA was $158.5 million compared to $134.0 million, an increase of 18.3%.
• Cash flow from operations was $49.0 million, a decrease from $140.2 million, and Free Cash Flow was $(38.9) million, a decrease from $51.1 million, both decreases primarily driven by delayed payments resulting from the Change Healthcare data breach. Since the end of the first quarter, the delayed payments have been largely caught up.

Management Commentary

Richard Barasch, Chairman and Interim CEO of AdaptHealth, commented, “I am pleased to report that AdaptHealth had an excellent first quarter. Our Sleep and Respiratory product lines remained strong and our Diabetes product line is moving in the right direction. We delivered 6.2% non-acquired revenue growth and an 18.3% increase in Adjusted EBITDA driven by Adjusted EBITDA Margin of 20.0%.”

Mr. Barasch continued, “Despite the temporary dislocation caused by the Change Healthcare data breach, our expectations for Free Cash Flow for the first half and for the full year remain unchanged. We have continued to reduce our debt in excess of required payments and expect that we will be below 3x leverage in 2024. As I step away, I am proud of all that our team has accomplished during my tenure as CEO and I am quite confident that our progress will continue under Suzanne Foster’s leadership.”

Conference Call

Management will host a teleconference today, Tuesday, May 7, 2024, at 8:30 am ET to discuss the results and business activities with analysts and investors.

Interested parties may participate in the call by dialing:

• (800) 579-2543 (Domestic) or
• (785) 424-1789 (International)

When prompted, reference Conference ID: AHCO1Q24

Webcast registration: Click Here

Following the live call, a replay will be available for six months on the Company's website, www.adapthealth.com, under "Investor Relations."

About AdaptHealth Corp.

AdaptHealth is a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment (HME), medical supplies, and related services. The Company provides a full suite of medical products and solutions designed to help patients manage chronic conditions in the home, adapt to challenges in their activities of daily living, and thrive. Product and service offerings include (i) sleep therapy equipment, supplies, and related services (including CPAP and bi PAP services) to individuals suffering from obstructive sleep apnea, (ii) medical devices and supplies to patients for the treatment of diabetes (including continuous glucose monitors and insulin pumps), (iii) HME to patients discharged from acute care and other facilities, (iv) oxygen and related chronic therapy services in the home, and (v) other HME devices and supplies on behalf of chronically ill patients with wound care, urological, incontinence, ostomy and nutritional supply needs. The Company is proud to partner with an extensive and highly diversified network of referral sources, including acute care hospitals, sleep labs, pulmonologists, skilled nursing facilities, and clinics. AdaptHealth services beneficiaries of Medicare, Medicaid, and commercial insurance payors, reaching approximately 4.1 million patients annually in all 50 states through its network of approximately 670 locations in 47 states.

Forward-Looking Statements

This press release includes certain statements that are not historical facts but are forward-looking statements for purposes of the safe harbor provisions under the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements generally are accompanied by words such as “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “should,” “would,” “plan,” “predict,” “potential,” “seem,” “seek,” “future,” “outlook,” and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. These forward-looking statements include, but are not limited to, statements regarding projections, estimates and forecasts of revenue and other financial and performance metrics and projections of market opportunity and expectations and the Company’s acquisition pipeline. These statements are based on various assumptions and on the current expectations of AdaptHealth management and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on, by any investor as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of the Company.

These forward-looking statements are subject to a number of risks and uncertainties, including the outcome of judicial and administrative proceedings to which the Company may become a party or governmental investigations to which the Company may become subject that could interrupt or limit the Company’s operations, result in adverse judgments, settlements or fines and create negative publicity; changes in the Company’s customers’ preferences, prospects and the competitive conditions prevailing in the healthcare sector. A further description of such risks and uncertainties can be found in the Company’s filings with the Securities and Exchange Commission. If the risks materialize or assumptions prove incorrect, actual results could differ materially from the results implied by these forward-looking statements. There may be additional risks that the Company presently knows or that the Company currently believes are immaterial that could also cause actual results to differ from those contained in the forward-looking statements. In addition, forward-looking statements reflect the Company’s expectations, plans or forecasts of future events and views as of the date of this press release. The Company anticipates that subsequent events and developments will cause the Company’s assessments to change. However, while the Company may elect to update these forward-looking statements at some point in the future, the Company specifically disclaims any obligation to do so. These forward-looking statements should not be relied upon as representing the Company’s assessments as of any date subsequent to the date of this press release. Accordingly, undue reliance should not be placed upon the forward-looking statements.

Use of Non-GAAP Financial Information

The Company uses EBITDA, Adjusted EBITDA, Adjusted EBITDA Margin and Free Cash Flow, which are financial measures that are not in accordance with generally accepted accounting principles in the United States, or U.S. GAAP, to analyze its financial results and believes that they are useful to investors, as a supplement to U.S. GAAP measures. In addition, the Company’s ability to incur additional indebtedness and make investments under its existing credit agreement is governed, in part, by its ability to satisfy tests based on a variation of Adjusted EBITDA.

The Company believes Adjusted EBITDA and Adjusted EBITDA Margin are useful to investors in evaluating the Company’s financial performance. The Company uses Adjusted EBITDA as the profitability measure in its incentive compensation plans that have a profitability component and to evaluate acquisition opportunities, where it is most often used for purposes of contingent consideration arrangements.

EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin should not be considered as measures of financial performance under U.S. GAAP, and the items excluded from EBITDA and Adjusted EBITDA are significant components in understanding and assessing financial performance. Accordingly, these key business metrics have limitations as an analytical tool. They should not be considered as an alternative to net income or any other performance measures derived in accordance with U.S. GAAP or as an alternative to cash flows from operating activities as a measure of the Company’s liquidity.

The Company uses free cash flow, which is a financial measure that is not in accordance with U.S. GAAP, in its operational and financial decision-making and believes free cash flow is useful to investors because similar measures are frequently used by securities analysts, investors, ratings agencies and other interested parties to evaluate the Company's competitors and to measure the ability of companies to service their debt. The Company's presentation of free cash flow should not be construed as a measure of liquidity or discretionary cash available to the Company to fund its cash needs, including investing in the growth of its business and meeting its obligations.

Free cash flow should not be considered as a measure of financial performance under U.S. GAAP. Accordingly, this key business metric has limitations as an analytical tool. It should not be considered as an alternative to any performance measures derived in accordance with U.S. GAAP or as an alternative to cash flows from operating activities as a measure of AdaptHealth’s liquidity.

ADAPTHEALTH CORP.
Condensed Consolidated Balance Sheets (Unaudited)
(in thousands)		March 31, 2024			December 31, 2023
Assets
Current assets:
Cash		$	79,566		$	77,132
Accounts receivable			429,558			388,910
Inventory			108,585			113,642
Prepaid and other current assets			38,272			69,338
Total current assets			655,981			649,022
Equipment and other fixed assets, net			501,892			495,101
Operating lease right-of-use assets			111,232			110,465
Finance lease right-of-use assets			30,427			31,962
Goodwill			2,718,428			2,724,958
Identifiable intangible assets, net			124,591			130,160
Other assets			20,001			21,128
Deferred tax assets			341,141			345,854
Total Assets		$	4,503,693		$	4,508,650
Liabilities and Stockholders' Equity
Current liabilities:
Accounts payable and accrued expenses		$	340,234		$	391,994
Current portion of long-term debt			40,000			53,368
Current portion of operating lease obligations			31,530			29,270
Current portion of finance lease obligations			9,245			9,122
Contract liabilities			34,040			38,570
Warrant liability			11,474			4,021
Other liabilities			26,169			10,654
Total current liabilities			492,692			536,999
Long-term debt, less current portion			2,159,161			2,094,614
Operating lease obligations, less current portion			84,115			85,529
Finance lease obligations, less current portion			21,057			22,746
Other long-term liabilities			275,639			302,093
Total Liabilities			3,032,664			3,041,981
Total Stockholders' Equity			1,471,029			1,466,669
Total Liabilities and Stockholders' Equity		$	4,503,693		$	4,508,650

ADAPTHEALTH CORP.
Consolidated Statements of Operations (Unaudited)
		Three Months Ended
(in thousands, except share and per share data)		March 31,
		2024				2023
Net revenue		$	792,497			$	744,626
Costs and expenses:
Cost of net revenue			675,693				655,396
General and administrative expenses			48,378				47,521
Depreciation and amortization, excluding patient equipment depreciation			11,365				15,532
Goodwill impairment			6,530				—
Total costs and expenses			741,966				718,449
Operating income			50,531				26,177
Interest expense, net			32,472				31,955
Change in fair value of warrant liability			7,453				(21,914	)
Other loss, net			5,105				1,175
Income before income taxes			5,501				14,961
Income tax expense (benefit)			6,610				(1,714	)
Net (loss) income			(1,109	)			16,675
Income attributable to noncontrolling interest			1,025				968
Net (loss) income attributable to AdaptHealth Corp.		$	(2,134	)		$	15,707
Weighted average common shares outstanding - basic			132,914				134,525
Weighted average common shares outstanding - diluted			132,914				135,976
Basic net (loss) income per share		$	(0.02	)		$	0.11
Diluted net loss per share		$	(0.02	)		$	(0.06	)

ADAPTHEALTH CORP.
Consolidated Statements of Cash Flows (Unaudited)
		Three Months Ended March 31,
(in thousands)		2024				2023
Cash flows from operating activities:
Net (loss) income		$	(1,109	)		$	16,675
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization, including patient equipment depreciation			92,876				93,813
Goodwill impairment			6,530				—
Equity-based compensation			4,533				5,916
Change in fair value of warrant liability			7,453				(21,914	)
Reduction in the carrying amount of operating lease right-of-use assets			10,730				8,486
Reduction in the carrying amount of finance lease right-of-use assets			2,255				427
Deferred income tax expense (benefit)			4,389				(2,327	)
Change in fair value of interest rate swaps, net of reclassification adjustment			(367	)			(579	)
Amortization of deferred financing costs			1,309				1,309
Payment of contingent consideration from an acquisition			(1,850	)			—
Changes in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable			(40,647	)			5,920
Inventory			5,056				(8,149	)
Prepaid and other assets			33,610				(4,503	)
Operating lease obligations			(10,653	)			(9,451	)
Operating liabilities			(65,080	)			54,625
Net cash provided by operating activities			49,035				140,248
Cash flows from investing activities:
Purchases of equipment and other fixed assets			(87,891	)			(89,120	)
Payments for business acquisitions, net of cash acquired			—				(447	)
Net cash used in investing activities			(87,891	)			(89,567	)
Cash flows from financing activities:
Proceeds from borrowings on lines of credit			75,000				50,000
Repayments on long-term debt and lines of credit			(25,000	)			(30,000	)
Repayments of finance lease obligations			(2,291	)			(981	)
Payments for shares purchased under share repurchase program			—				(9,224	)
Proceeds from the exercise of stock options			545				—
Proceeds received in connection with employee stock purchase plan			607				1,021
Payments relating to the Tax Receivable Agreement			(1,432	)			(3,202	)
Payments for tax withholdings from restricted stock vesting			(1,139	)			(2,492	)
Payments of contingent consideration and deferred purchase price from acquisitions			(5,000	)			(674	)
Net cash provided by financing activities			41,290				4,448
Net increase in cash			2,434				55,129
Cash at beginning of period			77,132				46,272
Cash at end of period		$	79,566			$	101,401

Non-GAAP Financial Measures

EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin

This press release presents AdaptHealth’s EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin for the three months ended March 31, 2024 and 2023.

AdaptHealth defines EBITDA as net income (loss) attributable to AdaptHealth Corp., plus net income (loss) attributable to noncontrolling interests, interest expense, net, income tax expense (benefit), and depreciation and amortization, including patient equipment depreciation.

AdaptHealth defines Adjusted EBITDA as EBITDA (as defined above), plus equity-based compensation expense, change in fair value of the warrant liability, goodwill impairment, litigation settlement expense, and certain other non-recurring items of expense or income.

AdaptHealth defines Adjusted EBITDA Margin as Adjusted EBITDA (as defined above) as a percentage of net revenue.

The following unaudited table presents the reconciliation of net (loss) income attributable to AdaptHealth Corp. to EBITDA and Adjusted EBITDA, and the reconciliation of net (loss) income attributable to AdaptHealth Corp. as a percentage of net revenue to Adjusted EBITDA Margin, for the three months ended March 31, 2024 and 2023:

		Three Months Ended March 31,
		2024							2023
(in thousands, except percentages)		Dollars				Revenue Percentage			Dollars				Revenue Percentage
Net (loss) income attributable to AdaptHealth Corp.		$	(2,134	)		(0.3	)%		$	15,707			2.1	%
Income attributable to noncontrolling interest			1,025			0.1	%			968			0.1	%
Interest expense, net			32,472			4.1	%			31,955			4.3	%
Income tax expense (benefit)			6,610			0.8	%			(1,714	)		(0.2	)%
Depreciation and amortization, including patient equipment depreciation			92,876			11.7	%			93,813			12.6	%
EBITDA			130,849			16.5	%			140,729			18.9	%
Equity-based compensation expense (a)			4,533			0.6	%			5,916			0.8	%
Change in fair value of warrant liability (b)			7,453			0.9	%			(21,914	)		(2.9	)%
Goodwill impairment (c)			6,530			0.8	%			—			—	%
Litigation settlement expense (d)			5,105			0.6	%			—			—	%
Other non-recurring expenses, net (e)			4,015			0.5	%			9,233			1.2	%
Adjusted EBITDA		$	158,485			20.0	%		$	133,964			18.0	%
Adjusted EBITDA Margin						20.0	%						18.0	%

(a)		Represents equity-based compensation expense for awards granted to employees and non-employee directors.
(b)		Represents a non-cash charge or gain for the change in the estimated fair value of the warrant liability.
(c)		Represents a non-cash goodwill impairment charge relating to an immaterial business disposal during 2024.
(d)		Represents a $4.2 million charge for the change in fair value of shares expected to be issued in connection with the settlement of a previously disclosed securities class action lawsuit, as well as an expense of $0.9 million to settle a shareholder derivative complaint. The proposed settlements remain subject to final court approval and other customary closing conditions.
(e)		The 2024 period consists of $1.2 million of expenses associated with litigation, $1.0 million of consulting expenses associated with systems implementation activities, a $0.7 million write-down of assets, and $1.1 million of other non-recurring expenses. The 2023 period consists of $7.1 million of expenses associated with litigation, $1.2 million of consulting expenses associated with systems implementation activities, and $0.9 million of other non-recurring expenses.

Free Cash Flow

This press release presents AdaptHealth’s Free Cash Flow for the three months ended March 31, 2024 and 2023.

AdaptHealth defines Free Cash Flow as net cash provided by operating activities less cash paid for purchases of equipment and other fixed assets.

The following unaudited table reconciles net cash provided by operating activities to the free cash flow measure for the three months ended March 31, 2024 and 2023:

		Three months ended
(in thousands)		March 31,
		2024				2023
Net cash provided by operating activities		$	49,035			$	140,248
Purchases of equipment and other fixed assets			(87,891	)			(89,120	)
Free cash flow		$	(38,856	)		$	51,128

 

View source version on businesswire.com: https://www.businesswire.com/news/home/20240507034319/en/

AdaptHealth Corp.

Jason Clemens, CFA

Chief Financial Officer

IR@adapthealth.com

Source: AdaptHealth Corp.

FAQ

What are AdaptHealth Corp.'s first quarter 2024 financial results?

AdaptHealth Corp. reported a 6.4% increase in net revenue to $792.5 million for the first quarter of 2024. However, the company incurred a net loss of $2.1 million compared to net income of $15.7 million in the same period last year.

What caused the decrease in Cash Flow from operations and Free Cash Flow for AdaptHealth Corp. in the first quarter of 2024?

The decrease in Cash Flow from operations to $49.0 million and Free Cash Flow to $(38.9) million was primarily driven by delayed payments resulting from the Change Healthcare data breach.

How did AdaptHealth Corp.'s Adjusted EBITDA perform in the first quarter of 2024?

AdaptHealth Corp.'s Adjusted EBITDA increased by 18.3% to $158.5 million for the first quarter of 2024, with an Adjusted EBITDA Margin of 20.0%.