Option Care Health Reports Financial Results for Fourth Quarter and Full Year 2024

Rhea-AI Summary

Option Care Health (NASDAQ: OPCH) has released its Q4 and full-year 2024 financial results, showing strong revenue growth but mixed profitability metrics. Q4 2024 highlights include net revenue of $1,346.4M (up 19.7% YoY), net income of $60.1M, and adjusted EBITDA of $121.6M (up 8.9% YoY).

Full-year 2024 performance showed net revenue of $4,998.2M (up 16.2% YoY), though net income decreased to $211.8M from $267.1M in 2023. The company's gross profit margin declined to 20.3% from 22.8% in 2023.

For 2025 guidance, Option Care Health projects net revenue of $5.3B-$5.5B, adjusted EBITDA of $450M-$470M, and adjusted EPS of $1.59-$1.69. The company repurchased approximately $90.0M of stock in Q4 2024.

Positive

• Revenue growth of 19.7% in Q4 2024
• Q4 adjusted EPS up 15.8% to $0.44
• Full-year revenue up 16.2% to $4.99B
• $90M stock repurchase in Q4 2024
• Projected revenue growth to $5.3B-$5.5B in 2025

Negative

• Gross profit margin declined from 22.8% to 20.3% in 2024
• Full-year net income decreased from $267.1M to $211.8M
• Cash flow from operations down 12.9% to $323.4M
• Diluted EPS declined 16.9% to $1.23 in 2024

Insights

Financial Analyst

Option Care Health delivered strong revenue growth in Q4 2024, with a 19.7% increase to $1.35 billion, capping a full year where revenue grew 16.2% to $5.0 billion. However, this top-line expansion comes with notable margin compression, as gross margins declined from 22.0% to 19.9% in Q4 and from 22.8% to 20.3% for the full year.

The divergence between GAAP and adjusted metrics reveals important dynamics. While adjusted EPS increased 15.8% to $0.44 in Q4 and 10.5% to $1.58 for the year, GAAP EPS declined 16.9% for the full year to $1.23. This significant gap primarily stems from amortization expenses and integration costs as the company scales operations.

The declining cash flow trend is concerning - Q4 operating cash flow dropped 29.1% to $36.1 million, while full-year cash flow decreased 12.9% to $323.4 million. This cash flow compression coupled with $90 million in Q4 share repurchases signals management's confidence but warrants monitoring of the company's capital allocation strategy.

The 2025 guidance projects continued but decelerating growth, with revenue of $5.3-5.5 billion (approximately 8% growth at midpoint) and adjusted EBITDA of $450-470 million (roughly 3.5% growth). The modest adjusted EPS growth forecast ($1.59-1.69 versus $1.58 in 2024) suggests ongoing margin challenges despite scale advantages.

As the home healthcare market continues expanding due to aging demographics and cost-containment pressures from insurers and government programs, Option Care Health's market leadership position remains valuable. However, investors should closely monitor gross margin trends, cash flow generation, and the company's ability to translate revenue growth into proportional earnings growth in coming quarters.

BANNOCKBURN, Ill., Feb. 26, 2025 (GLOBE NEWSWIRE) -- Option Care Health, Inc. (the “Company” or “Option Care Health”) (Nasdaq: OPCH), the nation’s largest independent provider of home and alternate site infusion services, announced today financial results for the fourth quarter and full year ended December 31, 2024.

Fourth Quarter 2024 Financial Highlights

• Net revenue of $1,346.4 million, up 19.7% compared to $1,124.4 million in the fourth quarter of 2023
• Gross profit of $268.4 million, or 19.9% of net revenue, up 8.6% compared to $247.1 million, or 22.0% of net revenue, in the fourth quarter of 2023
• Net income of $60.1 million, compared to net income of $57.2 million, in the fourth quarter of 2023 and diluted earnings per share of $0.35, up 9.4% compared to diluted earnings per share of $0.32 in the fourth quarter of 2023
• Adjusted net income of $75.5 million, compared to adjusted net income of $66.7 million in the fourth quarter of 2023 and adjusted diluted earnings per share of $0.44, up 15.8% compared to adjusted diluted earnings per share of $0.38 in the fourth quarter of 2023
• Adjusted EBITDA of $121.6 million, up 8.9% compared to $111.6 million in the fourth quarter of 2023
• Cash flow from operations of $36.1 million, down 29.1% compared to cash flow from operations of $51.0 million in the fourth quarter of 2023
• Repurchased approximately $90.0 million of stock in the fourth quarter of 2024

Full Year 2024 Financial Highlights

• Net revenue of $4,998.2 million, up 16.2% compared to $4,302.3 million in full year 2023
• Gross profit of $1,013.0 million, or 20.3% of revenue, up 3.2% compared to $981.2 million, or 22.8% of revenue, in full year 2023
• Net income of $211.8 million, compared to net income of $267.1 million in full year 2023 and diluted earnings per share of $1.23, down 16.9% compared to diluted earnings per share of $1.48, inclusive of the impact from non-operating income, in full year 2023
• Adjusted net income of $272.8 million, compared to adjusted net income of $257.7 million in full year 2023 and adjusted diluted earnings per share of $1.58, up 10.5% compared to adjusted diluted earnings per share of $1.43 in full year 2023
• Adjusted EBITDA of $443.8 million, up 4.4% compared to $425.2 million in full year 2023
• Cash flow from operations of $323.4 million, down 12.9% compared to $371.3 million in full year 2023

John C. Rademacher, Chief Executive Officer, commented, “The Option Care Health team’s execution produced solid financial results in the fourth quarter and full year 2024, demonstrating resilience in a dynamic and challenging period, while continuing to place the patient at the center of everything that we do. I am excited about the road ahead and the opportunity to leverage our capabilities to provide more patients high quality, affordable care, in a setting in which they wish to receive it.”

Full Year 2025 Financial Guidance

For the full year 2025, Option Care Health expects to deliver the following financial results:

• Net revenue of $5.3 billion to $5.5 billion
• Adjusted diluted earnings per share of $1.59 to $1.69
• Adjusted EBITDA of $450 million to $470 million
• Cash flow from operations of at least $320 million
• Effective tax rate of 25% - 27%
• Net interest expense of approximately $55 million to $60 million

Conference Call

Option Care Health will host a conference call to discuss its financial results later today at 8:30 a.m. EST. The conference call can be accessed via a live audio webcast that will be available online at investors.optioncarehealth.com. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.

About Option Care Health

Option Care Health is the nation’s largest independent provider of home and alternate site infusion services. With over 8,000 team members, including more than 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is reimagining the infusion care experience for patients, customers and teammates. To learn more, please visit our website at optioncarehealth.com.

Investor Contact

Mike Shapiro
Chief Financial Officer
T: (312) 940-2538
mike.shapiro@optioncare.com

Forward-Looking Statements - Safe Harbor

This press release may contain “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements can be identified by words such as: “anticipate,” “intend,” “plan,” “believe,” “project,” “estimate,” “expect,” “may,” “should,” “will” and similar references to future periods. Examples of forward-looking statements include, among others, statements we may make regarding future revenues, future earnings, regulatory developments, market developments, new products and growth strategies, integration activities and the effects of any of the foregoing on our future results of operations or financial conditions.

Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: changes in laws and regulations applicable to our business model; changes in market conditions and receptivity to our services and offerings; pending and future litigation; potential liability for claims not covered by insurance; and loss of relationships with managed care organizations and other non-governmental third party payers. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our periodic reports as filed with the SEC.

Any forward-looking statement made by us in this press release is based only on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.

Note Regarding Use of Non-GAAP Financial Measures

In addition to reporting financial information in accordance with generally accepted accounting principles (GAAP), the Company is also reporting Adjusted net income, Adjusted EBITDA and Adjusted earnings per share ("Adjusted EPS"), which are non-GAAP financial measures. These adjusted measures are not measurements of financial performance under GAAP and should not be used in isolation or as a substitute or alternative to net income, earnings per share, or any other performance measure derived in accordance with GAAP, or as a substitute or alternative to cash flow from operating activities or a measure of the Company’s liquidity. In addition, the Company's definitions of Adjusted net income, Adjusted EBITDA, and Adjusted EPS may not be comparable to similarly titled non-GAAP financial measures reported by other companies. As defined by the Company: (i) Adjusted net income represents net income before intangible asset amortization expense, stock-based compensation expense, and restructuring, acquisition, integration and other expenses, net of tax adjustments (ii) Adjusted EBITDA represents net income before net interest expense, income tax expense, depreciation and amortization, stock-based compensation expense, loss on extinguishment of debt, and restructuring, acquisition, integration and other expenses, and (iii) Adjusted earnings per share represents Adjusted net income divided by weighted average common shares outstanding, diluted. As part of restructuring, acquisition, integration and other expenses, the Company may incur significant charges such as the write down of certain long‑lived assets, temporary redundant expenses, professional fees, certain litigation expenses and reserves related to acquired businesses, potential retention and severance costs and potential accelerated payments or termination costs for certain of its contractual obligations. Management believes that these adjusted measures provide useful supplemental information regarding the performance of Option Care Health’s business operations and facilitate comparisons to the Company’s historical operating results. We have not reconciled Adjusted EBITDA or Adjusted diluted earnings per share guidance to net income as management believes creation of this reconciliation would not be practicable due to the uncertainty regarding, and potential variability of, material reconciling items. Full reconciliations of each adjusted measure to the most comparable GAAP financial measure are set forth below.

Schedule 1
OPTION CARE HEALTH, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (IN THOUSANDS)(UNAUDITED)
	December 31,
		2024			2023
ASSETS
CURRENT ASSETS:
Cash and cash equivalents	$	412,565		$	343,849
Accounts receivable, net		409,733			377,658
Inventories		388,131			274,004
Prepaid expenses and other current assets		112,198			98,744
Total current assets		1,322,627			1,094,255
NONCURRENT ASSETS:
Property and equipment, net		127,367			120,630
Intangible assets, net		16,993			20,092
Referral sources, net		284,017			315,304
Goodwill		1,540,246			1,540,246
Other noncurrent assets		130,493			126,508
Total noncurrent assets		2,099,116			2,122,780
TOTAL ASSETS	$	3,421,743		$	3,217,035
LIABILITIES AND STOCKHOLDERS’ EQUITY
CURRENT LIABILITIES:
Accounts payable	$	610,779		$	426,513
Other current liabilities		169,367			191,796
Total current liabilities		780,146			618,309
NONCURRENT LIABILITIES:
Long-term debt, net of discount, deferred financing costs and current portion		1,104,641			1,056,650
Other noncurrent liabilities		132,718			120,404
Total noncurrent liabilities		1,237,359			1,177,054
Total liabilities		2,017,505			1,795,363
STOCKHOLDERS' EQUITY		1,404,238			1,421,672
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$	3,421,743		$	3,217,035

Schedule 2
OPTION CARE HEALTH, INC. CONDENSED CONSOLIDATED STATEMENTS OF EARNINGS (IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)(UNAUDITED)
	Three Months Ended December 31,								Year Ended December 31,
		2024				2023				2024				2023
NET REVENUE	$	1,346,418			$	1,124,390			$	4,998,202			$	4,302,324
COST OF REVENUE		1,078,039				877,267				3,985,209				3,321,101
GROSS PROFIT		268,379				247,123				1,012,993				981,223
OPERATING COSTS AND EXPENSES:
Selling, general and administrative expenses		164,727				147,783				630,251				607,427
Depreciation and amortization expense		16,615				14,784				60,909				59,201
Total operating expenses		181,342				162,567				691,160				666,628
OPERATING INCOME		87,037				84,556				321,833				314,595
OTHER INCOME (EXPENSE):
Interest expense, net		(10,879	)			(12,432	)			(49,029	)			(51,248	)
Other, net		4,891				6,801				10,795				95,395
Total other (expense) income		(5,988	)			(5,631	)			(38,234	)			44,147
INCOME BEFORE INCOME TAXES		81,049				78,925				283,599				358,742
INCOME TAX EXPENSE		20,916				21,748				71,776				91,652
NET INCOME	$	60,133			$	57,177			$	211,823			$	267,090
Earnings per share, basic	$	0.36			$	0.32			$	1.23			$	1.49
Earnings per share, diluted	$	0.35			$	0.32			$	1.23			$	1.48
Weighted average common shares outstanding, basic		168,816				176,055				171,567				178,973
Weighted average common shares outstanding, diluted		169,980				177,743				172,845				180,375

Schedule 3
OPTION CARE HEALTH, INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (IN THOUSANDS)(UNAUDITED)
	Year Ended December 31,
		2024				2023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$	211,823			$	267,090
Adjustments to reconcile net income to net cash provided by operations:
Depreciation and amortization expense		63,498				62,200
Deferred income taxes - net		12,656				12,766
Other non-cash adjustments		55,661				50,684
Changes in operating assets and liabilities:
Accounts receivable, net		(32,075	)			224
Inventories		(114,127	)			(51,000	)
Accounts payable		183,395				47,703
Other		(57,439	)			(18,372	)
Net cash provided by operating activities		323,392				371,295
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition of property and equipment		(35,606	)			(41,866	)
Proceeds from sale of assets		—				3,743
Business acquisitions, net of cash acquired		—				(12,494	)
Other investing activities		(864	)			(5,889	)
Net cash used in investing activities		(36,470	)			(56,506	)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of debt		49,959				—
Purchase of company stock and related excise taxes		(252,726	)			(250,261	)
Other financing activities		(15,439	)			(14,865	)
Net cash used in financing activities		(218,206	)			(265,126	)
NET INCREASE IN CASH AND CASH EQUIVALENTS		68,716				49,663
Cash and cash equivalents - beginning of the period		343,849				294,186
CASH AND CASH EQUIVALENTS - END OF PERIOD	$	412,565			$	343,849

Schedule 4
OPTION CARE HEALTH, INC. RECONCILIATION BETWEEN GAAP AND NON-GAAP MEASURES (IN THOUSANDS)(UNAUDITED)
	Three Months Ended December 31,								Year Ended December 31,
		2024				2023				2024				2023
Net income	$	60,133			$	57,177			$	211,823			$	267,090
Interest expense, net		10,879				12,432				49,029				51,248
Income tax expense		20,916				21,748				71,776				91,652
Depreciation and amortization expense		17,469				15,777				63,498				62,200
EBITDA		109,397				107,134				396,126				472,190
EBITDA adjustments
Stock-based incentive compensation expense		8,523				7,571				36,143				30,479
Loss on extinguishment of debt		—				—				377				—
Restructuring, acquisition, integration and other (1)		3,639				(3,103	)			11,143				(77,486	)
Adjusted EBITDA	$	121,559			$	111,602			$	443,789			$	425,183
Net income	$	60,133			$	57,177			$	211,823			$	267,090
Intangible asset amortization expense		8,596				8,629				34,405				34,381
Stock-based incentive compensation expense		8,523				7,571				36,143				30,479
Restructuring, acquisition, integration and other (1)		3,639				(3,103	)			11,143				(77,486	)
Total pre-tax adjustments		20,758				13,097				81,691				(12,626	)
Tax adjustments (2)		(5,356	)			(3,615	)			(20,668	)			3,220
Adjusted net income	$	75,535			$	66,659			$	272,846			$	257,684
Earnings per share, diluted	$	0.35			$	0.32			$	1.23			$	1.48
Adjusted earnings per share, diluted	$	0.44			$	0.38			$	1.58			$	1.43
Weighted average common shares outstanding, diluted		169,980				177,743				172,845				180,375

(1) Restructuring, acquisition, integration and other for the year ended December 31, 2023 includes the Amedisys merger termination fee, net of merger-related expenses

(2) Tax adjustments for the three months and year ended December 31, 2024 and 2023 includes the estimated income tax effect on non-GAAP adjustments based on the effective tax rate

FAQ

What was Option Care Health's (OPCH) revenue growth in Q4 2024?

OPCH's Q4 2024 revenue grew 19.7% year-over-year to $1,346.4 million from $1,124.4 million in Q4 2023.

How much did Option Care Health's (OPCH) gross profit margin decline in 2024?

OPCH's gross profit margin decreased from 22.8% in 2023 to 20.3% in 2024.

What is Option Care Health's (OPCH) revenue guidance for 2025?

OPCH expects net revenue between $5.3 billion to $5.5 billion for full-year 2025.

How much stock did Option Care Health (OPCH) repurchase in Q4 2024?

OPCH repurchased approximately $90.0 million of stock in Q4 2024.

What was Option Care Health's (OPCH) cash flow from operations in 2024?

OPCH generated $323.4 million in cash flow from operations in 2024, down 12.9% from $371.3 million in 2023.