Accendra Health (ACH) Q1 2026 earnings summary

Executive summary

• Q1 2026 results aligned with expectations, marking the first full quarter as a standalone home-based care company after separation from Owens & Minor, with transition services and separation activities progressing on schedule.

• Net revenue for Q1 2026 was $627.8 million, down from $673.9 million in Q1 2025, reflecting the impact of a terminated large commercial payor contract and changes in collection rates and volume growth.

• Adjusted EBITDA for Q1 2026 was $58.4 million, down from $96.0 million in Q1 2025, impacted by cost increases, inflation, and payor mix changes.

• Completed the sale of the Products & Healthcare Services (P&HS) business for $375 million in cash, retaining a 5% equity interest, resulting in a higher margin profile and more stable cash flow.

• Announced a $1.5 billion balance sheet optimization transaction with creditor commitments to strengthen liquidity, extend maturities, and reduce leverage.

Financial highlights

• Net revenue for Q1 2026 was $627.8 million, down 6.8% year-over-year, primarily due to the termination of certain commercial payor contracts.

• Adjusted EBITDA was $58.4 million, in line with expectations but down from $96.0 million in Q1 2025.

• Free cash flow was negative $2.0 million, reflecting typical seasonal softness and significant one-time items.

• Extraordinary payments included $19 million to the IRS, $22 million in legal and advisory fees for the P&HS divestiture, and $82 million in proceeds from asset sales.

• Net debt remained flat at $1.77 billion; cash and cash equivalents were $336.9 million at March 31, 2026.

Outlook and guidance

• Affirmed 2026 outlook for revenue and adjusted EBITDA, with management expecting sufficient liquidity to meet obligations over the next twelve months.

• Expect greater revenue growth in the latter half of the year, with at least 65% of adjusted EBITDA in Q3 and Q4.

• Annualized cash interest expense expected to increase by about $40 million due to refinancing, with half impacting the second half of 2026.

• No material impacts to operating income are anticipated from remaining contract terminations with the commercial payor beyond Q1 2026.

• Outlook based on assumptions regarding market conditions, consumer demand, supply chain stability, and interest rates.