BrightSpring Health Services (BTSG) Q4 2025 earnings summary

Executive summary

• Achieved strong revenue and adjusted EBITDA growth in Q4 and FY 2025, exceeding guidance and driven by operational efficiencies, strategic acquisitions, and strong segment performance in Pharmacy Solutions and Provider Services.

• Divestiture of the Community Living business approved, expected to close Q1 2026, with $715M net after-tax proceeds earmarked for debt reduction.

• Closed acquisition of Amedisys and LHC Home Health Assets, adding 107 branches and $345M pro forma revenue.

• Maintained high patient satisfaction and quality scores across all service lines.

• Focused on operational execution, technology, and integrated care for high-acuity, complex populations.

Financial highlights

• FY 2025 revenue: $12.911B, up 28% year-over-year; Pharmacy Solutions: $11.446B (+31%), Provider Services: $1.465B (+11%).

• FY 2025 adjusted EBITDA: $618M, up 34%; adjusted EBITDA margin: 4.8% (+20bps).

• Q4 2025 revenue: $3.551B (+29%); Q4 adjusted EBITDA: $184M (+41%).

• Cash flow from operations: $490M for 2025; leverage ratio reduced to 2.99x from 4.16x.

• Adjusted EPS: $0.33 for Q4, $1.00 for full year.

Outlook and guidance

• 2026 revenue guidance: $14.45B–$15.0B (+11.9%–16.2%); Pharmacy Solutions: $12.6B–$13.1B; Provider Services: $1.85B–$1.9B.

• 2026 adjusted EBITDA guidance: $760M–$790M (+23.1%–27.9%), including $30M from Amedisys/LHC acquisition.

• Expect sequential quarterly growth in 2026, with margin expansion driven by operational efficiencies and product mix.