BrightSpring Health Services (NASDAQ:BTSG) used an investor day event at its Louisville headquarters to outline its home- and community-based healthcare strategy, describe its pharmacy and provider businesses, and update investors on growth expectations, leverage reduction and capital deployment priorities.
Company overview: “home and community” model and integrated care
Chief Executive Officer Jon Rousseau positioned BrightSpring as a “leading Home and Community health services company,” serving seniors and specialty populations through two major segments: Pharmacy services delivered via “closed-door” distribution and Provider services delivered in patients’ homes and community settings.
Rousseau highlighted integrated care as both a current capability and a future growth opportunity, citing cross-referrals among service lines, “one-stop service solutions” for assisted living facilities, and expansion of home-based primary care as a “quarterback” for coordinating complex patient care and enabling value-based arrangements.
Pharmacy businesses: specialty, infusion, and home & community pharmacy
Rousseau described BrightSpring’s three pharmacy lines: Specialty Pharmacy (Onco360 focused on oncology and CareMed focused on rare and orphan diseases), infusion (Amerita), and Home and Community Pharmacy (PharMerica and related brands). He said the company dispenses more than 40 million prescriptions annually and can provide coverage “within three hours” across its footprint, calling scale “absolutely vital” for purchasing, contracting, automation and operating leverage.
Specialty pharmacy leaders outlined growth driven by limited distribution drugs (LDDs), manufacturer relationships and “first to market” execution. Onco360/CareMed executives said the business grew from 12 sales representatives and 39 LDDs in 2014 to 275 sales reps and more than 149 LDDs today, and described the platform as the “largest independent oncology rare orphan pharmacy” in the U.S. They also cited high service metrics, including CareMed receiving a 100 net promoter score in Q4 2025 (its third “perfect 100” in five quarters) and a 2025 “time to first fill” of approximately four days.
Amerita President Rich Denness described a “super-regional” infusion footprint with exposure to both acute and chronic (specialty) infusion. He noted the home and alternate site infusion market growth cited in the presentation and emphasized geographic expansion and M&A as key priorities. Denness also referenced Amerita’s involvement in Alzheimer’s therapy administration, saying the company is a key provider of Leqembi and has been selected by Eisai to participate in an Alzheimer’s advisory board. Amerita reported net promoter scores “running at 94%” and cited operational turnaround times of 30–45 minutes for acute and 12–14 days for specialty.
Home and Community Pharmacy President Scott Greenwell described a “new PharMerica,” with distinct leadership and sales focus across business segments including skilled nursing, assisted living/senior living, hospice pharmacy and IDD-related pharmacy. Greenwell said the business serves more than 4 million patients across 120 pharmacies and 6,500 facilities, supported by 4,700 employees. He discussed investments in onboarding standardization, automation (including robotic process automation and machine learning), and “PBM tools” such as formulary and utilization management to manage total cost of care and improve customer experience.
Technology and AI: operational automation and clinical support
Chief Information Officer Charlie Wardrip and Chief Technology Officer Viji Evers discussed investments in an integrated data and technology platform supporting line-of-business needs and enterprise data sharing. Evers said her remit includes “technology advancement, including AI, ML, and intelligent automation,” with an emphasis on improving quality outcomes, revenue and productivity while reducing costs. Wardrip said the company is pursuing AI initiatives in three broad areas: supporting clinical care, supporting revenue growth (including referral management and M&A integration), and reducing overhead through automation.
Provider businesses: home health, hospice, rehab, and personal care
On the Provider side, leaders described growth and quality initiatives across home health, hospice, rehabilitation and personal care, and emphasized how these services connect to pharmacy operations.
Home Health President Elizabeth Robinson detailed home health and private duty services, noting the business provides skilled nursing, therapy, aides and social work. She said the home health industry is valued at $119 billion and cited a 7% annual growth rate. Robinson said BrightSpring has 181 branches serving 27,000 patients and highlighted the integration of acquired LHC and Amedisys branches, emphasizing the value of certificate-of-need (CON) state presence. She said 81% of the acquired branches are in CON states and that the integration is expected to be completed by year-end. Robinson also stated the acquired branches are expected to add $30 million in EBITDA, with “longer upside” anticipated from additional efficiencies and growth.
Hospice Chief Commercial Officer Rhonda Sanders said hospice operates in 21 states and 93 locations, and described palliative care as a key upstream driver, stating the company serves more than 3,000 palliative patients with “about an 80% conversion” to hospice. She cited quality measures including hospice visits in the last days of life at 76.1% versus a national average of 48.3%, and said over 74% of hospice agencies have four-star or better ratings. Sanders also discussed growth levers including deeper penetration in existing markets, de novos, CON applications, and targeted growth through ACOs and value-based entities.
Rehab & Personal Care leader Kim More described the company’s neuro-focused rehabilitation continuum and its expansion into senior living outpatient therapy through “Rehab in Motion” under Medicare Part B. She said the company operates in 20 senior living communities with expansion underway through de novos, partnerships and acquisitions. More also detailed Personal Care scale, citing operations in 21 states across more than 160 locations, more than 16,000 individuals served, and 13 million hours of care delivered annually. She said the personal care business generates approximately $402 million in annual revenue and highlighted quality and compliance metrics shared in the presentation.
Financial update: leverage reduction, 2026 guidance, and 2028 framework
CFO Jen Phipps said BrightSpring reduced leverage from about 4.5x post-IPO to 2.99x at year-end 2025, and to 2.6x pro forma for the community living transaction. Phipps said the company expects to be under 2x leverage in 2026 “before any uses of capital,” citing EBITDA growth and cash flow generation. Rousseau previously noted operating cash flow of about $500 million in 2025 and said the company expects operating cash flow to be “about the same” in 2026 after removing community living and adding growth.
The company reiterated its previously announced 2026 guidance (excluding community living and excluding acquisitions not yet closed):
- Revenue: $14.45 billion to $15.0 billion
- Pharmacy Solutions revenue: $12.6 billion to $13.1 billion
- Provider Services revenue: $1.85 billion to $1.9 billion
- Adjusted EBITDA: $760 million to $790 million
Phipps also provided a framework for organic growth beyond 2026, citing 15% to 20% organic adjusted EBITDA CAGR from the end of 2026 through 2028, off the “high point” of 2026 guidance. Rousseau said the company believes it can grow 2025 EBITDA by roughly 70% to 85% through 2028 on the company’s current view of organic growth.
On capital deployment, Phipps said the company sees “at least $2 billion” of incremental capital availability through 2028 for potential M&A, emphasizing flexibility rather than guidance.
Throughout the event, executives repeatedly returned to quality metrics, operational discipline, scale advantages and technology investment as the foundation for growth, while also acknowledging that integrated care and value-based models represent longer-term opportunities that require dedicated resources and continued execution.
About BrightSpring Health Services (NASDAQ:BTSG)
BrightSpring Health Services (NASDAQ: BTSG) is a leading provider of home and community-based care and workforce solutions aimed at seniors, individuals with disabilities and those facing behavioral health challenges. The company’s operations encompass a broad spectrum of services, including personal care, skilled nursing, therapy, habilitation and supported living, as well as specialized behavioral health programs delivered through both clinical and non-clinical channels.
Through its network of subsidiary brands, BrightSpring offers integrated care in the patient’s home environment, fostering independence and improving quality of life.
