Thanks for joining us everyone. My pleasure to have AdaptHealth with us this afternoon. Jason Clemens, CFO, Luke Montgomery's in the audience. Jason, let's see where to start. I think you described this year as a transition year. There's been a lot of investments in the organization to streamline operations. I think, you guys like to say we're getting the trains running on time, a lot of focus on technology and automation. Maybe just frame some of the things that you guys are doing, how you feel like you're progressing against those investments, so we can just kinda start there. Sure. Sure. Be happy to. Thanks for having us, Whit. In terms of that transitional year in 2025 you referenced, a couple of key things that we were able to accomplish. I'd say first and foremost was really decoupling the sales force- Yep ... from operations and turning into a really core commercial organization. There were different things operationally that we did there. The commissions program was installed. There's been some fine-tuning to that for 2026, that was really impressive to see the team pull off that implementation. I've been around some commissions launches that have not gone so well over the years, this one went off without a hitch. That was a big deal for us. I'd say secondly, within operations, you know, we've really standardized the operating system or the operating model at AdaptHealth. You know, each region now has the same dedicated infrastructure that starts on the front end and through intake, document intake. That's getting more and more technology is getting deployed there. The first step is really to get work done in the same manner in every region across the country. Certainly core operations, patient setup, and then the deliveries that we do 40,000 of every day to our patients' homes. That was a big deal in terms of transition and getting ready for some of the technology that Suzanne's talked about on our earnings calls and where we're heading with that for next year. Then finally, we ended the year with significant pull forward of investment and infrastructure from employees to vehicles to locations and outfitting and patient equipment to support the new agreement with Kaiser Permanente, which is a capitated contract, to serve over 12 million members as the exclusive DME provider for the health system. We're framing 2025 really as a year of transition and investment. 2026 as noted in our guidance is really all about growth. You've done a lot on the distribution side and, you know, the location in Asheville you referenced. Do you have any numbers around like order to set up, kinda where we are with the sleep business today? Sure. Sure. We had reported in Q1 of 2025, I guess it was now a year ago, that we had slipped in a couple of markets in terms of time to set up. The average in the industry runs about 17-18 days from the point of the patient is scripted by the physician, and an order is then downstream placed with a DME provider. There's a lot that needs to happen in between, typically prior authorization, verification of insurance, and then ultimately, contacting the patient, scheduling the patient for either a live or virtual setup. We exited 2025, at nine days to set up. That was an extraordinary amount of work, but also technology. I mean, some of the AI chatbots, that Suzanne's referenced, you know, they are now reaching into our capacity models, so for each of our 640 locations to understand the schedule. You know, we offer single person setups as well as group setups. Many states require a respiratory therapist to physically set that patient up on the CPAP and, you know, get the settings right, get them fitted for mask and the related consumables. We also reinstated virtual setups. That's been a welcome change. We leveraged that capability in the pandemic, but frankly, weaned off of that after kinda operations got back to normal. I don't know about you or anyone in this room, but for me, I'd much prefer a virtual setup and somebody to send me my CPAP as opposed to having to schedule time to go see somebody to do it. Mm-hmm. That's been a welcome change, and that's also helped bring down those setup times. We're running at record setup times for the company. What's the mix of in-person versus virtual? It's still heavily in person, 90%. That 10% virtual, it is growing. You know, we are starting to market that capability through the patient leaving the physician's office. We have a placard with our QR code. It'll bring you into our app. You know, that's one thing to highlight. We're now over 300,000 patients are registered on the AdaptHealth myAPP. That really starts unlocking the ability to communicate with the patient, secure their reorders, schedule. All can be performed within the app and without the help of AdaptHealth employees. Of course, we're there if they need them. If the patient wants to speak to somebody. Ideally, I think for the patient and for the company, the app really opens up that capability of doing things electronically. How do you feel like you're progressing around resupply in general? In resupply in general, I'd say, you know, sleep resupply operations are as strong and consistent as they've ever been. We did ask that team to also take on diabetes resupply back in September 2024. They've done a great job with that. We actually set a new record in the fourth quarter of 2025 for the sequential refills and hitting retention records within the diabetes business. That's really the crown jewel of the company in many ways is the ability to resupply. We know that we're significantly better than the competition in the industry. The average DME company will resupply a patient about 2.1x - 2.2 x per year. For AdaptHealth, we're over 2.9 x a year that the technology knows exactly what the patient's eligible for when they're eligible for it through the managed care contract integrations. That goes through our workflows, mostly with humans, but also humanless touch to contact with the patient, ultimately secure the order and ultimately secure the sale to send them their next resupply order. I think this past quarter, you described the census growth as, you know, hitting record levels, for sleep and maybe respiratory as well. As well as DME. As well as DME. Really everywhere with the exception of CGM. Yeah. Aside from some of the things that you've already talked about, what are some of the other factors that you think are driving the demand side of the equation right now? As I said, you and I have talked about this a million times. Yeah. It's like, I see no reason why this business shouldn't be, you know, consistently a, you know, low to mid-single digit same store kind of volume grower over time in a, you know, reasonable industry backdrop. Yeah. As, as you said, we've discussed this many times. We agree. You know, we're also coming out of the some of the noise on the top line due to disposition activity that we started back in 2024 and kind of the stub period of that activity will end in the first half of 2026. We have hit record census in each of the core categories, sleep, respiratory, as well as DME. I mean, literally every key product with the exception of diabetes. Now, some of that is due to the sales reconfiguration that we talked about and incentivizing the sales team differently for more referrals. Some of that is through the operating model changes we made to increase the time to set up as well as to increase the conversion ratios of those referrals coming in. Some of this is frankly due to the landscape within DME. I mean, the various vectors that are continuously putting pressure to consolidate within the industry is absolutely working in our favor. You know, one of those vectors is our ability to cap to capitate business with large payers, which we demonstrated at scale first with Humana and now as the exclusive provider for Kaiser Permanente. We've got other cap payers as well, and we are continuing to work a pipeline. We've got people that focus on this all day, every day in terms of selling and pricing and running these models. Separately, you know, there is pressure from a regulatory front, out of CMS. You know, I think as a small player, as you're handling the regulatory requirements that have been increased, as well as just general inflation in the manufacturing environment, as a smaller player, it's just getting more and more challenging to compete with scaled players, particularly Adapt and our technology forward infrastructure. Finally, M&A. I mean, we did deploy a little over $40 million towards tuck in M&A in 2025. You know, this is all kind of pipeline and deal dependent, but that's probably a decent number to think about 2026. Of course, we don't guide any acquisition activity until or unless we're able to close deals. We do see certain pockets of the country where it would make sense, again, market conditions dependent, to continue that. Inside of the Medicare Advantage rule, born out of that was some, I guess, fraud that had, that they had identified within the DME sector. I think there's now a, I don't know, a moratorium or something on new provider numbers or whatever it's called. That's right. Yeah. Do you wanna talk about that for a minute and what you think I mean, I think that's kind of what... Sure. ...you're re-referencing. Yeah. I mean, it was, you know, this recent moratorium, it was announced as part of the kind of recent Dr. Oz campaign to identify fraud, waste, and abuse broadly across healthcare. Specifically within DME, the CMS had identified just over a billion-dollar scheme of a company shipping urology, like catheter type supplies to patients. Many of these patients didn't exist, many of these shipments never happened. That was a big headline that happened last year and has fueled the interest in the CMS putting a six-month moratorium on new licensing. Which from the AdaptHealth perspective, I mean, we've got our license and PTANs that have been stood up for a very, very long time. There is nuance in potential M&A activity that if you're a DME looking to acquire a target that has changed their majority ownership in the last three years during this moratorium, that's disallowed. The reality is most DMEs have been around much longer than that, at least ones that we would be looking to acquire. That is a nuance within the rule. Other than that, I mean, we're supportive. We think that anything that wrings out fraud, waste, and abuse in the industry is good as we continue to look towards consolidating, but also just professionalizing the overall industry. reminds me of the there was that 36-month change of control provision in home health years ago. That's right. Very similar. Very similar to that. Back to the portfolio. You've mentioned some of the divestiture activity. You'll lap that from a business comp standpoint. Are we largely done with some of the portfolio changes, some of the simplification initiatives that you had underway? Well, I don't know if we'll ever be done. That's it. Well, at least the chunkier ones. Sure. Yeah. Sure. I'd say that, Whit, to your point, there were a handful of business lines that we divested over the last two years. One was home infusion. A second one was a company called ActivStyle, which was essentially direct-to-consumer advertising for incontinence products. The third was Custom Rehab, which are essentially motorized, custom-built wheelchairs and accessories. Through the years, as we acquired DME businesses, we would acquire pieces and parts of these types of businesses in different parts of the country. They had all been run for us subscale. You know, and none of them were driving significant ancillary revenue into the core, which is really sleep and respiratory, as well as DME. That's how we assessed the portfolio at that time. We were identified buyers. You know, we were able to sell everything at or above our trading multiples. We felt great about the value creation and we used all those dollars to pay off more debt of the company. I'd say that today, you know, as we assess the portfolio, as well as the competitive bid environment, the regulatory environment, I mean, there could be opportunity here and there to trim the portfolio through further divestiture activity, but there's also opportunity to grow the portfolio. I mean, there are new products coming within sleep and respiratory in particular, you know, that we continue to assess the viability of the products and as we qualify them and they're paid for by CMS, I mean, we'll continue to bring those products forth. Okay. Forgot what I was gonna ask next. You just mentioned it, I've forgotten. Just talk about diabetes for a minute. Sure. Been a journey, and you guys have found your sea legs a little bit here. There's been kinda some shifts in payer mix towards government. How do you feel about the progress you're making and maybe stabilizing some of the payer mix shift that you've seen? Yeah. I think stabilizing is the right word. You know, our census, I'd start there, is now actually in a great spot. That's because of the resupply operations and those changes that I referenced that occurred at the end of 2024. As we identify new referral points and bringing more patients into the funnel, right? That's really where the payback is. It's in that resupply capability, and our team's doing a pretty good job there. Revenue's still not yet in 2025 growing again. It's because some of that payer mix pressure that you referenced. We don't anticipate large or fast moves in payer mix for diabetes in 2026. We do think that there will be modest shift to a more of a pharmacy reimbursement that we'll have to find more sales to make up for that shift in the DME channel. We are actively hiring new sales reps for our diabetes business to do that. Okay. We've talked about this pharmacy versus DME thing for a while. Do you feel like there's a point where the challenges are going to begin to stabilize, or is this just ongoing incremental pressure that you feel like you're gonna see each year? I'll answer the first part or the second part first. In that we do think that there will be continued pressure from the payers, particularly the ones that own large PBMs, to market to their patient populations to encourage them to move to a pharmacy benefit. We don't think that that landscape will change. To counter that, we have continued to invest in our pharmacy operations with the intent of our salespeople as they're selling into endocrinology practices as well as primary care practices. We really want the option to sell both. We wanna be the easy button for those referring providers, so they don't need to think about whether we're in network with this payer or that payer or pharmacy or not pharmacy. We wanna be able to offer everything. Pharmacy has grown as a percent of our diabetes revenue. Frankly, it's doubled in the last six quarters. It's now just under 10% of the diabetes revenue. We're putting a little more investment in the tech, basically the patient accounting platform, to get things more efficient and help protect that margin in the diabetes segment. I guess the last thing I'd say that, you know, 'cause we are putting a little bit of capital into that, I mean, the segment now represents less than 5% of our Adjusted EBITDA for the company. We think with Kaiser coming on, which excludes diabetes, the size of that business relative to the entire enterprise will likely continue to shrink over time, but at the end of the day, we intend to grow it just like the rest of our three segments. Is diabetes carved out of all of your capitated arrangements? Not all of them. It is carved out of Kaiser and Humana. We had announced a new cap agreement in the third quarter of last year that we are experimenting with capitating diabetes pumps as well as CGMs. I guess I'd say that so far so good. However, it's not even been six months with that contract. We're really focused in those utilization curves for CGM. We think they're gonna look differently than some of those very steady DME, sleep, respiratory DME utilization curves. Yep. Before we get ahead of ourselves and try to cap too much, we just wanna make sure we get a little time behind us and make sure that it's performing against model. How is Humana performing right now? Surprises, lessons learned? Anything you'd share? Well, I guess I'd say, surprises, I'd probably say, you know, somewhat anticipated, also somewhat pleasantly surprised at the membership growth with Humana in 2026. I mean, you know, as the exclusive DME partner for their HMO business in 33 states, that's a good thing for AdaptHealth. That's going just fine. We did extend into a multi-year contract with Humana a little under a year ago, that was evidence of the first two years went quite well. We signed a multi-year extension. You know, in terms of performing against the daily, weekly, monthly metrics that we provide to Humana, we're feeling very good, and we expect that to continue. In terms of lessons learned, I'd say the primary lesson learned is for patients that are potentially already in a cap arrangement. You know, Kaiser is a great example of that. You know, there's different ways to start those contracts and take care of those patients. One approach is to come in, contact the patient, the referring provider, get new scripts, get the paperwork refreshed, get a new product, schedule the time with the patient, enter the home, swap the equipment. I mean, operationally, just patient by patient, that's complicated. It's also expensive. As we saw on the back half of 2023, we had to absorb a considerable amount of cost to stand up Humana. Well, we're handling Kaiser differently. We reported in the earnings call, two weeks ago that we were successful in completing some acquisitions, not just in the fourth quarter in Hawaii being a new- Mm-hmm state with a brand-new DME. We had also bought out some equipment from a DME provider of equipment on patients. We were able to secure a second deal for about $47 million that we'd that we completed just before the earnings call to further secure start dates for the Kaiser implementation. I'd say that's really the key learning. You know, we're quite pleased so far with doing this differently and we're feeling pretty good about hitting our contract dates for Kaiser. Well, this room gets really nervous when they see Humana grow membership 25% in a year. Sure. How are you feeling about the amount of risk you're gonna be taking on- Sure ... this year with the year that they're gonna have? Sure. Well, you know, we're talking about Medicare population. The utilization of DME in the Medicare population is extraordinarily steady. Whether you're with Humana or you're with United or you're with any of these payers, there's not an outsized move in particular states that we have any concern at all on utilization. The ratios are the same. It's essentially just more patients that we're getting paid every month per member. The utilization of that membership is going to only be somewhere between 2% and 4% of the membership are actually actively using DME at any one time. The reason for that if you think even of your family or your neighbors or friends, how many of them today are utilizing a wheelchair or bed at home or an oxygen concentrator at home? I mean, it's likely your answer is zero or one or not a lot. A year ago, it was likely in that same ballpark, and a year from now, it's probably- Right ... going to be the same. It's just when you need these products, you absolutely need them. The utilization and the requirement for these products- Right ... it's a very slow-moving curve. Okay. We're naming it Kaiser now? Yeah. Okay. You've accelerated the transition, if we wanna call it that, in the fourth quarter. Yep. More revenue, more cost. What, what drove the desire to, you know, accelerate the implementation of that contract? Sure. You know, I wouldn't say that it was driven by the desire to stand up the infrastructure more quickly. It was really driven by our ability to do that. Most of this infrastructure are employees. You know, we have said that we needed 1,200 employees to support this new capitated arrangement. We've accomplished that. You know, so a tremendous amount of employees that we were able to bring onto the company, as well as the locations, the vehicles, and you know, as of the earnings call, we've also talked about the equipment. You know, our desire was to have everything ready a couple months in advance. Basically in a new site-It's outfitted, it's designed and outfitted. You've got employees at the ready. It's filled with patient equipment that gives you the ability to train new employees. Some might have been coming from other DME companies. We run our business very differently. It's very technology-enabled. There's certain workflows that have to be well understood and practiced in a test environment. We had a lot of hotel rooms in the state of California and in other areas filled for kind of temporary training centers. There was a lot that we were able to accomplish frankly, faster than we thought we could. If I try to think through the lens of the health insurer and the benefit of delegating the DME risk to you, is it more driven by being able to lower the medical expense per member per month? Or is it... No ...eliminating the simplifying it by having a narrower provider network and the administrative stuff, more the G&A per member per month? That's really where it's at Whit. Yeah. You know, imagine you're running a plan for a payer in the state of Florida. You will likely have hundreds of DME companies in that network. Most of them will be paid at varying rates, some higher than you'd like, some you're happy with. The performance of their DMEs, I mean, some will be very good, most will not. DME, even though it's a small dollar amount, it's a small monthly reimbursement per member, it can create an extraordinary percentage of complaints from the membership, that's because if oxygen doesn't show up on time, right, patients are very unhappy, physicians are very unhappy. Same with DME. If you're not getting patients discharged out of the hospital when the hospital wants to get the patient home securely and safely, right? Hospital systems are upset. It can create an extraordinary amount of noise, and rather than managing hundreds of operators using different metrics and different performance requirements, you move to one who's willing to offer you a very competitive reimbursement rate in exchange for a whole lot of volume at once. Administratively, that's a lot of words, I think, to say yes. That's really where the value is. Stars, I would imagine. Without question. Yeah. Sure. Just on the capitated, strategy... Yep ... what's the appropriate level of growth that you think you can onboard in any given year? Should we expect every year, 12, 18 months, we're gonna see, you know, another potential contract announced or, you know, what do you think? Future potential contracts announced without question, because we have an active pipeline. We work to sell and price these deals, you know, all day. Now, another contract of the order of magnitude of a Humana or a Kaiser, we'll see. I mean, I think until we were able to execute on Humana, you know, pulling off a transition with Kaiser was not in the cards because no one in the industry had proven the ability to transition that many patients all at once. And although there was some extra cost associated, the patient satisfaction was very good, as was the referring provider satisfaction. you know, our hope is these are long sales cycles, there's a whole lot of large hospital systems in the country, I can think of 12 offhand, that also, like Kaiser, also have an insurance product. How does this unlock certain hospital systems as they think about their DME utilization as well as what we can offer to the insurance side of things? We are continuing to pursue the model. We like the model a lot, and we're taking it a day at a time. All right. We got five seconds here, so why don't we just wind it down now? All right, man. Sounds great. Good seeing you. Thanks for coming. Thanks for having us. Good to see you guys.