All right, we'll go ahead and get started. I'm Richard Close, covering Digital and Tech-Enabled Health Services here at Canaccord. Thank you for joining the conference. Excited to have AdaptHealth here. A lot going on in the business, to say the least. From the company, we have Suzanne Foster, CEO, Jason Clemens, CFO, also Luke Montgomery of IR here as well. Thank you for joining us. Obviously, a lot going on, so glad to have you here. You reported last week, so it's probably worth it just go over last week's results. What the main takeaway is there. Obviously, some volatility, so maybe what investors are missing or some of the points that came up would be great. Great. Well, thanks for having us, and thanks for the opportunity. I think to understand Q2 results, I'd like to just take a minute to talk about, give some context to anyone who's new to the story around what we've set out a couple years to accomplish. I won't go in too much detail, but I think it's important to understand where we are in our journey. AdaptHealth, a couple years ago, I came into the role, and at the time, what we found was we were a company that was made up of over 150 acquisitions, small acquisitions that came together. Company was founded about a decade ago in a time when durable medical equipment and home medical equipment were going through one of the first consolidation times. The government had come in, putting a competitive bid. The industry was made up of a lot of mom and pops. Adapt saw an opportunity back then to consolidate and bring these companies together because they figured size and scale mattered. You fast-forward to a couple years ago, the acquisition strategy had been very successful. We had become the number one in terms of size and scale, but a lot of the integration work, the workflows, the inner operations of the business, really we were still operating not as one big company, but as a bunch of little parts. We've been on this journey to integrate that and establish more standard work in a market where we saw that there was tremendous growth. We had set out two years ago to say the first thing we need to do is drive organic growth. We had stalled in our growth, really from a capacity perspective. Without that standard work, we couldn't quite drive the capacity we needed. We also had, through that acquisition strategy, acquired a lot of technology or product portfolio that was sub-scale. We had to pay down debt. That was kind of the key mission we were on. Over the last two years, what we did is we immediately set out on a product portfolio rationalization, which has really came to a conclusion in Q2. In Q2, we announced the sale of our diabetes business, for reasons I can go into later. Our e-commerce business we spun out. We exited some of our supplies drop-ship business that is subject to future competitive bid. That followed a series of dispositions over the last two years, all with the intention of focusing the business on sleep, respiratory, and supporting home medical equipment. That strategy is because we believe the sleep market is enjoying a very good time right now. Sleep awareness, all of the GLP, the wearables, it's driving awareness, and that market is growing, evidenced by our growth of 15% this last quarter. We're breaking records in terms of referrals coming in. Then respiratory, the same thing. That is a steady business growing with the population, so we have very strong clinical value propositions in those two segments. Q2, if I summarize, we had a lot of moving parts in terms of the portfolio, completing that portfolio rationalization I just talked about, but there were two isolated situations that we're working through. The base business is performing well, 16% growth at top, across the board, 10% coming from our new West Coast expansion and a contract with a big IDN out there, an integrated delivery network, and over 5% coming from the base business. The two issues that we're wrestling with was, one, we finished our first full quarter of taking on the new capitated contract. We're responsible for 13 million of their members, and we onboarded all of that into 40 new locations, new people, new sites, and there was just things in our assumptions a couple quarters ago that didn't go the way we thought they would. We have experience in capitated, but there was things that we just missed in the first two quarters of how that onboarding would happen. So we're working through that to get that profitable and stabilized. The second issue we had is we announced that we had a supplier/manufacturer situation where on June 30, we couldn't reach, or we didn't have the opportunity to reach the right terms. Given the timing of earnings call, we had to announce the risk we saw if we couldn't reach the right outcome in terms of a rebate volume structure. Those were the two things we highlighted. That really, I think, is the summary of Q2. You hit on a lot of the stuff I was going to ask. Okay. But let's hit the diabetes first, because we sat down in early June and talked about where the business was and/or is, and where our position in it. It wasn't, I guess, too surprising to see something happen with the diabetes maybe sooner rather than later. It came sooner rather than later from that standpoint. But talk a little bit about the decision to get out of diabetes. Obviously, a lot of change has happened in that product category over the last handful of years. But you stabilized it, consolidated the resupply to Nashville, and saw some improvement there. So why, ultimately, was this the right time to sell that business? Sure. So our business, we report in four segments. There's about $600 million that sit in a diabetes business. And a couple of years ago, again, just the context here was we weren't sure there was a strategic fit with the rest of the portfolio for diabetes specifically. But we said to everybody, "We need to first fix this business." It was declining growth. It was in a lot of trouble. And we couldn't tell immediately if it was our execution or if it was industry dynamics. So what we said to everybody is, "First, we're going to get in there and figure that out, stabilize it, before we can even sell it." And sure enough, it was a combination. What was going on in the diabetes business is there was a shift to pharmacy, not medical benefit, so the big shift there. The second thing that was happening later was that there was a competitive bid that came. Those two things were happening. But I said at the time, I don't think those were the things that were ultimately driving our results. Performance was a real issue. And if you listened historically, we talked about what we did to fix it, and I said, "Let us stabilize it. Let us fix it. We know how to do it. And then we'll make the strategic decision of whether it fits into our portfolio." So about six months ago, maybe a year ago, we realized the cross-sell opportunities, the hypothesis that originally existed when the prior regime bought diabetes in, brought it in, didn't hold true. So as the competitive bid became a true fact that it was, when the government came out and said, "Yeah, there is going to be competitive bid for this," we thought, we're not the right owners for this, for two reasons. Because you have a warehouse distribution, so there's some margin that's taken out there. We'd have to invest in a pharmacy channel, a real one, in order to win. And the other markets we serve, sleep and respiratory, are much more attractive. So for us to take a dollar and put it towards building the capability that we would need to make diabetes profitable and successful just did not make sense with our debt profile and use of capital. So opportunistically, we started conversations with a buyer who has all that. They are the perfect owner for this asset. Cardinal Health's buying it. I used to work there. I know this. They have a warehouse system that's dedicated to their at home. Perfect. Very scalable. They have a pharmacy channel. They had just purchased Advanced Diabetes Supply. They're buying into this market. The remote item delivery for competitive bid is going to really shrink this to a couple of key players. They are perfect to win in this market. It was essentially a win-win in our opinion, where it allowed us to exit it, put it where it belongs, allow us to take our capital and our attention and our focus by simplifying the business, and use that to pay down debt and to also put all the extra dollars we have in growing our sleep and respiratory business. Okay. That's helpful. With that transaction, there's some impact with respect to guidance, and you called out $60 million in overhead costs that remain with the go forward business. Can you talk a little bit about that $60 million? There's some coming out over a period of time. What about the remaining? Can you get that out? Real quick on that. I don't need context there. $60 million's staying with continuing ops, and we think half of that will come out within the first year. Think about this. There are things that are staying with the business that we will not need after we transact. We think fairly shortly after closing the deal, we'll be able to work on getting a majority of that out. We've said over the course of the year, we'll get half of that out, and the other half we'll get out through growth and tuck-in M&A in our sleep and respiratory core in that second year. Okay. Just to dive deeper into the capitation. It's relatively new to the area, or the industry over the last handful of years. You've had success with Humana. You get this great contract with a large West Coast. Can you talk a little bit about confidence in capitation agreements going forward, and then how you're thinking about what has happened initially with this onboarding? It's the biggest ever, right? Yeah. How confident are you with that book of business going forward? When it comes to capitation, I believe, been in healthcare my whole career, that an alignment of interest is what you are trying to drive in healthcare. When you compare a capitated model to a fee-for-service model, just in the spirit of the administrative cost, the investment, the ease of doing business, the eventual cost per transaction of patient is much better under a capitated model. That is proven out, particularly with our Humana relationship. If you were around the story back then, there was a blip when we brought that on. That was a big deal. We went through a blip. We thought we solved for all those problems in our new one, but there were other problems that I will come back to. Stepping back, what capitation does for our business is it smooths out the transition from that patient, from the prescriber to us. It allows us not to need salespeople around that business because it is an exclusive relationship. It allows us to go in, secure that volume of patients, and then get what we call the halo effect. Imagine you are a referring provider in a location and 2 of the 5 or 3 of the 5 main insurers that you prescribe for, you have to use AdaptHealth. You just by habit start saying, "I will use AdaptHealth." That is what we call the halo effect, and we have seen that happen. Then specifically to our West Coast, we were very concentrated in the East Coast, Midwest, East Coast company. We had a very little footprint in the Californias or even Washington. When this opportunity came up to service this IDN with 13 million members, we knew that we had to put in the infrastructure. They were leaving a company they were with for 21 years, and they wanted to come over to us. We committed to building the infrastructure, but the other reason they wanted to come over is because they wanted better service, and they wanted our technology. We can come back to technology later, but we believe we are leading the industry in the ability to have a digital engagement with a patient and the way that we receive the referrals from our hospital customers, and that was the value prop. We went into this with the investment to stand up 40 new locations. Hundreds, if not thousands of vans, our fleet. Thousands of new people with this new partner. Even the best planning, there were things that the partner did not even know. They had been in such a long-term relationship that they were not even sure how their hospital systems were operating. I have explained it as there is really two things going forward. One is the utilization data. We are coming to terms with them on what is the true baseline and how do we make sure that some of the startup utilization we share in that. We are having discussions so that we can get to a straight utilization that these are based on. The second thing is the way it is ordered. Even though they have a national footprint in the West Coast, they own hospitals, and their ordering patterns in their hospitals is just stat or urgent, regardless if that patient needs it immediately. In the first quarter of servicing this business, we responded, and we went to the Nth degree to make sure that our service levels were top-notch. That came with a cost, even though the patient may not have needed it. Now what we are doing with our partner is realizing how we scale that back. Things like drop ship, the use of technology, what can be ordered urgent and what cannot be ordered urgent. That is why I am very confident we are going to fix the cost basis in this. The last piece of that West Coast expansion is the assumption always was that once we get in there and these 40 locations can be used to service just that customer, and it is stabilized, that we would then be able to go in and get the fee-for-service business in the rest of that geography, and we have not been able to do that right now. It is not a lever we can pull because the government has what is called a DME moratorium. You cannot get a Medicare provider number right now. That is expected to hopefully, there will be news out in August around whether that expires or continues. We are hoping it expires because we believe the government realized that goes against their competitive bid strategy. If that happens, we can start now adding salespeople to bring in additional business into that. We did not need that for the outlook of that deal, but that will be. We are ready to take on new business on that footprint, and that will be incremental growth. Because remember, we believe this is durable growth out there, and we have been driving it through thinking that we could build on that footprint. Good. You covered a couple of my questions there that I had, and the halo effect is real. We have seen it with other companies we have covered have been on the wrong side of that, so looking forward to that. Jason, maybe on CapEx, to stand up this contract has been pretty significant in terms of the increase in CapEx in the first half of this year. Some of that is, I guess, one time maybe. Can you talk about what you think right CapEx is for this business on a go-forward basis? Sure. For continuing operations, we think just a touch above 13%. So, between 13% and 14% of total revenue is the right way to think about CapEx on the go-forward business. I would say about 90% of that, given the quarter, is patient equipment CapEx. Then finally, particularly in Q2, there was considerable CapEx non-patient equipment, about $25 million. Mostly vehicles, but also the build-out of warehouses, so some leasehold improvement, racks and stacks, and those kind of things that are capitalized. But going forward, we believe this is a 13% to 14% of revenue CapEx business. Okay. Perfect. Let's talk about some of the-- We've covered some of the problems, but what's going right in your business? You talked about sleep, respiratory study. What's making the sleep market so good at the current moment? You also did a JV recently, so I want you to talk a little bit about that and what the opportunity is. But just on the sleep, where can we go from here? We like this market a lot. What we're seeing is that, and, hey, listen, you can also listen to ResMed's earnings. That really talks about it. I think they've done a really good job in terms of the clinical value of the product. So it always starts with the value proposition of the product, which I think is tremendous. Now with this rise in wearables and GLPs, there's hope for people with sleep disorders. They're coming in and saying, "Okay, it's a multi-prong approach. I don't just have to wear a CPAP, but I can also go on GLPs that help me feel better, and now I'm sleeping better," and it's this cycle. Wearables are alerting people that, wow, maybe I have it, and I didn't even realize I wasn't sleeping that well. Those trends seem to be real, and we're seeing that in record referrals coming our way. What we're trying to do is, the way our business works is that the manufacturers are out there with sales forces pitching why use their particular product. Right? So you'll have the React and ResMed and maybe eventually Philips or even Fisher & Paykel. They're out there saying, "Use our product, doctor." Our sales force goes in and says, "When you decide, then service that business through us. We're the ones that will source the product, we will bill the insurance, and we will get the product to the patient." We're trying to make that as quick and easy as possible for the patient, because a lot of time, traditionally, a patient would go in and have to have a sleep study within a sleep center. They'd have to wait months right now to get that. What's also happening is there is this introduction of home diagnostic testing, where literally you can take a test at home and you can have a CPAP sometimes within a week. That's changed the market tremendously because the steps that were required even a year ago were long and onerous. After you took the sleep study, you'd have to wait for the result. You see the doctor again, then we'd have to get ahold of you, play phone tag. You'd have to come in to a setting and be taught how to use it. All of that has changed. With home diagnostic testing, virtual setups, and what I talked about on the earnings call, this introduction of AI face mask fitting, you can do everything from your home now and be on therapy within days. We're trying to drive that streamlining of making it easier for patients to get on. Then once they're on, we've built that digital engagement where you don't have to wait for a call from us to reorder every quarter. You can immediately now through our myAPP, my Adapt Patient Portal. I know for other industries, it seems weird that we're just getting an app, but yes. You can go right on and order whatever it is you want. You can chat. You can ask clinical questions. Streamlining that, I think is also driving adoption and adherence at a level that we've never seen before. Can you talk a little bit about the progress with the technology in the myAPP in terms of the adoption? Sure. We set out about a year, a little over a year ago to say we need to really strengthen this relationship directly with the patient. We came out with myAPP, and each feature comes out literally monthly. We're coming out with new features. The latest one, like I said, we're connecting into things like AI mask fitting that allows patient. Oh, well, I talked about that already, that allows for completion from, hey, do I have OSA? They'll get the app right at the time before they're even a patient. We're building out that to say, first of all, you can decide whether or not you even have it, all the way through billing and resupply. That's all technology that we've built into myAPP. Hmm. All right. Should we think about customer acquisition costs or marketing and advertising? Is it- No, because what we're doing is our sales reps now go out with a card that has a QR code on it, and essentially they're leaving in the doctor's offices. The doctors love it. Because at the time they say, "Hey, Richard, I'm going to prescribe you this. Scan this QR code," and from that moment forward, you're already in touch with us. We're taking that workload off of the patient, I mean, off of the doctor. They're handing these out. They have little things in their offices. We are also partnering with home diagnostic testing companies- Yeah that says, "Here, you can go be referred here. You're essentially bypassing in-person sleep clinic to some extent? We're giving that option because severe cases- There's way too much demand There's a long wait. Yeah. We're trying to other ways to get people diagnosed early. We are investing in that through myAPP. There isn't a customer acquisition cost. It's just educating the doctor that it exists. Mm-hmm. We have a minute left. We should talk about capital allocation. You mentioned on the diabetes, using that proceeds to pay down debt. Can you just give us some thoughts in terms of going forward, what your capital allocation strategies- Super easy. Yep, super easy. First, it's continued organic growth. The volume is out there. The market is out there. We're going to continue to invest in our sleep and respiratory and where it makes sense in our home medical equipment to support those two markets. The second one is pay down debt. We've committed to two and half times. We're going to hit that. Then the last one is any tuck-in M&A in the sleep and respiratory space focused on either geographies that we need or proximity to geographies that we already secure. Good. Well, I think we're about out of time. Thank you. Obviously, a lot going on, so I appreciate you guys being here. A lot of positive things going on as well. So thank you. Thank you, Richard. Thank you, everybody.
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