Good morning, and welcome to the second day of the Jefferies 2024 Global Healthcare Conference. I'm Brian Tanquilut, Healthcare Services Analyst here at Jefferies. And with us this morning is BrightSpring Health Services. And joining us this morning is Jon Rousseau, the company's CEO. Jon, thanks for doing this. Maybe let's start if you can do just a State of the Union for BrightSpring. Yeah, thanks, Brian. Good morning, everybody. You know, at BrightSpring, we're really continuing to drive broad-based growth in the organization, with our position serving very large markets, a very high need and demand in seniors and in specialty populations, and that's really been a hallmark of the organization here for the last seven years, continuing to drive not only double-digit growth, but broad-based growth across all of our service lines. You know, we're also really with that volume growth and scale, leveraging, a lot of our platform for efficiencies and best practices throughout the business. So, you know, more recently, while we've seen, you know, really exceptional growth in our Specialty Pharmacy business, there's really almost all the businesses are growing at double digits in the organization today, again, as we focus on these big populations with really high-quality service offerings. Jon, maybe just a little bit of a background because, you know, you've only been public for, what, five months, roughly? So just for the folks in the room or on the webcast who are not very familiar with your business, maybe if you can just go through your business lines and sort of, you know, what kind of growth rates and margins are we thinking about across the different business segments to level set the discussion. Yeah. Thanks, Brian. You know, again, at BrightSpring, we deliver really three pillars of services: Pharmacy Services, Provider Services, and we're building out Home-based primary care. Those are very complementary. Again, we're delivering these services to very large markets that total about $1 trillion in market size, and they're all growing at attractive rates, just given the need for these populations. We really focus on quality in our organization across the board. We have a plethora of quality metrics from third parties in every one of our businesses that demonstrates our leading quality, and we really focus on sales and marketing as well to penetrate these markets with our high-quality solutions that dramatically reduce costs for the healthcare system. If you start with that first pillar of pharmacy, we really do three things. We do Specialty Pharmacy in oncology and rare and orphan and neuro. We're one of the two biggest independent pharmacies in the U.S. in that space, really focusing on oncology, which is the biggest part and highest growth market within Specialty. In addition to that, we do home infusion and in-clinic infusion, and then we also provide Home and Community Pharmacy. I would say the oncology market is growing at the fastest rate, you know, well into the double digits, the mid-teens. We are outpacing that growth rate by two or threefold at this point in time, given our quality and our sales force. On the Infusion side, depending on the therapeutic category, that's about an 8% to 9% growth market on average. You know, we see ourselves growing at more than that into the mid-teens again, historically and into the future. Home and Community Pharmacy, so that is, that is really not retail, so this is closed-door pharmacy. We go to the customer and to the patient wherever they are, whether that's a senior living community, somebody at home on home health or hospice, a hospital, behavioral companies, skilled nursing facilities, we go to the customer and to the patient. That's an industry that historically grows at about 4% to 6%, and here, more recently, last year, we were about at double digits, at about 9% to 10%. Through Q1, we were at 14% growth in home and community. You know, those are very attractive pharmacy markets overall, defined by going to the patient, serving patients with very different acute needs, and where really scale is paramount. On the provider side of our company, we segment into home health, hospice, and primary care. You know, those are 6% to 8% growth markets, depending. And then on the behavioral side of our business, we have a community living business serving behavioral populations in their homes. That's a market that's more of a steady Medicaid payer market at about 3% to 4% growth. And then we have a really attractive rehab business, also focusing on behavioral neuro populations, very highly skilled neuro, growing well into the double digits as well. So again, back to my earlier point, you know, broad-based growth and double-digit growth is really a hallmark across numerous of our pharmacy and provider businesses. Again, all characterized by very high-need populations, where our high-quality services really drive a tremendous ROI for people. No, that's very compelling, Jon. So maybe as I think about, you know, tying that growth view back to your current- year performance, you beat expectations for Q1, adjusted full- year guidance as well. Maybe you can just walk us through what worked in the quarter and what drove that guidance adjustment, as well as your philosophy and guidance setting as a whole. Yeah. Thanks, Brian. Q1 was a good quarter year-over-year. I think as an organization, we grew revenue at about 27%. We had very strong EBITDA growth as well, year-over-year, into the double digits. You know, it was broad-based growth again. You know, certainly, Specialty Pharmacy was our fastest-growing business, you know, into the mid-30% range. But Home and Community Pharmacy grew 14% in the quarter, and then on the Provider side, we had nice top-line revenue growth of about 7% to 8%, but we also saw a nice margin performance in the business based on our focus on operational execution, and, and efficiencies as well. So, you know, I think Q1 was a really good example of what we've seen for seven years, where we've demonstrated about a 14% CAGR over that period of time on both revenue and EBITDA, where we saw complementary contributions across the portfolio from the businesses, and it all comes together in a really nice way like it has for really the last seven years, for a long period of time. Jon, you're putting up really big growth numbers in Infusion and Specialty Pharmacy. So just curious what you would attribute that growth rate to and what your outlook is. I know you gave a little bit of color there, but what are the drivers of that growth? And maybe we can touch on LDDs as well, since obviously that's a core topic for that space. Sure, sure. You know, again, for the whole company this year, adjusted for that quality incentive payment that we've mentioned before, you know, we estimate to grow at 9% to 12% from an EBITDA perspective. I think for a company of our size, you know, i.e., over $500 million of EBITDA, that has put us in some pretty rarefied air of maybe one other company growing at that sort of rate over the last 15 years or so. So we're gonna continue to focus on doing that, you know, through our quality, through our operational excellence, and through our focus on sales and marketing. You know, Specialty Pharmacy is, has been a nice, growth driver for us. You know, really our focus there again is on the oncology market. I think that's about 40% of the overall Specialty Pharmacy industry, growing at about 15%. You know, again, we've been able to grow that business at 2x to 3x the industry average, really through our quality. We have a 93 Net Promoter Score in that business from patients and from referral sources, just outstanding quality. That allows us to have tremendous relationships with biopharma and manufacturers who are bringing new drugs to market. They do so in limited drug distribution networks, where only some pharmacies are in that network that are able to distribute the drug. We have been able to win a lot of these LDDs, Limited Distribution Drugs, because of our quality and our relationships with manufacturers, and the focus on the patient. As you can imagine, oncology patients, you know, these are life-saving, life-sustaining drugs. They care deeply about white glove service and adherence and longevity for their patients, so they're very careful about the pharmacies they wanna work with. Our ability to continue to win these limited distribution drugs has really helped to fuel our growth. We have 117 limited distribution drugs today. We expect to win about 18 more in the next 16 months, and then we have a large commercial sales force that is out there working with families and doctors every day to pull through those referrals. So high quality leads to great relationships upstream with biopharma to win access to these drugs, and then we have a large sales force that's continuing to pull it through. You know, we see continued momentum in the business. There is a huge pipeline of oncology drugs at the FDA. It's never been larger. In particular, the drugs that we launched last year are ramping as fast as we've ever seen. That was one of the contributors to the outsized performance, even above our own expectations in Q1. But we like our franchise position in oncology that's been built over the last decade. Jon, how are you thinking about biosimilars and how that affects your business, positive or negative? Yeah, we don't really see any material impact from biosimilars. We see a positive impact from generics. We really focus not only on new brands that are launching to market in these limited networks, but we also focus on high-value generics. There's been several of those brand-to-generic conversions over the past few years that have been helpful to the organization, and there's about 11 big brands that are going generic over the next 5 or 6 years, and we view those as significant tailwinds for the business as well. You know, generics are obviously good for everybody. Maybe shifting gears a little bit, let's focus on your—o h. They're on our presentation. If you go to our company IR website and look at the deck we've posted, I think it's slide 11, and we show what those are. Awesome. But some examples of those would be Imbruvica, Pomalyst, and Xtandi, Ibrance. Yeah. So as we think about maybe tying to that generic question, right? Is that primarily on your specialty side or is that on the institutional pharmacy side where it benefits you? So as an organization, you know, I think one of the things we do as a Home and Community Pharmacy, again, it's just very different from retail, where we go to people and deal with very specialized populations. You know, we drive generic utilization across the board, and what we do as a pharmacy is drive patient adherence and cost containment in the industry. So, you know, we really view ourselves as the good guys in the value chain, making sure people get their drugs in a very customized way when they have different needs and really try to drive cost containment for everybody in the system. On the Home and Community side of our business, generics are about 90% of our volume. I would say on specialty, it's probably about 60% to 70% of our volume. Infusion is more of a brand market. That makes sense. Maybe, Jon, one of the questions we get asked is, as you know, I, I think a lot of investors know the legacy institutional pharmacy or Home and Community Pharmacy that you guys operate. How is that differentiated from the larger competitor in the, in the market, and why are you or how are you growing faster than, than the competitor? So again, in Home and Community Pharmacy, just to make sure everybody understands what that is, we are going to the customer and to the patient every day. You know, we often have to be there within 3 hours. We can be anywhere to any door in the United States with our pharmacy network within 3 hours. You know, that and our scale are serious competitive advantages and barriers to entry. You really cannot compete in pharmacy without massive scale and in Home and Community Pharmacy and in Infusion without a very fast local presence. So that is what we have focused on building out over the last 20 years in that business. Again, our customer base, you know, is across a myriad of different people and settings in the community: assisted living, skilled nursing— Hospitals, people in their home on hospice, home health, behavioral population, drug treatment centers. There are just a myriad of places every day where people need their medication therapies, and that's where we are for them. You know, we have really focused on diversifying that business into all of the attractive channels out there. You know, senior living, behavioral, hospice pharmacy. You know, these are areas where we have leveraged our scale and all of our purchasing capabilities and our operational synergies to really enter into and try to further penetrate all of the attractive channels within the Home and Community Pharmacy segment. And then on top of that, that quality and leveraging our scale, Brian, we've really focused on sales and marketing and really trying to get to as many customers as we can, to contract with them, and really articulate our strong value proposition. That's resulted in us being able to grow that business, you know, at volume rates that have been really strong over the last year in particular. And in Q1, again, that business grew at about 14%. So we have very, very high quality with our service levels and Net Promoter Score, and our ability to leverage our scale and our platform into attractive markets has made us more diverse than others. And then we really are more aggressive, I think, from a sales and marketing perspective. Jon, maybe to follow up to that point, right? You've seen strength across all your business lines. You're gaining market share. Maybe I'll shift to the Infusion side of the business. You know, what is the competitive environment like today in infusion, and how are you winning share? Yeah, you know, infusion is a market that, that we, that we really like for the long term. Obviously, you've got, you know, you've got a, a larger competitor and, and player there who's done a really nice job. You know, after, after them, there's about five or six companies that we would fall into with, call it, 5% or, or so market share. You know, we think, you know, between new therapies coming to market, some of the existing therapies in, in certain categories, you know, there's an interesting opportunity in infusion over the long term, whether it's in the home or, or whether it's in clinics. You know, that's a market on the acute side that's gonna grow more at 3% to 5%, and depending on the therapeutic category, on the specialty chronic side, you know, that'll grow, you know, 8% to 15%, again, depending on the therapeutic category. You know, we're going through a real operational focus this year in our own business, trying to centralize some functions and to try to really streamline the intake process for patients. Everything in infusion is about service levels and speed, and that's what we're really focused on. But longer term, we're excited to continue to make commercial investments in the sales side of that business and, really try to grow our market share in the industry, over time. Gotcha. So maybe shifting gears to a question that we've been asked since the IPO or pre-IPO processes. You have different assets within the company, all are showing strength, but how do you synergize them? Or why, why does it make sense to all own all these assets today? Yeah. Thanks, Brian. We get a lot of benefits from our combined enterprise and organization today, that I think is the very reason we've been able to grow at our growth rates for the last seven years in a pretty different way. You know, number one, just from an efficiency perspective, we have a lot of advantages in our procurement. Given the scale of our organization, we're able to invest in automation, we're able to leverage OpEx and IT to be more efficient from a cost perspective. You know, really, third, we drive best practices across the organization. You know, whether that's in quality and compliance, whether that's in HR, whether that's in sales and marketing, we really try to drive excellence in those functions down through the service lines, hopefully in a way that smaller local competitors just aren't able to do or don't have the expertise that we're able to leverage, you know, in our functions in the organization. You know, also, we've been able to really drive a lot of acquisition synergies. You know, our growth historically has been three things: volume growth, efficiencies, and then accretive acquisitions. And so our platform, in addition to leveraging efficiencies and contracting and best practices, you know, we've been able to really drive very attractive pro forma EBITDA multiples in our acquisitions by leveraging that scale as well. Then you look at the volume and the quality and the revenue side, most of our patients that we serve on the provider side of our business, in hospice, in behavioral services, they all receive their pharmacy from us. So, you know, that's a material volume and revenue synergy for the organization. You know, a really good example of that, you know, in terms of it being the best thing for the patient, I think last November, there was a JAMDA study. You can just look up JAMDA Continue CareRx. We were published in a study that showed patients receiving both our home health and our in-home medication management program, which is called Continue CareRx, had a 73% reduction in hospitalization. I mean, that is just profound. We've never seen anything like that, and I think it's a really good example of a clinical synergy when you're addressing both the provider side, in this case with home health, with the in-home medication management side as well. Because, you know, lack of appropriate med management and adherence is one of the top two reasons why people go to the hospital. So, you know, we really continue to focus on multiple services for our patients. Every single one of the complex seniors and specialty populations that we serve has a need for multiple services. So if we have the ability to better coordinate and provide those services, that's an advantage for them, and it's obviously a scale advantage for us. As we look forward, we're leaning into bundled services for our customers, like hospitals and senior living communities and skilled nursing facilities. They want one provider who can provide these multiple services. And then as we build out home-based primary care, I think that's ultimately a much, much bigger opportunity. You know, why are we building out this third leg of home-based primary care along with pharmacy and provider? We have access to about 400,000 patients a year internally through our pharmacy business and our home health. That is a huge amount of patients that we can hopefully move under our home-based primary care and serve in a much better way. And then home-based primary care is the holder of the pen, you know, moving up the value stream within healthcare, you know, coordinating patient services better across all of our service lines. Ultimately, if we can manage those patients in an ACO or a payer model with more attractive economics, where we're able to realize all of the savings we drive in the system, you know, that's the ultimate goal for that third leg of home-based primary care, and that's what we're building towards. And, you know, we have a lot of milestones in that area, even in the last year and here recently. Jon, since you alluded to M&A in that last comment, one of the things that we've noticed is that you guys have been delivering on the promise of, you know, doing tuck-in deals pretty consistently. So just curious how you view the M&A strategy and what the pipeline looks like for deals. Yeah, very, very consistent strategy with everything we've executed on over the last 7 years. We operate in huge markets that remain extremely fragmented. You know, you could continue to do tuck-in acquisitions for the next decade. Our track record is about 60 acquisitions in the last 5 years, but importantly, these just really complement our 9% to 10% historical organic growth rate, and these are largely characterized as tuck-ins. Our median EBITDA multiple over the last 5 years on those deals is about 4x. So we're really able to drive growth by bringing our operational prowess to bear when we acquire these acquisitions, and then, as mentioned before, we're able to leverage our acquisition synergies as well. So these are highly accretive acquisitions that have historically largely been characterized by tuck-ins across the board, and given the markets we operate in, there remains a huge opportunity as the largest healthcare services provider in the U.S., outside of the payers and the big hospital systems today, to really continue to augment our organic growth with highly accretive tuck-ins. We've done four of those year-to-date. Our growth in Q1 and last year was almost all organic. You know, we expect to see a little bit of impact from these acquisitions as we go through the rest of the year, favorable to our EBITDA. But it's an area that we've really developed a proficiency in. Most of our transactions are proprietary, given our relationships and markets, and we integrate these acquisitions within either the first day on the contracts or typically within 30 days and very consistent operations within our organization. It is a one company approach, where they are integrated extremely quickly. Now, thanks for that, Jon. Then maybe shifting gears to margins, recognizing that you have different business lines that have different margin profiles, but I know that you've set a margin goal in the past for the company to get to roughly 6%. So maybe if we can walk through what it would take and what are the levers that you need to pull to get to that target? Yeah, thanks, Brian. You know, we really focus as much as we can internally in the organization on gross profit dollar growth and EBITDA dollar growth. You know, at the same time, we're obviously cognizant to margin, you know, as that drives EBITDA dollar growth. We had very strong EBITDA growth in Q1, consistent with our last seven years and long-term track record. Outside of our Specialty Pharmacy business, our EBITDA margin year-over-year in Q1 increased. You know, any change in our EBITDA margin has purely been due to change in mix in the organization as our Specialty Pharmacy business has continued to grow, given its explosive growth rates. But I think continued growth on the Provider side, continued growth in Infusion and Home and Community Pharmacy, and then a continued focus on operational initiatives. At any point in time, you know, we literally have about 20 different operational initiatives going within the organization. Those will continue to be a nice tailwind for us this year as we seek to be more and more efficient and leverage our scale and automate over time. I think home-based primary care and accretive acquisitions, as we continue to execute on those strategies, will be additive to the margin in the future as well. John, we've got two minutes left, so maybe just to close, I'm curious what you think investors need to think about as it relates to the BrightSpring.