Here. We have President and CEO Mike Alkire and Chief Administrative and Financial Officer Glenn Coleman. Thank you both for joining us. You know, I think the big focus for the past several weeks and months now has been the macro backdrop, what's going on there with tariffs, now the executive order on drug prices. There's a lot of focus on this presidential administration. Will they? Won't they with tariffs? Can you talk about what your healthcare provider members are currently experiencing as they think about all these uncertainties and really how Premier is positioned to help them? Yeah, sure. First of all, thanks for having us. So a couple of things. You sort of mentioned, you know, the issues associated with tariffs, and, you know, that's coming and going. I feel like that's incredibly fluid. We'll see how that kind of plays out. You know, given that some of the negotiations that happened over the weekend with China, you know, I think I'm a bit more bullish that we'll get some resolution around that. Things that are given that I'm not so sure that will change in any short period of time are, you know, the labor crisis that's affecting the healthcare system. I think everybody's aware of this that follows healthcare. You know, we had a lot of folks resigning during COVID, people that we had expected to be in the labor force for a number of years. I just think that they got burned out and decided that was not for them. We have significant shortages, you know, and a lot of people talk about, you know, nursing shortages. Boy, when you go around talking with healthcare systems executives, you know, we are talking about radiation technologists, pharm techs, just core people that you need to keep a hospital running. We still are struggling quite a bit with labor shortages. The impending Medicaid cut that was kind of championed, there were some conversations around yesterday. I think that is about, I do not know, potentially a, you know, like $80 billion impact on healthcare. That is going to be huge. The healthcare systems are going to have to think about structurally how they are going to realign themselves so that they can absorb that kind of impact. Tariffs are, you know, I think shorter term, I think labor is longer term. These Medicaid cuts, these impending Medicaid cuts are going to be big drivers of how healthcare systems are going to operate. In terms of how are we sort of, you know, aligned to sort of support them. I know there are going to be some questions associated with, you know, are these things going to have an impact on their ability to spend money on services and those kinds of things. I got to tell you, we've made the right levels of investments in technology to do a number of things. First, we've got a lot of core capabilities to help healthcare systems understand how their performance is and how they think about spending cost curves. You know, we like to go in and have broad-based conversations around things around, are you negotiating the right rates with payers? Are you doing the right things in terms of standardizing your clinical care? Are you doing the right things in supply chain? You know, are you doing the right things in labor? Are you utilizing labor appropriately? We do a lot of analytics. We have a ton of data, obviously. We have technology where we can actually help them benchmark and understand the improvement opportunities where, you know, they need to drive performance improvement. After you do those exercises around performance improvement, what's very, very unique about our capabilities is we have the ability to write things into the workflow, which is Epic and you think about Cerner and those kinds of EMRs. That's something that's very unique to us in that, you know, we've been doing this now probably for three or four years where we've been impacting the way that how physicians, you know, treat patients and those kinds of things through alerts and drop down, you know, boxes and those kinds of things. Anyway, I think we're very, very well positioned to help healthcare systems think about, you know, the future and how they need to be actually building out capabilities to support their community. Yeah, I'd add a couple of things. On a tariff point, we recently built a tool for our members where they can see where product is being sourced from, what the impact of the tariffs is. That's been very helpful for them as they manage through this tariff discussion, which is fluid. In addition, as Mike mentioned, we're integrated into the workflows of our members. From an AI point of view, we're doing a lot around reimbursement, coding, ensuring that our members are being properly reimbursed. That's a big focus for us moving forward. Yeah, I want to talk about the tariffs a little bit around some of the things Mike you mentioned. You know, we did our quarterly survey, found that hospitals were worried about maybe a 6-7% increase in cost around tariffs. And clearly it's fluid. No one knows what's going to happen as it relates to their P&L. You mentioned a couple of things, standardizing supply chain, using technology and benchmarking, AI, you know, that you've been building out for a long time period. As you think about the concerns that your customers are having today, does the tariff piece, does that add urgency for them to add specific things from Premier? And, you know, what have you seen in your recent conversations with your customers around those opportunities? Yeah, so first of all, from a tariff standpoint, you know, the healthcare systems don't have the ability to absorb those tariffs, right? I know you're out having conversations and you're hearing 6-7%, but I will tell you, their operating margins are not, many of them are, you know, 2-3%. Some of them are pretty flat depending on the parts of the country that they're in. They don't have the ability to consume tariffs at those levels. Yes, there's a heightened sense of urgency. Glenn talked about some tools that we've developed where, you know, based on where products are manufactured, you guys know that's pretty sophisticated in terms of how the tariffs are levied. We have some pretty sophisticated capability to understand the various parts of a product where it's being, you know, manufactured, and then we can actually help them understand really what the impact, the real impact is. Most importantly, help them understand products that won't be impacted by the tariffs, right? That's really important that they have the options to understand, you know, where tariffs are going to be, you know, where they could be negated. It is, it's interesting. It's driving all forms of conversation, and this is something that's really important. Now they're looking for, you know, additional streams of revenue. How do I maximize the relationships with the state? How do I ensure I've got better access capability? I'm seeing a big shift to more market-oriented kind of capability for the health systems, identifying, you know, how to get people into the system, how to ensure that once they're in the system, they're being, you know, appropriately treated, but, you know, maintained within the system. I am starting to see a lot of strategic interest in that side of our business as well. That is all being driven by the threat of tariffs. I will also say the potential impact on Medicaid. I would add most of our contracts are what we call firm for the term. There is fixed pricing in those agreements for multiple years, which legally and contractually helps our members out. You know, having said that, we do have a committee that we establish with our members where it may be appropriate to pass some of that pricing through. That is really a decision that is based upon our members saying yes, not us. Because at the end of the day, we want to make sure we have healthy supply chains, right? If we have supply shortages or sole source suppliers in certain cases, we want to make sure that they are not pulling out of the market. We have established some committees and we will see some of that probably pass through at some point in time. Yeah. It just depends how tariffs get implemented and, you know, the length of contracts. One of the things that's kind of interesting, people always ask, how does this differ from COVID? In some cases, it's very similar to what happened with COVID in that, you know, suppliers are going to hold their pricing as much as they possibly can hold it. You know, most likely, if they can't actually provide the product at a reasonable margin, they'll come and say, look, we'll have to go through an agreement. To Glenn's point, that's where this committee kind of kicks in and they determine whether or not they're going to accept this or not. If the answer is not, then they're going to be looking for alternatives that, you know, where people are not going to be, or their health system is not going to be as impacted by these tariffs. I mean, that's just how the process will continue to work out. It's too early to tell. I don't want to be overly positive, but if we can keep working through some of these tariffs, I'm hoping that as some of these contracts come back up in a year, two years, three years, that you're not going to see the impacts that we're worried about. Okay. Interesting. I want to just last question on tariffs there. Glenn, you mentioned firm for the term. I like that phrase. As you think about tariffs, there's a lot of different stakeholders that could be impacted. You have the manufacturer, obviously the GPO, provider, patient, insurance company. There's a lot of different ways for tariffs to flow through the system. You mentioned that there's a lot of, you know, you have fixed terms for your products. How do you, how would you envision, you know, let's just say a blanket 5% increase? Like how would that, how would you expect that to go through, you know, if that went through today for the next year? Like who is going to take the brunt of that impact? Again, too early to tell, but I think it'll be spread across healthcare. You're going to have some suppliers going to have to take the brunt of it. You know, because they're just in a scenario where very healthy market and there's competition where people may be not exposed to the same kind of tariffs. You're going to have wholesalers that in some cases are going to wholesalers and distributors. I've already got some that say that they're going to hold the line on what they're going to do in terms of passing along that pricing. That means they're going to hold some of it. I think we'd be naive to say that the healthcare systems aren't going to be, you know, potentially impacted by it, which, you know, then potentially, you know, if you go all the way full circle, might impact, you know, patients and then might impact federal government at some point, right? Where they might have to do increases in market baskets and those kinds of things to ensure that some of these communities can continue to be served by some of these health systems. Yeah. It's hard, it's really early. It's really hard for us to be laser-like focused to say these are the folks who are going to absorb it. I think it's going to be category specific. Got it. That makes sense. I want to pivot a little bit here to the GPO business. You know, you're almost through renewals. You know, I think there's a lot of interest around, you know, what the reset baseline for this business could look like. You know, can you talk about how we should think about the baseline heading into next year and your ability to resume growth in 2027 and beyond? Yeah. If you look at where we are today, about 80% of the way through as we exit this quarter, which means we have 20% to go, we think ultimately we'll be pretty much complete by the end of fiscal year 2026 with all the negotiations. There may be a few that are still outstanding, but the vast majority will be done by the end of fiscal year 2026. The aggregate blended fee share is probably in the high 60% versus low 60% today when we're all said and done. Having said that, our supply chain services business continues to do much better than expected, really driving better contract penetration. We've talked about 3.5% growth year to date on the most recent earnings call, seeing good growth across key categories for us, medical, surgical, diagnostics, food, pharmacy. Those are important categories for us, all seeing growth. Lots of opportunity to continue to get more contract penetration. If you look at the total spend that we captured today in the hospital system, it's probably 50-60% on the acute side. On the non-acute side, it's even less than that. We still have a long runway ahead of us relative to the amount of contract penetration we can get. We're pretty excited about the gross administrative fees growing. Obviously, for the next 12 months or so, we're still going to be dealing with higher fee shares, offsetting a lot of that gross administrative fee growth. We've outperformed so far this year. We had another beat and raise quarter in Q3. We said we'd be at the high end of our guidance range for supply chain services as we exit the year. Yes, year-over-year, we are down, but we're doing a much better job of managing the overall headwinds. I think as we go into 2027, I think we'll start to see the inflection points after growth. Got it. Appreciate those comments. Glenn, you talked about contract compliance, your 50-60% penetrated within your hospital customers. Where, I do not want to call it low-hanging fruit, but where are the biggest opportunities for, you know, we have talked about contract compliance for a while in 2025, where are the opportunities today? Are they the same opportunities as it was, you know, three to five years ago? Has it evolved? Are there new things that you are looking at? Just curious kind of where your customers are improving contract compliance in here. Yeah, I think driving more product categories onto contract is obviously going to help us as we go forward. Having customers that are doing our SURPASS program, which is a compliant program, is going to help the overall spend levels. If you look at just other categories outside of medical supplies, you know, we have a purchase services business. Everything outside of goods that you're buying. These are third-party services for everything from landscaping to maintenance to linen services, things of that nature. That's untapped, right? That's untapped spend that we're going after. I think physician preference items is another area where physicians are still using preference items. We have a clinically equivalent product that's out there at a cheaper price, really driving towards that in terms of getting more spend on contract versus a physician using a product that they're comfortable with, that they've been trained on and all of that. Those are the areas that we think there's more opportunity on. A couple of things real quick on PPI. Again, I think from a differentiation standpoint, we have the data and the intelligence to work with those physicians and PPI to show them, you know, whether or not there's any, you know, clinical differentiation from an outcome standpoint. For the most part, that's what they're really keen on understanding, is there really any outcome differentiation. We have some very, very unique data capability, number one. Number two, once we actually do begin to, you know, train physicians and looking at some of these areas, we have the ability then to, you know, through the workflow, be able to ensure that, you know, they're following different formularies and doing the appropriate work and those kinds of things. Very core system, very, very unique to our organization. Then the purchase services, you know, we required an asset a few years back that, again, it's not just an analytic capability, but it is actually a health care GPO. Because purchase services is so vast, I do think you need infrastructure like that to really get after it. Otherwise, it just becomes a consulting exercise. Again, I think, you know, that's very differentiated for our offering versus others in the market. Great. One last one on the GPO here. Can you talk a little bit about the competitive landscape? Glenn, you talked a little bit about net admin fees into, you know, next year and kind of where the trajectory could go. Can you talk about if anything's evolved in the competitive landscape, you know, for net admin fees and whether or not there's been more competition, less competition, if the environment has become more stable? Just anything you can talk about from a competitive landscape perspective. I will always say that it's a very competitive environment, right? There's a few of us that sort of lead the industry and then there's others that, you know, may be regional and those kinds of things. The environment is very, very competitive. I think it, you know, it comes down to these committed programs that Glenn talked about, who can truly, you know, drive, you know, outstanding value from a pricing standpoint and then the technology, of which, you know, we've made some pretty significant investments in doing, you know, building out diagnosis technology around looking at opportunity for driving standardization. We've made some pretty significant investments on doing more pricing kind of studies and those kinds of things where maybe we don't have a specific contract in a category where we could bring price benchmarking and those kinds of things. Very, very, some very unique stuff that we could kind of create. I think that it'll always be competitive. I think that some of our competitors do some things that we do and some do not. You know, our job is really to ensure that, you know, we've got the right teams in place that are going off to the market and moving market share towards today. Yeah, I would say I don't think it's gotten any more competitive. It's just competitive in general. I don't think the market has changed in that perspective. To Mike's point, the way we win is we differentiate with our technology and we differentiate with our data. We have access to 45% of all hospital discharges in the U.S.. We have access to data that nobody else has access to. We really try to use that data to our advantage when we look at the GPO business. Yeah. As we kind of, that takes me to the next set of questions here around the performance services business. You know, the benchmarking product that you have, really in a normal environment, seems like it would be a really great opportunity for your customers and your prospects to learn more about how they compare to their competitors. You know, can you talk a little bit about how, and you kind of alluded to it a little bit, Glenn, you know, in this type of environment where there's so much uncertainty, what are the opportunities? I guess can you talk about what type of penetration do you have into your customer base using benchmarking, for example? Can you talk about the types of modules that you sell there? Is there an opportunity to sell more? It seems to me like this business is clearly a competitive advantage because you have access to, you know, you mentioned 45% of claims. You know, can you talk about those things? Yeah. So that 45% is really focused on adult discharge data. So if you think about charges, that's where that number comes from. We do pull in all the, you know, claims data for exercises. We do pull in EMR data. You know, and we're building out performance improvement agendas. I think the things that differentiate us as we focus towards helping our health systems drive performance improvement, one, you know, we bought that Truven 100 Top platform a couple of years ago. It's really interesting. I was down at my son's graduation at the University of Texas, and I see the banner on a non-Premier health system, HCA, I think it was. But it's always good to have, you know, other health systems that do not necessarily partner with you in the supply chain or significantly in performance services that do some of our tech stuff. It is really nice to see them carrying a moniker like that, right? Because then it gives us the opportunity to go in and help them either reaffirm why they perform the way they do or help ones that actually, you know, want to become a 100 Top performer, help them understand how they can get there and what are the things they need to do in terms of either care standardization, driving costs lower, you know, those kinds of things. It starts with that. Glenn's talked about the data on a number of different answers. It comes with the data and the benchmarking that we do behind the scenes. We create collaboratives where the best performing health systems actually talk about why they're performing at the levels that they do. There are, you know, it's an educational opportunity for those that aren't. You know, we have, that's sort of that one to many opportunity. We have the one-on-one advisory capability. I'll tell you, we've got brand new leadership in the company, incredibly excited about Dave Zito and others that have been, you know, joining the organization. It just brings a whole different level of advisory capability that we didn't have in the past. You know, I will tell you, we've always been focused on performance improvement. They now do stuff around revenue, revenue cycle. They do stuff on contract negotiations. They do stuff on how to work more effectively with states and those kinds of things. There's just a whole different capability that we didn't have just a matter of, you know, a year or two ago. Really, really excited about that. And then as I started the whole conversation, we have the ability, once we do drive that performance improvement, to lock it in, lock it into the workflow, which is really differentiated, you know, in the market. You know, if you can actually kind of codify how to, you know, provide care at the best outcomes and the lowest cost, that's something very unique. And it's something that healthcare systems vitally need. Really helpful. I want to move over to the guidance and the outlook because the quarter was really strong on, you know, the sequential improvement we saw around fee growth. Can you talk about, you know, what drove the strength there as we look at fee growth in the third quarter and really the cadence into fiscal 4 Q, which I think guidance is implying might be flat or down? You know, what drove the strength in 3 Q? Talk about, you know, I guess what you're seeing early so far in 4 Q. Yeah. I mean, both of our segments had outperformance in Q3. It was largely supply chain services, but performance services also outperformed expectations. If I look at supply chain services, clearly the gross administrative fees continuing to grow in the categories. We have been, I think, pretty conservative on our assumptions around what we can do around that top line growth. We have been beating some numbers, even though it is down year-over-year. We look at the net admin fees because of the fee share. We are ramping up some new members as well. That should continue as we get, you know, into Q4 and beyond. Those are our competitive wins. I would say on the whole, that is going well. We have a smaller part of our supply chain business, which is digital supply chain and supply chain co-management, which are actually growing. That is helping as well to offset some of the headwinds we are seeing on the fee share. Supply chain services sequentially was actually up a meaningful number, about $12 million, all of it flowing through to EBITDA. It is a very high margin business. It is dollar for dollar drop through when we have those fees. On the performance services side, we had a really strong quarter on enterprise licenses. These are software licenses with our technology, with our customers, really showing that we do have some pretty good momentum there. That can be choppy from quarter to quarter. You know, you look at Q2, we were a little bit light. Q3, we were actually above expectations. When we look at our guidance for Q4, to your point, we are modeling sequentially to be down slightly. These enterprise licenses are expected to drop down Q3 to Q4. We're being a bit conservative around what we think we're going to do. Could that be better? Of course, it could be. If we get a couple of deals signed here, that would certainly help us overachieve in Q4. On the supply chain services side, again, it's more fee share pressure from Q3 to Q4, even though it's modest. And we have, you know, a roll-off of certain customers and some new customers ramping up, and that's causing some of the sequential decline there. But I'm optimistic that if we can have a solid Q4, we'll actually show, you know, sequentially flat numbers or maybe even a bit of sequential growth. But right now, we're guiding to down slightly on a sequential basis. Got it. I want to kind of take that commentary. I think, Glenn, on the call, you talked a little bit about the framework around the model, growth, admin fee growth, and how that flows through to net admin fee growth. You know, as you think about, and I'm not looking for guidance for, you know, for looking guidance, but as you think about fiscal 2026 and you think about the trajectory of the business, you know, is there any way to think about just like high-level thoughts about momentum heading into next year? Yeah, I think certainly we're going to have better performance than we had this year would be an expectation. We'll be on the back end of the fee share renegotiations. We still have the annualized effect from the ones we did this year, + 20% or so to go as we go into next year. If you kind of look at that pressure, offset it with some gross administrative fee growth, offset it with some of the other areas of supply chain we would expect to grow, like supply chain co-management, where we've won a couple of new deals there as well. You know, net net, you'd still expect to be down, but not nearly the magnitude that we saw this fiscal year. In the performance services side of our business, I would just say we're very optimistic on some of the plans to reinvigorate that part of our business. You know, we just brought in a new leader overseeing that business. Same new leader was hired three, four, five months ago. And we've got a lot of new people that have joined us that bring a new capability to the organization. So I'm really excited about the opportunity and potential we have, especially in our consulting and advisory services business that goes with everything that we sell from the GPO side and supply chain services to the performance services side of the business. You know, we're not going to give guidance yet, but clearly that would be an area we would expect to grow over the long term when you look at performance services. I would just say for now, you know, better than this year in terms of the performance levels, but still, you know, modeling probably slightly down overall. Got it. As we think about capital deployment here, you've been very active with share repurchases. You know, as we think about the business here, looking forward, clearly the trajectory of margins, you know, there, you know, could go in different directions. As you think about M&A, share repo, you know, the potential for stabilization in the net admin fee, you know, how do you think about capital deployment, you know, given where the share price is? What is sort of the framework you have heading into next year? If I could just talk at the highest level, then we can talk a little bit about framework. We've got to get back to growth, right? I mean, that's the focus of capital. Areas where we want to continue to think about additional capital investment are things in our clinical decision support, the AI machine learning capability. We're doing a bunch of stuff with, you know, prior authorization. We're doing stuff with coding and documentation, very unique stuff, incredibly excited. Looking for add-ons, bolt-ons, tuck-ins in those areas. In supply chain, you know, we're going to continue to look around technologies that can support us in the maybe purchase services, you know, PPI kind of areas. Those are going to be areas that, you know, we think have an opportunity for growth, but also will differentiate us in the market. The last thing you kind of asked Glenn to point on, but Glenn, I did want to mention that why we're so, you know, positive about the future is the TRA payment goes away and we have $100 million of additional cash flow that starts coming post the July timeframe. Yeah, that's two months away. Just taking a step back, we have a really good balance sheet. One of the real positives walking into this role was a company that's not highly levered. We're less than one times. The only reason why we have debt right now outstanding is we did a $200 million share buyback and we borrowed off our credit facility to buy back shares, given it was at a very attractive level at $17, $18 per share. That looks like it was a good decision at this point. Very low leverage, generate really good cash flows. Cash flows, we're going to see the inflection starting in two months because of the $100 million benefits that we're going to start to see coming through. That's a big positive. My hit on the capital deployment priority is growth, growth, growth. It is going to be organic investment coupled with tuck-in acquisitions to get us to where we want to be. You mentioned the areas that we are looking at. We pay a very attractive dividend yield. We are just around 4% today. That will continue as we go forward. On the share buyback side, I would just say we bought back $800 million or about, excuse me, 38 million shares over the last 18 months. That is about one third of our share count. We have had some significant share buybacks. I think we are going to probably put a pause on that, given where we are at, and really focus on the growth areas that Mike talked about. Perfect. Sounds good. We will leave it there. Thank you, Glenn. Thank you, Mike. Appreciate it. Thank you. it. Thank you.