My name's Craig Bijou, one of the medical device analysts here at BofA, and it's a pleasure to have Teleflex in from the company. Liam Kelly, CFO, and then Lawrence Keusch, Vice President, IR and Strategy Development. Thank you guys. Yeah. Tom is the CFO. CEO. Sorry, Liam. I don't wanna take Tom's title on him, you know? No, my mistake. Sorry, Liam. If we can just start with, you know, Q1 top line results guidance. You guys reported last week. Appreciate your comments on a good start. Sounds like you had momentum simply beyond some of the procedure recovery that we saw. You know, I guess maybe just walk through some of the sector growth, the strong sector growth and, you know, if there were any one-time items that you might have seen in the quarter. First of all, I'd say we were very pleased with our first quarter results across the board, not just on revenue, but as you went down through the income statement, we're happy with our margins, happy with our earnings. Obviously, we gave guidance in February, so we'd had a good view of the quarter before we guided, and we guided to growth at the midpoint of 6% ex days with five extra shipping days within the quarter. As it turned out, we delivered over 7% growth in the quarter on a revenue line, and what the improvements really that came from our OEM business did better than we'd anticipated. That business has continued to perform exceptionally well. Our Catheter Business and our Suture Business and the acquisition of HPC that we had done two years ago continues to drive momentum within our OEM business. Our interventional access business also did better. Within that, you've got MANTA, which is obviously a high growth portfolio and doing exceptionally well converting the large bore closure market. Beyond that, our intraosseous business within interventional access did well, and our complex catheters did better than expected. All of this kinda happened in March. From a geographic perspective, and I don't wanna double count because some of the businesses that did better, in particular interventional, did better in Asia. Asia had a really good start to the quarter. Again, the interventional portfolio there did better. All in all, we were really pleased with the first quarter. We delivered, as I said, over 7%. In for Teleflex, that's around $7 million. At the low end of our guidance range, we pushed through all the $7 million, and we updated the low end of our guidance range from 4.75%-5%, and left the upper end at 6.25%. Also FX worked in our benefit, we had about $4 million benefit from FX, and we also rolled that through on the full year. Have to say, we were really pleased with the first quarter, and it gives us a lot of confidence into the remainder of the year to deliver on our guidance. Yeah. A lot of the investor questions following the quarter, you know, the strong growth that you mentioned in Q1, the implication, you did raise the lower end of the guidance, but it implies, you know, a slowing of growth for the rest of the year. I know, you know, I know you'd rather have a good start, and I know that's part of, you know, part of your message. I guess, you know, is there anything that's concerning or anything that we should be thinking about for the rest of the year why growth couldn't be where it was in, you know, Q1? Yeah. I think, as CEO of a company and I think as an investor, crikey, we all want a front-end loaded plan, because we've delivered on the front-end load of the plan. It was always front-end loaded. Mm-hmm. When we gave guidance, it was front-end loaded. The beat we pushed through in our full year guidance. There's nothing concerning me with the outlook for the remainder of the year. I feel, as I said a little earlier, I feel really good about what we delivered in the first quarter. It gives me increased confidence in what we can do for the remainder of the year. I feel really confident on delivering the midpoint of our range, which is 5.625% top line growth. What you'll see as you go through the year, there are a few comparable issues that investors need to be aware of. If you consider Standard Bariatrics, the acquisition, we anniversary that in Q4. The return of Langston Catheter to the marketplace, we anniversary that in Q3. The hemostatic portfolio within AEM had a really strong Q2. It'll have a tough comp there just simply because of timing of some military orders. Notwithstanding all those comps, I think it's a great start. It gives us a lot of confidence for the remainder of the year. Again, like I said, our plan was always front-end loaded. And the five extra days, you know, where the growth I'm stating excludes those five extra days, because you'll lose five days in Q4. Got it. One area that sticks out as something that didn't probably go as planned, well, it went according to plan, but I guess not according to expectations from the sell side investors, UroLift. You know, maybe we can just start with kind of what you're seeing on the patient visits. I know that it was down, you know, 3%, 4% for the first couple months. I don't know if you have March data yet on that. That I think on a year-over-year basis was, you know, relatively similar to what Q4 was. You know, maybe just start with kind of your interpretation of, you know, what you're seeing from the patient visit data and kinda what that means for, you know, for UroLift procedures in the U.S. What we saw in January and February was patient flow declines of 3.6% through the first two months of the quarter. We don't have March as of yet. As soon as we do, we'll advise. As most investors will know, last year, 2022, we saw double-digit declines over 21, and 21 was below 2019. We're double digits down on patient flow pre-COVID. Notwithstanding that, the last year, the decline really began as you went through the year. From Q2 onwards, you started to see the biggest impact of the decline, and we'll anniversary that as we go through the year. My expectation is that that product will begin to pick up as we go through the year, and my expectation is that it will return to growth. Everything that's within our control, we're managing. We had a really strong doc training in Q1. We had a really strong American Urological Association Meeting in Chicago that was nice to see. We also had probably our toughest comp in Q1 because it grew 2% the prior year, whereas the comps get easier also as you go through the year. You marry all of that up, and my expectation is that the product will continue to recover as we go through the year. I do anticipate that patient flow will improve, I do anticipate the staffing shortages will improve because we've seen staffing get better and 90% of our business is done in the hospital. You've seen it in MedTech too. Mm-hmm. with other companies. One question that, you know, that I have on the patient visits, I guess, you know, and maybe you have a perspective on why hasn't that come back? We've seen especially in Q1, we've seen even some of the higher acuity procedures have returned, and those were ones that probably were lagging through COVID. We've seen those come back and it still seems like whether it's UroLift-specific procedures or urology patient visits haven't come back to the same extent that we've seen the recovery in other procedures. I would just love to kinda get your perspective on, you know, is that, you know, the office staffing new? What else is it about that market that is somewhat different than what we're seeing in other markets? Yeah. I'm seeing what you're seeing in other markets- Mm-hmm. in 90% of my business. Yeah. What have, what has 90% of Teleflex got in common? It's all in the four walls of the hospital. It's really a dynamic of hospital versus a office site of service. For two consecutive quarters now, we've seen growth in UroLift in the hospital site of service. That's encouraging. The office is still a challenge. There's no getting away from it. Staffing shortages there are continuing to impact on the product. Therefore, the expectation is that we'll get better. It's really a site of service phenomenon is what I'm seeing. Patient flow is an impact, and staffing is the other impact. Staffing is acutely worse in the office site of service. Yeah. Is that improving? I mean, if you, if you dig a little bit deeper, you know, obviously hospital setting, it's been going well. International seems to be on track to expectations, which, you know, I know you guys said UroLift was in line with your expectations, but from our perspective, it seemed like office setting might have gotten a little bit worse in Q1 relative to Q4. Yeah. Like I said, the office is definitely a challenge. Sure. There's no getting away from it. Do I expect it to get better? I do. Why is that? Well, we trained a good bolus of docs in the first quarter. We trained a good solid bolus of docs in Q4. They're not all in the hospital. Mm-hmm. We're training docs in across all sites of service. The 900 docs we trained during COVID, we still couldn't get them to the same efficiency level as those that we trained pre-COVID and those that we're training today. That's just a fact, a reality. It really is, as you're onboarding a physician to this product, it really is that initial engagement, the training, the adoption of the technology right out of the gate is critically important, and we've learned that as we've gone through. Now we're in a normalized environment from a COVID perspective, I mean, COVID is long in the rear view mirror, thank God. The hospital staffing getting better will ultimately have to play out in the office site of service. It's pretty much the same pool of talent you're going after. With that normalizing, I think the office will have to get better. Okay, one last one on UroLift, and then we can move on. It's more of a clarification. You know, when you talk about UroLift getting back to growth in the U.S. or, or in total, is that for the entire year of 2023? Would that be a quarter? I guess, how should we think about, you know, that comment? Obviously, it's gonna progress and get better throughout the year, but how should we think about that? I'm thinking of 2023. I expect UroLift to return to growth in 2023. I think there are some good early indicators from the point of view of the comps, for example, from the training as an example, the DTC as an example, and of course, all of the work we're doing internationally. The launch in Japan is going really, really well. We've begun in China. We have done some work in Spain. We've done some work in Italy. We're working on reimbursement in France, Taiwan, India, Brazil. There's a lot of geography still to come along, but we do need the U.S. to get to growth. Yep. In all transparency, the international market just isn't big enough to carry the day and won't be for a couple of years. We do need the U.S. to get back to growth. Got it. Okay. I wanna shift to margins. Sure. You know, maybe a starting point is kind of, you know, where, you know, your perspective on the macro trends, you know, raw material inflation, freight, you know, and even some supply chain logistics seem to be getting better. You know, you guys see a lot of it. You're a lot closer to it, so kind of. Yeah. -perspective? Definitely sea freight is getting better, and it's in line with our plan. We had anticipated that it would get better as you go through the year. It peaked early last year at the height of the cost level. That's encouraging. Resins, and materials have stabilized. The peak in that was really Q4, and it stabilized in Q1, so I expect that to at least continue to be stable as we go through the remainder of the year. And hopefully it'll get a little bit better, but we'll monitor it very, very closely. Resin indices have started now to move in the right direction. It's normally a short couple of quarters afterwards that we begin to see that bleed through. I think the whole supply chain disruption seems, in my view at least, to be getting better. Labor for us was never that big of an impact. I think if I look across, and Craig Bijou, you do this much more than me, I'm sure, but if you look across all of MedTech in Q1, I thought we stuck out a little bit in the positive from a margin perspective, 'cause we show a positive gross margin in Q1, even with the supply chain disruption that's clearly there for everybody in MedTech. You bring up a good point because I would agree with you there on the margin, year-over-year improvement that you saw, and it leads me to a couple of other questions. You know, I didn't mean to feed you questions here, buddy. You know, I guess my perspective, and you may agree or not, is that you have a little bit more negative view on margin improvement throughout the year versus some of the other large cap MedTech. You know, second half, you know, I think margins are supposed to get better. You know, I was wondering, you know, is that view? And it kind of shows up in the numbers. I think I actually asked on the, on the call. Like, you had a very strong margin quarter, well over what you did year-over-year. I think gross margin was 100 basis points better. That's higher than the guidance that you're expecting for the full year on a year-over-year basis. You know, maybe can you frame kind of what you see playing out from a margin perspective, throughout the year? We're talking gross margin, but I mean, on the operating margin side as well. Yeah. It all starts with gross margin, as we'd all agree. Our guidance for gross margin was for the full year, to 59%-59.5%. We started off good and solidly at 59.4%. At the upper end of our guidance range, but firmly within our guidance range, as an organization. As you go through the year and on a year-over-year basis, there is the phenomenon of FX playing as you go through the year. If you go back to a year-over-year comp, the currencies moved a lot as you went through the year. Excluding the FX impact, the underlying margin expansion is really good as you go through the year. It is being clouded a little bit because of what's going on with FX. That's really why the guide is 59%-59.5%, and we delivered a good solid 59.4%. We feel very comfortable in our 59%-59.5%, and we feel we'd be in a great position to deliver that. I guess the underlying part of your question, is there anything out there that you're worried about from a gross margin? There isn't. There's nothing that would give me concern on our ability to hit our guidance on gross margins as I sit here today. From an Op margin perspective, we're not getting the leverage you'd normally expect for Teleflex to get on the Op margin, and there's a few reasons for that. Even though they did improve by 20 basis points in the first quarter, it was a good start again across the board. There's a few phenomena. Number one, because of the performance of UroLift last year, bonuses were underpaid in the prior year. We're peanut butter spreading them back to 100% for the year, and that's an impact. You also have the impact of Standard Bariatrics coming into the income statement, and that doesn't really start to leverage until 2025. That has an impact on the deleveraging. It was tough to recruit people last year, and a good bit of our recruitment was in the second half of the year. There's a little bit of a carryover from that as well. Notwithstanding that, again, I feel confident in our op margin guidance for the full year. Great. Then maybe go, you know, take that to the LRP margin expectations. I think it's, you know, 250 to 300 basis points by 2025 based on the guidance that you gave for 2023. You need 250 to 300 basis points in 2024, 2025 of margin improvement. I think what probably goes not fully recognized as the MSA. Yeah I mpact and what the benefit you're gonna see from that. You know, I guess, you know, maybe just kind of walk through how we should be thinking about, you know, beyond the MSA, and you can certainly comment on what the MSA will be. Beyond the MSA, how, you know, why should we feel confident that you can actually hit those margin improvement numbers? Absolutely. On our Q1 call, we advised the investment community that our margin expansion would actually be 250 basis points on the gross margin line and 200 on the op margin line. That was our updated long-range plan. Why I think investors should feel fairly comfortable and why we feel comfortable we can get there, it's 200. Everything again starts at the gross margin line, it's 250 basis points on the gross margin line. We pick up 100 basis points from the MSA alone. What the phenomenon that happens is you exit 2023, and on the first day of 2024, the MSA that we have with Medline for the divestiture of their surgery assets goes away. We lose $70 million roughly of revenue on the top line, but it's very low margin revenue. That actually gives us a full%. The gross margin expansion that we as a company must deliver is 150 basis points, which is 75 basis points a year, which just through mix in the high growth portfolio and our ongoing restructuring plans, we feel we've a really solid path to deliver that. You drop the op margin line of 200 basis points. The 100 basis points doesn't all drop through, but you pick up around 30 or 40 basis points from that. The one-time phenomenon this year of bonuses getting accrued back in doesn't reoccur. The hiring phenomenon doesn't reoccur. Therefore, we should feel confident in the rest of the gross margin dropping through and allowing us to achieve that 200 basis points. Yeah. One question on that. Obviously, the high growth products are gonna drive some of that growth over your LRP. I think you're getting leverage from the hiring that you mentioned in 2022. You're seeing that leverage in 2023. You know, are you guys, you know, I guess in terms of hiring and the ability to leverage, you know, your sales force, existing sales force to get that high growth product revenue, like I mean, I guess the question is, are you gonna have to add more sales reps in 2024, 2025 to hit that top line revenue? We always go into every year fully invested behind our high growth portfolio. That was our strategy this year. It'll be our strategy next year. As products start to ramp, the incremental investment gets less and less and less because you've covered the whole country. You've got a sales force calling on that call point. The need to continue to add gets a little less. On the other side, farther down on the income statement, though, we do want to spend a little bit more on R&D. If you exclude OEM, we spend about 4.7% of revenues in R&D. We'd like to tick that up a little bit over the next number of years, that's the ultimate reason why when you get $250 on the gross line, you're not getting any leverage, you're getting $200 on the op line. It's those few phenomenons that are driving that. We think that's the right thing to do for the long-term sustainability of our growth profile. Yeah. wanna shift to M&A- Yeah And even some optimization, questions. You guys obviously have talked about M&A for a while. You did the Standard Bariatrics deal, you know, I think investors probably would have expected more, and there's probably a lot of reasons why that's the case. I guess when you look at the environment, you know, have you been close on deals? I know you're looking at a lot of deals, and would just love to understand kinda, you know, how you see the. Is there a disconnect between valuations? I don't think it's a valuation disconnect. I think we've been holding a lot of hands. We've been active out there in the marketplace. For me, it's about bringing the right asset into Teleflex, and I think investors should be secure in the knowledge that we will be incredibly disciplined as a company when it comes to M&A. Are we active? We're active. Are we looking at late-stage technologies? Yes. Are we looking at tuck-ins right now? Yes, we are. Are we looking at scale right now? We are. We're looking at every aspect of M&A right now. We do want to bring in the right asset, and as I said, I think investors should be secure in the knowledge that we will remain disciplined. When we bring something in, you can be sure we have turned over every rock. We've done our due diligence. We're certain that this is the right product to bring into the Teleflex family. I think there are enough assets out there, for us to either put a string of pearls together and do a number of tuck-ins, in different business units or do a large-scale transaction. It's a question of which fish we can get in the boat, candidly now, not rather are we fishing. Follow-up on that scale. You know, how do you guys define a scale acquisition? I mean, what's the size? You know, I know you probably have, or I think you've said you have $2 billion in firepower. Yeah. From a revenue perspective, you know, what is a scale acquisition by your definition? You know, maybe following on that, what areas of the business do you think would lend itself more to a scale acquisition versus tuck-ins? Absolutely. For us, when we're talking about scale, we're talking about TAM parameter, let's call it $80 million to $250 million-$300 million in revenue. We look for assets that are immediately accretive to our gross margin. We look for assets that we can leverage to get accretive to our op margin in a reasonable amount of time. We'll accept some dilution in the shorter term, as long as we see an ability to get there in a reasonable amount of time. The areas of the business for scale versus tuck-in, I think that, I like the cath lab. I mean, there's no getting away from it. You normally get higher margin products. It's normally a growth or segment. You're moving patients from an operating room to a much more efficient site of service. You get paid more to do that. I think the intensive care call point is a really important one for us. That's where our vascular team are every single day. Emergency medicine has been a great opportunity for us. At the right time, urology is an area where we should bring something in. Once we see UroLift return to growth, bringing something in there would be appropriate, I believe. From a tuck-in, I'd do another tuck-in in surgical once they've integrated us down to bariatrics. I'd do a tuck-in in the morning for OEM, if I could find it. HPC was a win-win-win, a fantastic acquisition for us. Those are the areas I think we would look. For me, it's all about call point. Where are we gonna leverage our call point, either within the United States or how can we globalize that product? If you look at VSI and NeoTract when we acquired them, they had very, very little revenue outside the United States. We took all of that business direct overseas. We launched UroLift in countries that it might never have gotten launched in had it not been for Teleflex. That's a lot of the value creation that we bring, putting a focus in the U.S. and then globalizing the product and bringing it to a worldwide patient population. Just to follow up. On urology, I guess, I mean, you can go a number of different directions. You're beyond UroLift today. I mean, any, you know, any thoughts on, you know, specifically, is it, you know, BPH or just it's broader urology? I think it's men's health, I would say. It would probably be a broader category. I think that there's a number of exciting areas in the area of men's health. Our sales force today globally is focused on the urologists that's focused on men. There's a lot more than BPH in that space. I mean, if you could find something in the BPH, that'd be marvelous, but there's a lot more there than just BPH. Okay. There's a lot of really exciting technologies in the urology call point. We have about a minute left, but I wanted to touch on the strong OEM growth. Oh, yeah. Very strong. You know, maybe remind us of the areas that you're manufacturing, what the end markets you're supplying. Is there any read-through the... You're one of many OEMs that have done extremely well this quarter. Any read-through for, you know, procedure growth later on in the year? Our OEM business is a fantastic business, and it's incredibly well run by Greg and his team. The areas that we are in We spend a lot of our portfolio is in complex catheters, extrusions. What we did about four years ago was we built these innovation centers in our OEM plants. That is where our customers come with their ideas. They'll come to us for two days, they will come with an idea, they will leave with a prototype, they'll go back to their sales and marketing teams and their customers. They'll present that to them. You have buy-in. A lot of our OEM expansion is because of new business that we've brought in over a period of time. We're definitely getting a bounce from procedures as well in the core business. What we really saw in the first Q was our Catheter Business and a strong rebound in our Suture Business. those are the two main catheters. Investors who know us will be familiar, we did a HPC acquisition a couple of years ago. That has continued to perform exceptionally well, and that's why I said, Craig, if I could find another tuck-in to give those guys, I'd give it to them in the morning. We have good visibility, to the other part of your question, on our OEM business. It's not gonna be 34% every quarter. I think it's gonna continue to perform very well for the whole year and probably, and into next year easily. It's gonna be a big driver in our LRP. Great. Okay, I think we're out of time. Thank you, Liam, Larry. Thank you very much. Appreciate it. Thank you. Thank you. Thank you. Cheers. Okay. Test. All right, good morning, everybody. Travis Steed, Bank of America medical device analyst. Kicking off the first day here. Glad to have Adam Elsesser from Penumbra, CEO. Thanks. Thanks for having us. Yeah. Thanks for joining us. Curious if you wanna just open with any opening remarks or anything, jump straight into Q&A? Yeah, I think we can go straight into Q&A. We're just a week off of our earnings call. Right. I think we've laid out where we feel the business is right now pretty well. Yeah. Yeah. Sounds good. When you think about the Q1, you know, some of the trends you saw with some of the new launches in January, February and into April, maybe just to kind of level set us kinda what you're seeing, you know, March, April, you know, versus the earlier part of the year with some of the early momentum that you've had with some of the product launches and overall procedure environment as well? Well, start with maybe overall procedure. It certainly feels better than last year, where particularly in the second quarter there was a lot of conversation amongst all device companies around staffing and, and all that. It's obviously not a hundred percent, but we don't hear that. You know, no one is talking about that in the same way. There's a lot more optimism, a lot more positivity, if you will, in the hospital setting. As it relates to the launch of Flash and now Lightning Bolt, it's kind of amazing. It's wonderful. It's the culmination... You know, I shouldn't say culmination. It's the beginning of the next phase of 19 years of work to see the excitement around it, the uptick, you know, bringing in new customers. You know, being able to treat these patients faster and easier and safer than ever before is, it's kind of fun. Sure. On the venous side, and procedures grew 30% sequentially. Like, how does that look historically? I'm just curious what the step-up was. Yeah. Any way to think about historical seasonality, how much of this was really- Yeah. Coming from the launch. I think historically most of everyone would agree that the step from fourth quarter to first quarter is not a major step up. It's usually the other way around. Fourth quarter tends to be the best quarter. We called that out because obviously our, you know, customers that were otherwise using Lightning 12 didn't grow 30%. You know, the majority of that came from new customers. The excitement around that, the reorder rates are the same as old customers, as we said. It just, I think is a factual indication of the excitement around this. As everyone knows, launches aren't linear. There's a process. Sometimes you get to try, you know, the hospital gives you permission to buy a couple of products, and if you like them, then you can start the value analysis committee process. Other times you have to just start that independently before you can try it. There are sort of various methods across all, you know, 1,000+ hospitals that we go into. We're in the early stages of that. What gives us a lot of confidence is the sheer number of physicians and hospitals that are actively involved in that process, who really want to use this product. Many of them were able to try it, and then they have to go through the process. Others, you know, there's a little delay there. Others are able to just, you know, or have to just start the process. It all comes back to, you know, what we're hearing, what we're seeing, the number of accounts in process that gives us a lot of confidence that this is what people have wanted. On the reorder rates, you're seeing an acceleration in those reorder rates in April? You know, I don't have those numbers exactly enhanced, so I don't wanna miscount. Yeah, the enthusiasm and the business as we continue into this quarter and the next is not going down. It's not staying flat. The business is very strong. When you think about, like, where in the process with the VAC committee is, where you are with, you know, opening new accounts, et cetera, how do you phrase, like, where you are in this launch? You know, like, do you wanna use, like, third inning or... I know you're not a baseball guy, I don't think. Just maybe talk about, like, where we are in this launch, you know, how much further it's gonna take to be kind of fully launched. Yeah I f you will. Well, for those who know me, using baseball analogy is a little silly 'cause I'm not a big sports fan, but I think we're in the first inning. I think we have a lot of accounts in this country. We have a huge number of patients that we know can benefit, that physicians are telling us. You know, we talked about that on the quarter earnings call, where, you know, we put out for the first time in a long time what the possibility was that patients we can impact with these products. There's no way we're not in the first inning toward that opportunity. You know, and maybe it's in, in the first, you know, part of the first inning. That's the most exciting part. I've had the opportunity to talk with a number of very, you know, senior physicians in all the subspecialties who have used both Lightning Bolt and Lightning Flash, and talk to them more sort of philosophically. Like, are we now... Can we now see how this ends, if you will? Like, obviously, our products will keep iterating. We've been known for that. We'll tweak them, you know, here and there. But within that idea, can we see to where all of these patients that aren't even being treated today with any kind of mechanical or even interventional means, can they be treated? Can we help them? Uniformly, these folks are like, the level of enthusiasm and excitement about doing that work to do that and to bring in those patients and help them, is what we've been waiting for. Like, it's what the work has led up to. You know, from my vantage point, you know, having 19 years this, I personally am so excited about the next five years. I can't wait to be in the middle of bringing this change to this field. It wasn't that long ago, where I was sitting probably in this exact room in 2016 after we went public and there was a conversation about our vascular business, which was basically a quarter old. The question was, "Is that a market?" You know, for the 800,000 people that we can impact, yeah, it's a market. They want relief, and they want their clot taken out. Now we can see how we get there in the easiest and safest manner. Yeah, I remember that conversation. You said we would talk about stroke at some point. Here we are. Here we are. True to your words. Maybe just think about like initially, like the initial launch through Q1, what you're seeing in terms of opening the market up, you know, the getting into those 800,000 procedures. You know, are you seeing like new doctors come in that haven't used mechanical thrombectomy in the past? Yeah. Maybe talk about the market development a little bit. It depends on which product we're talking about. With Lightning Bolt, which is our arterial product, you know, if you're using a mechanical product, there are certainly some other products, but we're the primary one today. Obviously, the lot of our conversations now are with people who are doing either catheter-directed lysis or the bigger chunk is people who are doing open surgery. We said on the call that those conversations are really positive and exciting. There's a lot of interest to bring this in and try it. We've had some early success. I mentioned a particular case on the earnings call. That growth, if you will, or that excitement is gonna come primarily from people who aren't doing mechanical 'cause that's the majority of those. On the venous side, with Flash, it's a little bit different. You know, you're really starting with folks who are already believing in mechanical. We're just sort of getting, you know, the constant innovation and evolution of products. You know, Flash is leading the way. You know, you can't really stop progress and that's the exciting part of the field. Most of the growth in the short term, you know, Last quarter, this quarter, next couple of quarters, is gonna come from people who are already in. We're not excluding anyone who wants to start to use the product. But by definition, it's primarily gonna be that. Would you think it's fair to characterize, like, the Lightning Bolt launch a little slower? We saw 30% sequential growth in the venous side of the business and procedures. Yeah. this quarter. How it ends up, you know, hard to tell, but the trajectories are slightly different because you're starting with someone who's not doing an interventional procedure, so it's gonna take a touch longer. You know, don't expect the same type of numbers, you know, out of the box. It's hard to know, you know, three or four years from now. You know, three or four years from now, there are more venous patients than arterial, so by definition, that will still probably be bigger. Right. What did you assume in the guidance? I know you raised the guidance, you know, from $1 billion. Mm-hmm. To 1.4-1.6. In terms of that assumption, what are you assuming on those two product launches and Yeah. We didn't break out by product, you know, I think it's not probably a smart idea to do that right now. We'll give updates obviously throughout the year as we see those trajectories. You know, directionally, you know, it will be more Flash than arterial. Okay. just, you know, this year- Right Of the issues we just talked about and the pace of the trajectory. Like, Flash could be like double the size of both by the time we get to the end of the year? yeah, I'm not that good at math, so I. Okay. Fair I can't probably answer that. No, that's fair. Is there a good sense for kind of the breakdown of the arterial versus the venous side of the business now and how to think about which one's bigger? Again, I think it's fair to say that the venous side is bigger, because more people are doing interventional, you know, mechanical device use than on the arterial right now. Right. Okay. Then on the VAC committees, follow the same process with Lightning Bolt as Flash with where. Yeah. Yeah. There's nothing new about this. You know, 19 years of selling products, the, you know, the process is the same. You know, some go quick, some don't. You gotta go through all... It's just the reason I mention it is just to, in all of our excitement, you know, we still have to do that. You know, there is still a process that we have to take time in and, you know, it would be awesome if we didn't have to, but, you know, we have to. I think you said you're moving into some large hospitals. When you think about that initial launch, were they smaller hospitals? Are you just now moving into larger hospitals that take longer or? I only mentioned that one on the call because I wanted to sort of level set, you know, that one of the larger systems, we're just getting started. Right. Which is great, and there's a lot of excitement there. You know, it varies between large and small in the rest of the customers that have already come on board. Right. That makes sense. Maybe thinking about the market development a little bit more. I know we are bouncing around here a little bit, but the 800,000 patients on the venous side, like, do you have the technology you need to go after all those patients at this point for future iterations to get there? Kind of the same question on the arterial side of the business as well? That's a great question. The answer is the idea, the technology, the proprietary technology around computer orchestrated aspiration is the technology that will get us there. That's the most important point. Because we see that, because physicians are now talking about that, we can focus our energies, and I talked about that on the call, around these areas over the next bunch of years. There are gonna be tweaks. There are gonna be additional, you know, things. Somebody asked a question, you know, today, which I thought was an insightful question. We used to call Lightning Bolt. Now we call it Lightning Bolt 7. Right. You know, I think that, you know, it's pretty obvious why we added a number there. You know, so those type of things will come, but none of the things that will come that we think are helpful will be, you know, are sort of new innovations. You know, they're sort of blocking and tackling things that we've done throughout our career as a company. That's pretty exciting. The team's, as I said, really focused on getting there pretty quickly. Do you need more clinical data, or is it more just like to develop this market? You know, data's always helpful. It depends on the type of data, you know. There are obviously certain studies like STORM-PE, which we announced, which now that Flash is here, we'll be enrolling very soon, where we can show the use of mechanical, our Flash device versus anticoagulants. I think that will be helpful in the PE space. I think each other, you know, DVT and arterial are slightly different. I think, you know, we'll add whatever data is necessary, but I think it's a little bit different than an area like PE. You saw the stroke market develop. Now how would you think about the trajectory of kind of the venous market, arterial market, and when you think about where the stroke market is in relation today? Yeah. So the- I think that's a great question. I think the biggest difference between the stroke market and these other areas is you don't have to move the patient in a time-sensitive way. That's a huge deal. Some of the procedures are obviously time-sensitive, you know, certain PE cases, certain arterial cases, a lot of arterial cases. Not all of them are as time-sensitive, but even if they are, you really aren't moving the patient for the most part, as more and more capability gets built out in the hospitals and desire to treat them interventionally. Without that is the big barrier. I think you're gonna see a different... Well, we've already seen a different uptick, you know, in the last sort of since 2016 when, you know, we were sort of talking about it. I think that's in large part because the logistics are in our favor. Right. Maybe more on the, on the vascular side or, sorry, the arterial side. like, what's the awareness like within the physician community? It's like I really just struggle to understand why you would have more of an open procedure or use lytics when now that you've got this new technology? Yeah. I don't see it that way. You know, great physicians have been trying to help these patients for a long time and, you know, vascular surgeons have done great work, you know, by getting out clot, you know, in that manner. They've been doing it for a long time, and it's generally been pretty successful. I don't see it as, you know, that simple, like everyone should stop. They, they have to hear about it. They have to experience it. I think it's pretty compelling once you do, and that's our experience so far, which has given us confidence. You know, that obviously we can't go to every single physician at once, you know, and so it's gonna take some time. All of the reactions and all the positive trends and the reactions are what's giving us this confidence. That's helpful. If anybody in the audience has questions, feel free to jump in too. Just raise your hand. We can keep this interactive. Maybe on switching to stroke- Yeah. Yeah. for the Thunderbolt, trial. I think you said you'd give an update in the next month or two, or quarter or two. Yeah. Like, is that getting closer? Yeah. -getting the enrollment? Let me sort of share. Enrollment, the trial is going well. The enrollment is never as fast as anyone obviously wants. And we'll be able to sort of get a better sense of when it will end. None of that should worry anyone. That's a positive thing. The reason is, that right now we have this moment in time with RED 43 and SENDit, which goes inside 72, where the ability to track our catheters to the face of the clot is back in fact to what it was back in the days when we had Xtra Flex. Unfortunately, you know, and I don't wanna revisit, you know, those controversies, but there are a lot of people who loved that product, and it really enabled them to treat successfully because the trackability was so good. Now with SENDit, which is a inner catheter inside, it comes loaded inside 72, we are seeing physicians who had moved away from our aspiration system coming back because it's so trackable. And in fact, the comments are like, "Oh my God, this is even more trackable than Xtra Flex," which is a high compliment. Obviously it doesn't have any of the other downsides. The team and our sales and marketing team are pretty excited about having time to take share, you know, back and repenetrate the market so that when Thunderbolt comes, there's no discussion about what catheter. You know, they're already using our catheters, and Thunderbolt just attaches to it. In some funny way, this actually has worked out really well, because we have the time to make this about the catheters and they're performing unbelievably well. We're seeing the share shift back. Again, we don't need it. I mean, from a revenue standpoint, we have a lot of growth ahead in our other business, so we're in pretty good shape right now. When you think about the share, like I don't know where you think you are in terms of gaining that share back, how much further you can go, in terms of like how much share you lost? Can you get it all back? Get a portion of it back? How long that takes? Yeah. Think through some of the share dynamics in the stroke market. Yeah. I mean, the market's evolved in stroke. You know, it used to be when we went public, you know, we have some big companies we competed against. Now, there's like six or seven small private companies that all have catheters that, you know, and so on. It's a lot more disjointed than it used to be. It's not one company that we're... You know, it's just the market, which I think makes it easier, not harder. You know, as we start to take share, you know, it starts to redefine the space. There's a lot of excitement. There's a lot of momentum. The morale on the team is, you know, sort of back to a, you know, really good right now because of that. It's fun. Do you feel like the market's accelerating a little bit as well? You know, probably. You know, nothing. If you can, pretty easily treat the stroke because you can get the catheter there quickly and treat it, you know, you're probably gonna be pretty excited about treating it. That leads to, you know, the effort that is necessary to grow the business. You know, hard to quantify really market growth, you know, across the board versus share right now. You know, it's easier to define share. You know, so we're optimistic, you know, but let's wait a few quarters to see. Right. Makes sense. The Thunderbolt launch, like, how would you think about the momentum of that, you know, in terms of comparing it to, like, the Flash launch, the Bolt launch? Is it a little slower? I mean, still over 6% sequentially. Yeah. Well, Thunderbolt hasn't launched. Right. We're just enrolling in the trial. When it does launch. Yeah. I think it will be pretty good. Again, the only caution, and it's not a caution about the product or anything, is stroke is the most penetrated and the smallest of the markets we're talking about. The opportunity is still smaller than the other ones. I only say that to remind everyone that's not at all that we're not passionate about the work we're doing and our motivation. What will show up as a driver for us over the next five years, stroke will play, I think, a significant part of that, but it will still be smaller than the other ones. When you think about the international opportunity, moving some of these products internationally... Yeah I mean, it's obviously China is a bit bumpy with the VBPs and stuff like that. Maybe just spend some time on getting people comfortable with the launches and growth internationally over this year and the next few years. Yeah. We've been fortunate to have a pretty strong international business. Jason's answered the question around China before. You know, we're not immune from those issues, but the way the deal is structured and also the fact that most of those products are, you know, prior generations, allows us to have opportunity for growth, you know, in China as well. Where we are now more focused is how to bring these latest generations of product, Flash, Bolt, ultimately Thunderbolt, to the international markets and in what form so that, you know, we're getting proper reimbursement, proper focus, rather than just sort of selling what we can. That's a great, you know, That's a great place to be where we can sort of step back and do the work, right and not feel rushed, you know, to use international or grow because we're gonna have a lot of growth here for a while. I think that puts us in a pretty good spot, not just now, but really over the next 5+ years. Makes sense. I know Maggie's not here, but just to throw in a high-level gross margin question. I'm trying to think of the best way to ask you this question. Uh-oh. maybe. Gross ... just to think through, when you think about innovation, and how much of a focus is margins when it comes to innovation and pricing and all that? Yeah. When you think about the new product launches, like how much of this margin to 70%. Yeah gross margin is coming from the launches itself? I was gonna tell a joke and I realized it might not work. You know, but I'll say it anyway. We, we used to obviously not focus on margins. You know, we were all about, the pace of innovation, you know, constantly improving the product. We frankly didn't spend a lot of time on it. Obviously with COVID and what, you know, the pressure on margins and our size, the combination of that obviously led to an appropriate need to pay attention to both, gross margins, operating margins and so on. I think what you're seeing is that we're doing that, and I'm pretty proud of that because we challenged, you know, on the operations side coming out of COVID as we were able to get back to sort of more normal, not spread out the lines, not do, you know, have all the safety measures in place to some more normal semblance of a operation that had a sort of different cost structure to it. In addition, this newer group of technologies, computer orchestrated aspiration, by definition, has a slightly more, you know, accretive margin higher. When you add that work together with the product mix coming, I think we're gonna be in pretty good shape. I wish margins, you know, on the growth margin side could change faster. You know, there's, you know, things run through over a period of time. It's not immediate. You know, that's just the nature of running an operation where we make all of our own product and, you know, have all of that, plus product launches that come all the time. That's just the nature of where we are. I think we're in really good shape. We have a pretty good visibility to the next year or two, and it puts us in a good shape. On the operating side, you know, I care a lot about, you know, being profitable. You remember when we first went public, I, we were profitable. You know, we didn't know you didn't have to be profitable. We certainly know and care about running a profitable business. We showed that this quarter, obviously, as we are focused on, you know, being focused on our spending, you know, and getting the best benefit. When you go forward, you know, we're pretty built out. I mean, I'm not gonna say we're not gonna hire a lot of people, you know, people, but, you know, we don't need to hire. You know, we don't need to double our sales force to get where we're going. We have a good sales force. They cover the country. We can see some leverage coming, you know, particularly in SG&A, pretty clearly over the next couple of years. As you start generating cash, how are you thinking about the use of that cash? That's a good question. Our focus is on driving, you know, the best thing we can do right now, and I'm not saying it costs money, but is to do the work necessary to treat all of the people that can be treated, first in this country and then in other countries, for clot in their arteries, their veins, and their lungs. If we can do that in stroke, and if we can do that, you know, all of these other issues are taken care of. That is our focus. We don't need to add little things here and there, because that's our focus. Well, that's helpful. Last 50 seconds here, there was some questions on the MAUDE database, I just wanted to give you the-. Yeah. The airtime to, you know. Yeah. You know, I think everyone knows over the last couple years, we take complaints and MDRs very seriously. We're obviously quite conservative in the way things are reported. If you go look at those, they obviously, you know, there's nothing about the Flash algorithm or the product really that are relevant to that, those events and I think everyone knows that. I think it's pretty obvious. All right. right. Thanks, Alan. Thank you. Thanks for coming. All right. Thank you. Appreciate it. Just a home infusion provider in the U.S. and today with us is John Rademacher, President and CEO, and also Mike Shapiro, CFO. Gentlemen, I guess only a few days ago, you made a big announcement, a merger with Amedisys. Maybe first you can, just, you know, very, high level, key, you know, main points that, we should, you know, keep in mind when it comes to this merger before we jump into more detailed questions. Great. Well, thank you, Joanna. Thrilled to be here. Excited to talk not only about the progress that we've made as Option Care Health, but more importantly, the vision that we have as we see the businesses coming forward. Before we start, certainly want to make certain that everyone understands we may be making some forward-looking statements, based on, you know, our assumptions and expectations moving forward. There's risks inherent with that. We ask and encourage you to go to our investor website to take a look at those risks and understand that in the safe harbor aspects of that. First and foremost, just wanna hit on how excited we are of the progress that we've made as an organization. Lost in last week's news was, really a strong quarter that the organization delivered, and our team continues to be focused around delivering high quality care, at an appropriate cost in a setting which patients wanna receive that. Really great progress on all of the key initiatives that we have, and such an incredible foundation that we're building from. A lot of really strong momentum. The team continues to be focused around capturing market share from that perspective. Good execution within our procurement area, and focus around the cost of goods as we move that. Also really strong cash velocity as we looked at the way that our revenue cycle management team continues to execute and the concept of having and establishing a perfect claim from the moment we receive the referral. Really strong momentum in the first quarter. Continued solid foundation that we're building from, and I think that builds even more confidence in the announcement that we made and why we're excited about the opportunities that sit ahead of us as we think about combining with Amedisys and creating a very unique platform to serve patients in the home or in an alternate infusion suite. With this background where you mentioned the strong results, in the home infusion business, so I guess the key question is, you know, why diversify away? Yeah. Why not stay a pure, home infusion kind of, company? Look, we've worked really hard to establish an incredibly solid foundation to build from, and we've been talking for a while around the need to look broader around care as it's being delivered into the home. You know, as we went through a lot of work coming out of the integration work that we did with the BioScrip merger and started to push ourselves forward, we looked at five key trends. As an organization and also, you know, in conversations with my board of directors, looked at five things that really are going to be trends that are going to influence and impact the way that care is delivered moving forward. First and foremost, scarcity of labor and clinical labor is with us. Organizations that are well-organized to capitalize on that, we think will be well-positioned to continue to grow and succeed in the marketplace. The second area is that payers are really starting to change their view around focusing around total cost of care. Whether you wanna call that value-based reimbursement or other models, we know that the reimbursement model will be changing over time and thinking about what we need to do to provide broader services with that. We believe the home is going to be a important center of care, and that the ability to have additional services and additional capabilities to wrap around the patient is going to be a mission-critical success factor. We know that aging demographics continue to push more individuals to being Medicare eligible. We know that a vast majority of them are choosing Medicare Advantage as being the platform and the program that they will utilize. The fifth thing is, we know that many of the patients that are on service today that have chronic conditions are polychronic. They have a multitude of needs that they are working through, not just the infusion, not just the infusion drug, but they have broad needs, not only for infusion services but other things that wrap around them. The ability that we have as an organization and where we think the power of this combination is to really address all five of those areas and being better positioned around a marketplace that's changing, around a need that is developing, and providing additional services while we're in the home in the preferred position that we have. Right. I guess, you know, thinking about the core of the Amedisys business, the Home Health, right, and the rate cuts that are coming, or there is one already happening this year, and then potentially more, you know, next year and into 2025. You know, what is the impetus to act on this now ahead of, you know, knowing where these rates will shake out on the Medicare side for Home Health? Yeah. We did a lot of research heading into this. You know, one of the things we've heard is, and you'll see it in the proxies as it comes forward, we've been talking with Amedisys since last summer, last fall, and thinking about what this combination will be. This isn't new news. In many instances, folks have been anticipating some of the changes that are in there. As we ran through our analysis, both what we did internally and using experts that helped to inform us around the process, we think that we have built into the model an appropriate assessment of those types of changes. We also believe that as we're looking forward, that the marketplace is pretty much factored that in, into the price points and when we looked at the exchange ratio with the Amedisys, you know, transaction. Look, there's certainly a range that's in there. We are conservative by nature in the way that we approach it, and we think that we've been appropriate in anticipating what a June and then ultimately November, you know, announcement will be as we're thinking about that moving ahead. I guess, you mentioned you've been looking at this asset for some time and kind of sitting where it fits. Just curious, you know, how this came about. Were you looking at different types of, you know, verticals in home care? You know, why did you decide to go with Home Health hospice platform? Also there's other options as in, like, there's other platforms, so why Amedisys versus, you know, some other platform? Yeah. We've been doing a lot of work with the strength of the business and with the focus around thinking around how we were going to evolve. We've been talking about opening the aperture for a while. We've been talking about what are there additional services that we can do when we're in the home, and how can we think differently around a model that would be more effective in streamlining the way the care plans are delivered and utilizing critical resources in a more efficient way. We've talked about. We announced a relationship with Amedisys going back to Operation Warp Speed and helping to deal with the public health emergency and thinking about how do we get the monoclonal antibodies into the marketplace. That partnership or that relationship started at that basis. We continued in conversations, especially with hospital at home and things that were happening in the Contessa space. You know, the orbits continued to circle and we saw a really important opportunity to work more closely and then to create something better as we looked at the capability sets of both organizations. We're really confident that as we're looking forward, all of the capabilities that exist there today just put us in a better position to meet the needs and the changing needs as we look forward. There's a lot of capability set. We identified and we called out on the, on the call on Wednesday that the ability to cover a broad spectrum of the care continuum, everything from what we can do with preventative care and focus around those chronics and medication or chronic management through a post-acute event, the hospital at home and SNF at home capabilities, all the way to palliative, whether it's curative or comfort, to end of life. Having that broad of a spectrum, and the ability to cover that much of the care continuum, we think helps to better position us as a partner of choice for payers. It positions us better to take a look at how to leverage and utilize the clinical capabilities of the broader organization. I believe it creates a better outcome for patients that move across that continuum across their lifespan. One thing I'd add, Joanna, specific to your question around why Amedisys within this space. I think as John and I have shared, we've spent an exceptional amount of our time looking at a number of assets, a number of opportunities for us to deploy shareholder capital. As we really dug into the Home Health space, and we really explored their track record, both around their history of providing high quality results, unparalleled patient satisfaction in this space, and their quality and compliance track record. We found that to be truly differentiated in this space, and we thought that that was a very complementary cultural aspect as we looked at building upon the platform that we've established. In prior questions, you mentioned payer relationships and I guess shifting to different models. I guess before we go there, the other, I guess, headwind for Home Health, right, is the Medicare Advantage and how this is a negative mixture as that payer grows and the membership grows much faster than fee for service. Would this merger, is one of the rationale here is that you're gonna try to address it or, you know, as a combined entity, try to influence the MA contract with the on the Home Health side? Is there maybe some benefits you see also on the infusion side, on the flip side from having those two assets together? Yes. As we look at it and the conversations that we've had and, until we could announce, they were limited in the format. What we hear from the payer community is, like, this focus around the total cost of care and trying to drive better clinical outcomes at a lower cost and aligning around that. We have in the conversations, and you've seen in some of the announcements that Amedisys has made, is they're starting to make some progress in getting better rates with certain payers that are more of a case rate and episodic as opposed to the fee per visit type of structure. We think that there will be traction there. I go back to the first, trend, that I, that I identified, and that is access to clinical resources, there's a scarcity value there. I think the better you can align around the aligned needs of the payers, which is they want to get their members into these types of settings and provide high quality care at an appropriate cost, the more we can make certain that we have a position at the table to have those conversations and make certain that we're paid fair value for the value that we deliver. That's going to be part of it. I think having both the infusion as well as the Home Health capabilities and being able to look at how to rationalize the use of the clinical resources, and we know there's waste in the system. There's ways for us to become more efficient and effective in the way that we're addressing the needs of patients in the home. That's a benefit for the patient, that's a benefit for the payer, that's a benefit for us from a capacity standpoint in being able to leverage and utilize the model in new and more efficient ways. I think across all of that, there's an opportunity to really think differently, in delivering care in the home in a much more comprehensive and a much more robust manner. I guess what gives you confidence that the response from the plans, from the commercial plans will be positive? Obviously the track record for the Home Health has not been really that great, because even for Amedisys, you mentioned they made some traction on these new contracts, but obviously it's been very elongated process. What gives you confidence that now things, you know, will be different? We've talked about this, in other settings as well. No one's knocking on our door saying they wanna give us more money in the infusion space either. I mean, we fight for every aspect of reimbursement to make certain that we're fairly paid from that standpoint. We believe that there's a compelling value proposition here to drive better outcomes for their members, for their patients. We know that in every conversation that we have at the health plans, and I'd say this is true for Home Health as well, is, you know, they're focused on making certain that they have appropriate prices, right? Scale is gonna be important to make certain that we can drive operating efficiencies and we can price our products appropriately. The second thing they always look for is access. They need to make certain that you can have a wonderfully low-priced product, but if you don't have any access and you don't have the clinicians to be able to take those patients on the service, they're gonna linger in the higher cost settings. You have to make certain that access is part of that. The third thing is quality. As Mike said, we believe with the Amedisys team, they're focused around quality, their star ratings, independent accreditation bodies rank them high in their quality, and that's something that payers really want. We saw the impacts of some of the payers in Medicare Advantage who didn't get the star ratings and who suffered some impacts because of that. High star ratings is gonna be very important. The last thing is around patient satisfaction, member satisfaction, right? They've got to win their members on an annual basis in many of those instances. Our continued focus around those four dimensions and building programs that are in alignment with that, we think is right squarely aligned with the needs of the payers as they move forward. Those conversations can happen. I can tell you know, since the announcement on Wednesday and the news getting into the marketplace, certainly we've had conversations because we now can have more open conversations with some of our key health systems and some of our key payer relationships. I can tell you they're all excited. They wanna learn more. They wanna hear more around what the capabilities will be. There was positive response from those key, you know, customers that we have in helping to think differently around how to have a smooth transition of care out of the hospital into the home and how to develop new programs that are aligned with the payer's needs. We're encouraged by that initial feedback and know that there's gonna be a lot of work post-close to continue those conversations moving forward. I guess talking about payers, previously you mentioned a value-based care, right? The shift, we obviously hearing from pretty much every single payer talking or payer and provider talking about this. On that front, you know, what gives you confidence that you can, you know, do it right and you can coordinate all these different services you're gonna have under one roof? Because obviously we know that at United, Optum is pretty much working on that, but they have a dedicated payer to work with, right, the UnitedHealth plan. I guess, you know, what gives you confidence that you can do it as well as them or maybe better? I think the independence that we have allow us to have open conversations and strategic conversations with many of the payers in the marketplace. Not all payers are as endowed as United is with its capability set. The ability for us to have those conversations and to start thinking differently and then meeting the needs and building programs that are aligned with the specific plans, we think is an advantage. That independence allows us to do things and innovate with them through the process. You know, that aspect... Look, we have a very productive relationship with United today, even in the infusion space and they have captive capabilities that they have there. We have very productive relationship with Aetna, and they have, you know, capability set as well. Our ability to have that independence to continue to innovate, to continue to meet the needs, hear their voice, and respond quickly through that process and the agility that we've been able to demonstrate even in our existing model, we think will be an advantage for us to have those conversations and help to steer the way the market's gonna go. We've had, I think with many in the room, we've had conversations. It's hard to really define value base in a clear way, but we know it's evolving. We know total cost of care is something that is front and center it needs to be dealt with. Having the ability to think more broadly, not just on the infusion event, but on the total patient care and being a bigger part of that care plan, we think allows us to have a stronger voice in that process and a better position in order to be part of the change that's coming. Just wrapping it up, because obviously we understand the long-term, strategic value and, you know, where you're headed with this combination, but kind of trying to, you know, put numerically, some of the benefits, or, you know, how the model will change after the merger is completed. You know, how should we think about the growth algorithm for this entity, combined entity, you know, longer term? Yeah, that's a great question. Look, first and foremost, the leadership team on the Option Care Health side has a track record of knowing how to integrate complex organizations in a manner where we can unlock shareholder value while preserving unparalleled patient cares. In the last three and a half years... Since tackling the BioScrip integration, you know, we've unlocked more than 130% in total shareholder return at a time where we brought together two different organizations with admittedly some challenges, inheriting the BioScrip platform. Looking forward, we get really excited not only with the capabilities on the Option Care Health side, but rolling up our sleeves with the leadership on the Amedisys side to really build a new platform. From an outlook, as we think about, we talked about, you know, unlocking $75 million in synergies, $50 million of cost side synergies, and $25 million from incremental revenue and programs with payers and referral sources. That would be by year three. That's not the end zone. That's not the finish line. That's an interim expectation. As we draw the line out, we see a compelling financial proposition. We see this combined organization generating top line of high single digits. We see low double-digit adjusted EBITDA earnings going forward, which would imply that, you know, out of the gate, we'll be in the neighborhood of 10% EBITDA margins, and we would expect to modestly accrete. Double-digit earnings growth compounding and expanding the EBITDA margins over time. You draw the line out, you know, we're three and a half years post BioScrip. If we were to draw the line out, assuming we close the transaction later this year in 2027, that implies we'll be generating north of $9 billion in revenue. Our profitability from an adjusted EBITDA perspective, we estimate will be between $900 million and $1 billion with a double-digit EBITDA margin. Out of the gate, from a cap structure perspective, on a pro forma combined basis, we're 2 x leverage. I think one of the other key headlines is the cash generation capabilities. you know, I think by 2025, a couple of years getting into the integration, we would expect to be exceeding half a billion dollars of cash flow from operations. Given the capital efficiency of this platform, we think the ability to down the road deploy further capital in shareholder-friendly manner is incredibly compelling. We're really excited about building on the track record of integration and delivering growth, and we think that that doesn't change with this combination by any means. Good to hear that. On the synergies, can you give us a little more details? The $75 million, the 50s, the costs. Sure. Can you kinda flesh it out a little bit what this entails and maybe, you know, on the timing of when we should start seeing some benefits of that setting? We start getting after that day one. Even with the BioScrip transaction 3.5 years ago, we never stopped driving, whether we call it acquisition-related synergy or whether we call it doing our jobs and driving cost efficiency in the business. Naturally, bringing two public companies together, you would expect things like public company costs, board expenses, public filing, audit, et cetera. We look more broadly across this enterprise. Just the indirect spend pool alone, excluding the cost of the clinicians in providing care, there's $1.3 billion in SG&A. I think most folks know our track record at being relentless around focusing efficiencies while also making sure that we're investing to grow. I think most folks know where they would place their bets on the over-under on delivering the $50 million of cost synergies. We have a very high degree of confidence in that. I think what's more exciting or equally as exciting is, you know, the momentum that we see from the commercial strategies going forward, which we think complements that. From a cost side, we think we'll start unlocking that in the first year and build on that momentum from thereafter. I guess the other piece is the 25 EBITDA from the revenue synergies. Can you give us a sense of the magnitude of these revenue synergies and what it actually entails? Is it the commercial contracting benefits? Is this cross-selling? Kind of more details? Is it more on the infusion side or Home Health side, or is it equally spread out when it comes to these revenue synergies you would expect? I'll start, and Mike certainly can add to it. Out of the blocks, we'd look at probably four key areas in which we do it. Certainly, making the commercial team more effective to capture demand in the marketplace, to make certain that we are well positioned there. We've talked before about reach and frequency and taking a look at where our position on that. There are situations today where both organizations may have resources embedded within a facility. We may need two there. We may need one, and we can redeploy to other opportunities in that marketplace. We'll be thoughtful around that commercial execution and looking for those opportunities for cross-sell, up-sell through that process. I'd say both in the opportunities that sit with the infusion side to potentially pull more patients onto infusion services that require that. We'll focus there, but also in helping those discharge planners look for a one-stop shop to be able to discharge a patient that may need home infusion services and Home Health services and helping to coordinate that in a better way. I'd say the second area is in the hospital at home, and the focus around the Contessa platform and what exists there. A big portion of that cost and the spend there is on infusion products, which is why we've got a partnership with them and had really fostered that. We'll look to capitalize there, and drive some efficiencies and effectiveness as they're thinking about that program and how to effectively utilize it. That builds into SNF at home, as well as the hospital at home program. The third area is, and I talked about some of the things that are necessary to wrap around the patients, in the chronics to provide a better care, coordination to be able to provide additional services while we're in the home, and think differently around not just the infusion event, but the space in between those infusion events to drive better clinical outcomes. The last area is, look, this creates an incredibly strong platform in order for new products to enter the marketplace, so new therapeutical categories. We've talked, and folks are very familiar with what's going on with some of the Alzheimer's therapies and what may come there. We've been very conservative around our approach that we need to have a clear understanding of the path to payment and how that would be reimbursed through the process. You would have a platform that would allow you to really capitalize on the footprint, the community-based service model, and be a partner of choice if there is a clear path to payment, and that would move forward. This platform just gives us a tremendous opportunity to participate different in the marketplace if those events were to start to happen. That's not the only reason, but it's an additive benefit of a stronger platform and more capability sets that are required to have a comprehensive solution. We have a few minutes left. Just coming back all the way to your introductory comments about your the home infusion business. Obviously, we didn't spend that much time on the call on Wednesday talking about the quarter and you mentioned it was strong, you know, it came in better. Maybe just two questions there 'cause in terms of the topics during the conferences around the utilization and labor. Mm-hmm. In terms of the volume, sounds like things were tracking there well, maybe can you flash into chronic versus acute? Also specifically for on the acute care business, we heard all the hospitals seeing, you know, very favorable trends even when it comes to volumes in Q1 and also into Q2. Kinda can you talk about the, you know, trends in your business? We'd love to talk about the first quarter, Joanna. Look, we're really proud, and as John mentioned, the momentum coming out of the first quarter, we feel really good. It was balanced execution across the board. We see continued strength in our acute portfolio as we've become and continue to be that dependable partner of choice to health systems transitioning patients out of the hospital. With some of the competitive dynamics from earlier in 2022, we've continued to capitalize on those opportunities, and we saw robust growth in the acute portfolio, which we've been very candid. We see longer term growing in the low single digits. We delivered mid-single digit performance, and that's some of our higher gross margin profile therapies. At the same time, we continue to be a good collaboration partner on the chronic side. We're really excited about the balanced top line results that we've delivered. As we skew more towards chronic, again, that's more of a predictable and stable revenue base, which also helps to flatten out our years more than if, for those of you that have been following home infusion, rewind a few years, you typically saw a little bit more of a depressed start to the year, driven by the acute side. Equally as exciting, look, our procurement team is the best in the industry. We continue to fight for every basis point on the therapy margin side, and we have reached new highs in our penetration of our ambulatory infusion centers, which we continue to aggressively expand. We exited the first quarter with over 26% of our nursing events occurring in one of our centers. That was in the high teens a couple of years ago before we really started that concerted effort. Not only does that help us from a clinical labor capacity perspective, but it helps us drive margin improvement because we're driving better utilization of that costly clinical labor component. Down below, you know, our focus on spending leverage, back to my earlier comments, continues to be relentless. We continue to deploy automation and technology in our revenue cycle side, which has led to the highest cash velocity we've reported internally as well as, you know, driving better labor efficiency within our indirect labor investments. Just really excited about the momentum. We were north of 9% EBITDA margin in the first quarter. Equally as important, we generated approximately $90 million in cash flow from operations and actually increased our cash balances despite deploying $75 million for a share repurchase from Walgreens. Just really excited at the strength of the first quarter and the momentum we're carrying that into the back half of the year. The only other thing I would add to that is we also announced Naven Health, and that was a combination of Infinity Infusion Nursing and Specialty Pharmacy Nursing Network to create Naven Health that's focused around making certain that we have access to the clinical resources that are necessary. Really great progress from that standpoint. Net new, so the number of new nurses that we have available increased over the quarter. We expect as this moves forward, we'll continue to see that progress. Remember, that focus originally was on infusion nursing on that. We created Naven Health because it will also give us the opportunity to expand as we're looking at a broader need for Home Health and hospice into that process to be able to utilize that engine to help support the growth of the business as we move forward. Excited about the potential that that brings us as well. I think that's all the time we have. I'm glad you mentioned Maven 'cause it was on my list too. Yeah. Which is exciting. Thank you, gentlemen. Yeah. Thank you, Joanna. Thank you, everyone.