Option Care Health (NASDAQ:OPCH) executives said the company delivered 2025 results in line with figures it had pre-announced in January and reaffirmed its 2026 outlook, while continuing to navigate reimbursement and mix headwinds tied to STELARA and biosimilar conversions.
Scale, payer programs, and referral momentum
President and CEO John Rademacher emphasized the company’s national scale as the “nation’s largest independent provider of home and alternate site infusion therapy,” highlighting 50-state licensure and what he described as consistent clinical outcomes and same-day service for large health systems and payers. Rademacher said the company served more than 315,000 unique patients in 2025 and completed over 2.5 million infusion events.
On the provider side, Rademacher said hospital systems facing economic pressure continue to look for ways to transition patients safely out of inpatient settings, noting that Option Care embeds registered nurses in hospital systems to support transitions of care. He also cited support for hospital 340B programs, describing Option Care’s role as facilitating eligible pharmacy arrangements and passing 340B savings back to hospitals; he said it is not a meaningful contributor to the company’s overall economics and is treated as a pass-through.
Technology and site expansion investments
Management discussed ongoing investments in automation and artificial intelligence, particularly within revenue cycle functions. Rademacher said the company has automated key patient administration tasks such as invoice processing and cash posting, and that about 40% of claims are processed without human intervention. In response to questions, executives said AI use cases are expanding beyond revenue cycle management to areas including call center/customer service “agentic” tools, workforce optimization, and inventory management, while noting the company has not put AI into clinical protocols.
The company also continued to invest in ambulatory infusion clinics. Rademacher said more than 25 centers now offer “advanced practitioner” capabilities. He provided context around Intramed Plus, which Option Care acquired in 2025: on a pro forma basis for Intramed Plus, infusion clinic visits grew more than 25% in the fourth quarter versus the prior year. He added that in the quarter, more than 34% of nursing visits occurred in an infusion suite or clinic, which he said supports both capacity and efficiency.
2025 financial performance and cash flow dynamics
CFO Meenal (who presented the financial results) said full-year 2025 net revenue was $5.6 billion, up 13% from the prior year, driven by “balanced growth” across acute and chronic therapies. Acute revenue grew in the mid-teens, while chronic therapies grew in the low double digits. She said STELARA biosimilar adoption created a 160-basis-point revenue headwind in 2025 due to lower reference price and reimbursement.
- Gross profit dollars: up 7.4% year over year
- SG&A: 12.1% of sales, down 50 basis points versus last year
- Adjusted EBITDA: $471 million, up 6%; margin of 8.3%
- Adjusted diluted EPS: $1.72, up 9%
- Operating cash flow: $258 million for 2025
- Net debt leverage ratio: 2.0x at year-end
Meenal said the company finished 2025 below its prior operating cash flow guidance of $320 million, citing strategic inventory purchases that produced favorable economics and higher-than-expected working capital needs for limited distribution therapies. She said the company “ramped up” working capital for certain limited distribution therapies to support long-term growth and noted that as sales increased 13%, working capital needs rose with the business.
On capital allocation, the company said it invested in growth and capacity, including adding more than 80 infusion chairs during 2025. It also completed the Intramed Plus acquisition, which Meenal said exceeded initial expectations, and repurchased more than $300 million of shares during 2025. Management also noted the board expanded the share repurchase authorization by $500 million.
2026 outlook reaffirmed; STELARA headwinds expected to be even through the year
Option Care reaffirmed the 2026 guidance it provided in January. Meenal said the outlook reflects a 400-basis-point revenue growth headwind driven by “STELARA IRA and STELARA biosimilars conversion,” as well as a $25 million to $35 million gross profit headwind tied to STELARA and biosimilar conversion. She said the gross profit headwind is expected to be realized evenly over the year, though she acknowledged that year-over-year comparisons may be more challenging in the first quarter given the prior-year timing of STELARA-related impacts.
- 2026 revenue: $5.8 billion to $6.0 billion (4% growth at the midpoint)
- Adjusted EBITDA: $480 million to $505 million
- Adjusted diluted EPS: $1.82 to $1.92
- Operating cash flow: greater than $340 million
Additional 2026 modeling items provided included expected net interest expense of $50 million to $55 million, an estimated tax rate of 26% to 28%, and an assumed first-quarter share count of 159 million shares.
In Q&A, management said early 2026 trends were “in alignment” with expectations and that nothing had prompted a change in guidance. Executives also discussed segment expectations, describing acute market growth as low single digit but indicating Option Care’s expectations are closer to mid-single-digit growth in acute for 2026, while chronic growth was described as high single digit to low double digit despite STELARA-related headwinds. They also noted that growing chronic faster than acute can pressure gross margin percentage due to mix.
Working capital focus and M&A pipeline
Looking ahead, Meenal said the company expects operating cash flow to rise more than 30% in 2026 versus 2025, supported by initiatives to reduce working capital, especially inventory. She described cash generation as seasonal, with the first quarter typically the low point and most cash generated in the back half of the year.
On M&A, management said it remains active in evaluating tuck-in acquisitions and adjacencies, with executives emphasizing discipline and the need for deals to be both strategic and financially attractive. Rademacher closed the call by pointing to what he described as the resilience of the platform, strength of the team, and confidence in the company’s ability to capture demand.
About Option Care Health (NASDAQ:OPCH)
Option Care Health (NASDAQ: OPCH) is a leading provider of home and alternate site infusion services in the United States. The company specializes in the administration of injectable therapies, including antibiotics, nutrition, hydration, immunoglobulin, pain management and specialty pharmaceuticals. Through its nationwide network of infusion pharmacies and nursing professionals, Option Care Health delivers customized care plans and in-home nursing visits to patients managing complex or chronic conditions outside of a hospital setting.
Option Care Health traces its current structure to the completion of its merger with BioScrip in early 2021, combining two of the industry’s most experienced home infusion businesses.
