Name: AMEDISYS INC Q4 2024 Earnings Call
Start: 2025-02-26T00:00:00.000Z

Executive Summary

Q4 2024 revenue was $598.1M (+4.8% YoY, +1.8% QoQ); GAAP diluted EPS was -$0.62 due to a $48.4M non-cash impairment and $17.4M merger-related expenses, while adjusted EPS was $0.96 (+2% YoY, -4% QoQ) .
Segment performance: Home Health revenue rose to $377.0M (+5% YoY), Hospice to $212.9M (+3% YoY), and High Acuity Care to $8.1M (+37% YoY), though High Acuity Care recorded a $48.4M impairment and an operating loss of -$53.0M .
Operating metrics mixed: DSO improved to 43.0 (from 44.4 in Q3 and 47.7 YoY), net debt fell to $75.7M (0.3x net leverage), while visiting clinician CPV rose with wage inflation; hospice net revenue per day increased with 2024 reimbursement update .
No earnings call was held due to the pending UnitedHealth Group merger; supplemental slides were furnished. Regulatory backdrop includes a final hospice rate +2.9% (10/1/24) and a home health industry rule +0.5% (1/1/25) .

What Went Well and What Went Wrong

Volume growth: Home Health same-store admissions +8% and volume +7%; Hospice average daily census +0.5%; High Acuity Care admissions +29% .
Quality and patient satisfaction: 88% of care centers at 4+ Stars (Jan 2025 final release); patient satisfaction star improved to 4.02 vs industry .
Cash and liquidity: CFFO $70.3M, free cash flow $59.8M; net debt down to $75.7M; DSO improved to 43.0 from 44.4 in Q3 and 47.7 a year ago .

GAAP loss: Q4 GAAP diluted EPS -$0.62 driven by $48.4M goodwill/intangibles impairment and $17.4M merger-related expenses; operating income swung to -$19.6M from +$34.0M YoY .
Margin pressure: Consolidated EBITDA margin fell to 9.1% (vs 9.9% Q3 and 10.4% Q3 2023) amid growth in lower-margin payors and wage inflation; visiting clinician CPV rose YoY and sequentially .
High Acuity Care: Segment recorded an operating loss of -$53.0M, including the impairment; limited risk revenue per episode declined YoY .

Metric	Q4 2023	Q3 2024	Q4 2024
Revenue ($USD Millions)	$570.8	$587.7	$598.1
GAAP Diluted EPS ($)	$0.59	$0.51	-$0.62
Adjusted EPS ($)	$0.94	$1.00	$0.96
Adjusted EBITDA ($USD Millions)	$56.7	$58.1	$54.6
Gross Margin %	44.0%	42.9%	42.7%
Adjusted EBITDA Margin %	9.9%	9.9%	9.1%

Segment ($USD Millions)	Q4 2023	Q3 2024	Q4 2024
Home Health	$358.9	$372.1	$377.0
Hospice	$206.0	$207.9	$212.9
High Acuity Care	$5.9	$7.7	$8.1
Total	$570.8	$587.7	$598.1

KPI	Q4 2023	Q3 2024	Q4 2024
DSO (days)	47.7	44.4	43.0
Net Debt ($USD Millions)	N/A	$138.2	$75.7
Net Leverage (x)	N/A	0.6x	0.3x
Visiting Clinician CPV ($)	$107.82	$108.09	$110.93
Total CPV ($)	$119.94	$120.74	$124.06
Hospice net revenue/day ($)	$174.10	$173.74	$179.02
Hospice ADC (patients)	12,859	13,004	12,925

Home Health average Medicare revenue per episode $3,030; Medicare visits per episode 12.0; total visits 1,812,048; admissions 109,686 .
Hospice cost per day $94.38; average discharge length of stay 95 days; hospice admissions 12,157 .
High Acuity Care total admissions 907 (248 full risk, 659 limited risk); impairment $48.4M; operating loss -$53.0M .

Metric	Period	Previous Guidance	Current Guidance	Change
Consolidated financial guidance	Q4 2024 / FY 2025	Not provided	No formal guidance; no earnings call due to pending UHG merger	Maintained (no guidance)
Hospice reimbursement	Effective 10/1/2024	Prior 2023 update +3.1%	Final industry rule +2.9%	Maintained rate increase backdrop
Home Health reimbursement	Effective 1/1/2025	2024 +0.8% (company est.)	Industry estimated impact +0.5%	Lower incremental uplift vs prior year

Note: No Q4 earnings call was held due to pending merger; trends drawn from supplemental slides and prior-quarter materials .

Topic	Previous Mentions (Q2, Q3 2024)	Current Period (Q4 2024)	Trend
Labor inflation & CPV	CPV rising on wage inflation/health insurance; visiting clinician CPV $106.00 (Q2), $108.09 (Q3)	Visiting clinician CPV $110.93; total CPV $124.06; EBITDA margin pressure	Continued cost pressure
Payer mix shift (lower margin)	Mix shift cited as offset to rate increases; HH gross margin compression	EBITDA margin down 160 bps in HH on lower-margin payors; 40 bps down in Hospice on higher labor costs	Margin headwinds persist
Regulatory reimbursement	2024 HH +0.8% (company est.), Hospice +3.1% (10/1/23)	Hospice +2.9% (10/1/24); HH +0.5% (1/1/25)	Ongoing modest rate tailwinds
High Acuity Care scaling	Admissions growth (Q2-Q3); operating losses narrowing	Strong admissions (+29%), but impairment and operating loss -$53.0M	Strategic reassessment/impairment
Quality & patient satisfaction	89% care centers at 4+ Stars (Oct 2024); PS star 3.78	88% at 4+ Stars (Jan 2025); PS star 4.02	Stable high quality
Working capital/collections	DSO improved (52.1 in Q2 to 44.4 Q3, aided by collection timing)	DSO 43.0; CFFO $70.3M	Continued improvement

“Amedisys will not conduct a quarterly earnings call to discuss the fourth quarter and year end results” due to the pending merger with UnitedHealth Group; supplemental slides were furnished .
Segment drivers (from supplemental slides):
- “Medicare revenue per episode up 1.1% primarily due to the rate increase effective 1/1/2024… EBITDA margin decreased 160 basis points driven by the growth in lower margin payors and wage inflation.” (Home Health) .
- “Net revenue per day +2.8% primarily due to the +2.9% Hospice rate update effective 10/1/2024… EBITDA margin down 40 basis points primarily due to higher labor costs…” (Hospice) .
Culture/quality: “Every day, our employees bring warmth, compassion and clinical expertise into the homes of our patients… it is a profound honor to recognize their incredible commitment.” — Richard Ashworth, President & CEO (Spirit of Excellence Awards) .

S&P Global consensus data for Q4 2024 (EPS and Revenue) was unavailable due to missing CIQ mapping for AMED; as a result, we cannot provide a vs-consensus comparison for this quarter. Values that would normally be retrieved from S&P Global are unavailable at this time (Values retrieved from S&P Global)*.

Volume-led topline growth with YoY revenue up 4.8% and sequential growth of 1.8%, but adjusted margins compressed on wage inflation and payer mix; watch staffing costs and CPV trends for margin recovery .
GAAP loss driven by High Acuity Care impairment; despite admissions growth, the segment’s economics and strategic fit require monitoring post-impairment .
Hospice rate update supports revenue/day, but higher labor costs offset margin; the net effect is modestly supportive but insufficient to expand consolidated margins near term .
Working capital improvements and lower net leverage (0.3x) enhance financial flexibility into the merger timeline; DSO and cash conversion remain positive catalysts .
Quality remains best-in-class with high Star ratings and improved patient satisfaction; supports referral relationships and volume durability even amid reimbursement changes .
Merger uncertainty (including DOJ action risk) remains an overhang on stock narrative; lack of a call limits near-term guidance clarity, shifting focus to regulatory milestones and integration prospects .
Near-term trading: expect sensitivity to updates on merger/regulatory developments and labor cost signals; medium-term thesis hinges on payer mix normalization, productivity initiatives, and hospice stability .