Inflation Reduction Act Impact
Q: How will the IRA affect your business?
A: The Inflation Reduction Act's impact is mostly in 2026; we have one drug on the list in specialty oncology, IMBRUVICA, but we see no risk due to constructive conversations with the manufacturer. " " In infusion, STELARA is isolated and not material to us. " " " For LTC pharmacy, CMS clarified a true-up mechanism that reduces risk significantly. " " Overall, we feel in a good place with very low risk looking ahead. " "

Biosimilars and Pricing Adjustments
Q: What's your exposure to biosimilars and pricing changes?
A: Biosimilars aren't relevant in our specialty oncology and rare disease business. " In infusion, only STELARA has biosimilar activity, representing just 0.2% of revenue and less than 0.5% of gross profit, so we see no material impact. " " We view the STELARA situation as idiosyncratic and isolated " , and it won't materially change our outlook for next year. " "

2025 Guidance and Growth Drivers
Q: What are key headwinds and tailwinds for 2025?
A: While not giving formal guidance yet, we feel positive about continuing our double-digit revenue and EBITDA growth into next year. " Tailwinds include strong momentum in specialty pharmacy, especially in oncology and rare diseases. " We expect 15 LDD launches this year, with 4 or 5 exclusives. " Infusion investments will start paying off, with double-digit volume growth and margin improvement expected. " Home health, hospice, and rehab are also expected to grow at double-digit rates. "

Q4 Margin Improvement
Q: How will margins improve in Q4?
A: Q4 is typically our highest margin quarter. " Drivers include the generic launch of SPRYCEL, new hospice rates, and decreased start-up costs from onboarding new customers. " " We also expect continued volume growth and leveraging of fixed costs. " "

Capital Deployment Priorities
Q: What are your capital deployment plans for next year?
A: We'll continue our strategy of focusing on accretive acquisitions in long-term care pharmacy and infusion on the Pharmacy side, and rehab, home health, hospice, and home-based primary care on the Provider side. " We target small, high-ROI investments, including CON tuck-ins and de novo expansions. " We're focused on reaching a specific leverage target and remain agile for unique opportunities. "

Specialty Pharmacy Growth
Q: What's driving growth in specialty pharmacy?
A: Specialty pharmacy is showing strong momentum, particularly in oncology and rare diseases. " The generic launch of SPRYCEL is a tailwind, and another drug is expected to go generic in Q1. " " We have 15 LDD launches this year, with manufacturers selecting us in ultra-narrow networks. " Specialty and infusion revenue grew over 40% in the quarter. "

Impact of Part D Changes on Utilization
Q: Are lower patient costs under Part D increasing utilization?
A: Yes, the Part D changes making drugs more affordable are positive for us. " We've seen robust volume growth in oncology and expect another bump in January due to these changes. "

Home-Based Primary Care Efforts
Q: How are your primary care efforts progressing?
A: Our home-based primary care business is growing organically, with patient volumes up 40%-50% this year. " We're aiming for $7 million EBITDA this year and targeting over 100,000 patients in 5-7 years. " Key milestones include securing ACO contracts and integrating our I-SNP acquisition. "

Medicare Advantage Impact
Q: How does MA plan pressure affect your business?
A: MA's impact is mainly on our home health business, which is about 30% MA. " We've had constructive relationships with payers, negotiating sustainable rates. " The high demand and low supply in home health means 40% of those needing care don't receive it, highlighting the importance of our services. "

Provider Segment Margin Improvement
Q: What drove Provider segment margin improvement in Q3?
A: Margin improvement was due to volume growth, positive mix shift to higher-margin businesses like home health, hospice, and rehab, and over $20 million in cost reductions from efficiency projects. " We also benefited from rate support in hospice and community living. "

Nonrecurring Items and Guidance
Q: Were nonrecurring items included in guidance?
A: Yes, start-up costs and the payer settlement dating back six years were included in guidance. " We also had increased nonrecurring expenses from finalizing legal cases and acquisition and integration costs. "

Sequential Growth in Q4 Guidance
Q: How are you thinking about Q4 growth trends?
A: Q4 implies 15%-16% year-over-year growth and a sequential increase of $10-$15 million. " We expect strong growth across Pharmacy and Provider segments, similar to Q3. " Seasonal factors and initiatives like the full impact of the SPRYCEL generic launch support this growth. "

Haven Hospice Acquisition
Q: What's the contribution from the Haven deal?
A: The Haven Hospice deal is going well; we expect $1-$2 million EBITDA this year and see it as a $15 million opportunity over several years. "

Home and Community Pharmacy Onboarding
Q: Can you update on the new long-term care client?
A: We successfully onboarded a customer across over 200 buildings, generating about $1 million monthly EBITDA. " Lingering costs will decrease through Q4 and into Q1. "

Capital Allocation to Noncore Businesses
Q: Are any areas considered noncore for capital allocation?
A: No significant changes; we'll continue focusing on core areas like rehab, home health, hospice, and home-based primary care. " We're dedicated to our existing strategy and remain opportunistic. "