BrightSpring Health Services, Inc. is a Louisville, Kentucky-headquartered provider of home and community-based health services for complex populations (Nasdaq: BTSG, 6.75% Tangible Equity Units: BTSGU), operating through two segments: Pharmacy Solutions (specialty pharmacy, PBM, infusion, mail-order) and Provider Services (home health, rehab, personal care). For Q2 2026 (continuing operations post-Community Living divestiture March 30, 2026), net revenue of $3.873B was up 23.0% YoY ($3.148B), with Pharmacy Solutions at $3.407B (+22%, prescriptions flat at 10.8M but revenue/script +22% to $314, gross profit/script +28% to $27.50) and Provider Services at $466M (+30%, home health census +54% to 46,448). Gross profit $493M (+31.5%), Adjusted EBITDA $206M (+44.2%, margin 5.3% vs 4.5%), net income $87M (vs $9M). Leverage 2.15x (down from 2.27x at March 31). $300M First Lien paydown and rate refinancing. June 2026: KKR/management secondary offering with concurrent $60M share repurchase (1.026M shares). FY2026 guidance raised: Revenue $15.1-15.4B (+17-19.5% YoY ex-divestiture), Adjusted EBITDA $820-845M (+32.8-36.8%), Amedisys/LHC branches acquisition adding ~$35M EBITDA.
The investment thesis rests on three variables. The Pharmacy Solutions margin expansion and the specialty mix shift is the load-bearing pharmacy variable, with prescriptions flat (10.8M) but revenue/script +22% to $314 and gross profit/script +28% to $27.50, reflecting favorable drug mix, PBM contract improvements, and specialty penetration, and the strategic intent is to continue the margin per script trajectory while growing specialty volumes. The Provider Services census growth and the branch acquisition integration is the load-bearing provider variable, with home health average daily census +54% YoY to 46,448, rehab persons served +9%, and the Amedisys/LHC branch acquisition (~$35M EBITDA contribution expected in 2026), and the strategic intent is to integrate the acquired branches while scaling the organic home health platform. The deleveraging and the capital structure optimization is the load-bearing financial variable, with leverage at 2.15x (targeting further reduction), $300M First Lien paydown with interest savings, the $60M buyback alongside KKR secondary, and the strategic intent is to reduce leverage toward the low-2x range while maintaining acquisition flexibility.