What changed in this filing

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Item 7. Management’s Discussion and Analysis

2026-02-24 compared with 2025-02-26 · 56 added, 66 removed, 162 unchanged (43% of the section changed)

7 unchanged sentences

Option Care Health and its wholly-owned subsidiaries provide infusion therapy and other ancillary healthcare services through a national network of 196 locations around the United States.

The Company contracts with managed care organizations, third-party payers, hospitals, physicians, and other referral sources to provide pharmaceuticals and complex compounded solutions to patients for intravenous delivery in the patients’ homes or other non-hospital settings.

Our services are provided in coordination with, and under the direction of, the patient’s physician.

Our multidisciplinary team of clinicians, including pharmacists, nurses, dietitians and respiratory therapists, work with the physician to develop a plan of care suited to each patient’s specific needs.

We provide home infusion services consisting of anti-infectives, nutrition support, therapies for neurological disorders and chronic inflammatory disorders, immunoglobulin therapy, and other therapies for chronic and acute conditions.

The Company operates in one segment, infusion services.

Update on the Impact of the Change Healthcare Cybersecurity Incident

As previously disclosed, on February 21, 2024, Change Healthcare, a subsidiary of UnitedHealth Group, experienced an incident in which a cybersecurity threat actor gained access to some of its information technology systems (“Change Healthcare Cybersecurity Incident”).

Since the time of the system disruption, Option Care Health has worked continuously to find alternative processes to help maintain patient care and overall operations.

As of December 31, 2024, the Company has not identified any compromise or unauthorized access of its systems or networks due to this third party incident.

As of the end of the second quarter of 2024, the Company reconnected to key applications maintained by Change Healthcare and as of the end of the fourth quarter of 2024, the Company has fully recovered.

During the fourth quarter of 2024, the Company did not experience a material financial impact from the Change Healthcare Cybersecurity Incident on the financial results as reported.

The Company continues to maintain strong liquidity and, having resumed submission of all claims to payers, has determined that the Change Healthcare Cybersecurity Incident did not materially impact the Company, including its business operations, financial condition or results of operations.

Our national footprint enables us to collaborate with health systems and national payers to provide high quality care at an appropriate cost in a comfortable setting.

We have established key relationships that allow us access to local resources to ensure responsiveness to our patients’ needs.

At the center of everything we do is the patient.

This is the driving force behind all of our actions and the partnerships that we have broadly across the healthcare ecosystem.

Composition of Results of Operations

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Interest Expense, Net .

Interest expense consists principally of interest and fee payments on the Company’s outstanding borrowings under the ABL Facility, First Lien Term Loan, Revolver Facility, Senior Notes, amortization of discount and deferred financing fees, payments associated with the interest rate cap, and interest income earned on cash and cash equivalents.

Interest expense consists principally of interest and fee payments on the Company’s outstanding borrowings under the First Lien Term Loan, Revolver Facility, Senior Notes, amortization of discount and deferred financing fees, payments associated with the interest rate cap, and interest income earned on cash and cash equivalents.

Refer to the “Liquidity and Capital Resources” section below for further discussion of these outstanding borrowings.

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Equity in earnings of joint ventures consists of our proportionate share of equity earnings or losses from equity investments in two infusion joint ventures with health systems.

During the year ended December 31, 2024, other income (expense) primarily includes activity related to non-operating income and expenses.

During the year ended December 31, 2023, other income (expense) primarily includes the termination fee, net of merger-related expenses, received on behalf of Amedisys, Inc.

(“Amedisys”).

On May 3, 2023, the Company entered into a definitive merger agreement (the “Amedisys Merger Agreement”) with Amedisys, a leading provider of healthcare in home health and hospice settings.

On June 26, 2023, the Company entered into an agreement to terminate the Amedisys Merger Agreement (the “Mutual Termination Agreement”).

Under the terms of the Mutual Termination Agreement, the Company received a payment of $106.0 million in cash on behalf of Amedisys (the “Termination Fee”).

Other (expense) income primarily includes activity related to non-operating income and expenses.

Income Tax Expense .

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Change in Unrealized (Loss) Gain on Cash Flow Hedge, Net of Income Tax Benefit (Expense) .

Change in unrealized (loss) gain on cash flow hedge, net of income tax benefit (expense), consists of the (loss) gain associated with the changes in the fair value of hedging instruments related to the interest rate cap, net of income taxes.

Change in unrealized (loss) gain on cash flow hedge, net of income tax benefit (expense), consists of the (loss) gain associated with the changes in the fair value of derivatives designated as hedging instruments related to the interest rate cap, net of income taxes.

Results of Operations

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NET INCOME $ 207,585 3.7 % $ 211,823 4.2 %

OTHER COMPREHENSIVE (LOSS) INCOME, NET OF TAX:

OTHER COMPREHENSIVE INCOME (LOSS), NET OF TAX:

Change in unrealized (loss) gain on cash flow hedges, net of income tax benefit (expense) of $2,272 and $1,284, respectively

11 unchanged sentences

Gross profit margin 19.3% 20.3%

The increase in net revenue during the year ended December 31, 2024 was primarily driven by organic growth in the Company’s portfolio of therapies, consisting of acute revenue that had high single digits growth relative to the prior year while chronic revenue grew in the high teens.

The increase in cost of revenue was primarily driven by the growth in revenue, therapy mix, and acute drug supply chain disruption, as well as the comparable impact of certain temporary favorable therapy procurement dynamics in the prior year.

The decrease in gross profit margin was primarily due to the launch of certain new higher cost therapies included within chronic growth (including rare and orphan therapies) and to the same comparable impact of certain temporary favorable procurement dynamics in the prior year that did not continue into 2024.

Additionally, the Company received notice of a manufacturer’s intention to significantly reduce the spread at which the Company procures a certain therapy relative to drug reference prices beginning in early 2025, which is expected to negatively impact gross profit by approximately $60 million to $70 million in 2025.

The increase in net revenue during the year ended December 31, 2025 was primarily driven by organic growth in the Company’s portfolio of therapies, consisting of acute revenue that had mid-teens growth relative to the prior year while chronic revenue grew in the low double-digits.

Acute growth was largely driven by the impact of shifts in the competitive landscape, which increased the volume of patient service.

The increase in cost of revenue was primarily driven by the growth in revenue and therapy mix.

The decrease in gross profit margin was primarily due to mix, including certain higher cost therapies included within chronic growth (including rare and orphan therapies) as well as biosimilar adoption, partially offset by certain mitigation efforts executed in the first quarter of 2025.

Management expects these dynamics to negatively impact gross profit by $25 million to $35 million in 2026.

Operating Expenses

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Total operating expenses $ 749,989 $ 691,160 $ 58,829 8.5 %

The increase in selling, general and administrative expenses during the year ended December 31, 2024 was primarily due to an increase in salaries, benefits, and general costs to support the business;

however, these expenses have declined as a percentage of revenue to 12.6% for the year ended December 31, 2024 compared to 14.1% for the year ended December 31, 2023, due to the Company’s focus on leveraging existing infrastructure to control spending.

The increase in selling, general and administrative expenses during the year ended December 31, 2025 was primarily due to investment in internal resources and other general costs to support both ongoing business needs as well as future business growth.

Selling, general and administrative expenses have declined as a percentage of revenue to 12.1% for the year ended December 31, 2025 compared to 12.6% for the year ended December 31, 2024, due to the Company’s focus on leveraging existing infrastructure to control spending.

The increase in depreciation and amortization expense was primarily due to the Intramed Plus acquisition.

See Note 3, Business Acquisitions , of the consolidated financial statements for further information.

Other Income (Expense)

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Equity in earnings of joint ventures 7,409 5,964 1,445 24.2 %

Other, net 4,831 89,865 (85,034) (94.6) %

Other, net (7,857) 4,831 (12,688) NM (1)

Total other (expense) income $ (55,006) $ (38,234) $ (16,772) 43.9 %

The decrease in interest expense, net during the year ended December 31, 2024 was primarily attributable to additional interest income generated from our cash and cash equivalents, partially offset by an increase in the Company’s First Lien Term Loan principal balance, compared to the year ended December 31, 2023.

(1) Not meaningful

The increase in interest expense, net during the year ended December 31, 2025 was primarily attributable to less interest income generated from our cash and cash equivalents due to lower interest rates, partially offset by a decrease in the interest rate on the Company’s First Lien Term Loan, compared to the year ended December 31, 2024.

See Note 11, Indebtedness , of the consolidated financial statements for further information.

The decrease in other, net during the year ended December 31, 2024 was due to the $106.0 million payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses during the year ended December 31, 2023.

There was no comparable activity during the year ended December 31, 2024.

The change in other, net during the year ended December 31, 2025 was primarily attributable to accruals for an abandoned or unclaimed property voluntary disclosure agreement program related to the pre-merger operations of BioScrip, Inc.

(“BioScrip”), which was entered into by BioScrip prior to its merger with the Company in 2019.

As of December 31, 2025, the matters related to this program are ongoing.

Additionally, the change in other, net was attributable to the $4.7 million loss on extinguishment of debt from the Company’s debt refinancing during the year ended December 31, 2025 with no comparable activity during the year ended December 31, 2024.

Income Tax Expense

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The Company recorded income tax expense of $75.3 million and $71.8 million, which represents an effective tax rate of 26.6% and 25.3% for the years ended December 31, 2025 and 2024, respectively.

The variance in the Company’s effective tax rate of 25.3% and 25.5% for the years ended December 31, 2024 and 2023, respectively, was primarily attributable to the difference in state taxes, various non-deductible expenses, and a change in state valuation allowance.

The variance in the Company’s effective tax rate of 25.3% for the year ended December 31, 2024, compared to the federal statutory rate of 21%, was also primarily attributable to state taxes, various non-deductible expenses, and a change in state valuation allowance.

The income tax expense for the year ended December 31, 2023 includes $21.8 million of tax expense related to the Termination Fee received, under the terms of the Mutual Termination Agreement, net of merger-related expenses, and the release of $5.8 million of state valuation allowance in September 2023.

The income tax expense for the year ended December 31, 2025 includes the release of $0.4 million of state valuation allowance, compared to a $2.2 million release in 2024.

The variance in the Company’s effective tax rate of 26.6% and 25.3% for the years ended December 31, 2025 and 2024, respectively, compared to the federal statutory rate of 21%, as well as year-over-year changes, was primarily attributable to the inclusion of state taxes in multiple jurisdictions, various non-deductible expenses, and changes in state valuation allowance.

Net Income and Other Comprehensive (Loss) Income

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Net income $ 207,585 $ 211,823 $ (4,238) (2.0) %

Other comprehensive (loss) income, net of tax:

Other comprehensive income (loss), net of tax:

Change in unrealized (loss) gain on cash flow hedges, net of income tax benefit (expense) (6,941) (3,931) (3,010) 76.6 %

1 unchanged sentence

Net comprehensive income $ 200,644 $ 207,892 $ (7,248) (3.5) %

The change in net income for the year ended December 31, 2024 was attributable to the $106.0 million payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses during the year ended December 31, 2023.

There was no comparable activity during the year ended December 31, 2024.

The change in net income was attributable to the factors described in the above sections.

For the years ended December 31, 2025 and 2024, the change in unrealized (loss) gain on cash flow hedge, net of income tax benefit (expense) was related to the change in fair market value of the $300.0 million interest rate cap hedge executed in October 2021.

Net comprehensive income decreased to $207.9 million for the year ended December 31, 2024, compared to net comprehensive income of $260.9 million for the year ended December 31, 2023, primarily as a result of the changes in net income discussed above.

Net comprehensive income decreased to $200.6 million for the year ended December 31, 2025, compared to net comprehensive income of $207.9 million for the year ended December 31, 2024, primarily as a result of the factors described in the above sections.

Liquidity and Capital Resources

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As of December 31, 2025, the Company had $396.0 million of borrowings available under its credit facilities (net of $4.0 million undrawn letters of credit issued and outstanding), described further below.

During the year ended December 31, 2023, the Company’s positive cash flows from operations have enabled investments in pharmacy, infusion suites, and information technology infrastructure to support growth and create additional capacity in the future, as well as to pursue acquisitions and share repurchases.

The Company’s primary uses of cash and cash equivalents include supporting our ongoing business activities, investment in capital expenditures in both facilities and technology, and the pursuit of acquisitions and share repurchases.

During the years ended December 31, 2025 and 2024, the Company’s positive cash flows from operations have enabled investments in pharmacy, infusion suites, and information technology infrastructure to support growth and create additional capacity in the future, as well as to pursue acquisitions and repurchases of Company shares.

The Company’s primary uses of cash and cash equivalents include supporting our ongoing business activities, internal investment in resources to support future growth, investment in capital expenditures in both facilities and technology, the pursuit of acquisitions, and the pursuit of share repurchases.

Ongoing operating cash outflows are associated with procuring and dispensing drugs, personnel and other costs associated with servicing patients, as well as paying cash interest on outstanding debt and cash taxes.

Ongoing investing cash flows are primarily associated with capital projects and business acquisitions, the improvement and maintenance of our pharmacy facilities and investment in our information technology systems.

Ongoing financing cash flows are primarily associated with the quarterly principal payments on its outstanding debt, along with potential future share repurchases.

Our business strategy includes the deployment of capital to pursue acquisitions that complement our existing operations.

Ongoing financing cash flows are primarily associated with the quarterly principal payments on our outstanding debt, along with potential future share repurchases.

Our business strategy includes strategic deployment of capital to internal investments in resources, infrastructure, and technologies to support future growth, the pursuit of strategic tuck-in and adjacent acquisitions that complement our existing operations and the pursuit of share repurchases.

We continue to evaluate acquisition opportunities and view acquisitions as a key part of our growth strategy.

The Company historically has funded its acquisitions with cash and cash equivalents with the exception of the Merger.

The Company has generally funded its acquisitions with cash and cash equivalents.

The Company may require additional capital in excess of current availability in order to complete future acquisitions.

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The Company’s ability to make principal and interest payments on any borrowings under our credit facilities and our ability to fund planned capital expenditures will depend on our ability to generate cash and cash equivalents in the future, which to a certain extent, is subject to general economic, financial, competitive, regulatory and other conditions.

Based on our current level of operations and planned capital expenditures, we believe that our existing cash and cash equivalents balances and expected cash flows generated from operations will be sufficient to meet our operating requirements for at least the next 12 months and beyond.

Based on our current level of operations and planned capital expenditures, we believe that our existing cash and cash equivalents balances, expected cash flows generated from operations, and credit facility will be sufficient to meet our operating requirements over the next 12 months and beyond.

We may require additional borrowings under our credit facilities and alternative forms of financings or investments to achieve our longer-term strategic plans.

Credit Facilities

On May 8, 2024, the Company entered into the third amendment to the amended and restated First Lien Credit Agreement dated as of October 27, 2021 (the “Third Amendment”).

The Third Amendment, among other things, (i) provides for an additional $50.0 million of incremental First Lien Term Loan indebtedness and (ii) reduces the interest rate on the First Lien Term Loan from Term Secured Overnight Financing Rate (“SOFR”) (including a credit spread adjustment) plus 2.75% to Term SOFR plus 2.25% and removes the credit spread adjustment with respect to such First Lien Term Loan.

The principal balance of the First Lien Term Loan is repayable in quarterly installments of $1.6 million plus interest, with a final payment of all remaining outstanding principal due on October 27, 2028.

The quarterly principal payments commenced in March 2022.

Under the Third Amendment, interest on the First Lien Term Loan is payable monthly on either (i) SOFR (with a floor of 0.50% per annum) plus an applicable margin of 2.25% for Term SOFR Loans (as such term is defined in the Third Amendment);

or (ii) a base rate determined in accordance with the Third Amendment, plus 1.25% for Base Rate Loans (as such term is defined in the Third Amendment).

On December 7, 2023, the Company entered into the second amendment to the amended and restated First Lien Credit Agreement dated as of October 27, 2021 (the “Second Amendment”).

The Second Amendment, among other things, provides for revolving credit commitments by the applicable Revolving Credit Lenders in an aggregate amount of $400.0 million (the “Revolver Facility”) pursuant to which such lenders have agreed to make Revolving Credit Loans to the Company.

The Revolver Facility matures on the date that is the earlier of (i) December 7, 2028 and (ii) the date that is 91 days prior to the stated maturity date applicable to any Term B Loans.

Borrowings under the Revolver Facility will bear interest at a rate equal to, at the option of the Company, either (i) the Term SOFR applicable thereto plus the Applicable Rate or (ii) the then-applicable Base Rate plus the Applicable Rate, which Applicable Rate shall be, subject to certain caveats thereto, as follows (i) until delivery of financial statements and related Compliance Certificate for the first full fiscal quarter ending after the effective date of the Second Amendment, (A) for Term SOFR Loans, 1.75%, or (B) for Base Rate Loans, 0.75% and (ii) thereafter, the Applicable Rate for Term SOFR Loans and Base Rate Loans, based upon the Total Net Leverage Ratio as set forth in the most recent Compliance Certificate received by the Administrative Agent pursuant to the terms of the Credit Agreement.

As of December 31, 2024, the Company had $4.1 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the Revolver Facility of $395.9 million.

On September 22, 2025, the Company entered into the fourth amendment (“the Fourth Amendment”) to the amended and restated First Lien Credit Agreement (the “Credit Agreement”) dated as of October 27, 2021.

The Fourth Amendment, among other things, (i) refinances the existing term loans with a new class of term loans (the “First Lien Term Loan”), reduces the interest rate on the First Lien Term Loan from Term Secured Overnight Financing Rate (“SOFR”) plus 2.25% to Term SOFR plus 1.75% and extends the maturity date of the First Lien Term Loan to September 22, 2032, (ii) provides for an additional $49.6 million of incremental First Lien Term Loan indebtedness, and (iii) extends the maturity date of the revolving credit commitments under the Credit Agreement (the “Revolver Facility”) to September 22, 2030.

Under the Fourth Amendment, the principal balance of the First Lien Term Loan is repayable in quarterly installments of $1.7 million plus interest, with a final payment of all remaining outstanding principal due on September 22, 2032.

Interest on the First Lien Term Loan is payable monthly on either (i) the SOFR plus an applicable margin of 1.75% for Term SOFR Loans;

or (ii) a base rate, plus 0.75% for Base Rate Loans.

The Senior Notes bear interest at a rate of 4.375% per annum, which are payable semi-annually in arrears on October 31 and April 30 of each year, and which began on April 30, 2022.

The Senior Notes mature on October 31, 2029.

The Company’s Revolver Facility provides for borrowings up to $400.0 million pursuant to which such lenders have agreed to make Revolving Credit Loans to the Company.

The Revolver Facility matures on the date that is the earlier of (i) September 22, 2030 and (ii) the date that is 91 days prior to the stated maturity date applicable to the Senior Notes to the extent any amount of the Senior Notes remains unpaid and outstanding as of the date that is 91 days prior to the stated maturity date applicable to the Senior Notes.

Borrowings under the Revolver Facility will bear interest at a rate equal to, at the option of the Company, either (i) the Term SOFR applicable thereto plus the Applicable Rate or (ii) the then-applicable Base Rate plus the Applicable Rate, which Applicable Rate shall be, subject to certain caveats thereto, as follows (i) until delivery of financial statements and related Compliance Certificate for the first full fiscal quarter ending after the effective date of the Fourth Amendment, (A) for Term SOFR Loans, 1.75%, or (B) for Base Rate Loans, 0.75% and (ii) thereafter, the Applicable Rate for Term SOFR Loans and Base Rate Loans, based upon the Total Net Leverage Ratio as set forth in the most recent Compliance Certificate received by the Administrative Agent pursuant to the terms of the Credit Agreement.

As of December 31, 2025, the Company had $4.0 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the Revolver Facility of $396.0 million.

Interest payments over the course of long-term debt obligations total an estimated $338.1 million based on final maturity dates of the Company’s credit facilities.

9 unchanged sentences

Net cash used in financing activities (277,305) (218,206) (59,099)

Net increase in cash and cash equivalents 68,716 49,663 19,053

Net (decrease) increase in cash and cash equivalents (179,941) 68,716 (248,657)

Cash and cash equivalents - beginning of period 412,565 343,849 68,716

1 unchanged sentence

Cash Flows from Operating Activities

The decrease in cash provided by operating activities during the year ended December 31, 2024 was primarily due to the $106.0 million payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses during the year ended December 31, 2023, changes in accounts receivable and accrued compensation and employee benefits.

Additionally, changes in accounts payable and inventory were driven by organic growth in the Company as well as strategic supply chain purchases.

The change in cash provided by operating activities during the year ended December 31, 2025 was primarily due to increases in inventories due to strategic purchases and a focus on maximizing the impact from volume based rebates and prompt pay purchase discounts.

The change was also largely related to an increase in accounts receivable driven by revenue growth.

The change in cash provided by operating activities for the year ended December 31, 2024 was largely driven by an increase in accounts payable due to timing of strategic purchases in inventories ahead of expected future price increases on certain drugs.

Cash Flows from Investing Activities

The decrease in cash used in investing activities during the year ended December 31, 2024 was primarily due to prior year acquisition activity with no comparable activity during the year ended December 31, 2024.

See Note 3, Business Acquisitions and Divestitures , of the consolidated financial statements for more information.

The increase in cash used in investing activities during the year ended December 31, 2025 was primarily related to the Intramed Plus acquisition activity with no comparable activity during the year ended December 31, 2024.

Cash Flows from Financing Activities

The decrease in cash used in financing activities was primarily related to the Company’s debt refinancing in May 2024, in which $50.0 million in proceeds from issuance of debt was received, which partially offset $250.0 million in repurchase of common stock during the year ended December 31, 2024, whereas the cash used in financing activities during the year ended December 31, 2023 was primarily related to the Company’s $250.0 million repurchase of common stock.

The increase in cash used in financing activities was primarily related to the Company’s $310.0 million repurchase of common stock and related excise taxes during the year ended December 31, 2025, compared to $252.7 million repurchase of common stock and related excise taxes during the year ended December 31, 2024.

The increase was partially offset by the Company’s debt refinancing in September 2025, in which $49.6 million in net proceeds from issuance of debt was received.

Critical Accounting Estimates

The Company prepares its consolidated financial statements in accordance with United States generally accepted accounting principles (“GAAP”), which require the Company to make estimates and assumptions.

The Company evaluates its estimates and judgments on an ongoing basis.

Estimates and judgments are based on historical experience and on various other factors that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses for the period presented.

The Company evaluates its estimates and assumptions on an ongoing basis.

Estimates and assumptions are based on historical experience and on various other factors that are believed to be reasonable under the circumstances, the results of which form the basis for making assumptions about the carrying values of assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses for the period presented.

The Company’s actual results may differ from these estimates, and different assumptions or conditions may yield different estimates.

The following discussion is not intended to be a comprehensive list of all the accounting policies, estimates or judgments made in the preparation of our financial statements.

The following discussion is not intended to be a comprehensive list of all the accounting policies, estimates or assumptions made in the preparation of our financial statements.

A discussion of our significant accounting policies, including further discussion of the accounting policies described below, can be found in Note 2, Summary of Significant Accounting Policies , within the notes to the consolidated financial statements included in Item 8 of this Annual Report.

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After applying the criteria from ASC 606, an allowance for doubtful accounts is established only as a result of an adverse change in the payers’ ability to pay outstanding billings.

As of December 31, 2024 and 2023, the Company had no allowance for doubtful accounts.

As of December 31, 2025 and 2024, the Company had an immaterial allowance for doubtful accounts.

The Company recorded an allowance for implicit price concessions based on its historical experience of additional revenue being recorded or revenue being written off when amounts received are greater than or less than the originally estimated net realizable value.

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Management’s estimates and assumptions include, but are not limited to, the future cash flows an asset is expected to generate and the weighted-average cost of capital.

See Note 3, Business Acquisitions and Divestitures , for further discussion of business acquisitions.

See Note 3, Business Acquisitions , for further discussion of business acquisitions.

Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.

What changed 10-K

Item 7. Management’s Discussion and Analysis