OPCHOption Care Health, Inc.
Industry Healthcare services Updated 28 Sep 2026 Price 23 Oct 2026
If management hits its targets, one share in 12 months
$31.22 → $35.22
Promises vs. what happened
14 claims · 8 decksEvery target management put in a slide deck, and whether they hit it, missed it, or quietly dropped it.
| Promise | Made in | What happened | |
|---|---|---|---|
| FY24 revenue, EBITDA and cash flow | Q1 '24 | all three held | Held |
| FY25 revenue $5.2-5.4B | Q4 '24 | $5,649M — beat | Held |
| FY25 EBITDA $445-465M after Stelara | Q4 '24 | $471M — beat | Held |
| Q2 '26 sequential revenue and EBITDA | Q1 '26 | +6.8% and +11.9% — beat | Held |
| A new $500M buyback authority | Q4 '24 | used; $525M of $1B left | Held |
| Stelara to cost $60-70M of gross profit | Q4 '24 | about $70M, then the line was renamed | Dropped |
| Tuck-in M&A a capital priority | Q3 '25 | dropped from the priorities, Aug '26 | Dropped |
| FY26 operating cash flow $340M | Q1 '26 | cut to at least $320M; open | Open |
| Q3 '26 sequential revenue and EBITDA | Q2 '26 | open | Open |
| FY25 operating cash flow over $320M | Q1 '25 | $258M — missed | Missed |
| Chronic low double digits, acute low single | Q4 '24 | reversed: chronic flat, acute leads | Missed |
| CID headwind 400bps and $25-35M | Q4 '25 | 600bps and $55M, three months later | Missed |
| FY26 revenue $5.8-6.0B | Q4 '25 | cut to $5.675-5.775B | Missed |
| FY26 EBITDA $480-505M | Q4 '25 | top cut to $495M | Missed |
What they’re pitching
the headline page, deck by deckThe headline from each quarterly results deck over two years, so you can see what they want you to focus on, and when it changes.
'24Q3
'24Q4
'24Q1
'25Q3
'25Q4
'25Q1
'26Q2
'26
Track recordOff page one Q3 '24
GuidanceOff page one Q2 '26
The headwindOff page one Q1 '26
BuybacksPage one since Q2 '26
Chronic/acuteOff page one Q2 '26
The marketFirst seen Q1 '24
LeverageOff page one Q4 '25
on the headline page further in the deck not in the deck▲ onto page one▼ off page one● first mentionTap a mark for the quote.
Execution track record and double-digit growth
“CONTINUED TRACK RECORD OF STRONG EXECUTION”
Deck William Blair 44th Annual Growth Stock Conference, June 2024 · p. 7 ·
Execution track record and double-digit growth
“CONSISTENT TRACK RECORD OF EXECUTION AND ATTRACTIVE GROWTH PROFILE”
Deck Bank of America Leveraged Finance Conference, December 2024 · p. 5 ·
Execution track record and double-digit growth
“CONSISTENT TRACK RECORD OF EXECUTION AND ATTRACTIVE GROWTH PROFILE 12024 unaudited preliminary estimated results reported January 13, 2025 2CAGRs are based on midpoint of 2024 unaudited preliminary estimated range of results reported January 13, 2025”
Deck 43rd Annual J.P. Morgan Healthcare Conference, January 2025 · p. 7 ·
Execution track record and double-digit growth
“CONSISTENT TRACK RECORD OF EXECUTION AND DELIVERING ON OUR GROWTH COMMITMENTS”
Deck William Blair 45th Annual Growth Stock Conference, June 2025 · p. 7 ·
Execution track record and double-digit growth
“Strong Financial and Operating Performance with Track Record of Double-Digit Growth in Revenue, Adjusted EBITDA, and Cash Flow Generation6 4”
Deck Bank of America Leveraged Finance Conference, December 2025 · p. 4 ·
Execution track record and double-digit growth
“Track Record of Double-Digit Growth”
Deck 44th Annual J.P. Morgan Healthcare Conference, January 2026 · p. 14 ·
Execution track record and double-digit growth
“Track Record of Double-Digit Growth”
Deck Investor Presentation August 2026 · p. 15 ·
Guidance raised or reaffirmed
“19OCH00004 o Delivered strong financial results in Q1 o Net revenue of $1.2B, up 12.8% o Adjusted EBITDA of $98.3M, up 4.8% over prior year o Absorbed impact of Change Healthcare disruption and maintained high level of patient care and referral source responsiveness o Repurchased $40M in stock in Q1 prior to onset of Change Healthcare disruption o Opened four new Ambulatory Infusion Suites in Q1 o Raised bottom end…”
Deck William Blair 44th Annual Growth Stock Conference, June 2024 · p. 7 ·
Guidance raised or reaffirmed
“o Delivered strong financial results in Q3 o Net revenue of $1.3B, up 17.0% from prior year o Adjusted EBITDA of $115.6M, up 5.3% from prior year and up $7.2M sequentially over Q2 2024 o Adjusted net income of $70.7 million, or $0.41 adjusted diluted earnings per share o Repurchased $41.9M in stock in the quarter o Reported net debt leverage to 1.5x, lowest leverage profile since BioScrip merger in 2019 o Tightened…”
Deck Bank of America Leveraged Finance Conference, December 2024 · p. 7 ·
Guidance raised or reaffirmed
“Raised guidance based on first quarter momentum1”
Deck William Blair 45th Annual Growth Stock Conference, June 2025 · p. 3 ·
Guidance raised or reaffirmed
“Raised full year 2025 guidance based on continued strong performance2”
Deck Bank of America Leveraged Finance Conference, December 2025 · p. 5 ·
Guidance raised or reaffirmed
“ALL RIGHTS RESERVED o Mixed Q1 results o Strong execution across Acute o Transitional period for Chronic o Continued focus on strategic initiatives o Full-year 2026 guidance o Adjusting Net Revenue guidance and Cash Flow from Operations target o Maintaining Adj.”
Deck Q1 2026 Earnings Call Presentation · p. 3 ·
Stelara and chronic inflammatory (CID) headwind
“ Guidance inclusive of impacts from previously announced Stelara pricing adjustments, which are expected to reduce gross profit by $60 million to $70 million in 2025 compared to 2024”
Deck 43rd Annual J.P. Morgan Healthcare Conference, January 2025 · p. 8 ·
Stelara and chronic inflammatory (CID) headwind
“Well positioned for ’26; 5% Adj. EBITDA growth translates to 7% Adj. EPS growth2, incorporating Stelara and Stelara biosimilars-related headwind of ($25M) – ($35M)”
Deck 44th Annual J.P. Morgan Healthcare Conference, January 2026 · p. 5 ·
Stelara and chronic inflammatory (CID) headwind
“Growth Highlights vs. PY o Revenue +1% o Acute: High single digit growth o Chronic: Slight decline o IG/neuro portfolio solid growth o Offset by chronic inflammatory portfolio (CID)”
Deck Q1 2026 Earnings Call Presentation · p. 4 ·
Stelara and chronic inflammatory (CID) headwind
“Growth Highlights o Revenue +7% sequential / +2% YoY o Acute: High single-digit growth vs. PY o Continue to outperform industry growth o Chronic: Revenue in line with PY, sequential growth o Strong growth in IG/Neuro and Rare & Orphan portfolios o Partially offset by CID decline vs. PY o Q2 ’26 sequential patient census growth in CID o Adj.”
Deck Investor Presentation August 2026 · p. 11 ·
Capital deployment and share repurchase
“ ~$290M in shares repurchased since January 2023”
Deck William Blair 44th Annual Growth Stock Conference, June 2024 · p. 5 ·
Capital deployment and share repurchase
“ >$400M in shares repurchased since January 2023”
Deck Bank of America Leveraged Finance Conference, December 2024 · p. 5 ·
Capital deployment and share repurchase
“ Announced new $500 million share repurchase authorization on January 13, 2025”
Deck 43rd Annual J.P. Morgan Healthcare Conference, January 2025 · p. 8 ·
Capital deployment and share repurchase
“ Repurchased $100 million of stock – underscores strong confidence in business and long-term inherent value”
Deck William Blair 45th Annual Growth Stock Conference, June 2025 · p. 3 ·
Capital deployment and share repurchase
“Repurchased $62 million of stock – underscores strong confidence in business and long-term inherent value”
Deck Bank of America Leveraged Finance Conference, December 2025 · p. 5 ·
Capital deployment and share repurchase
“Prioritize capital deployment to continue reinvesting in the business, pursue adjacent & accretive M&A and execute periodic share repurchases 1Growth represents ’25 midpoint of unaudited preliminary results range compared to 2024 2Growth represents ’26 midpoint of guidance compared to ’25 midpoint of unaudited preliminary results range”
Deck 44th Annual J.P. Morgan Healthcare Conference, January 2026 · p. 5 ·
Capital deployment and share repurchase
“ALL RIGHTS RESERVED 10 2026 Priorities o Taking decisive actions to reaccelerate revenue growth trajectory and drive greater long-term value creation o Near-term capital allocation reprioritization, focusing on internal investments for profitable growth and share repurchases o Focused on rebuilding momentum from reset through coverage, conversion, and enhanced service levels”
Deck Investor Presentation August 2026 · p. 10 ·
Chronic vs acute portfolio mix
“~73% Chronic Therapies ~27% Acute Therapies”
Deck William Blair 44th Annual Growth Stock Conference, June 2024 · p. 4 ·
Chronic vs acute portfolio mix
“~75% Chronic Therapies ~25% Acute Therapies”
Deck Bank of America Leveraged Finance Conference, December 2024 · p. 4 ·
Chronic vs acute portfolio mix
“ Overall growth expectation of low double digits with broad range of underlying growth profiles at therapy level”
Deck 43rd Annual J.P. Morgan Healthcare Conference, January 2025 · p. 9 ·
Chronic vs acute portfolio mix
“ Overall growth expectation of low double digits with broad range of underlying growth profiles at therapy level”
Deck William Blair 45th Annual Growth Stock Conference, June 2025 · p. 8 ·
Chronic vs acute portfolio mix
“Acute Therapies o Branded and biosimilar therapies o Typical product margins of 5-30%2 o Average treatment cycle greater than one year o Demand growth expectation of low double digits, with broad range of underlying growth profiles at therapy level o All Other is a diverse category of branded and biosimilar therapies, none of which represents more than 3% of consolidated revenue”
Deck Bank of America Leveraged Finance Conference, December 2025 · p. 7 ·
Chronic vs acute portfolio mix
“ALL RIGHTS RESERVED o Mixed Q1 results o Strong execution across Acute o Transitional period for Chronic o Continued focus on strategic initiatives o Full-year 2026 guidance o Adjusting Net Revenue guidance and Cash Flow from Operations target o Maintaining Adj.”
Deck Q1 2026 Earnings Call Presentation · p. 3 ·
Chronic vs acute portfolio mix
“Growth Highlights o Revenue +7% sequential / +2% YoY o Acute: High single-digit growth vs. PY o Continue to outperform industry growth o Chronic: Revenue in line with PY, sequential growth o Strong growth in IG/Neuro and Rare & Orphan portfolios o Partially offset by CID decline vs. PY o Q2 ’26 sequential patient census growth in CID o Adj.”
Deck Investor Presentation August 2026 · p. 11 ·
Home infusion market and site-of-care shift
“UNIQUELY POSITIONED TO STRENGTHEN AND GROW SHARE WITHIN U.S. HOME INFUSION MARKET”
Deck William Blair 44th Annual Growth Stock Conference, June 2024 · p. 4 ·
Home infusion market and site-of-care shift
“Strongly Positioned to Capture Growing Demand 5”
Deck 43rd Annual J.P. Morgan Healthcare Conference, January 2025 · p. 5 ·
Home infusion market and site-of-care shift
“Uniquely Positioned to Capture Growing Demand CONTINUING TO EXPAND PATIENT ACCESS AND INCREASE THE NUMBER OF PATIENTS SERVED 1NHIF 2020 Trend Report, DHC data, and Management estimates 2Reflects FY 2024 revenue data;”
Deck Bank of America Leveraged Finance Conference, December 2025 · p. 6 ·
Home infusion market and site-of-care shift
“Shifts Toward Cost-Effective Home and Alternate Site Care Models o U.S. Home Infusion industry projected to grow high single digit % annually, driven by therapy growth, cost pressures & patient preference including”
Deck 44th Annual J.P. Morgan Healthcare Conference, January 2026 · p. 7 ·
Home infusion market and site-of-care shift
“Secular and Industry Trends Driving Toward Lower-Cost Home and Alternate Site Care”
Deck Investor Presentation August 2026 · p. 7 ·
Balance sheet and leverage
“Contributing to 2.0X net debt leverage as of 1Q243EXPANSIVE FOOTPRINT2 DIVERSE PORTFOLIO2”
Deck William Blair 44th Annual Growth Stock Conference, June 2024 · p. 3 ·
Balance sheet and leverage
“o Delivered strong financial results in Q3 o Net revenue of $1.3B, up 17.0% from prior year o Adjusted EBITDA of $115.6M, up 5.3% from prior year and up $7.2M sequentially over Q2 2024 o Adjusted net income of $70.7 million, or $0.41 adjusted diluted earnings per share o Repurchased $41.9M in stock in the quarter o Reported net debt leverage to 1.5x, lowest leverage profile since BioScrip merger in 2019 o Tightened…”
Deck Bank of America Leveraged Finance Conference, December 2024 · p. 7 ·
Balance sheet and leverage
“Refinanced term loan, reducing borrowing costs and extending maturity while adding $50 million in liquidity”
Deck Bank of America Leveraged Finance Conference, December 2025 · p. 5 ·
Balance sheet and leverage
“Robust balance sheet and strong liquidity position”
Deck 44th Annual J.P. Morgan Healthcare Conference, January 2026 · p. 13 ·
Balance sheet and leverage
“Net Debt to Adjusted EBITDA Leverage Ratio 2.1x”
Deck Investor Presentation August 2026 · p. 20 ·
What they keep talking about · 9
The themes that show up deck after deck, and the ones that disappear.
- Track record
- In seven of eight, and still on the closing slide of the August '26 deck as "Track Record of Double-Digit Growth" — beside a 2026 revenue guide of about +1%.
- Guidance
- In five of eight. Every deck through December '25 led with a raise or a tightening. The first earnings deck, Q1 '26, led with a cut.
- The headwind
- In four of eight. Called Stelara through January '26, then renamed the chronic inflammatory (CID) portfolio — and it grew each time it was renamed: 400bps and $25-35M, then 600bps and $55M.
- Buybacks
- In seven of eight, shown cumulatively: $715M by Q3 '25 and $975M by H1 '26. Acquisitions left the capital priorities in August '26.
- Chronic/acute
- In seven of eight as a pie chart, last drawn in December '25 on fiscal 2024 data. From Q1 '26 it is words only: acute high single digits, chronic flat to declining.
- The market
- In five of eight. A $100bn total-infusion-market box sourced to a 2020 report, reproduced unchanged in every deck it appears in.
- Leverage
- In five of eight: 2.0x, then 1.5x, then 1.9x, then 2.1x — rising as the buybacks did, not as the debt did.
- New
- The first earnings-call deck in the company's history, Q1 '26, with a quarterly results slide. The Q2 '26 call then had no deck at all, and the August presentation carried the Q2 slide instead.
- Quiet
- The chronic/acute mix and the largest payer's share both stop after December '25. The therapy concentration test moved from 5% of revenue to 4% of gross profit, and the operating cash flow guide left the January '26 deck.
Every quarterly report we’ve saved · 10
The press releases and shareholder letters behind this page.
- Q2 2026 release · filed copy 29 Jul 2026
- Q1 2026 release · filed copy 30 Apr 2026
- Q4 2025 release · filed copy 24 Feb 2026
- Q4 2025 release · 8-K 12 Jan 2026
- Q3 2025 release · filed copy 30 Oct 2025
- Q2 2025 release · filed copy 30 Jul 2025
- Q1 2025 release · 8-K 29 Apr 2025
- Q4 2024 release · filed copy 26 Feb 2025
- Q4 2024 release · 8-K 13 Jan 2025
- Q3 2024 release · filed copy 30 Oct 2024
Archived as text; the links open the copies filed on EDGAR or the investor-relations site.
What analysts asked them
8 calls · Q3 24 – Q2 26The last eight earnings calls: what analysts kept asking about, which questions got dodged, and how much the CEO did the talking.
Share of questions by topic, call by call. A topic that suddenly dominates is usually the problem. The last row is how much of the answering the CEO did, rather than the CFO or others.
| Share of questions about… | Q3 24 | Q4 24 | Q1 25 | Q2 25 | Q3 25 | Q4 25 | Q1 26 | Q2 26 |
|---|---|---|---|---|---|---|---|---|
| Demand & customers | 6% | 25% | · | 6% | 12% | 5% | · | · |
| Growth & sales | 17% | 50% | 12% | 18% | 24% | 15% | 43% | 42% |
| Pricing & margins | 17% | 38% | 25% | 29% | 47% | 35% | 43% | 42% |
| Guidance & outlook | 17% | 50% | 12% | 6% | 18% | 25% | 50% | 26% |
| Capacity & supply | 11% | 25% | · | 12% | · | 10% | · | · |
| Capital & financing | 6% | · | · | 24% | 29% | 15% | 21% | 11% |
| Competition | 17% | 12% | 25% | 6% | 12% | 15% | 29% | 5% |
| Products & technology | 6% | · | · | 18% | 6% | 25% | 7% | · |
| Macro & regulation | · | · | 38% | 12% | 6% | 5% | · | · |
| Other | 44% | 12% | 38% | 18% | 12% | 25% | 14% | 21% |
| Questions | 18 | 8 | 8 | 17 | 17 | 20 | 14 | 19 |
| How much the CEO talked | 49% | 76% | 66% | 40% | 76% | 64% | 44% | 54% |
Who’s in charge, who’s selling
read from the filings · 2 Oct 2026Shareholder votes against the board and pay, plus which executives have been selling their own shares.
Tier 1 · live
$813M bought back at about $29.70, and the pay is on earnings per share
Over 2021-25 the company turned $1,429M of operating cash flow into $180M of capital spending, $303M of acquisitions and $813M of buybacks, with no dividend. The arithmetic worked — the diluted count fell about 10%, from 181.2M to 163.4M, with 149.8M outstanding at 2026-06-30. The price did not: the 2023, 2024 and 2025 repurchases averaged about $31.46, $27.01 and $30.51, roughly $29.70 across the three, against $23.26 now. The authorisation was doubled to $1bn and $525M was still open at 2026-06-30. Set beside that, the performance shares pay 75% on three-year adjusted earnings per share.
Tier 2 · worsening
A new finance chief, a growth chief gone eight days after the cut, and two board seats removed
Meenal Sethna became chief financial officer on 2025-10-01, succeeding Michael Shapiro, who stayed as an adviser to 2026-03-31; the FY2025 guides were Shapiro's and the FY2026 guides are hers. On 2026-04-30 the Q1 call cut the revenue guide. Eight days later the chief growth officer, who ran specialty commercial and sales operations, departed — the 8-K gives no reason. And the board went from eleven directors elected in May 2025 to nine in May 2026: Elizabeth Betten and David Golding were not on the slate, and nothing read says why.
Tier 2 · improving
The audit chair sold near the high; four insiders then bought a third lower
Over the year to 2026q2 the SEC insider data sets record ten open-market purchases by seven insiders worth $4,538,251 against two sales by two insiders worth $1,168,698 — net buying, and no sale under a pre-set plan. Inside that, R. Carter Pate, who chairs the audit and finance committee, sold 30,287 shares at $32.05 on 2026-02-27, three days after the FY2026 guide was issued and nine weeks before it was cut. Then from 2026-05-04 the chief executive bought 12,500 at $21.18, the chief financial officer 16,225 at $20.16, the director Kraemer 36,610 at $21.41 and the director Sullivan 24,154 at $20.69.
Tier 2 · worsening
The payer share and the chronic mix stopped being published as chronic stopped growing
Two of eight tracked measures were dropped. The chronic-versus-acute mix was a pie chart through December 2025 — still on fiscal 2024 data — and from Q1 2026 there is no mix, only words: acute growing high single digits, chronic flat to declining. The largest payer's share, about 14-15%, also stops after December 2025, though the Q2 2026 10-Q still gives it at approximately 14%. The therapy concentration test moved from "no therapy above 5% of revenue, excluding Stelara" to "no single therapy above 4% of gross profit". And the closing slide still read "Track Record of Double-Digit Growth" in August 2026, beside a 2026 revenue guide of about +1%.
Tier 3 · stable
One payer at 14%, and manufacturers who may cancel supply on minimal notice
The largest payer provided about 14% of revenue in the first half of 2026, down from 15%; no other payer is above 10% and government programmes are about 13%. The 10-K's own words on the other side: "Most of the manufacturers of the pharmaceuticals we sell have the right to cancel their supply contracts with us without cause and after giving only minimal notice." Both main competitors are owned by the counterparties — Optum Infusion by UnitedHealth, Coram by CVS — so the two largest rivals are also network gatekeepers. The chronic-inflammatory episode is that structure working: the manufacturer and the payer repriced the provider twice in six months.
Where shareholders voted no
At each annual meeting shareholders vote on who sits on the board, what the executives are paid and whether the company may create more shares. These are the votes that drew the most "no"s at the last two meetings: the shares voted against (or withheld) each year, then what share of all votes cast that was. Under each one, what the vote was about and what a no means.
| 2025 | 2026 | Share 2026 | |
|---|---|---|---|
| Say on payExecutive pay. Shareholders say whether they accept what the top executives were paid. The vote is advisory: the board can ignore it, but a large no is a public rebuke and boards usually change the pay plan after one. | 3.6M | 4.2M | 2.9% |
| Kraemer (independent chair)A board seat. Shareholders vote to keep this person on the board, the group that hires, pays and can fire the CEO. A no, or a withheld vote, says they want this director out, often because of the committee they sit on or a decision they signed off. | 3.8M | 2.2M | 1.5% |
| Wright (compensation chair)A board seat. | 1.4M | 2.0M | 1.4% |
| Deckmann (quality chair)A board seat. | 1.2M | 2.0M | 1.3% |
| Pate (audit chair)A board seat. | 1.1M | 1.8M | 1.2% |
| Rademacher (CEO)A board seat. | 0.7M | 0.5M | 0.3% |
| Ratify KPMGThe auditor. Keeping the outside accounting firm that checks the company's books. This almost always passes; a sizeable no means shareholders doubt the audit or think the firm has been in place too long. | 0.6M | 1.1M | 0.8% |
Insiders who sold the most stock
Reported sales by executives and directors, biggest first.
| SEC insider data sets, Jul '25-Jun '26 | Sold | Note |
|---|---|---|
| All insiders | $1.17M sold | against $4.54M bought by 7 people — net buying, 10 purchases to 2 sales |
| R. Carter Pate, audit chair | $0.97M | 30,287 shares at $32.05 on 27 Feb '26, not under a 10b5-1 plan |
| Pre-planned share of sales | 0.0% | neither sale discloses a pre-set 10b5-1 plan |