BrightSpring Health Services (NASDAQ:BTSG) reported second-quarter 2026 results that exceeded its baseline expectations, led by growth in its Pharmacy Solutions and Provider Services businesses, while reaffirming confidence in its updated full-year outlook.
Chief Executive Officer Jon Rousseau said the company generated $3.9 billion in second-quarter revenue, up 23% from a year earlier, and adjusted EBITDA of $206 million, an increase of 44%. Adjusted EBITDA margin rose 80 basis points year over year to 5.3%.
Pharmacy Solutions Drives Revenue and Profit Growth
Pharmacy Solutions revenue totaled $3.4 billion, rising 22% year over year, while adjusted EBITDA increased 44% to $180 million. The segment’s gross profit rose 28% to $298 million.
Specialty and infusion revenue was $2.9 billion, up 30% from the prior-year quarter. Chief Financial Officer Jen Phipps said the performance reflected branded limited-distribution-drug, or LDD, growth and new launches, script growth, fee-for-service programs, generic drugs, acute infusion growth and commercial execution.
Rousseau said specialty and infusion script growth reached 31%, while specialty pharmacy script growth was 32% year over year, according to management’s comments during the call. The company added two ultra-narrow-network LDDs during the quarter, bringing its total LDD portfolio to 155. Through the first half of 2026, it launched 12 LDDs, including four exclusive partnerships and eight ultra-narrow arrangements.
The company said it is expanding its specialty capabilities beyond oncology into rare, orphan and other complex therapies. Rousseau said BrightSpring’s existing clinical liaison organization and experience managing LDD programs provide a foundation for pursuing those opportunities.
In infusion, Rousseau said acute-care volume rose more than 20% year over year and chronic infusion volume increased nearly 20%. The company sees room to expand its acute infusion business into another 12 to 15 states over the next five years, he said.
Home and community pharmacy revenue declined 8% to $540 million. Phipps attributed the decrease to an approximately $50 million second-quarter impact from the Inflation Reduction Act, or IRA, as well as BrightSpring’s exits from certain uneconomic customers. The company expects IRA-related revenue impact in home and community pharmacy of about $45 million in each remaining quarter of 2026, for about $200 million for the full year.
Despite those revenue pressures, management said home and community pharmacy EBITDA improved year over year, supported by operational improvements and technology investments.
Provider Services Revenue Rises 30%
Provider Services revenue increased 30% from a year earlier to $466 million, with adjusted EBITDA rising 33% to $75 million. Segment adjusted EBITDA margin expanded approximately 30 basis points to 16.1%.
Home healthcare revenue rose 51% to $278 million, driven by average daily census growth, de novo expansion and acquired Amedisys and LHC branches. Those acquired branches contributed approximately $78 million in revenue and $8 million in adjusted EBITDA during the quarter.
BrightSpring now expects the acquired Amedisys and LHC assets to contribute approximately $35 million in adjusted EBITDA in 2026. Phipps said the company increased that expectation as integration progressed ahead of its prior assumptions. The company has moved its business lines and branches onto its home-based care system and is completing final integration steps, she said.
Rehab care revenue increased 12% to $82 million, while personal care revenue grew 7% to $107 million. Rousseau said personal care growth was supported by hours served that remained above industry growth levels. He also said clinician retention metrics have improved each year and are at what the company considers best-practice levels.
The company cited quality measures including a 99% timely initiation-of-care rate in home health, an 89% overall hospice rating under the Consumer Assessment of Healthcare Providers and Systems survey, rehab patient satisfaction above 97%, and personal-care client satisfaction of 4.6 out of five.
Cash Flow, Debt Reduction and Ratings Upgrades
BrightSpring reported $44 million in operating cash flow for the quarter. Excluding a roughly $100 million one-time cash tax payment related to the community living sale, operating cash flow was $144 million.
Net debt was approximately $1.7 billion as of June 30, and the company’s leverage ratio was 2.15 times. BrightSpring repaid about $300 million of its term loan during the quarter using proceeds from the community living transaction and repriced the loan to SOFR plus 200 basis points, compared with SOFR plus 325 basis points at the time of its initial public offering.
Moody’s upgraded BrightSpring’s rating to Ba3 from B1, while S&P upgraded its issuer credit rating to BB- from B+. Management said the company expects to end 2026 with leverage below 2 times before potential acquisitions.
Rousseau said BrightSpring has a substantial acquisition pipeline and signed several small tuck-in and geographic-expansion transactions during the prior quarter. He said the company remains disciplined on valuations and primarily targets tuck-in acquisitions and adjacent markets where it can apply operational capabilities and synergies.
2026 Outlook
For 2026, BrightSpring expects total revenue of $15.1 billion to $15.425 billion, representing growth of 17.0% to 19.5% over 2025 after excluding community living in both periods.
- Pharmacy Solutions revenue is expected to range from $13.2 billion to $13.5 billion.
- Provider Services revenue is expected to range from $1.9 billion to $1.925 billion.
- Total adjusted EBITDA is expected to be $820 million to $845 million, representing growth of 32.8% to 36.8% over 2025 on a comparable basis.
- Operating cash flow is expected to be approximately $600 million, excluding community-living-related cash flow effects.
Phipps said BrightSpring expects sequential adjusted EBITDA growth in both the third and fourth quarters, though the company will be comparing against a strong second half in 2025. Rousseau said management remains optimistic about the company’s position entering the second half of the year, citing broad-based operating momentum, ongoing technology and automation investments, and continued growth opportunities across its healthcare markets.
About BrightSpring Health Services (NASDAQ:BTSG)
BrightSpring Health Services (NASDAQ: BTSG) is a leading provider of home and community-based care and workforce solutions aimed at seniors, individuals with disabilities and those facing behavioral health challenges. The company’s operations encompass a broad spectrum of services, including personal care, skilled nursing, therapy, habilitation and supported living, as well as specialized behavioral health programs delivered through both clinical and non-clinical channels.
Through its network of subsidiary brands, BrightSpring offers integrated care in the patient’s home environment, fostering independence and improving quality of life.
