AdaptHealth Corp. (NASDAQ:AHCO) Q4 2022 Earnings Call Transcript

Joanna Gajuk: That’s super helpful. The last 1 on the — you mentioned some efforts of cost cutting in the press release. And so do you assume some incremental cost cutting in your guidance? And what is it and how much exactly, thank you. Just curious about sort of with that 3% to 4% of revenue converting into free cash flow. What is that outlook on acquisitions in 2023 vis-a-vis where your leverage stands today .

Jason Clemens: Sure. I’ll take a part of the question. I’m going to ask Steve and Josh to weigh in on free cash flow expectations and how that relates to M&A. Regarding the acquisition activity within 2022, I’d remind you, it was very, very early in the year, and it was quite immaterial, was about $17 million, I believe, of acquired revenue in ’22. That was essentially all completed on or before early Q2. And so there is extremely limited impact of kind of stub period revenue part of our guidance and our expectations. Steve, do you want to take the acquisition?

Stephen Griggs: Sure, Jason. Thanks. So obviously, in 2022, we did limited acquisitions, I think just 2 or 3, very minor impact to our business. we would expect that to be higher in 2023. We’ll probably use the vast majority of the cash flow generated for those acquisitions. So if you use those numbers that Jason put out at 3%, 4%, 3.5% of revenue. That type of cash will probably go towards acquisitions and a rounding error towards that. So I would guess they’re going to be in they provide just short of $100 million.

Operator: We’ll take our next question from Matthew Blackman with Stifel.

Mathew Blackman: Maybe, Jason, to start, you mentioned in the prepared script that baked into the ’23 guide is some sustained headwinds that you saw in 2022. And there are a lot of moving parts. I just want to make sure I can wrap my arms around it. It sounded like headwinds in diabetes and sleep and maybe also to some extent on respiratory and HME. And then on EBITDA, it sounds like continued inflation and then product mix headwind. Can you fill in the blanks? What am I missing there? And is there anything else to call out? And then 1 quick follow-up.

Jason Clemens: Sure, Matt. No, I don’t believe you were missing anything. I would say as part of the — a little over 1 point of adjusted EBITDA margin expansion that we do expect for 2023 over 2022, we expect about half of that coming from — a little over half of that coming from labor and operating expense and the remainder coming from the cost — the actual cost of goods growth. . So in other words, top line growing 7.7%, we do not believe our COGS, our labor and OpEx will grow at that same pace. And so we expect to get operating leverage and enhanced margin.

Mathew Blackman: All right. Appreciate that. And then diabetes, curious what your thoughts are on why we saw the payer mix shift emerge here in the fourth quarter? Just any thoughts and I assume it’s sustained into 2023. But just any thoughts on why that is, whether it was transient, it doesn’t sound like it, what the trigger may have been for that?

Stephen Griggs: Our reps are out there calling on doctors and they get their patients. And I think in the businesses that we’re working on, particularly at our cross-sell that we’re doing to GPs, they’re more government-based patients. And so I think just the emphasis on the sales side was just more towards that type of doctor and resulted in that type of patient. So we expect that to continue throughout 2023. So we’ll see more government payers in our diabetes mix than we’ve had in the past. And I think that’s really that we’re calling them on more primary care physicians than ever before, and we would expect that to continue.

Mathew Blackman: So it sounds like this is largely manifesting in the CGM side of the business rather on the pump side.