Performance was driven by a 13% revenue increase, with acute therapies growing in the mid-teens and chronic therapies in the low double digits despite biosimilar headwinds.
Management attributed the 160 basis point revenue headwind in 2025 to patient transitions toward Stelara biosimilars, which carry lower reference prices and reimbursement rates.
Strategic positioning as the nation’s largest independent provider allowed the company to serve over 315,000 unique patients, leveraging 50-state licensure to capture demand from national payers and health systems.
Operational efficiency improved through technology deployment, with approximately 40% of claims now processed without human intervention, enabling growth without proportional labor increases.
The acquisition of Intramed Plus outperformed initial expectations, contributing to a 25% increase in infusion clinic visits in the fourth quarter on a pro forma basis.
Payer partnerships deepened as the company added 5 regional and 2 nontraditional site-of-care programs to help insurers manage rising medical loss ratios (MLRs) by shifting care to lower-cost settings.
2026 revenue guidance of $5.8 billion to $6 billion assumes a 400 basis point headwind from the Stelara Inflation Reduction Act (IRA) impact and biosimilar conversions.
Adjusted EBITDA guidance of $480 million to $505 million incorporates a $25 million to $35 million gross profit headwind related to Stelara, expected to be realized evenly throughout the year.
Operating cash flow is projected to exceed $340 million, representing over 30% growth, driven by initiatives to reduce working capital and normalize inventory levels following strategic year-end buys.
The company expects to launch at least two new pharma manufacturer programs in 2026, focusing on high-complexity rare and orphan products that require specialized clinical oversight.
Management anticipates continued expansion of the advanced practitioner model, transitioning more existing sites into infusion clinics to support higher-acuity therapies and improve nursing capacity.
Strategic inventory buys in late 2025 created a working capital carry that impacted cash flow, but this is expected to normalize as inventory is utilized throughout 2026.
The transition to biosimilars creates a ‘mix challenge’ where faster growth in chronic therapies relative to acute may put downward pressure on gross margin percentages.
Medicare Advantage rate pressure on payers is viewed as a strategic tailwind, as it increases payer demand for Option Care’s lower-cost alternate site infusion services.
The company faces a year-over-year comparison challenge in Q1 2026 because Q1 2025 results were bolstered by forward-buying that mitigated early Stelara impacts.
