BrightSpring Health Services (BTSG -4.89%), a leading provider of integrated pharmacy and home-based healthcare services, released its second quarter 2025 results on August 1, 2025. The report showed GAAP revenue of $3,148 million, exceeding analyst estimates of $2,989.69 million. Adjusted earnings per share (EPS) came in at $0.22, surpassing the estimate of $0.19 and marking a significant increase compared to $0.06 in Q2 2024. Adjusted EBITDA (non-GAAP) reached $143 million, up sharply from $111 million in Q2 2024. Net income from continuing operations (GAAP) was $8.5 million, unchanged from Q2 2024. The quarter demonstrated solid top-line expansion, improved earnings metrics, and a raise in full-year guidance, even as profitability at the bottom line remained flat.
Metric | Q2 2025 | Q2 2025 Estimate | Q2 2024 | Y/Y Change |
---|---|---|---|---|
Adjusted EPS (Non-GAAP) | $0.22 | $0.19 | $0.06 | 266.7 % |
Revenue | $3,148 million | $2,989.69 million | $2,438 million | 29.1 % |
Adjusted EBITDA (Non-GAAP) | $143 million | $111 million | 28.8 % | |
Gross Profit | $375 million | $312 million | 20.2 % | |
Net Income from Continuing Operations | $8.5 million | $8.5 million | 0.0 % |
Source: Analyst estimates provided by FactSet. Management expectations based on management's guidance, as provided in Q1 2025 earnings report.
About the Business and Strategic Focus
BrightSpring Health Services focuses on delivering both pharmacy and home-based clinical care to patients with complex medical needs. The company combines large-scale medication dispensing with primary care, rehab, personal care, and other medical services in home and community settings. Its integrated approach allows it to serve over 450,000 patients at any one time, fill more than 41 million prescriptions in 2024, and provide approximately 19 million hours of care in 2024.
The company’s current strategy emphasizes integration of its pharmacy and provider services. This allows BrightSpring to target coordination of medical and medication needs, particularly for seniors and those with complex, chronic conditions. Critical success factors include executing on operational excellence, delivering high patient satisfaction, expanding home-based services, and maintaining strong regulatory compliance in a highly regulated industry.
Second Quarter Developments and Financial Performance
Revenue grew 29.1% in Q2 2025 compared to the same period last year. The Pharmacy Solutions segment, which includes specialty pharmacy and infusion products, drove most of this growth. Pharmacy Solutions revenue was $2,790 million, up 32% in Q2 2025, while Provider Services, which covers home health, rehab, and personal care, reported $358 million in revenue, up 11% in Q2 2025.
The quarter’s adjusted EBITDA, a non-GAAP measure that excludes certain non-cash and one-time charges, rose 28.8% to $143 million in Q2 2025. This reflects ongoing cost management, though gross profit growth (20.1%) in Q2 2025 was slower than revenue growth due to a heavier mix of lower-margin specialty pharmacy sales.
Flat net income from continuing operations (GAAP) of $8.5 million in Q2 2025 signals that cost pressures remain. The gap between EBITDA and net income is mainly driven by high non-cash items, including $19.5 million in share-based compensation, $19.8 million in transaction and integration costs, and $12.8 million in restructuring and divestiture expenses in Q2 2025. Together, these items contributed $52.1 million in non-GAAP adjustments in Q2 2025, up from $32.3 million in Q2 2024, highlighting the continued impact of one-off and incentive-based costs on reported profitability.
The company generated operating cash flow of $49.1 million in Q2 2025 and $150.7 million for the first half of 2025. Its balance sheet showed net long-term debt of $2.48 billion as of June 30, 2025, a slight decrease from $2.56 billion at December 31, 2024. The business continues to use cash flow to pay down debt, aiming for a year-end leverage ratio of 3.0x for FY2025, and maintains a longer-term leverage target of 2.0–2.5x.
Service Offerings and Business Trends
BrightSpring’s Pharmacy Solutions is its largest service line. This category includes specialty pharmacy products -- medications for complex or rare conditions -- and infusion therapies that are administered at home instead of in a hospital. The company continued to grow prescription volume and benefited from new medication launches. Specialty script growth, a key driver, reached 32% in Q1 2025, and the business now maintains a portfolio of 127 limited distribution drugs.
Provider Services delivers home health care, rehab services, and personal care. Home health includes primary and post-acute care delivered at home, while rehab focuses on rehabilitation therapy, and personal care provides support with activities of daily living. Provider Services saw positive revenue growth in Q2 2025, and The business maintained high patient satisfaction and outcomes, including a 35% lower hospitalization rate in home-based primary care compared to the national average.
BrightSpring’s national scale helps generate efficiencies, particularly in pharmacy procurement and process improvement. Management highlighted investments in new technology and enterprise-wide cost-saving programs. These help contain costs—even as operating expenses rise with the growing scale of services and ongoing regulatory compliance investments, which total over $200 million a year, according to the company's Annual Report on Form 10-K.
The quarter included ongoing monitoring of regulatory risks, particularly changes in drug pricing and reimbursement rates under government programs like Medicare and Medicaid. No new negative headlines emerged this period, but the company continues to prepare for potential 2026 regulatory changes. Competition remains high, with BrightSpring competing against large pharmacy and health care providers such as CVS Health and UnitedHealth Group. The company’s differentiated, integrated care model remains its primary method of standing out in the market.
Outlook and Guidance
Management raised its full-year 2025 revenue (GAAP) guidance to a range of $12,200 million to $12,600 million. Adjusted EBITDA (non-GAAP) guidance was raised to $590–$605 million for 2025. Segment outlooks anticipate 22.8–26.8% growth in Pharmacy Solutions and 10.0–13.8% growth in Provider Services for FY2025. Leadership attributed the guidance increases for FY2025 to strong pharmacy volume and steady operational gains in the provider segment.
Management did not declare or adjust any dividend. BTSG does not currently pay a dividend. Investors are encouraged to monitor the impact of non-GAAP adjustments on underlying margins, track regulatory developments that might influence reimbursement or pricing, and watch for ongoing developments in BrightSpring’s M&A strategy. No additional one-time material events were highlighted outside the transaction and restructuring costs discussed in the quarter.
Revenue and net income presented using U.S. generally accepted accounting principles (GAAP) unless otherwise noted.