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DATE

Friday, May 8, 2026 at 9 a.m. ET

CALL PARTICIPANTS

  • Chief Executive Officer — Keith Newton
  • Chief Financial Officer — Matthew DiCanio
  • Operator

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TAKEAWAYS

  • Total Revenue -- $569.6 million, a 13.7% increase year over year, with organic revenue up 6.3% excluding Nova and Pivot acquisitions.
  • Average Daily Patient Visits -- Over 54,000, rising 6.7%; excluding Nova, up 2.9%.
  • Workers' Compensation Visits -- Grew 9.6%, and revenue from this segment increased 11.8% to $337.7 million; excluding Nova, visits rose 6.2%, with revenue up 7.5% to $317.8 million.
  • Employer Services Visits -- Increased 4.8%, with segment revenue up 7.6% to $172.4 million; excluding Nova, visits rose 0.7%, with revenue increasing 3.2% to $160.7 million.
  • Revenue per Visit -- Increased 3.1% to $151; workers' compensation revenue per visit up 2% (to $213), and employer services up 2.7% (to $97).
  • On-site Health Clinics Revenue -- $37.2 million, up 125% due to the Pivot acquisition; organic growth in this segment excluding Pivot was 20.9%.
  • Adjusted EBITDA -- $120.7 million in Q1 2026, a 17.6% increase; adjusted EBITDA margin in Q1 2026 rose 69 bps to 21.2%.
  • Adjusted Net Income -- $51.5 million in Q1 2026, up from $42.2 million in Q1 2025; adjusted EPS $0.40 in Q1 2026, up from $0.33.
  • Trailing Twelve Month Adjusted EBITDA -- $450 million, up $85 million, or 23%, since the July 2024 IPO.
  • Free Cash Flow -- $9.9 million in Q1 2026, compared to negative $4 million in Q1 2025; operating cash flow in Q1 2026 rose to $21 million from $11.7 million.
  • Acquisition and De Novo Activity -- Three centers added via acquisition and one de novo center opened; guidance remains for eight to ten de novo centers in 2026 with a geographic rollout.
  • G&A Expenses -- Total G&A was $55.3 million or 9.7% of revenue (up from 9.3%); adjusted G&A was $50.2 million or 8.8% of revenue (up from 8.2%) mainly due to growth and technology investments post-Select separation.
  • Net Leverage Ratio -- 3.4x as of March, down slightly from year end, with expectations for further decline over the year.
  • Share Repurchases and Dividend -- Repurchased 661,000 shares for $15 million and paid $8 million in dividends; $65 million remains authorized for repurchases.
  • 2026 Financial Guidance Raised -- Revenue range increased to $2.275 billion to $2.375 billion, adjusted EBITDA range to $460 million-$480 million, and free cash flow increased to $215 million-$235 million; CapEx remains $70 million-$80 million.
  • Separation from Select Medical Corporation -- On-track, with more than 95% of new hires made and back-office technology milestones expected by summer 2026.

SUMMARY

The earnings call revealed that Concentra Group Holdings Parent (CON +2.37%) raised its full-year 2026 revenue, adjusted EBITDA, and free cash flow guidance, reflecting operational outperformance and momentum in core businesses. Management reported complete integration and synergy realization from the Nova and Pivot acquisitions, both ahead of original transaction multiple targets. The on-site health clinics segment approached a $150 million run-rate, with sustained organic growth and active pipeline expansion, while core occupational health services demonstrated both volume and rate-driven gains. Initiatives to separate from Select Medical Corporation are progressing ahead of schedule and expected to support scalable infrastructure and margin enhancement throughout 2026.

  • The board declared a $0.0625 per share dividend payable in June 2026, addressing investor returns in parallel with growth investments.
  • Net debt reduction is expected to accelerate in subsequent quarters as Q1 is historically the lowest free cash flow period.
  • The California workers' compensation rate increase effective March 1 is anticipated to boost per-visit revenue in future periods, with additional state-level rate actions expected but not quantified.
  • Management identified advanced primary care within on-site clinics as the largest new opportunity, enabled by the Epic platform to address previously untapped white space with both new and existing employer clients.
  • "We are comfortably ahead of where we anticipated we should be approximately one year into this deal," signaling that acquisition value creation is tracking above earlier projections.
  • The CEO confirmed that New York market entry is contingent on finalizing rate updates, with operational readiness and a selective expansion approach in place for rapid deployment upon regulatory clarity.
  • Weather was explicitly cited as a net positive for workers' compensation visit growth, especially in the Northeast region, due to increased slips and falls from more severe winter conditions.

INDUSTRY GLOSSARY

  • De novo center: A newly constructed or opened healthcare center, not acquired from an existing provider, used for geographic or market expansion.
  • Workers' compensation: Employer-funded insurance program covering medical care for employees injured on the job, a primary service category for Concentra.
  • Employer services: Preventative care, regulatory compliance, and testing services offered to businesses, typically at lower revenue per visit versus workers' compensation.
  • On-site health clinic: A medical clinic staffed and operated at an employer’s worksite, providing convenient care for employees and facilitating employer-paid care models.
  • CapEx: Capital Expenditures; funds used by a company to acquire, upgrade, and maintain physical assets such as property, industrial buildings, or equipment.

Full Conference Call Transcript

Keith Newton: Good morning, everyone. Welcome to Concentra Group Holdings Parent, Inc.'s first quarter 2026 earnings call. We have continued our momentum from 2025 and are pleased with a strong start to the year. Total company revenue was $569.6 million in Q1 2026 compared to $500.8 million in Q1 of the prior year, representing 13.7% growth year over year. Excluding contributions from the Nova and Pivot acquisitions in both current and prior year where applicable, revenue was $520.3 million in Q1 2026, resulting in a 6.3% increase over the prior year. Total patient visits increased 6.7% to an average of more than 54 thousand visits per day in the first quarter.

Our workers' compensation visits per day increased 9.6% and employer services visit volume increased 4.8% relative to prior year. Excluding the impact from the acquisition of Nova, total visits per day increased 2.9% in the first quarter; workers' compensation visits increased 6.2% and employer services increased 0.7%. We believe the stronger performance in our workers' compensation business has been a result of a combination of events. Most importantly, we have seen the continued improvement of our patient satisfaction with the experience they have in our centers along with the implementation of new technologies to help strengthen the account management and retention of our existing employer customers along with enhanced prospecting efforts for new employer customers.

The service level metrics we track at our centers, including average patient time in the centers, Google ratings, and patient net promoter scores, are all at or close to historical bests. Additionally, Q1 2025 was the easiest comp of all the quarters in 2026 due to a relatively dry winter last year compared to more ice and snow winter events this year that led to more slips and falls and resulting injuries. On the rate front, revenue per visit grew 3.1% during the first quarter relative to prior year. The growth was driven by a 2% increase in workers' compensation and a 2.7% increase in employer services revenue per visit.

The California workers' compensation rate increase took effect on March 1, so we anticipate upside to the workers' compensation rate growth over the remainder of the year. Adjusted EBITDA was $120.7 million in the quarter versus $102.7 million in the same quarter of the prior year, or a 17.6% increase. Adjusted EBITDA margin increased 69 basis points from 20.5% in Q1 2025 to 21.2% in Q1 2026. With our strong Q1 performance, our trailing twelve month adjusted EBITDA is now $450 million, up $85 million, or 23%, from our trailing twelve month adjusted EBITDA at the time of our IPO in July 2024.

Adjusted net income attributable to the company was $51.5 million and adjusted earnings per share was $0.40 for the first quarter 2026, representing strong growth over prior year of $42.2 million and $0.33 respectively. Quick update on 2025 acquisitions. Regarding our March 2025 acquisition of Nova, we have completed our integration efforts and captured all the synergies that we expect to capture. We are comfortably ahead of where we anticipated we should be approximately one year into this deal, and we are tracking well towards the original objective of reaching a transaction multiple below 7.5 times adjusted EBITDA. With our June 2025 acquisition of Pivot, we have a similar story.

Integration is complete, performance is strong, and we are ahead of our original estimate of a transaction multiple of below 9 times adjusted EBITDA. Regarding other growth efforts during the quarter, we added three centers via acquisition and one de novo center outside of Atlanta. On the de novo front, we continue to expect to open a total of eight to ten centers this year, with planned locations in Arizona, Idaho, Missouri, Illinois, Virginia, South Carolina, and Florida. With respect to additional small bolt-on M&A, we have several opportunities actively underway and look forward to sharing more detail in the future.

Finally, I would like to take a moment to recognize and thank Doctor John Anderson, our Chief Medical Officer since 2014, who, as previously disclosed, has announced his well-deserved retirement at the end of the year. Known affectionately across Concentra Group Holdings Parent, Inc. as Doctor A, he has been the foundational part of our organization for nearly five decades, including his time with predecessor companies. Over his career, Doctor Anderson has helped shape our mission, vision, and values, built a comprehensive clinical orientation and training program that supports long-term success in occupational health, embedded a strong patient-first mindset into our daily operations, and developed our best-in-class clinical model.

His decades of service, leadership, and clinical expertise have been invaluable, and we are deeply grateful for the lasting impact he has made on our organization. We are fortunate to have a strong pipeline of both internal and external candidates and will be conducting a thorough evaluation process with the expectation of filling the role in the coming months. To support a smooth transition, we expect to enter into a consulting agreement with Doctor Anderson for a period of time. I will now turn the call over to Matthew DiCanio for additional details on our financial results for the quarter and updated outlook for 2026.

Matthew DiCanio: Thanks, Keith, and good morning, everyone. In our occupational health operating segment, total revenue of $519.9 million in Q1 2026 was 9.9% higher than the same quarter of the prior year. Total visits per day increased 6.7% over the same quarter of the prior year and revenue per visit increased 3.1% from $147 in Q1 2025 to $151 in Q1 2026. Workers' compensation revenue of $337.7 million in Q1 2026 was 11.8% higher than prior year. Workers' compensation visits per day increased 9.6% from prior year during the quarter, and workers' compensation revenue per visit increased 2% from $209 in Q1 2025 to $213 in Q1 2026.

Employer services revenue of $172.4 million increased 7.6% in Q1 2026 from prior year. Employer services visits per day increased 4.8% from the same quarter prior year. And finally, employer services revenue per visit increased 2.7% from $94 in Q1 2025 to $97 in Q1 2026. As with past quarters, here are the same stats for Q1 excluding the impact of Nova to help isolate the core business from our Q1 2025 acquisition. This is the last quarter we plan to break out Nova as its contribution will be fully embedded in both Q2 2025 and Q2 2026 P&L.

Total revenue within the occupational health center operating segment was $487.8 million in Q1 2026, a 5.7% increase over the prior year. Total visits per day increased 2.9% over the same quarter prior year and revenue per visit increased 2.7% from $147 in Q1 2025 to $151 in Q1 2026. Workers' compensation revenue of $317.8 million in Q1 2026 was 7.5% higher than prior year. Workers' compensation visits per day, excluding Nova, were 6.2% higher than prior year during the quarter, and workers' compensation revenue per visit was 1.3% higher than prior year during the quarter. Employer services revenue of $160.7 million in Q1 2026 increased 3.2% from prior year.

Employer services visits per day, excluding Nova, were 0.7% higher than prior year during the quarter, and employer services revenue per visit was 2.4% higher than prior year during the quarter. I would like to take a moment to reemphasize an important distinction in our business mix. Our workers' compensation segment generates significantly higher revenue per visit and contribution than our employer services offering. Employer services remains an important part of our service offering, and it often is the initial point of entry with employer customers, but those services are typically completed at much lower contribution margins. As you can see, workers' compensation is the primary engine of our business, accounting for approximately two-thirds of our total center revenue.

As a result, in a low-hire, low-fire macroeconomic environment like the one we are experiencing today, employer services can show muted trends while the company continues to perform well overall. While this may be obvious to some, we felt it was important to underscore this dynamic given the significant growth disparity between employer services and workers' compensation visits this quarter. Moving on from our occupational health centers, our on-site health clinics operating segment had another strong quarter with reported revenue of $37.2 million in Q1 2026, a 125% increase from the same quarter of prior year. This was largely driven by the acquisition of Pivot On-site Innovations in Q2 2025.

Excluding the impact from that acquisition, our on-site health clinics operating segment revenue grew 20.9% year over year during the quarter. On-site health clinics total revenue is nearing a run-rate of $150 million, up from $64 million in 2024. We are encouraged by the continued strong organic growth in this business. We have a robust pipeline of opportunities across both occupational medicine and advanced primary care supported by a highly capable team following last year's Pivot acquisition that is well positioned to execute on our growth strategy. We remain excited about this segment given the meaningful cross-selling opportunities within our existing customer base, an expanding margin profile, the direct employer-paid revenue model, and the growing and sizable market opportunity.

We estimate the serviceable addressable market to be between $15 billion and $20 billion with only a small portion currently penetrated. This significant white space combined with our best-in-class service gives us strong conviction in the long-term potential of the business. And finally, other businesses, which include telemedicine, our pharmacy operations, and other occupational health related services businesses, generated $12.5 million in the quarter, a 10.4% increase against the same quarter prior year. We are impressed by the team's execution in these areas and the opportunities that exist to continue to grow at attractive growth rates.

Moving on to expenses, cost of services was $399.1 million, or 70.1% of revenue, in Q1 2026, an improvement from 71.3% of revenue for the same quarter prior year. We continue to realize incremental improvements in staffing efficiencies within centers, resulting in nice gains in center-level margin. Our total general and administrative expenses were $55.3 million, or 9.7% of revenue in Q1 2026, compared to 9.3% of revenue in the same quarter prior year.

Excluding items that are added back for the purpose of calculating adjusted EBITDA, including equity comp expense, one-time select separation costs, and M&A transaction costs, G&A expense was $50.2 million for the quarter, or 8.8% of revenue, compared to 8.2% of revenue in the same quarter prior year. The increase is predominantly driven by planned additions to our team and IT infrastructure resulting from our separation from Select. As a result, adjusted EBITDA margin increased from 20.5% in Q1 2025 to 21.2% in Q1 2026. To quickly comment on the separation, we continue to track very well and have now hired more than 95% of the total expected new FTEs.

Over the next month or so, we will complete several significant back-office technology separation milestones resulting in functional separation from Select by the end of this summer, well ahead of the November 2026 deadline. Now to touch on cash flows. In Q1, we generated $21 million in operating cash flow. This compares to $11.7 million in 2025, with the year-over-year increase largely resulting from higher earnings in Q1 2026. Investing activities used $14.8 million of cash in the first quarter and were driven by the acquisition of three net centers in California as well as investments in de novo centers, relocations, renovations, maintenance, as well as IT investments.

Free cash flow, or cash flow from operations less cash flow from investing activity excluding business combinations, totaled $9.9 million, an increase from prior year first quarter free cash flow of negative $4 million. This was driven by a combination of higher cash flow from operations and lower capital spend in Q1 2026. Finally, financing activities during the quarter resulted in net cash outflows of $24.4 million as we repurchased approximately 661 thousand shares totaling $15 million and paid $8 million in dividends. At the end of the first quarter, we had approximately $65 million remaining under the repurchase program authorized by the Board of Directors.

We ended the quarter with a total debt balance of $1.58 billion and a cash balance of $61.7 million. Our net leverage ratio per credit agreement at March was 3.4 times, down slightly from year end. Q1 is typically our lowest free cash flow quarter, so we expect to see an acceleration in the decline in our leverage ratio over the remainder of this year. Finally, we are pleased to announce continuation of our dividend this quarter, with the Concentra Group Holdings Parent, Inc. Board of Directors declaring a cash dividend of $0.0625 per share on 05/05/2026. The dividend will be payable on or about 06/09/2026 to stockholders of record as of the close of business in May 2026.

Moving on to 2026 guidance. Given the strong start to the year, we are revising our 2026 guidance, including increasing the low and high end of our revenue target range by $25 million to $2.275 billion to $2.375 billion; the low and high end of our adjusted EBITDA range by $10 million to $460 million to $480 million; and the low end of our free cash flow target range by $15 million and the high end by $10 million to $215 million to $235 million. Our CapEx range of $70 million to $80 million remains unchanged.

With respect to net leverage, given the increase to both adjusted EBITDA and free cash flow guidance, we expect to end the year comfortably below three times. Overall, a great start to the year, and our team is excited about initiatives we have in place to continue our trajectory. That concludes our prepared remarks, and we thank everyone for the time today. I will now turn the call back to the operator to open the call for questions.

Operator: Certainly. We will now open the call for questions. At this time, we will be conducting a question and answer session. If you would like to ask a question, please press 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press 2 if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment while we poll for questions. Your first question for today is from Ann Hynes with Mizuho. Great. Good morning, and thank you.

Ann Hynes: So, depending on who you look at, you beat consensus adjusted EBITDA estimates by 10% to 11%. What was your internal beat versus what consensus was? And what surprised you the most on the upside beat?

Operator: Thanks.

Matthew DiCanio: Yeah. Good morning, Ann. Hey, it is Matt. So I think, when you look at our results, what really drove the results in Q1 was the workers' compensation visits and also our cost of service and cost control. Our teams did a great job from a staffing perspective across the centers, and the visit volume was higher than expected. We are not necessarily going to comment on our internal budget, but those were the two main drivers of our performance in Q1.

Ann Hynes: And I know in your prepared remarks, you talked about weather. So was weather actually a positive impact in the quarter? And if it was, can you quantify how much it was?

Keith Newton: Yeah, Ann, this is Keith. Weather can be both negative and positive to us. We think that in this quarter, it was a net positive. In our business, ice and snow, depending upon the extent you get it and how long it is around, can create lots of slips and falls. The individuals that are coming to our centers typically, a lot of them are having to work during those time frames—either maintenance workers, street workers, whatever—and so we see quite a bit during the wintertime, the slips and falls. When you look back at 2025, it was a relatively mild, dry winter.

Our Northeast region, when you look at them geographically, was by far the region that was most up over the prior year, so indicative of weather. We certainly had center days where we had closures, but we have always been extremely aggressive about limiting that as much as possible because we are here to keep America working. So we are very aggressive about getting our centers open. There are people out there needing care as a result of those injuries. So we think overall, based on the extent of the weather this year compared to last year and our ability to minimize the number of days our centers are actually closed, that overall, it was a net gain.

Ann Hynes: Alright. Great. Thank you.

Operator: Your next question for today is from Justin Bowers with Deutsche Bank.

Justin Bowers: Good morning, everyone. Keith, just on that note of keeping America working, can you give us your perspective on economic activity based on what you are seeing with your customers and some of the prospects that you mentioned Concentra Group Holdings Parent, Inc. is doing? And then part two of that would just be, how are those trends correlating with the BLS and JOLTS data? I know those relationships had decoupled from historical patterns before and just curious if you are seeing any different trends.

Keith Newton: Yeah. So, I think coming out of last year and early part of this year, it has kind of been, as Matt mentioned earlier, the continued no-hire, no-fire type situation. So from a hiring perspective, we saw that early in the year. Now it seems like things are starting to accelerate a little bit. We are optimistic about that. I believe we have had the first two months in a row, including this month, with net job gains. So that definitely is a positive for the future. The second half of the question—

Matthew DiCanio: Yeah. I would just add a couple comments on the economic data. We saw some positive news today. Total employment continues to grow, especially blue collar, which is the patients that walk in our centers every day. There are fewer layoffs compared to prior year. So we are seeing stability. Obviously, with our employer services visit volume, it is still below historical averages, but the good news for us is total employment continues to grow and clearly we are gaining market share within the categories that we compete.

Keith Newton: The quit rates are usually indicative of growth in our employer services. Those still remain relatively stable or below norm. So we have not really seen much there. It seems to be more just straight new job growth that we are starting to see in the last, say, sixty days or so. I do not know if we would really change our opinion as far as what we have said in the past as far as the disconnect a little bit with what has been out there, but we are optimistic it starts to narrow. And again, workers' compensation is typically indicative of what is going on with total employment, and we are seeing blue collar continue to trend up.

Justin Bowers: Understood. Thank you. Appreciate it.

Operator: Your next question is from Benjamin Hendrix with RBC Capital Markets.

Benjamin Hendrix: Hey. Thank you. I may have a bad connection, but I am going to try to get this in here. Just any comments on your free cash flow guidance? Seems like the low end came up higher than EBITDA. You still continue to have really strong free cash flow conversion. Any thoughts on timing dynamics through the capital or other durations there? Thanks.

Matthew DiCanio: Yeah. Sure. Good morning, Ben. So we raised our free cash flow guidance. We obviously raised our EBITDA guide. So from a profit standpoint, we are moving higher. The CapEx was a little lower in Q1, but we still expect it to be between $70 million and $80 million for the full year. So really, we are just pushing up that guide there equivalent to what we saw from an EBITDA standpoint.

Operator: Thank you. Your next question is from Stephen Baxter with Wells Fargo.

Stephen Baxter: Hi. This is Mitchell on for Steve. Just on the rate side and workers' comp, I know you mentioned California rate taking effect in March. Just trying to understand what led to the revenue per visit being below your typical rate increase in Q1, and are you still on track for the 3% for the year?

Matthew DiCanio: Thank you. Yeah. Sure. I will take that. So overall, revenue per visit was up 3.1%. You will see in our investor deck workers' comp was up 2%, and employer services was up 2.7%. So there are some differences there because of visit mix. That is why the overall revenue per visit is higher than the individual components, with workers' comp visits growing faster than employer services in Q1. Keith mentioned the California rate increase went into place on March 1. So we did not have a couple months of that outsized rate increase, but that is now in effect, and we will see it for the rest of the year.

Also, there was some visit mix within the workers' comp rate growth. So it would have been higher than 2% if the visit mix was consistent with prior periods—maybe 2.3% to 2.4%. But overall, we are on track, and we had some more updates in April, and so we expect 3% potentially higher for the full year.

Keith Newton: Yeah. And the 3% that we have quoted in the past is really what we have seen on average through the years. There is going to be some a little higher, like last year, some a little lower. But again, this year, we feel pretty good about where it is going to end up—just some timing of when. And we are also, as Matt mentioned, seeing a little bit of mix going on with it also.

Operator: Great. Thank you. Your next question for today is from Joanna Gajuk with Bank of America.

Joanna Gajuk: Hey. This is Joaquin already got on for Joanna. So I just wanted to ask any update on the New York rates? And when do you expect to have a final if you do not have one already? And then once you know the rates, how quickly do you plan to expand to New York?

Keith Newton: I will take that one. No new update. I am not sure when we are going to hear something, but anticipate it will happen this year and that January 1 something will go into play. Right now, as we mentioned in the past, it is focused on the E&M codes, the evaluation and management codes that doctors use as far as coding level of service, and PT was not adjusted at all. So it definitely took a step forward. It is in an area where we could consider doing something now, albeit still not as attractive as what we want and what we see in other states. But we will continue to work on that. We can move pretty quickly.

We have done a lot of analysis in the state. We know where we want to be. We know what we want to do. But we also have a pretty good pipeline already built, so we can be selective when we start and when we pull the trigger there in New York. In the meantime, we are going to continue on the de novos that we talked about earlier that are already in the pipeline this year, and we have a robust pipeline built next year for additional de novos and small organic M&A out there.

There are certain things we will look at as we get further out in the year that could be a little bigger than those things, but we have tabled those for now, as we have mentioned in the past, as we get through the final decoupling from Select here in the near future, and we continue to delever a little bit more.

Joanna Gajuk: Thanks. And then just touching up again on the activity. So you have always highlighted onshoring as a tailwind for your business. What industries do you mainly have your eyes on? And then what portion of your de novos are targeted within this theme? Thanks.

Keith Newton: Well, as far as onshoring, manufacturing naturally is going to be the fit with what we do, so we will continue to watch what is going to happen there. But as far as onshoring manufacturing, that is going to take some time because typically that requires some sort of capital deployment that is not going to happen overnight. So we hope to see that in the future as we continue to hear about the trillions of dollars that potentially are going to get invested in the United States over coming months and years. The second part of the question, I did not catch that.

Matthew DiCanio: Joaquin, can you repeat the other part of your question?

Joanna Gajuk: Yeah. So it was just what portion of de novos were being targeted at this theme in the future. Thanks.

Matthew DiCanio: Yeah. So our de novo strategy is spread pretty much across the country. We track economic activity, industrial pockets of growth, things like that. So it is pretty spread all across the country. We have got a new state of Idaho that we are entering. We are growing in Texas, Florida, a lot of areas where you see continued infrastructure build-out and growth trends. The other thing I would add to what Keith was saying about onshoring is the construction industry will be important for us as well, especially with all the AI build-out. We are seeing pockets of that across the country that we believe are going to help our business as well.

Operator: Thank you. Your next question is from Benjamin Rossi with JPMorgan.

Benjamin Rossi: Hey, good morning, and thanks for taking my questions here. Just following up on the rate side and workers' comp, you mentioned some of that mix shift in workers' comp and then California went into effect on March 1. I know historically, you said most workers' comp fee schedule adjustments occur in Q1. So you got one month of California in the first quarter. But did this one include the bulk of your 2026 fee schedule benefit? Should we expect any other meaningful step-ups over the course of the year, like in October or later? Thanks.

Keith Newton: I believe we have said in the past approximately 75% to 80% of what we see typically is happening during the first quarter at some point in time, and that is pretty much what we saw this year. We have got Tennessee that is going to be happening in the second quarter that will be meaningful for us. And then there will be some annual updates that other states do throughout the summer and early fall, like in Arizona. At this point in time, we really do not know what they will be doing, but would not anticipate anything too material other than potentially inflation-adjusted activity around their fee schedule.

But that is what we really see happening for the rest of the year.

Benjamin Rossi: Understood. I guess this is just a follow-up on the on-site side and talk about the current opportunities that were in there in your opening comments. When you are assessing opportunities for your on-site health clinics, where do you see the current largest white space opportunities across things like new geographies, new employer relationships, deeper wallet share, or service line expansion? And do you think about sequencing here in the coming quarters?

Keith Newton: I would say D, all of the above. Where we are really gaining some traction is in the area of advanced primary care, which we have talked about in the past. We deployed Epic as the electronic medical record within the on-sites a year and a half or so ago. We are really starting to gain some traction there, which is a white space we typically did not play in just because we did not have the capabilities and the technologies to support that type of delivery of care. We are extremely competitive, definitely have the support and awareness of the broker world that supports a lot of the employer decisions around this.

We definitely have a seat at the table. Because of our infrastructure and footprint across the United States, it makes us extremely competitive with those that have historically focused on that. In addition to that, with our size now with the acquisition of Pivot, that combination has gone extremely well. We have had a lot of our employer base that we supported with those traditional more Occ Med type on-sites wanting to shift or wanting to expand into further sites. So we have got what we call the internal organic growth within existing employers and have been very successful as far as starting to add sites there across the United States.

We are really pulling all the levers—prospecting new, going after RFPs, expanding existing—and again, focusing on the advanced primary care type of on-site is probably the biggest white space that we historically did not play in.

Matthew DiCanio: And Ben, I will just add a couple comments just to reiterate in case people missed it in the opening remarks. Our on-site portfolio, excluding the Pivot acquisition, grew 20% in Q1, and the total on-site portfolio is now approaching $150 million in revenue, up from $64 million in 2024. So the teams are doing an unbelievable job, the leadership from our organization, but also the acquisition of Pivot which, as Keith mentioned, is ahead of schedule. We are really excited about the trends there and the upside for the future.

Benjamin Rossi: Great. I appreciate all the additional comments.

Operator: We have reached the end of the question and answer session, and I will now turn the call over to Keith Newton for closing remarks.

Keith Newton: Thank you, operator, and we appreciate everybody joining us today. We will talk again next quarter.

Operator: This concludes today's conference, and you may disconnect your lines at this time. Thank you for your participation.