Option Care Health (NASDAQ:OPCH) reported second-quarter 2026 results that exceeded its internal expectations, with revenue, adjusted EBITDA and adjusted earnings per share all improving sequentially. The home and alternate-site infusion provider maintained its full-year revenue outlook while narrowing its adjusted EBITDA and EPS guidance ranges.
Revenue totaled $1.4 billion, up 2% from a year earlier and 7% from the first quarter, according to Executive Vice President and Chief Financial Officer Meenal Sethna. Adjusted EBITDA rose 3% year over year and 12% sequentially to $117.5 million, while adjusted EPS increased $0.04 from the prior-year period to $0.45. The company generated $184 million in operating cash flow during the quarter.
Acute Growth and Chronic Portfolio Trends
Rademacher said Option Care’s acute therapy portfolio delivered high-single-digit organic revenue growth for a second consecutive quarter. The company saw sequential and year-over-year growth across key acute therapeutic categories and in the number of patients served.
“Our ability to consistently deliver for providers and their patients drove another quarter of above-market, high-single-digit revenue growth,” Rademacher said, adding that the company expects acute therapies to continue growing faster than the broader industry as it expands hospital and health-system partnerships.
Within chronic therapies, quarterly revenue was flat from a year earlier but increased by high single digits sequentially. The company reported sequential and year-over-year revenue growth in its immunoglobulin and neurology, or IG Neuro, portfolio, as well as growth in its rare and orphan portfolio.
The chronic inflammatory disease, or CID, portfolio began to stabilize after a first-quarter reset, with patient census increasing sequentially in the second quarter. Management expects to continue expanding the CID patient census through the remainder of 2026, while monitoring product mix and the patient base.
Sethna reiterated that the company’s 2026 projections include expected CID-related pressure of about 600 basis points on year-over-year revenue and a $55 million headwind to gross profit. She also said STELARA and related biosimilars are still expected to account for less than 1% of company net revenue and gross profit in 2026.
Margins, Cost Initiatives and Technology Investments
Gross profit dollars increased 2% sequentially but declined slightly from the prior-year quarter. SG&A expense fell 3% year over year to about 11% of revenue, driven primarily by lower indirect labor costs, expense controls and lower variable compensation, Sethna said. The company continues to invest in commercial resources intended to support future growth.
Management said it is deploying technology, automation and artificial intelligence tools across areas including patient onboarding, claims processing, communications, nurse scheduling, delivery routing and field productivity. Rademacher said the company is combining these tools with experienced clinical teams to improve authorizations, claims submission and operational efficiency.
Sethna told analysts that the company’s outlook is not primarily dependent on administrative cost cuts. Instead, she cited commercial productivity, recovery in CID patient census, technology deployment, procurement initiatives and payer-related site-of-care programs as contributors to expected second-half improvement.
Option Care added five ambulatory infusion facilities during the second quarter. Visits at its facilities increased more than 20% year over year, and more than 35% of nursing visits were conducted in an infusion suite or clinic during the quarter, Rademacher said.
Capital Allocation and Updated Outlook
The company repurchased $150 million of its shares during the quarter, representing nearly 5% of shares outstanding, according to Sethna. The repurchase reduced remaining authorization to $525 million. Option Care ended the quarter with net debt leverage of 2.1 times.
Management said its capital-allocation priorities remain organic investments in growth, capacity and cost optimization; periodic share repurchases; and potential acquisitions focused on portfolio adjacencies and tuck-in opportunities.
- Full-year 2026 revenue guidance was maintained at $5.675 billion to $5.775 billion.
- Adjusted EBITDA guidance was narrowed to $480 million to $495 million.
- Adjusted EPS guidance was narrowed to $1.85 to $1.92.
- Operating cash flow is still expected to be at least $320 million.
- Net interest expense is projected at $50 million to $55 million, and the full-year tax rate is expected to be 26% to 28%.
For the third quarter, Option Care expects sequential revenue growth in the low- to mid-single-digit range and sequential adjusted EBITDA growth in the mid-single-digit range. Sethna said the company expects seasonal growth to continue through the year, with the fourth quarter typically representing its largest quarter.
Market Access and Long-Term Positioning
Rademacher said the company is pursuing additional pharmaceutical manufacturer partnerships, including rare and orphan therapies. Some newly added therapies are not expected to begin service until late 2026 or early 2027, and management said its current outlook is principally based on the existing portfolio and expected momentum rather than a substantial contribution from unlaunched products.
Regarding a CMS proposal to expand Medicare coverage for certain home infusion pumps and drugs beginning in 2027, Rademacher said the proposal involves a narrow set of therapies and is not expected to be financially material. He said the company supports broader access to home and alternate-site infusion care, which it believes can reduce total healthcare costs.
Management also said it has not seen a significant impact from white-bagging practices. Rademacher noted that Option Care remains broadly in network with payers and PBMs and continues to pursue site-of-care initiatives with national and regional health plans.
“While we posted improved second quarter results, there is still work to do,” Rademacher said in closing. “However, we believe the actions we have taken so far, combined with the strength of our clinical platform and market position, provide a strong foundation to re-accelerate our long-term growth trajectory.”
About Option Care Health (NASDAQ:OPCH)
Option Care Health (NASDAQ: OPCH) is a leading provider of home and alternate site infusion services in the United States. The company specializes in the administration of injectable therapies, including antibiotics, nutrition, hydration, immunoglobulin, pain management and specialty pharmaceuticals. Through its nationwide network of infusion pharmacies and nursing professionals, Option Care Health delivers customized care plans and in-home nursing visits to patients managing complex or chronic conditions outside of a hospital setting.
Option Care Health traces its current structure to the completion of its merger with BioScrip in early 2021, combining two of the industry’s most experienced home infusion businesses.
