LifeStance Health reported Q4 2024 revenue growth of 16%, with full-year revenue up 19% amid operational losses.
Quiver AI Summary
LifeStance Health Group, Inc. announced its financial results for the fourth quarter and full year ending December 31, 2024, highlighting a 16% increase in quarterly revenue to $325.5 million and a 19% increase in annual revenue to $1.25 billion compared to the previous year. The company reported a net loss of $7.1 million for the fourth quarter and $57.4 million for the year, but achieved a significant growth in adjusted EBITDA, rising 62% to $32.8 million in the fourth quarter and more than doubling to $119.7 million for the full year. The clinician base expanded by 12% to 7,424, contributing to a 14% increase in visit volumes. Looking ahead, LifeStance forecasts 2025 revenues between $1.40 billion and $1.44 billion, with expectations of maintaining strong operational momentum while focusing on expanding access to mental healthcare.
Potential Positives
- Fourth quarter revenue reached $325.5 million, which is a 16% increase from the previous year, indicating strong financial growth.
- Full year revenue totaled $1,251.0 million, representing a 19% increase compared to the previous year, demonstrating sustained business expansion.
- Adjusted EBITDA for the full year grew by 103% to $119.7 million, showcasing significant improvement in operational profitability.
- The company projected robust full year 2025 revenue guidance of $1.40 billion to $1.44 billion, indicating confidence in continued growth and strategic positioning in the market.
Potential Negatives
- Despite a revenue increase of 19% for the year, LifeStance reported a significant net loss of $57.4 million, raising concerns about its overall profitability.
- The company's income from operations showed a loss for the full year and only a marginal gain of $1.1 million in the fourth quarter, indicating operational inefficiencies that need to be addressed.
- The company has a considerable net long-term debt of $279.8 million, which could pose financial risks moving forward, particularly if cash flow does not continue to improve.
FAQ
What are LifeStance's financial results for fourth quarter 2024?
LifeStance reported fourth quarter revenue of $325.5 million, reflecting a 16% increase compared to the fourth quarter of 2023.
How much did LifeStance grow in terms of clinicians?
The clinician base increased by 12%, reaching a total of 7,424 clinicians by the end of 2024.
What is LifeStance's revenue outlook for 2025?
LifeStance expects full year 2025 revenue to range between $1.40 billion to $1.44 billion.
What was LifeStance's net loss for the full year 2024?
LifeStance reported a net loss of $57.4 million for the full year 2024.
When is LifeStance's conference call to discuss financial results?
LifeStance will hold a conference call on February 27, 2025, at 8:30 a.m. Eastern Time.
Disclaimer: This is an AI-generated summary of a press release distributed by GlobeNewswire. The model used to summarize this release may make mistakes. See the full release here.
$LFST Insider Trading Activity
$LFST insiders have traded $LFST stock on the open market 3 times in the past 6 months. Of those trades, 0 have been purchases and 3 have been sales.
Here’s a breakdown of recent trading of $LFST stock by insiders over the last 6 months:
- ROBERT BESSLER has made 0 purchases and 2 sales selling 75,000 shares for an estimated $565,500.
- LISA K MILLER (See Remarks) sold 10,540 shares for an estimated $78,523
To track insider transactions, check out Quiver Quantitative's insider trading dashboard.
$LFST Hedge Fund Activity
We have seen 93 institutional investors add shares of $LFST stock to their portfolio, and 65 decrease their positions in their most recent quarter.
Here are some of the largest recent moves:
- JENNISON ASSOCIATES LLC added 5,949,438 shares (+278.4%) to their portfolio in Q4 2024, for an estimated $43,847,358
- T. ROWE PRICE INVESTMENT MANAGEMENT, INC. removed 4,481,379 shares (-100.0%) from their portfolio in Q4 2024, for an estimated $33,027,763
- MILLENNIUM MANAGEMENT LLC added 4,235,706 shares (+341.8%) to their portfolio in Q4 2024, for an estimated $31,217,153
- FMR LLC removed 3,547,339 shares (-9.6%) from their portfolio in Q4 2024, for an estimated $26,143,888
- MORGAN STANLEY added 2,399,124 shares (+52.2%) to their portfolio in Q4 2024, for an estimated $17,681,543
- DIMENSIONAL FUND ADVISORS LP added 1,643,390 shares (+87.4%) to their portfolio in Q4 2024, for an estimated $12,111,784
- POINT72 ASSET MANAGEMENT, L.P. removed 1,100,441 shares (-100.0%) from their portfolio in Q4 2024, for an estimated $8,110,250
To track hedge funds' stock portfolios, check out Quiver Quantitative's institutional holdings dashboard.
Full Release
SCOTTSDALE, Ariz., Feb. 27, 2025 (GLOBE NEWSWIRE) -- LifeStance Health Group, Inc. (Nasdaq: LFST), one of the nation’s largest providers of outpatient mental healthcare, today announced financial results for the fourth quarter and full year ended December 31, 2024.
(All results compared to prior-year comparative period, unless otherwise noted)
2024 Highlights and 2025 Outlook
Fourth quarter revenue of $325.5 million increased 16% and full year revenue of $1,251.0 million increased 19% compared to revenue of $1,055.7 million
Clinician base increased 12% to 7,424 clinicians, a sequential net increase of 155 in the fourth quarter and 779 for the full year
Fourth quarter visit volumes increased 14% to 2.0 million and full year visit volumes increased 15% to 7.9 million
Net loss of $7.1 million in the fourth quarter and $57.4 million for the full year
Net cash from operations of $62.3 million in the fourth quarter and $107.3 million for the full year
Adjusted EBITDA of $32.8 million in the fourth quarter and $119.7 million for the full year
Free Cash Flow of $56.0 million in the fourth quarter and $85.7 million for the full year
Expecting full year 2025 revenue of $1.40 billion to $1.44 billion, Center Margin of $440 million to $464 million, and Adjusted EBITDA of $130 million to $150 million
“The team delivered exceptional performance in 2024,” said Ken Burdick, Chairman and CEO of LifeStance. “We grew revenue 19%, more than doubled Adjusted EBITDA, and generated strong Free Cash Flow of $86 million. We have delivered consistently strong financial and operational performance over the last two years, and have begun to demonstrate the true potential of LifeStance. Looking ahead to 2025, we feel we are well-positioned to continue our strong momentum while delivering on our mission of expanding access to affordable, high quality mental healthcare.”
Financial Highlights | |||||||||||||||||||||||||
Q4 2024 | Q4 2023 | Y/Y | FY 2024 | FY 2023 | Y/Y | ||||||||||||||||||||
(in millions) | |||||||||||||||||||||||||
Total revenue | $ | 325.5 | $ | 280.6 | 16 | % | $ | 1,251.0 | $ | 1,055.7 | 19 | % | |||||||||||||
Income (loss) from operations | 1.1 | (32.3 | ) | (103 | %) | (31.6 | ) | (189.1 | ) | (83 | %) | ||||||||||||||
Center Margin | 109.4 | 83.3 | 31 | % | 402.4 | 302.1 | 33 | % | |||||||||||||||||
Net loss | (7.1 | ) | (45.0 | ) | (84 | %) | (57.4 | ) | (186.3 | ) | (69 | %) | |||||||||||||
Adjusted EBITDA | 32.8 | 20.3 | 62 | % | 119.7 | 59.0 | 103 | % | |||||||||||||||||
As % of Total revenue: | |||||||||||||||||||||||||
Income (loss) from operations | 0.3 | % | (11.5 | %) | (2.5 | %) | (17.9 | %) | |||||||||||||||||
Center Margin | 33.6 | % | 29.7 | % | 32.2 | % | 28.6 | % | |||||||||||||||||
Net loss | (2.2 | %) | (16.0 | %) | (4.6 | %) | (17.6 | %) | |||||||||||||||||
Adjusted EBITDA | 10.1 | % | 7.2 | % | 9.6 | % | 5.6 | % | |||||||||||||||||
(All results compared to prior-year period, unless otherwise noted)
In the fourth quarter, revenue grew 16% to $325.5 million, and for the full year, revenue grew $195.3 million or 19% to $1,251.0 million compared to revenue of $1,055.7 million. Strong revenue growth in the fourth quarter was driven primarily by improvements in total revenue per visit and higher visit volumes from net clinician growth.
In the fourth quarter, income from operations was $1.1 million, and for the full year, loss from operations was $31.6 million. In the fourth quarter, net loss was $7.1 million and for the full year, net loss was $57.4 million.
In the fourth quarter, Center Margin grew 31% to $109.4 million, or 33.6% of total revenue. For the full year, Center Margin grew 33% to $402.4 million, or 32.2% of total revenue.
In the fourth quarter, Adjusted EBITDA increased 62% to $32.8 million, or 10.1% of total revenue. Adjusted EBITDA as a percentage of revenue increased in the fourth quarter as a result of higher total revenue per visit and lower center costs as a percentage of revenue. For the full year, Adjusted EBITDA grew 103% to $119.7 million, or 9.6% of total revenue.
Balance Sheet, Cash Flow and Capital Allocation
For the year ended December 31, 2024, LifeStance provided $107.3 million cash flow from operations, including $62.3 million during the fourth quarter of 2024. The Company ended the fourth quarter with cash of $154.6 million and net long-term debt of $279.8 million.
2025 Guidance
LifeStance is providing the following outlook for 2025:
The Company expects full year revenue of $1.40 billion to $1.44 billion, Center Margin of $440 million to $464 million, and Adjusted EBITDA of $130 million to $150 million.
For the first quarter of 2025, the Company expects total revenue of $320 million to $340 million, Center Margin of $100 million to $114 million, and Adjusted EBITDA of $27 million to $33 million.
Conference Call, Webcast Information, and Presentations
LifeStance will hold a conference call today, February 27, 2025 at 8:30 a.m. Eastern Time to discuss the fourth quarter and full year 2024 results. Investors who wish to participate in the call should dial 1-800-715-9871, domestically, or 1-646-307-1963, internationally, approximately 10 minutes before the call begins and provide conference ID number 4372752 or ask to be joined into the LifeStance call. A real-time audio webcast can be accessed via the Events and Presentations section of the LifeStance Investor Relations website (https://investor.lifestance.com), where related materials will be posted prior to the conference call.
About LifeStance Health Group, Inc.
Founded in 2017, LifeStance (Nasdaq: LFST) is reimagining mental health. We are one of the nation’s largest providers of virtual and in-person outpatient mental healthcare for children, adolescents and adults experiencing a variety of mental health conditions. Our mission is to help people lead healthier, more fulfilling lives by improving access to trusted, affordable, and personalized mental healthcare. LifeStance and its supported practices employ approximately 7,400 psychiatrists, advanced practice nurses, psychologists and therapists and operates across 33 states and more than 550 centers. To learn more, please visit www.LifeStance.com.
We routinely post information that may be important to investors on the “Investor Relations” section of our website at investor.lifestance.com. We encourage investors and potential investors to consult our website regularly for important information about us.
Forward-Looking Statements
Statements in this press release and on the related teleconference that express a belief, expectation or intention, as well as those that are not historical fact, are forward-looking statements. These statements include, but are not limited to, statements with respect to: full year and first quarter guidance and management's related assumptions; business plans and objectives; and other statements contained in this press release that are not historical facts. When used in this press release and on the related teleconference, words such as “may,” “will,” “should,” “could,” “intend,” “potential,” “continue,” “anticipate,” “believe,” “estimate,” “expect,” “plan,” “target,” “predict,” “project,” “seek” and similar expressions as they relate to us are intended to identify forward-looking statements. They involve a number of risks and uncertainties that may cause actual events and results to differ materially from such forward-looking statements. These risks and uncertainties include, but are not limited to: if reimbursement rates paid by third-party payors are reduced or if third-party payors otherwise restrain our ability to obtain or deliver care to patients, our business could be harmed; we may not grow at the rates we historically have achieved or at all, even if our key metrics may imply future growth, including if we are unable to successfully execute on our growth initiatives and business strategies; if we fail to manage our growth effectively, our expenses could increase more than expected, our revenue may not increase proportionally or at all, and we may be unable to execute on our business strategy; our ability to recruit new clinicians and retain existing clinicians; we conduct business in a heavily regulated industry and if we fail to comply with these laws and government regulations, we could incur penalties or be required to make significant changes to our operations or experience adverse publicity, which could have a material adverse effect on our business, results of operations and financial condition; we are dependent on our relationships with supported practices, which we do not own, to provide healthcare services, and our business would be harmed if those relationships were disrupted or if our arrangements with these entities became subject to legal challenges; we operate in a competitive industry, and if we are not able to compete effectively, our business and financial condition would be harmed; the impact of health care reform legislation and other changes in the healthcare industry and in health care spending on us is currently unknown, but may harm our business; if our or our vendors’ security measures fail or are breached and unauthorized access to our employees’, patients’ or partners’ data is obtained, our systems may be perceived as insecure, we may incur significant liabilities, including through private litigation or regulatory action, our reputation may be harmed, and we could lose patients and partners; our business depends on our ability to effectively invest in, implement improvements to and properly maintain the uninterrupted operation and data integrity of our information technology and other business systems; our existing indebtedness could adversely affect our business and growth prospects; and other risks and uncertainties set forth under “Risk Factors” included in the reports we have filed or will file with the Securities and Exchange Commission, including our Annual Report on Form 10-K for the year ended December 31, 2023 and subsequent filings made with the Securities and Exchange Commission. LifeStance does not undertake to update any forward-looking statements made in this press release to reflect any change in management's expectations or any change in the assumptions or circumstances on which such statements are based, except as otherwise required by law.
Non-GAAP Financial Information
This press release contains certain non-GAAP financial measures, including Center Margin, Adjusted EBITDA, and Adjusted EBITDA margin. Tables showing the reconciliation of these non-GAAP financial measures to the comparable GAAP measures are included at the end of this release. Management believes these non-GAAP financial measures are useful in evaluating the Company’s operating performance, and may be helpful to securities analysts, institutional investors and other interested parties in understanding the Company’s operating performance and prospects. This press release also refers to Free Cash Flow, which is calculated as net cash provided by (used in) operating activities less purchases of property and equipment. Management believes Free Cash Flow is a useful indicator of liquidity that provides information to management and investors about the amount of cash generated from our operations that, after investments in property and equipment, can be used for future growth. These non-GAAP financial measures, as calculated, may not be comparable to companies in other industries or within the same industry with similarly titled measures of performance. Therefore, the Company’s non-GAAP financial measures should be considered in addition to, not as a substitute for, or in isolation from, measures prepared in accordance with GAAP, such as net loss or loss from operations.
Center Margin and Adjusted EBITDA anticipated for the first quarter of 2025 and full year 2025 are calculated in a manner consistent with the historical presentation of these measures at the end of this release. Reconciliation for the forward-looking first quarter of 2025 and full year 2025 Center Margin, Adjusted EBITDA guidance and Free Cash Flow is not being provided, as LifeStance does not currently have sufficient data to accurately estimate the variables and individual adjustments for such reconciliation. As such, LifeStance management cannot estimate on a forward-looking basis without unreasonable effort the impact these variables and individual adjustments will have on its reported results.
Management acknowledges that there are many items that impact a company’s reported results and the adjustments reflected in these non-GAAP measures are not intended to present all items that may have impacted these results.
Consolidated Financial Information and Reconciliations | ||||||||
CONSOLIDATED BALANCE SHEETS | ||||||||
(unaudited) | ||||||||
(In thousands, except for par value) | ||||||||
December 31, | ||||||||
2024 | 2023 | |||||||
CURRENT ASSETS | ||||||||
Cash and cash equivalents | $ | 154,571 | $ | 78,824 | ||||
Patient accounts receivable, net | 131,802 | 125,405 | ||||||
Prepaid expenses and other current assets | 26,137 | 21,502 | ||||||
Total current assets | 312,510 | 225,731 | ||||||
NONCURRENT ASSETS | ||||||||
Property and equipment, net | 166,041 | 188,222 | ||||||
Right-of-use assets | 147,878 | 170,703 | ||||||
Intangible assets, net | 190,799 | 221,072 | ||||||
Goodwill | 1,293,346 | 1,293,346 | ||||||
Other noncurrent assets | 7,724 | 10,895 | ||||||
Total noncurrent assets | 1,805,788 | 1,884,238 | ||||||
Total assets | $ | 2,118,298 | $ | 2,109,969 | ||||
LIABILITIES AND STOCKHOLDERS' EQUITY | ||||||||
CURRENT LIABILITIES | ||||||||
Accounts payable | $ | 7,242 | $ | 7,051 | ||||
Accrued payroll expenses | 117,461 | 102,478 | ||||||
Other accrued expenses | 46,942 | 35,012 | ||||||
Contingent consideration | — | 8,169 | ||||||
Operating lease liabilities, current | 49,449 | 46,475 | ||||||
Other current liabilities | 7,792 | 3,688 | ||||||
Total current liabilities | 228,886 | 202,873 | ||||||
NONCURRENT LIABILITIES | ||||||||
Long-term debt, net | 279,790 | 280,285 | ||||||
Operating lease liabilities, noncurrent | 148,699 | 181,357 | ||||||
Deferred tax liability, net | 14,329 | 15,572 | ||||||
Other noncurrent liabilities | 309 | 952 | ||||||
Total noncurrent liabilities | 443,127 | 478,166 | ||||||
Total liabilities | $ | 672,013 | $ | 681,039 | ||||
COMMITMENTS AND CONTINGENCIES | ||||||||
STOCKHOLDERS’ EQUITY | ||||||||
Preferred stock – par value $0.01 per share; 25,000 shares authorized as of December 31, 2024 and December 31, 2023; 0 shares issued and outstanding as of December 31, 2024 and December 31, 2023 | — | — | ||||||
Common stock – par value $0.01 per share; 800,000 shares authorized as of December 31, 2024 and December 31, 2023; 382,735 and 378,725 shares issued and outstanding as of December 31, 2024 and December 31, 2023, respectively | 3,827 | 3,789 | ||||||
Additional paid-in capital | 2,259,818 | 2,183,684 | ||||||
Accumulated other comprehensive income | 929 | 2,303 | ||||||
Accumulated deficit | (818,289 | ) | (760,846 | ) | ||||
Total stockholders' equity | 1,446,285 | 1,428,930 | ||||||
Total liabilities and stockholders’ equity | $ | 2,118,298 | $ | 2,109,969 | ||||
CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS | ||||||||||||
(unaudited) | ||||||||||||
(In thousands, except for Net Loss per Share) | ||||||||||||
Year Ended December 31, | ||||||||||||
2024 | 2023 | 2022 | ||||||||||
TOTAL REVENUE | $ | 1,250,970 | $ | 1,055,665 | $ | 859,542 | ||||||
OPERATING EXPENSES | ||||||||||||
Center costs, excluding depreciation and amortization shown separately below | 848,571 | 753,569 | 622,525 | |||||||||
General and administrative expenses | 363,062 | 410,793 | 377,993 | |||||||||
Depreciation and amortization | 70,950 | 80,437 | 69,198 | |||||||||
Total operating expenses | $ | 1,282,583 | $ | 1,244,799 | $ | 1,069,716 | ||||||
LOSS FROM OPERATIONS | $ | (31,613 | ) | $ | (189,134 | ) | $ | (210,174 | ) | |||
OTHER EXPENSE | ||||||||||||
Gain (loss) on remeasurement of contingent consideration | 1,725 | 3,972 | (1,688 | ) | ||||||||
Transaction costs | (827 | ) | (89 | ) | (722 | ) | ||||||
Interest expense, net | (26,535 | ) | (21,220 | ) | (19,928 | ) | ||||||
Other expense | (363 | ) | (112 | ) | (218 | ) | ||||||
Total other expense | $ | (26,000 | ) | $ | (17,449 | ) | $ | (22,556 | ) | |||
LOSS BEFORE INCOME TAXES | (57,613 | ) | (206,583 | ) | (232,730 | ) | ||||||
INCOME TAX BENEFIT | 170 | 20,321 | 17,166 | |||||||||
NET LOSS | $ | (57,443 | ) | $ | (186,262 | ) | $ | (215,564 | ) | |||
NET LOSS PER SHARE, BASIC AND DILUTED | (0.15 | ) | (0.51 | ) | (0.61 | ) | ||||||
Weighted-average shares used to compute basic and diluted net loss per share | 379,147 | 367,457 | 355,278 | |||||||||
NET LOSS | $ | (57,443 | ) | $ | (186,262 | ) | $ | (215,564 | ) | |||
OTHER COMPREHENSIVE (LOSS) INCOME | ||||||||||||
Unrealized (losses) gains on cash flow hedge, net of tax | (1,374 | ) | (971 | ) | 3,274 | |||||||
COMPREHENSIVE LOSS | $ | (58,817 | ) | $ | (187,233 | ) | $ | (212,290 | ) | |||
CONSOLIDATED STATEMENTS OF CASH FLOWS | ||||||||||||
(unaudited) | ||||||||||||
(In thousands) | ||||||||||||
Year Ended December 31, | ||||||||||||
2024 | 2023 | 2022 | ||||||||||
CASH FLOWS FROM OPERATING ACTIVITIES | ||||||||||||
Net loss | $ | (57,443 | ) | $ | (186,262 | ) | $ | (215,564 | ) | |||
Adjustments to reconcile net loss to net cash provided by (used in) operating activities: | ||||||||||||
Depreciation and amortization | 70,950 | 80,437 | 69,198 | |||||||||
Non-cash operating lease costs | 39,502 | 39,987 | 38,161 | |||||||||
Stock-based compensation | 76,172 | 99,388 | 187,430 | |||||||||
Deferred income taxes | (958 | ) | (21,920 | ) | (16,733 | ) | ||||||
Loss on debt extinguishment | 5,032 | — | 3,380 | |||||||||
Amortization of discount and debt issue costs | 1,666 | 2,101 | 1,949 | |||||||||
(Gain) loss on remeasurement of contingent consideration | (1,725 | ) | (3,972 | ) | 1,688 | |||||||
Other, net | 1,431 | 7,080 | 218 | |||||||||
Change in operating assets and liabilities, net of businesses acquired: | ||||||||||||
Patient accounts receivable, net | (6,397 | ) | (24,175 | ) | (21,663 | ) | ||||||
Prepaid expenses and other current assets | (3,332 | ) | (3,070 | ) | (3,431 | ) | ||||||
Accounts payable | 501 | (5,605 | ) | 7,667 | ||||||||
Accrued payroll expenses | 14,984 | 26,484 | 12,100 | |||||||||
Operating lease liabilities | (46,748 | ) | (37,564 | ) | (13,169 | ) | ||||||
Other accrued expenses | 13,625 | 10,207 | 1,558 | |||||||||
Net cash provided by (used in) operating activities | $ | 107,260 | $ | (16,884 | ) | $ | 52,789 | |||||
CASH FLOWS FROM INVESTING ACTIVITIES | ||||||||||||
Purchases of property and equipment | (21,566 | ) | (40,520 | ) | (79,255 | ) | ||||||
Acquisitions of businesses, net of cash acquired | — | (19,820 | ) | (60,206 | ) | |||||||
Net cash used in investing activities | $ | (21,566 | ) | $ | (60,340 | ) | $ | (139,461 | ) | |||
CASH FLOWS FROM FINANCING ACTIVITIES | ||||||||||||
Proceeds from long-term debt, net of discount | 287,809 | 57,753 | 257,324 | |||||||||
Payments of debt issue costs | (1,818 | ) | (188 | ) | (7,266 | ) | ||||||
Payments of long-term debt | (289,494 | ) | (2,470 | ) | (187,766 | ) | ||||||
Prepayment for debt paydown | — | — | (1,609 | ) | ||||||||
Payments of contingent consideration | (6,444 | ) | (7,668 | ) | (12,515 | ) | ||||||
Taxes related to net share settlement of equity awards | — | — | (904 | ) | ||||||||
Net cash (used in) provided by financing activities | $ | (9,947 | ) | $ | 47,427 | $ | 47,264 | |||||
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS | 75,747 | (29,797 | ) | (39,408 | ) | |||||||
Cash and Cash Equivalents - Beginning of period | 78,824 | 108,621 | 148,029 | |||||||||
CASH AND CASH EQUIVALENTS – END OF PERIOD | $ | 154,571 | $ | 78,824 | $ | 108,621 | ||||||
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION | ||||||||||||
Cash paid for interest, net | $ | 24,992 | $ | 21,044 | $ | 14,365 | ||||||
Cash paid for taxes, net of refunds | $ | 57 | $ | 80 | $ | 2,237 | ||||||
SUPPLEMENTAL DISCLOSURES OF NON CASH INVESTING AND FINANCING ACTIVITIES | ||||||||||||
Equipment financed through finance leases | $ | — | $ | — | $ | 363 | ||||||
Contingent consideration incurred in acquisitions of businesses | $ | — | $ | 1,985 | $ | 11,221 | ||||||
Acquisition of property and equipment included in liabilities | $ | 1,469 | $ | 3,827 | $ | 7,891 | ||||||
Surrender of common stock | $ | — | $ | — | $ | 982 | ||||||
RECONCILIATION OF LOSS FROM OPERATIONS TO CENTER MARGIN | ||||||||||||
Year Ended December 31, | ||||||||||||
2024 | 2023 | 2022 | ||||||||||
(in thousands) | ||||||||||||
Loss from operations | $ | (31,613 | ) | $ | (189,134 | ) | $ | (210,174 | ) | |||
Adjusted for: | ||||||||||||
Depreciation and amortization | 70,950 | 80,437 | 69,198 | |||||||||
General and administrative expenses (1) | 363,062 | 410,793 | 377,993 | |||||||||
Center Margin | $ | 402,399 | $ | 302,096 | $ | 237,017 | ||||||
(1) | Represents salaries, wages and employee benefits for our executive leadership, finance, human resources, marketing, billing and credentialing support and technology infrastructure and stock-based compensation for all employees. |
RECONCILIATION OF NET LOSS TO ADJUSTED EBITDA | ||||||||||||
Year Ended December 31, | ||||||||||||
2024 | 2023 | 2022 | ||||||||||
(in thousands) | ||||||||||||
Net loss | $ | (57,443 | ) | $ | (186,262 | ) | $ | (215,564 | ) | |||
Adjusted for: | ||||||||||||
Interest expense, net | 26,535 | 21,220 | 19,928 | |||||||||
Depreciation and amortization | 70,950 | 80,437 | 69,198 | |||||||||
Income tax benefit | (170 | ) | (20,321 | ) | (17,166 | ) | ||||||
(Gain) loss on remeasurement of contingent consideration | (1,725 | ) | (3,972 | ) | 1,688 | |||||||
Stock-based compensation expense | 76,172 | 99,388 | 187,430 | |||||||||
Loss on disposal of assets | 363 | 112 | 218 | |||||||||
Transaction costs (1) | 827 | 89 | 722 | |||||||||
Executive transition costs | 644 | 636 | 1,274 | |||||||||
Litigation costs (2) | 1,591 | 51,034 | 851 | |||||||||
Strategic initiatives (3) | 1,292 | 3,925 | — | |||||||||
Real estate optimization and restructuring charges (4) | (309 | ) | 10,970 | — | ||||||||
Amortization of cloud-based software implementation costs (5) | 843 | — | — | |||||||||
Other expenses (6) | 172 | 1,786 | 4,091 | |||||||||
Adjusted EBITDA | $ | 119,742 | $ | 59,042 | $ | 52,670 | ||||||
(1) | Primarily includes capital markets advisory, consulting, accounting and legal expenses related to our acquisitions and to our underwritten public offering completed in the second quarter of 2024. | |
(2) | Litigation costs include only those costs which are considered non-recurring and outside of the ordinary course of business based on the following considerations, which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) the complexity of the case (e.g., complex class action litigation), (iii) the nature of the remedy(ies) sought, including the size of any monetary damages sought, (iv) the counterparty involved, and (v) our overall litigation strategy. During the years ended December 31, 2024, 2023 and 2022, litigation costs included cash expenses related to three distinct litigation matters, including (x) a securities class action litigation, (y) a privacy class action litigation and (z) a compensation model class action litigation. | |
(3) | Strategic initiatives consist of expenses directly related to a multi-phase system upgrade in connection with our recent and significant expansion. During the years ended December 31, 2024 and 2023, we continued a process of evaluating and adopting critical enterprise-wide systems for (i) human resources management, (ii) clinician credentialing and onboarding process, and for the year ended December 31, 2023, (iii) a scalable electronic health resources system. Strategic initiatives represents costs, such as third-party consulting costs and one-time costs, that are not part of our ongoing operations related to these enterprise-wide systems. We considered the frequency and scale of this multi-part enterprise upgrade when determining that the expenses were not normal, recurring operating expenses. | |
(4) | Real estate optimization and restructuring charges consist of cash expenses and non-cash charges related to our real estate optimization initiative, which include certain asset impairment and disposal costs, certain gains and losses related to early lease terminations, and exit and disposal costs related to our real estate optimization initiative to consolidate our physical footprint for the year ended December 31, 2023. As the decision to close these centers was part of a significant strategic project driven by a historic shift in behavior, the magnitude of center closures was greater than what would be expected as part of ordinary business operations and did not constitute normal recurring operating activities. During the year ended December 31, 2024, real estate optimization and restructuring charges consisted of certain gains and losses related to early lease terminations of previously abandoned real estate leases in 2023. | |
(5) | Represents amortization of capitalized implementation costs related to cloud-based software arrangements that are included within general and administrative expenses included in our consolidated statements of operations and comprehensive loss. | |
(6) | Primarily includes costs incurred to consummate or integrate acquired centers, certain of which are wholly-owned and certain of which are supported practices, in addition to the compensation paid to former owners of acquired centers and related expenses that are not reflective of the ongoing operating expenses of our centers. Acquired center integration and other are components of general and administrative expenses included in our consolidated statements of operations and comprehensive loss. Former owner fees is a component of center costs, excluding depreciation and amortization included in our consolidated statements of operations and comprehensive loss. |
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