BrightSpring Health Services, Inc. operates as a home and community-based healthcare services platform, focuses on delivering complementary pharmacy and provider services to complex patients.
The company has a differentiated approach to care delivery, with an integrated and scaled model that addresses critical services that the highest-need and highest-cost patients require. With a focus on Senior and Specialty patients, which includes Behavioral populations, the company’s platform provides pha...
BrightSpring Health Services, Inc. operates as a home and community-based healthcare services platform, focuses on delivering complementary pharmacy and provider services to complex patients.
The company has a differentiated approach to care delivery, with an integrated and scaled model that addresses critical services that the highest-need and highest-cost patients require. With a focus on Senior and Specialty patients, which includes Behavioral populations, the company’s platform provides pharmacy and provider services (both clinical and supportive care in nature) in lower-cost home and community settings, largely to Medicare, Medicaid, and commercially-insured populations. The company is an essential part of the nation’s health delivery network as a front-line provider of high-quality care to a large and growing number of people, who increasingly require a combination of specialized solutions to enable holistic health care management.
The company’s model focuses on delivering high-touch and coordinated services to medically complex clients and patients, which is a large, growing, and underserved population in the U.S. healthcare system.
The company has built a significant presence and capability in delivering complementary and high-touch daily healthcare services and programs to complex patients in their homes and in communities in order to address their multiple health needs and requirements more completely. In pharmacy, the company leverages its national infrastructure to provide daily medication therapy management to various customer and patient types, wherever they reside in the community, including home and in-clinic infusion patients, oncology and other specialty patients in their homes, residents of independent and senior living communities, people receiving hospice care, neuro and Behavioral clients’ and patients’ homes, residents of skilled nursing and rehabilitation facilities, hospital patients, and the homes of Seniors who are on a significant number of medications. Within provider services, the company addresses the clinical and supportive care needs of Senior and Specialty populations, including neuro and Behavioral patients, primarily in their homes, as well as some clinic and community settings. The company’s clinical services consist of home health and hospice and rehab therapy, and its supportive care services address activities of daily living and social determinants of health, as well. The company also provides home-based primary care for patients in senior living communities, long-term care, and individual homes to directly manage and optimize patient outcomes and to enable value-based care. By providing these complementary and necessary services for complex patients, the company’s care model is designed to address multiple patient needs and better integrate health services delivery to improve quality and patient experiences.
In the company’s pharmacy business, patients have an average of nine prescriptions at a given time and are supported by its local pharmacy model that delivers daily services, often within an hour or two, from over 180 pharmacies, infusion centers, and specialty oncology locations across all 50 states. The company has specifically focused on and built a fast, local, and ‘white-glove’ delivery model that is supported by expert clinical teams in the field, which fulfilled over 41 million prescriptions in 2024 across customer and patient settings and types. Patients who receive the company’s provider services average six chronic conditions per patient, and the company delivered approximately 19 million hours of quality and compassionate care in 2024 to home health, hospice, rehab, and home care patients and clients. Combined, the company’s daily pharmacy and provider services are delivered from and to approximately 11,300 office, clinic, and customer locations across the country, with over 450,000 patients serviced at any one time, including approximately 300,000 patients served in their homes at any one time.
Platform
The company’s high-quality and complementary health services offerings address significant and important patient and stakeholder needs. In the home and community settings where the company operates, patients with chronic conditions often require daily care, closely-managed medication regimens, and specialized clinical treatment, and its service model is defined by core pharmacy and provider services augmented by integrated care capabilities that are intended to maximize outcomes and minimize potential disruptions. The company’s quality outcomes achieved for Senior and Specialty patients and industry stakeholders are also mostly delivered in patient-preferred and lower-cost settings. The company’s breadth of service capabilities and proven outcomes position it as a provider of choice for patients, families, referral sources, customers, and payors.
Furthermore, scale is important in the industries and service areas that the company participates in, for numerous reasons, including realizing economies of scale, for example, in purchasing, technology, and related to fixed expenses, leveraging best practices and quality and operational oversight of the service lines, in payor contracting, being able to invest in attractive growth areas, and driving value through revenue, quality, and operational and cost synergies post acquisitions. The company’s service capabilities extend across all 50 states in the United States, with co-location of its pharmacy and provider services in 40 states. The company delivers a higher proportion of services in select regions with favorable demographics and regulatory environments, with approximately 47% of its revenue in 10 states for the year ended December 31, 2024.
The company’s scale, complementary service offerings, and geographic footprint also enable integrated and value-based care opportunities. Many of the company’s patients receive both pharmacy and provider services from the company, thus simplifying their experience and supporting positive outcomes.
Segments
The company’s services are organized and managed through two reportable segments: Pharmacy Solutions and Provider Services.
Pharmacy Solutions
The company opportunistically provides pharmacy services when and where demanded and as required to customers and patients in their homes and communities, often in coordination with the company’s provider services. The company filled over 41 million prescriptions in 2024 from over 180 pharmacies across all 50 states, with services delivered to approximately 7,100 customer locations, more than 60,000 individual or group homes, and over 400,000 patients, all through over 4,700 unique customer and payor contracts. The company’s leading pharmacy support across customer and patient settings is achieved through a focus on medication availability and reliability, cost containment, customer staff and patient support programs, clinical and regulatory education and support, and leading customer service. The company has a unique opportunity to increasingly provide more pharmacy services in the future to provider patients and patients transitioning across settings of care. Almost every one of the company’s patients who receive provider services from it has a significant medication support need given their polypharmacy profile, which the company has the opportunity to further address.
Pharmacy services are a universal need and ongoing connection point across medically complex populations. The company’s pharmacy services delivered into homes and community settings for complex patients are extremely different as compared to retail pharmacy, with more challenging customer and patient needs and service requirements. The average Senior fills approximately 52 medication prescriptions per year, while the company’s average pharmacy patient is usually prescribed approximately nine medications at a given time, or at least two times more than the average Senior. As a result, medication appropriateness, accuracy, and adherence are critical points of emphasis for promoting the overall long-term health and well-being of patients.
Infusion and Specialty Pharmacy
The company provides infused, injectable, and oral medication services in the home and clinic, focused on pharmaceutical therapies that require expert administration and high-touch clinical services to patients by the company’s pharmacists, registered nursing staff, and patient support teams. Infusion therapy services are a specialty form of pharmaceuticals that involve the intravenous administration of higher-cost, specially-handled medications that treat a wide range of acute and chronic health conditions, including for example, infections, auto-immune illnesses, oncology, multiple sclerosis, hemophilia, and nutritional deficiencies. The company’s certified oncology pharmacists are available 24/7 to provide support for patients and caregivers while working in close coordination with their physicians.
The company’s customer service and quality metrics are in line with, or better than, its peers, such as time-to-first-fill (3.6 day average turnaround time, which is significantly lower than the industry average of 9.7 day average turnaround time), overall MPR (93.3%, which is significantly higher than the generally accepted 80% threshold for compliance, which is also the threshold set forth in the company’s Blue Cross Blue Shield guarantee), and infusion patient satisfaction scores (94.5%, which is in line with the 95.6% national average). The company offers value-add services, including technology integrations and real-time analytics for both suppliers and payors. As a result of the company’s unique capabilities in serving pharmaceutical manufacturers and biotech companies, it has exclusive or preferred relationships in specialty oncology drugs, as manufacturers select the company’s pharmacy – exclusively or as part of a group of a few other pharmacies – to distribute and support their therapies in the market. The company has 125 limited distribution oncology drugs in the market, with an additional 18 in the pipeline still to launch, including 4 exclusive and 14 ultra-narrow drugs with limited pharmacy access.
Home and Community Pharmacy
The company’s home and community-based pharmacy solutions ensure that medications are accessible and clinically supported for patients outside of retail pharmacies. The company’s footprint of pharmacies covers all 50 states with a localized model that features ‘white-glove’ and customized programs and allows for faster response times and a better customer and patient experience. The company services customer locations typically multiple times a day and 24/7 as needed, within a radius of approximately 100 miles of a pharmacy location. The company’s services focus on achieving leading medication availability, cost containment, and clinical and regulatory education and support for its customers, and they are designed to provide a consistent, best-in-class experience for customers accompanied by local concierge support. Centralized intake and order entry drive consistency across operations and markets. The company’s pharmacy services are all customized to specific settings and patients among the Senior and Specialty populations served, for example, whether a patient receiving its medications is in a senior living community, a behavioral group home, or a hospice patient in their own home.
The company’s customers, supported by several thousand pharmacists, pharmacist consultants, and nurses, perform better than the national average, with its patients consistently outperforming non-patients on overall CMS quality measures.
In 2021, the company launched CCRx, which is a longitudinal medication therapy and risk management program for home health patients, attempting to solve one of the biggest challenges and opportunities in healthcare, which is the ongoing management of complex patients in their homes to reduce adverse health events and hospitalizations. CCRx includes patient and home assessments, initial and ongoing medication review and reconciliation, user-friendly adherence packaging, direct patient engagement, and education by pharmacists and clinicians. CCRx has been shown to reduce hospitalizations, and as such, is a key enabler in managing patients in value-based care constructs.
Provider Services
The company delivers a variety of impactful and valuable provider services to high-need, chronic, and complex patients in home and community settings. These services consist of clinical and supportive care to approximately 40,000 Senior and Specialty populations. While the clinical services that the company provides have demonstrated attractive volume growth over the past several years, supportive care services have also demonstrated stability and growth due to the valuable nature of these services that address activities of daily living and social determinants of health. Many of the company’s provider patients also receive their pharmacy services through the company, which helps to optimize their pharmacy and medication care and needs, simplify their experience, and improve their satisfaction. To this end, the company has endeavored to build out home-based primary care over the last several years to coordinate patient services.
First, the company is able to leverage its investments in human resources and people management initiatives and best practices across the enterprise, including in recruiting scale and centralization, onboarding and training, and career paths. Second, quality and patient satisfaction are critical, and the company is able to provide increased quality and compliance and operational oversight across all locations through additional regional and enterprise resources and functions. Third, the company drives strong sales and marketing best practices across geographies to drive strong referral and volume growth rates. Fourth, the company is able to drive economies of scale in supplier and payor contracting, in technology and systems, and in government affairs and advocacy. Fifth, the ability to address market opportunities and geographic coverage through de novo locations and tuck-in acquisitions that benefit from synergies adds value, which the company has demonstrated. Complementary scale in the pharmacy business is additive to provider services quality and growth, as the company’s pharmacy business’ presence and footprint across geographies provide for a base of integrated care patient opportunities.
Home Health Care
The company provides patient-centric, highly skilled, and compassionate clinical care to Seniors and others in their homes. For Seniors and other patients recovering from surgery or illness or living with chronic diseases, the company provides clinical home health care in the home. These services help patients avoid unnecessary hospitalizations, speed up recovery time, and allow people to stay and feel secure in their own homes, which they prefer. The company also provides physical, emotional, and spiritual comfort and support primarily for Senior patients with terminal illnesses and their families through its hospice services. The company’s services have also been shown to help manage end-of-life healthcare spending. Like patients receiving home health care, the company’s interdisciplinary hospice teams tailor individualized plans for patients and their families based on a comprehensive understanding of their needs. The company’s hospice patients require important daily pharmacy support, which it delivers through its pharmacy services. The company has an 9.3 HCI score, calculated using data from CMS provider reports for each of its providers, and the company’s nurse-to-patient visit frequency and staffing ratio is well above industry averages, as demonstrated by the fact that across its hospice services, the company’s average total visits per patient is 17.1 visits per month as compared to the national average of 15.6 visits per month. Additionally, on average, nursing visits per patient per month was 8.2 as compared to the national average of 6.8 visits per patient per month, which monthly average was based on a MedPac report in 2024. Additionally, for Seniors and others who require supportive care and activities of daily living support that address social determinants of health, including dietary and nutrition management and cognitive and social engagement, among others, the company offers these daily or weekly services.
The company is continuing to build out specialized and different primary care capabilities through its home-based primary care medical home model and platform, which it views as central to the future of optimizing patient management, including patient experiences, outcomes, and cost. The company’s primary care clinicians, including physicians it directly employs in certain states, optimize clinical and care decisions as they see and manage both Seniors and Behavioral (including I/DD) patients in senior living communities, in individual homes and in group homes, in skilled nursing and rehabilitation facilities, as well as through transitional care visits after patients leave hospitals or skilled nursing facilities. By engaging with patients more frequently and where they live, the company’s home-based primary care can mitigate health issues before they escalate further and conduct many applicable treatments and procedures in a home or community setting.
In addition to many of the company’s provider patients also receiving their pharmacy services from the company, its patients often receive multiple in-home provider services from the company to improve outcomes, including home-based primary care and home health or hospice and transitions from home health to hospice. Within the last two years, the company has built a Clinical (Nursing) Hub to be the contact and coordination point for patients, families, and their pharmacy and provider services. As more of its patients utilize the multiple needed services that they require and the company provides, it proactively monitors patients and deploys triage tools through its Clinical (Nursing) Hub to address risks and optimize quality outcomes in real time, particularly for higher risk patients. Within the Clinical (Nursing) Hub, the company centralizes on-call and tele-triage, performs high-risk patient monitoring and intervention, conducts ‘Aftercare’ patient calls, and manages care coordination opportunities across the enterprise.
Community and Rehab Care
The company’s Community and Rehab Care services provide both client- and patient-centric clinical care and supportive care to Senior and Specialty clients and patients living with age-related acute or chronic conditions, living with lifelong indications (including I/DD and autism), or recovering from a catastrophic neuro event (ABI/TBI or stroke) requiring intensive therapy. These services support individuals of all ages who need various forms of expert clinical care and therapy in addition to assistance with daily skill building and living. The majority of these clients and patients receive daily pharmacy support, delivered through its pharmacy business, along with ongoing behavioral therapy consults and primary care medical care, which is increasingly being delivered through its home-based primary care practice.
The company provides specialized, highly-skilled, and custom-designed rehabilitation services, including physical, speech, and occupational therapy and ABA, for clients and patients of all ages with a range of injuries and conditions, including brain and spinal cord injuries, stroke, pediatric neuro conditions, and autism. The company’s services make a dramatic impact on the trajectory of a patient’s independence, skills, and life and significantly lower longer-term costs. The company also offers a variety of programs for individuals with I/DD through its community living services, including group homes, supported living and family living models (host homes), behavioral therapy, vocational therapy, and case management. The company’s programs are principally administered in individuals’ homes and are predominantly based on individual support and clinical care plans designed to encourage greater independence and manage medical conditions, as the majority of I/DD individuals have multiple chronic conditions and require eight or more medications.
On January 17, 2025, the company entered into a purchase agreement with National Mentor Holding, Inc. to divest the company's community living services, home and community-based waiver programs, and intermediate care facilities (the ‘Community Living business’).
Competition
In the company’s infusion and specialty pharmacy services, it competes in the large and fragmented home infusion and specialty pharmacy markets, including Option Care Health, Inc., Coram CVS/specialty infusion services (a division of CVS Health), Accredo Health Group, Inc. (a unit of Cigna), Optum Specialty Pharmacy (a subsidiary of OptumRx, which is a unit of the UnitedHealth Group), and various regional and local providers.
In the company’s infusion and specialty pharmacy services, on a nationwide basis, the company competes with Omnicare, Inc., a division of CVS Health, and several others.
Sales and Marketing
In the company’s Pharmacy Solutions segment, potential referral sources and customers include physicians and specialists (prescribers), hospitals, senior living providers, behavioral (I/DD and other) providers, hospice providers, skilled nursing and rehabilitation providers, pharmaceutical manufacturers, and other health providers. The company receives substantially all of its Provider Services clients and patients through third-party referrals, including from healthcare providers, such as physicians, hospitals, skilled nursing and rehabilitation facilities, assisted living facilities, state, county, and city departments on aging, rehabilitation, mental health, behavioral health, and social services, MCOs, and other healthcare and social services providers, discharge planners, and case managers.
All of the company’s referral sources are generally made aware of the company’s available in-home, clinic-based, or community-based pharmacy and provider services through its team of clinical/account liaisons, patient care coordinators, clinicians, and operators, as well as through traditional and digital marketing initiatives and inside inbound/outbound call center teams. The company also provides ongoing market development through education and outreach to the industries and in the communities it serves in order to inform referral sources and healthcare participants about federal, state, and locally sponsored care options, the needs of different patient types, the benefits of its services, and to communicate its role in providing quality home and community-based health services.
The company has a specialized team of trade professionals that work with pharmaceutical manufacturers to understand their needs and pipeline of limited distribution drugs and construct programs to optimize the distribution, support, and usage of their products. The company augments these teams through marketing resources that provide optimized educational content and tools, and develop and manage market-specific education events and digital content and lead generation. The company utilizes customer relationship management, or CRM, technology tools to plan, track, and manage initiatives, activities, and results across teams. The company has built an inside team to outreach and educate its target industries and that works in close coordination with the development and marketing teams. The company’s centralized communications team catalogues and publishes important ongoing news and events, as well as client/patient testimonials, and quality results and white papers, which have been published in many peer-reviewed journals. The company also has a dedicated function in the organization that educates and advocates with policymakers at a higher level in partnership with industry associations and advocates, as champions for its clients/patients and employees.
Over the past several years, the company has increasingly worked with key healthcare system stakeholders, such as health systems (hospitals) and payors, to develop new, direct, and value-add relationships that focus on patient experiences and quality, including ACOs and MCOs that contract with CMS and the states for the servicing of federal and state Medicare and Medicaid programs, respectively.
Payors
The company is reimbursed for substantially all of its services by federal, state, and local government programs, such as Medicare, including Medicare Part D, and Medicaid state programs, MCOs and other state agencies. In addition, the company is reimbursed by commercial insurance, PBMs, and private pay consumers. Its pharmacy services are also reimbursed directly by some skilled nursing and rehabilitation facilities, hospice providers, Behavioral (including I/DD) providers, hospitals, and other provider customers.
Regulation
In addition to the False Claims Act, the various states in which the company operates have adopted their own analogs of the False Claims Act.
HIPAA requires the company to provide certain rights to individuals with respect to their health information. HIPAA also requires the company to enter into written agreements with certain contractors, known as business associates, to whom the company discloses PHI.
Occupational Safety and Health Administration regulations require employers to provide workers who are occupationally subject to blood or other potentially infectious materials with prescribed protections. These regulatory requirements apply to all healthcare facilities, including the company’s pharmacy and provider solutions.
History
The company was founded in 1974. It was incorporated in Delaware in 2017. The company was formerly known as Phoenix Parent Holdings Inc. and changed its name to BrightSpring Health Services, Inc. in 2021.
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