Option Care Health (OPCH) 10-Q 30 Oct 24 2024 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2024	Oct. 28, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Entity File Number	001-11993
Entity Registrant Name	OPTION CARE HEALTH, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	05-0489664
Entity Address, Address Line One	3000 Lakeside Dr.
Entity Address, Address Line Two	Suite 300N,
Entity Address, City or Town	Bannockburn,
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60015
City Area Code	312
Local Phone Number	940-2443
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Trading Symbol	OPCH
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		170,181,238
Entity Central Index Key	0001014739
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
CURRENT ASSETS:
Cash and cash equivalents	$ 483,026	$ 343,849
Accounts receivable, net	428,951	377,658
Inventories	310,599	274,004
Prepaid expenses and other current assets	98,798	98,744
Total current assets	1,321,374	1,094,255
NONCURRENT ASSETS:
Property and equipment, net	125,911	120,630
Operating lease right-of-use asset	89,210	84,159
Intangible assets, net	17,768	20,092
Referral sources, net	291,839	315,304
Goodwill	1,540,246	1,540,246
Other noncurrent assets	41,379	42,349
Total noncurrent assets	2,106,353	2,122,780
TOTAL ASSETS	3,427,727	3,217,035
CURRENT LIABILITIES:
Accounts payable	591,971	426,513
Accrued compensation and employee benefits	60,835	92,508
Accrued expenses and other current liabilities	81,893	75,010
Current portion of operating lease liability	22,013	18,278
Current portion of long-term debt	6,512	6,000
Total current liabilities	763,224	618,309
NONCURRENT LIABILITIES:
Long-term debt, net of discount, deferred financing costs and current portion	1,105,106	1,056,650
Operating lease liability, net of current portion	87,879	85,484
Deferred income taxes	45,008	34,920
Other noncurrent liabilities	279	0
Total noncurrent liabilities	1,238,272	1,177,054
Total liabilities	2,001,496	1,795,363
STOCKHOLDERS’ EQUITY:
Preferred stock; $0.0001 par value; 12,500,000 shares authorized, no shares outstanding as of September 30, 2024 and December 31, 2023	0	0
Common stock; $0.0001 par value: 250,000,000 shares authorized, 183,793,536 shares issued and 170,146,331 shares outstanding as of September 30, 2024; 182,905,559 shares issued and 174,575,537 shares outstanding as of December 31, 2023	18	18
Treasury stock; 13,647,205 and 8,330,022 shares outstanding, at cost, as of September 30, 2024 and December 31, 2023, respectively	(416,552)	(255,107)
Paid-in capital	1,224,059	1,204,270
Retained earnings	609,203	457,513
Accumulated other comprehensive income	9,503	14,978
Total stockholders’ equity	1,426,231	1,421,672
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 3,427,727	$ 3,217,035

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	12,500,000	12,500,000
Preferred stock, shares, outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	250,000,000	250,000,000
Common stock, shares, issued (in shares)	183,793,536	182,905,559
Common stock, shares, outstanding (in shares)	170,146,331	174,575,537
Treasury stock, at cost (in shares)	13,647,205	8,330,022

UNAUDITED CONDENSED CONSOLIDATE

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
NET REVENUE	$ 1,278,546	$ 1,093,014	$ 3,651,784	$ 3,177,934
COST OF REVENUE	1,021,797	838,748	2,907,170	2,443,834
GROSS PROFIT	256,749	254,266	744,614	734,100
OPERATING COSTS AND EXPENSES:
Selling, general and administrative expenses	156,999	158,214	465,524	459,644
Depreciation and amortization expense	14,659	15,005	44,294	44,417
Total operating expenses	171,658	173,219	509,818	504,061
OPERATING INCOME	85,091	81,047	234,796	230,039
OTHER INCOME (EXPENSE):
Interest expense, net	(12,345)	(11,786)	(38,150)	(38,816)
Equity in earnings of joint ventures	1,391	1,273	3,921	4,107
Other, net	(583)	(449)	1,983	84,487
Total other (expense) income	(11,537)	(10,962)	(32,246)	49,778
INCOME BEFORE INCOME TAXES	73,554	70,085	202,550	279,817
INCOME TAX EXPENSE	19,698	13,783	50,860	69,904
NET INCOME	53,856	56,302	151,690	209,913
OTHER COMPREHENSIVE (LOSS) INCOME, NET OF TAX:
Change in unrealized (loss) gain on cash flow hedges, net of income tax benefit of $1,998, $8, $1,785 and $57, respectively	(6,127)	53	(5,475)	(99)
OTHER COMPREHENSIVE (LOSS) INCOME	(6,127)	53	(5,475)	(99)
NET COMPREHENSIVE INCOME	$ 47,729	$ 56,355	$ 146,215	$ 209,814
EARNINGS PER COMMON SHARE:
Earnings per share, basic (in dollars per share)	$ 0.32	$ 0.31	$ 0.88	$ 1.17
Earnings per share, diluted (in dollars per share)	$ 0.31	$ 0.31	$ 0.87	$ 1.16
Weighted average common shares outstanding, basic (in shares)	170,636	178,826	172,490	179,956
Weighted average common shares outstanding, diluted (in shares)	171,941	180,528	173,848	181,286

UNAUDITED CONDENSED CONSOLIDA_2

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Change in unrealized (loss) gain on cash flow hedges, income tax benefit (expense)	$ 1,998	$ 8	$ 1,785	$ 57

UNAUDITED CONDENSED CONSOLIDA_3

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 151,690	$ 209,913
Adjustments to reconcile net income to net cash provided by operations:
Depreciation and amortization expense	46,029	46,423
Non-cash operating lease costs	17,892	14,610
Deferred income taxes - net	10,088	11,767
Loss on extinguishment of debt	377	0
Amortization of deferred financing costs	3,465	3,312
Equity in earnings of joint ventures	(3,921)	(4,107)
Stock-based incentive compensation expense	27,620	22,908
Capital distribution from equity method investments	1,250	4,000
Other adjustments	(1,845)	1,769
Changes in operating assets and liabilities:
Accounts receivable, net	(51,293)	(5,075)
Inventories	(36,595)	(28,362)
Prepaid expenses and other current assets	(3,175)	3,197
Accounts payable	164,754	50,726
Accrued compensation and employee benefits	(31,673)	4,197
Accrued expenses and other current liabilities	5,560	9,829
Operating lease liabilities	(16,833)	(13,019)
Other noncurrent assets and liabilities	3,880	(11,762)
Net cash provided by operating activities	287,270	320,326
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition of property and equipment	(25,266)	(21,981)
Business acquisitions, net of cash acquired	0	(12,855)
Other investing activities	0	(5,889)
Net cash used in investing activities	(25,266)	(40,725)
CASH FLOWS FROM FINANCING ACTIVITIES:
Stock-based compensation tax withholdings	(11,235)	(1,940)
Repayments of debt principal	(4,756)	(4,500)
Proceeds from issuance of debt	49,959	0
Deferred financing costs	(77)	0
Purchase of company stock	(160,122)	(175,108)
Other financing activities	3,404	(5,750)
Net cash used in financing activities	(122,827)	(187,298)
NET INCREASE IN CASH AND CASH EQUIVALENTS	139,177	92,303
Cash and cash equivalents - beginning of the period	343,849	294,186
CASH AND CASH EQUIVALENTS - END OF PERIOD	483,026	386,489
Supplemental disclosure of cash flow information:
Cash paid for interest	48,666	46,377
Cash paid for income taxes	45,258	53,699
Cash paid for operating leases	$ 21,861	$ 20,272

UNAUDITED CONDENSED CONSOLIDA_4

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Treasury Stock	Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Income (Loss)
Beginning balance at Dec. 31, 2022	$ 1,386,103	$ 0	$ 18	$ (2,403)	$ 1,176,906	$ 190,423	$ 21,159
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(1,902)				(1,902)
Stock-based incentive compensation	5,988				5,988
Purchase of company stock	(75,735)			(75,735)
Net income	39,208					39,208
Other comprehensive income (loss)	(3,443)						(3,443)
Ending balance at Mar. 31, 2023	1,350,219	0	18	(78,138)	1,180,992	229,631	17,716
Beginning balance at Dec. 31, 2022	1,386,103	0	18	(2,403)	1,176,906	190,423	21,159
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	209,913
Other comprehensive income (loss)	(99)
Ending balance at Sep. 30, 2023	1,440,083	0	18	(179,205)	1,197,874	400,336	21,060
Beginning balance at Mar. 31, 2023	1,350,219	0	18	(78,138)	1,180,992	229,631	17,716
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(247)				(247)
Stock-based incentive compensation	7,685				7,685
Purchase of company stock, and related tax effects	32			32
Net income	114,403					114,403
Other comprehensive income (loss)	3,291						3,291
Ending balance at Jun. 30, 2023	1,475,383	0	18	(78,106)	1,188,430	344,034	21,007
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	209				209
Stock-based incentive compensation	9,235				9,235
Purchase of company stock, and related tax effects	(101,099)			(101,099)
Net income	56,302					56,302
Other comprehensive income (loss)	53						53
Ending balance at Sep. 30, 2023	1,440,083	0	18	(179,205)	1,197,874	400,336	21,060
Beginning balance at Dec. 31, 2023	1,421,672	0	18	(255,107)	1,204,270	457,513	14,978
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(8,182)				(8,182)
Stock-based incentive compensation	9,605				9,605
Purchase of company stock, and related tax effects	(40,289)			(40,289)
Net income	44,791					44,791
Other comprehensive income (loss)	1,551						1,551
Ending balance at Mar. 31, 2024	1,429,148	0	18	(295,396)	1,205,693	502,304	16,529
Beginning balance at Dec. 31, 2023	1,421,672	0	18	(255,107)	1,204,270	457,513	14,978
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	151,690
Other comprehensive income (loss)	(5,475)
Ending balance at Sep. 30, 2024	1,426,231	0	18	(416,552)	1,224,059	609,203	9,503
Beginning balance at Mar. 31, 2024	1,429,148	0	18	(295,396)	1,205,693	502,304	16,529
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	1,299				1,299
Stock-based incentive compensation	7,608				7,608
Purchase of company stock, and related tax effects	(78,768)			(78,768)
Net income	53,043					53,043
Other comprehensive income (loss)	(899)						(899)
Ending balance at Jun. 30, 2024	1,411,431	0	18	(374,164)	1,214,600	555,347	15,630
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options, vesting of restricted stock, and related tax withholdings	(948)				(948)
Stock-based incentive compensation	10,407				10,407
Purchase of company stock, and related tax effects	(42,388)			(42,388)
Net income	53,856					53,856
Other comprehensive income (loss)	(6,127)						(6,127)
Ending balance at Sep. 30, 2024	$ 1,426,231	$ 0	$ 18	$ (416,552)	$ 1,224,059	$ 609,203	$ 9,503

NATURE OF OPERATIONS AND PRESEN

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS	NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS Corporate Organization and Business — Option Care Health, and its wholly-owned subsidiaries, provides infusion therapy and other ancillary health care services through a national network of 92 full service pharmacies and 93 stand-alone ambulatory infusion suites. The Company contracts with managed care organizations, third-party payers, hospitals, physicians, and other referral sources to provide pharmaceuticals and complex compounded solutions to patients for intravenous delivery in the patients’ homes or other nonhospital settings. The Company operates in one segment, infusion services. The Company’s stock is listed on the Nasdaq Global Select Market as of September 30, 2024. Basis of Presentation — The accompanying unaudited condensed consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States and contain all adjustments, including normal recurring adjustments, necessary to present fairly the Company’s financial position, results of operations and cash flows for interim financial reporting. The results of operations for the interim periods presented are not necessarily indicative of the results of operations for the entire year. These unaudited condensed consolidated financial statements do not include all of the information and notes to the financial statements required by GAAP for complete financial statements and should be read in conjunction with the 2023 audited consolidated financial statements, including the notes thereto, as presented in our Form 10-K. Principles of Consolidation — The Company’s unaudited condensed consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. All intercompany transactions and balances are eliminated in consolidation. The Company has investments in companies that are 50% owned and are accounted for as equity-method investments. The Company’s share of earnings from equity-method investments is included in the line entitled “Equity in earnings of joint ventures” in the unaudited condensed consolidated statements of comprehensive income. See Equity-Method Investments within Note 2, Summary of Significant Accounting Policies , for further discussion of the Company’s equity-method investments.

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Cash and Cash Equivalents — The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. As of September 30, 2024, cash equivalents consisted of money market funds. Prepaid Expenses and Other Current Assets — Included in prepaid expenses and other current assets are rebates receivable from pharmaceutical and medical supply manufacturers of $45.9 million and $52.0 million as of September 30, 2024 and December 31, 2023, respectively. Equity-Method Investments — The Company’s investments in certain unconsolidated entities are accounted for under the equity method. The balance of these investments is included in other noncurrent assets in the accompanying condensed consolidated balance sheets. As of September 30, 2024 and December 31, 2023, the balance of the investments was $23.6 million and $20.9 million, respectively. The balance of these investments is increased to reflect the Company’s capital contributions and equity in earnings of the investees. The balance of these investments is decreased to reflect the Company’s equity in losses of the investees and for distributions received that are not in excess of the carrying amount of the investments. The Company’s proportionate share of earnings or losses of the investees is recorded in equity in earnings of joint ventures in the accompanying unaudited condensed consolidated statements of comprehensive income. The Company’s proportionate share of earnings was $1.4 million and $3.9 million for the three and nine months ended September 30, 2024, respectively. The Company’s proportionate share of earnings was $1.3 million and $4.1 million for the three and nine months ended September 30, 2023, respectively. Distributions from the investees are treated as cash inflows from operating activities in the unaudited condensed consolidated statements of cash flows. During the three and nine months ended September 30, 2024, the Company received distributions from the investees of $0.5 million and $1.3 million, respectively. During the three and nine months ended September 30, 2023, the Company received distributions from the investees of $1.5 million and $4.0 million, respectively. See Note 15, Related-Party Transactions , for discussion of related-party transactions with these investees. Concentrations of Business Risk — The Company generates revenue from managed care contracts and other agreements with commercial third-party payers. Revenue related to the Company’s largest payer was approximately 15% for the three and nine months ended September 30, 2024. Revenue related to the Company’s largest payer was approximately 14% for the three and nine months ended September 30, 2023. There were no other managed care contracts that represent greater than 10% of revenue for the periods presented. For the three and nine months ended September 30, 2024, approximately 11% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. For the three and nine months ended September 30, 2023, approximately 11% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. As of September 30, 2024 and December 31, 2023, approximately 10% and 12%, respectively, of the Company’s accounts receivable was related to these programs. Governmental programs pay for services based on fee schedules and rates that are determined by the related governmental agency. Laws and regulations pertaining to government programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change in the near term. The Company does not require its patients or other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentration of credit risk relating to trade accounts receivable is limited due to the Company’s diversity of patients and payers. Further, the Company generally does not provide charity care; however, Option Care Health offers a financial assistance program for patients that meet certain defined hardship criteria. For the three and nine months ended September 30, 2024, approximately 68% and 67%, respectively, of the Company’s pharmaceutical and medical supply purchases were from four vendors. For the three and nine months ended September 30, 2023, approximately 73% of the Company’s pharmaceutical and medical supply purchases were from four vendors. Although there are a limited number of suppliers, the Company believes that other vendors could provide similar products on comparable terms. However, a change in suppliers could cause delays in service delivery, losses in revenue or decreased gross profit dollars, which could adversely affect the Company’s financial condition or operating results.

REVENUE

REVENUE	9 Months Ended
	Sep. 30, 2024
Revenue from Contract with Customer [Abstract]
REVENUE	REVENUE The following table sets forth the net revenue earned by category of payer for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Commercial payers $ 1,109,971 $ 957,601 $ 3,160,490 $ 2,765,513 Government payers 147,005 124,122 424,033 370,648 Patients 21,570 11,291 67,261 41,773 Net revenue $ 1,278,546 $ 1,093,014 $ 3,651,784 $ 3,177,934

INCOME TAXES

INCOME TAXES	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES During the three and nine months ended September 30, 2024, the Company recorded tax expense of $19.7 million and $50.9 million, respectively, which represents an effective tax rate of 26.8% and 25.1%, respectively. The variance in the Company’s effective tax rate of 26.8% and 25.1% for the three and nine months ended September 30, 2024, compared to the federal statutory rate of 21%, is primarily attributable to the difference between federal and state tax rates, various non-deductible expenses, and a change in state valuation allowance. During the nine months ended September 30, 2024, the Company released $2.2 million of state valuation allowance. On June 26, 2023, the Company entered into an agreement to terminate the merger agreement (the “Mutual Termination Agreement”) with Amedisys, Inc. (“Amedisys”). Under the terms of the Mutual Termination Agreement, the Company received a payment of $106.0 million in cash on behalf of Amedisys (“Termination Fee”). During the three months ended September 30, 2023, the Company recorded tax expense of $13.8 million. During the nine months ended September 30, 2023, the Company recorded tax expense of $69.9 million, which includes $22.1 million of tax expense related to the Termination Fee payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses. The tax expense for the three and nine months ended September 30, 2023 represents an effective tax rate of 19.7% and 25.0%, respectively. The variance in the Company’s effective tax rate of 19.7% and 25.0% for the three and nine months ended September 30, 2023, respectively, compared to the federal statutory rate of 21%, is primarily attributable to the difference between federal and state tax rates, various non-deductible expenses, and a change in state valuation allowance. The variance in the Company’s effective tax rate of 26.8% for the three months ended September 30, 2024, compared to 19.7% for the three months ended September 30, 2023 was primarily due to change in state valuation allowance. In September 2023, the Company released $5.8 million of state valuation allowance. The Company maintains a valuation allowance of $4.2 million against certain state net operating losses. In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets depends on the generation of future taxable income during the periods in which those temporary differences are deductible. In making this assessment, the Company considers the scheduled reversal of deferred tax liabilities, including the effect in available carryback and carryforward periods, projected taxable income, and tax-planning strategies. On a quarterly basis, the Company evaluates all positive and negative evidence in determining if the valuation allowance is fairly stated. The Company’s tax expense of $19.7 million and $50.9 million for the three and nine months ended September 30, 2024, respectively, consists of quarterly federal and state tax liabilities as well as recognized deferred federal and state tax expense. The Company’s tax expense of $13.8 million and $69.9 million for the three and nine months ended September 30, 2023, respectively, consists of quarterly federal and state tax liabilities as well as recognized deferred federal and state tax expense.

EARNINGS PER SHARE

EARNINGS PER SHARE	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
EARNINGS PER SHARE	EARNINGS PER SHARE The Company presents basic and diluted earnings per share for its common stock. Basic earnings per share is calculated by dividing the net income of the Company by the weighted average number of shares of common stock outstanding during the period. Diluted earnings per share is determined by adjusting the profit or loss and the weighted average number of shares of common stock outstanding for the effects of all potentially dilutive securities. The earnings are used as the basis of determining whether the inclusion of common stock equivalents would be anti-dilutive. The computation of diluted shares for the three and nine months ended September 30, 2024 and 2023 includes the effect of shares that would be issued in connection with warrants, stock options, restricted stock awards and performance stock unit awards, as these common stock equivalents are dilutive to the earnings per share recorded in those periods. The following table presents the Company’s common stock equivalents that were excluded from the calculation of earnings per share as they would be anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Stock option awards 779,876 984,567 855,323 1,180,376 Restricted stock awards 324,877 16,564 365,835 569,831 Performance stock unit awards — — 257,735 288,680 The following table presents the Company’s basic earnings per share and shares outstanding (in thousands, except per share data): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Numerator: Net income (1) $ 53,856 $ 56,302 $ 151,690 $ 209,913 Denominator: Weighted average number of common shares outstanding 170,636 178,826 172,490 179,956 Earnings per common share: Earnings per common share, basic $ 0.32 $ 0.31 $ 0.88 $ 1.17 (1) Net income for the nine months ended September 30, 2023 includes $62.8 million related to the termination payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses and taxes. The following table presents the Company’s diluted earnings per share and shares outstanding (in thousands, except per share data): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Numerator: Net income (1) $ 53,856 $ 56,302 $ 151,690 $ 209,913 Denominator: Weighted average number of common shares outstanding 170,636 178,826 172,490 179,956 Effect of dilutive securities 1,305 1,702 1,358 1,330 Weighted average number of common shares outstanding, diluted 171,941 180,528 173,848 181,286 Earnings per common share: Earnings per common share, diluted $ 0.31 $ 0.31 $ 0.87 $ 1.16 (1) Net income for the nine months ended September 30, 2023 includes $62.8 million related to the termination payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses and taxes.

LEASES

LEASES	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
LEASES	LEASES During the three and nine months ended September 30, 2024, the Company incurred operating lease expenses of $8.6 million and $25.3 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the unaudited condensed consolidated statements of comprehensive income. During the three and nine months ended September 30, 2023, the Company incurred operating lease expenses of $7.8 million and $22.3 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the unaudited condensed consolidated statements of comprehensive income. As of September 30, 2024, the weighted-average remaining lease term was 6.5 years and the weighted-average discount rate was 6.49%. Operating leases mature as follows (in thousands): Fiscal Year Ended December 31, Minimum Payments 2024 $ 7,464 2025 28,646 2026 25,880 2027 20,554 2028 13,517 Thereafter 43,813 Total lease payments 139,874 Less: interest (29,982) Present value of lease liabilities $ 109,892 During the nine months ended September 30, 2024, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the unaudited condensed consolidated statements of cash flow o f $23.0 million re lated to increases in the operating lease right-of-use assets and operating lease liabilities. During the nine months ended September 30, 2023, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the unaudited condensed consolidated statements of cash flow o f $26.1 million re lated to increases in the operating lease right-of-use assets and operating lease liabilities. As of September 30, 2024, the Company did not have any significant operating or financing leases that had not yet commenced.
LEASES	LEASES During the three and nine months ended September 30, 2024, the Company incurred operating lease expenses of $8.6 million and $25.3 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the unaudited condensed consolidated statements of comprehensive income. During the three and nine months ended September 30, 2023, the Company incurred operating lease expenses of $7.8 million and $22.3 million, respectively, including short-term lease expenses, which were included as a component of selling, general and administrative expenses in the unaudited condensed consolidated statements of comprehensive income. As of September 30, 2024, the weighted-average remaining lease term was 6.5 years and the weighted-average discount rate was 6.49%. Operating leases mature as follows (in thousands): Fiscal Year Ended December 31, Minimum Payments 2024 $ 7,464 2025 28,646 2026 25,880 2027 20,554 2028 13,517 Thereafter 43,813 Total lease payments 139,874 Less: interest (29,982) Present value of lease liabilities $ 109,892 During the nine months ended September 30, 2024, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the unaudited condensed consolidated statements of cash flow o f $23.0 million re lated to increases in the operating lease right-of-use assets and operating lease liabilities. During the nine months ended September 30, 2023, the Company commenced new leases, extensions and amendments, resulting in non-cash operating activities in the unaudited condensed consolidated statements of cash flow o f $26.1 million re lated to increases in the operating lease right-of-use assets and operating lease liabilities. As of September 30, 2024, the Company did not have any significant operating or financing leases that had not yet commenced.

PROPERTY AND EQUIPMENT

PROPERTY AND EQUIPMENT	9 Months Ended
	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
PROPERTY AND EQUIPMENT	PROPERTY AND EQUIPMENT Property and equipment was as follows as of September 30, 2024 and December 31, 2023 (in thousands): September 30, 2024 December 31, 2023 Infusion pumps $ 36,476 $ 36,943 Equipment, furniture and other 30,124 23,593 Leasehold improvements 117,827 99,725 Computer software, purchased and internally developed 52,513 50,572 Assets under development 26,007 33,668 262,947 244,501 Less: accumulated depreciation (137,036) (123,871) Property and equipment, net $ 125,911 $ 120,630 Depreciation expense is recorded within cost of revenue and operating expenses within the unaudited condensed consolidated statements of comprehensive income, depending on the nature of the underlying fixed assets. The depreciation expense included in cost of revenue relates to revenue-generating assets, such as infusion pumps. The depreciation expense included in operating expenses is related to infrastructure items, such as furniture, computer and office equipment, and leasehold improvements. The following table presents the amount of depreciation expense recorded in cost of revenue and operating expenses for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Depreciation expense in cost of revenue $ 568 $ 616 $ 1,735 $ 2,006 Depreciation expense in operating expenses 6,063 6,365 18,485 18,665 Total depreciation expense $ 6,631 $ 6,981 $ 20,220 $ 20,671

GOODWILL AND OTHER INTANGIBLE A

GOODWILL AND OTHER INTANGIBLE ASSETS	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL AND OTHER INTANGIBLE ASSETS	GOODWILL AND OTHER INTANGIBLE ASSETS There was no change in the carrying amount of goodwill for the three and nine months ended September 30, 2024. The carrying amount and accumulated amortization of intangible assets consist of the following as of September 30, 2024 and December 31, 2023 (in thousands): September 30, 2024 December 31, 2023 Gross intangible assets: Referral sources $ 514,388 $ 514,388 Trademarks/names 39,136 39,136 Other amortizable intangible assets 985 995 Total gross intangible assets 554,509 554,519 Accumulated amortization: Referral sources (222,549) (199,084) Trademarks/names (21,874) (19,698) Other amortizable intangible assets (479) (341) Total accumulated amortization (244,902) (219,123) Total intangible assets, net $ 309,607 $ 335,396 Amortization expense for intangible assets was $8.6 million and $25.8 million for the three and nine months ended September 30, 2024, respectively. Amortization expense for intangible assets was $8.6 million and $25.6 million for the three and nine months ended September 30, 2023, respectively.

INDEBTEDNESS

INDEBTEDNESS	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
INDEBTEDNESS	INDEBTEDNESS Long-term debt consisted of the following as of September 30, 2024 (in thousands): Principal Amount Discount Debt Issuance Costs Net Balance Revolver Facility $ — $ — $ — $ — First Lien Term Loan 633,244 (5,885) (8,030) 619,329 Senior Notes 500,000 — (7,711) 492,289 $ 1,133,244 $ (5,885) $ (15,741) 1,111,618 Less: current portion (6,512) Total long-term debt $ 1,105,106 Long-term debt consisted of the following as of December 31, 2023 (in thousands): Principal Amount Discount Debt Issuance Costs Net Balance Revolver Facility $ — $ — $ — $ — First Lien Term Loan 588,000 (6,974) (9,678) 571,348 Senior Notes 500,000 — (8,698) 491,302 $ 1,088,000 $ (6,974) $ (18,376) 1,062,650 Less: current portion (6,000) Total long-term debt $ 1,056,650 On May 8, 2024, the Company entered into the third amendment to the amended and restated First Lien Credit Agreement (the “Third Amendment”). The Third Amendment, among other things, reduces the interest rate on the First Lien Term Loan from Term Secured Overnight Financing Rate (“SOFR”) (including a credit spread adjustment) plus 2.75% to Term SOFR plus 2.25%, increases borrowings by $50.0 million, and removes the credit spread adjustment with respect to such First Lien Term Loan. The interest rate on the First Lien Term Loan was 7.50% and 8.21% as of September 30, 2024 and December 31, 2023, respectively. The weighted average interest rate incurred on the First Lien Term Loan was 7.56% and 7.84% for the three and nine months ended September 30, 2024, respectively. The weighted average interest rate incurred on the First Lien Term Loan was 8.11% and 7.71% for the three and nine months ended September 30, 2023, respectively. The interest rate on the Senior Notes was 4.375% as of September 30, 2024 and December 31, 2023. The weighted average interest rate incurred on the Senior Notes was 4.375% for the three and nine months ended September 30, 2024. The weighted average interest rate incurred on the Senior Notes was 4.375% for the three and nine months ended September 30, 2023. The Company assessed whether the repayment of the First Lien Term Loan indebtedness resulted in an insubstantial modification or an extinguishment of the existing debt for each loan in the syndication by grouping lenders as follows: (i) Lenders participating in both the First Lien Term Loan and Senior Notes; (ii) previous lenders that exited; and (iii) new lenders. The Company determined that $0.4 million of the First Lien Term Loan was extinguished. The First Lien Term Loan had insubstantial modifications for lenders that participated in both debt instruments, which resulted in a cash inflow from financing activities of $50.0 million in the unaudited condensed consolidated statements of cash flows. The Company incurred $1.6 million in fees, of which $0.1 million was capitalized, relative to the First Lien Term Loan and an immaterial amount of the total fees incurred was netted against the $50.0 million of debt proceeds as financing activities within the unaudited condensed consolidated statements of cash flows. The Company recognized a loss on extinguishment of debt of $0.4 million included in the line entitled “Other, net” in the unaudited condensed consolidated statements of comprehensive income. Long-term debt matures as follows (in thousands): Fiscal Year Ended December 31, Minimum Payments 2024 $ 1,628 2025 6,512 2026 6,512 2027 6,512 2028 612,080 Thereafter 500,000 Total $ 1,133,244 During the three and nine months ended September 30, 2024 and 2023, the Company engaged in hedging activities to limit its exposure to changes in interest rates. See Note 10, Derivative Instruments , for further discussion. The following table presents the estimated fair values of the Company’s debt obligations as of September 30, 2024 (in thousands): Financial Instrument Carrying Value as of September 30, 2024 Markets for Identical Item (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) First Lien Term Loan $ 619,329 $ — $ 634,827 $ — Senior Notes 492,289 — 475,000 — Total debt instruments $ 1,111,618 $ — $ 1,109,827 $ — See Note 11, Fair Value Measurements , for further discussion. On December 7, 2023, the Company entered into the second amendment to the amended and restated First Lien Credit Agreement dated as of October 27, 2021 (the “Second Amendment”). The Second Amendment, among other things, provides for revolving credit commitments by the applicable Revolving Credit Lenders in an aggregate amount of $400.0 million (the “Revolver Facility”), pursuant to which such lenders have agreed to make Revolving Credit Loans to the Company. As of September 30, 2024, the Company had $4.1 million of undrawn letters of credit issued and outstanding, resulting in net borrowing availability under the Revolver Facility of $395.9 million.

DERIVATIVE INSTRUMENTS

DERIVATIVE INSTRUMENTS	9 Months Ended
	Sep. 30, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
DERIVATIVE INSTRUMENTS	DERIVATIVE INSTRUMENTS The Company uses derivative financial instruments for hedging and non-trading purposes to limit the Company’s exposure to increases in interest rates related to its variable interest rate debt. Use of derivative financial instruments in hedging programs subjects the Company to certain risks, such as market and credit risks. Market risk represents the possibility that the value of the derivative financial instrument will change. In a hedging relationship, the change in the value of the derivative financial instrument is offset to a great extent by the change in the value of the underlying hedged item. Credit risk related to a derivative financial instrument represents the possibility that the counterparty will not fulfill the terms of the contract. The notional, or contractual, amount of the Company’s derivative financial instruments is used to measure interest to be paid or received and does not represent the Company’s exposure due to credit risk. Credit risk is monitored through established approval procedures, including reviewing credit ratings when appropriate. In October 2021, the Company entered into an interest rate cap hedge with a notional amount of $300 million for a 5-year term beginning November 30, 2021. The hedge partially offsets risk associated with the First Lien Term Loan’s variable interest rate. The interest rate cap instrument perfectly offsets the terms of the interest rates associated with the variable interest rate of the First Lien Term Loan. The following table summarizes the amount and location of the Company’s derivative instruments in the condensed consolidated balance sheets (in thousands): Fair Value - Derivatives in Asset Position Derivative Balance Sheet Caption September 30, 2024 December 31, 2023 Interest rate cap designated as cash flow hedge Prepaid expenses and other current assets $ 7,223 $ 9,746 Interest rate cap designated as cash flow hedge Other noncurrent assets 5,446 10,183 Total derivative assets $ 12,669 $ 19,929 The (loss) gain associated with the change in the fair value of the effective portion of the hedging instrument is recorded in other comprehensive (loss) income. The following table presents the pre-tax (loss) gain from derivative instruments recognized in other comprehensive (loss) income in the Company’s unaudited condensed consolidated statements of comprehensive income (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Derivative 2024 2023 2024 2023 Interest rate cap designated as cash flow hedge $ (8,125) $ 45 $ (7,260) $ (156) The following table presents the amount and location of pre-tax income recognized in the Company’s unaudited condensed consolidated statements of comprehensive income related to the Company’s derivative instruments (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Derivative Income Statement Caption 2024 2023 2024 2023 Interest rate cap designated as cash flow hedge Interest expense, net $ 3,056 $ 2,931 $ 9,005 $ 8,002

FAIR VALUE MEASURMENTS

FAIR VALUE MEASURMENTS	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
FAIR VALUE MEASUREMENTS	FAIR VALUE MEASUREMENTS Fair value measurements are determined by maximizing the use of observable inputs and minimizing the use of unobservable inputs. The hierarchy places the highest priority on unadjusted quoted market prices in active markets for identical assets or liabilities (Level 1 measurements) and gives the lowest priority to unobservable inputs (Level 3 measurements). The categories within the valuation hierarchy are described as follows: • Level 1 — Inputs to the fair value measurement are quoted prices in active markets for identical assets or liabilities. • Level 2 — Inputs to the fair value measurement include quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. • Level 3 — Inputs to the fair value measurement are unobservable inputs or valuation techniques. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. First Lien Term Loan : The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 9, Indebtedness , for further discussion of the carrying amount and fair value of the First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 9, Indebtedness , for further discussion of the carrying amount and fair value of the Senior Notes. Interest Rate Cap: The fair value of the interest rate cap is derived from the interest rates prevalent in the market and future expectations of those interest rates (Level 2 inputs). The Company determines the fair value of the investments based on quoted prices from third-party brokers. See Note 10, Derivative Instruments , for further discussion of the fair value of the interest rate cap. Money Market Funds: The fair value of the money market funds is derived from the closing price reported by the fund sponsor and classified as cash and cash equivalents on the Company’s condensed consolidated balance sheets (Level 1 inputs). There were no other material assets or liabilities measured at fair value at September 30, 2024 and December 31, 2023.

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES The Company is involved in legal proceedings and is subject to investigations, inspections, audits, inquiries, and similar actions by governmental authorities, arising in the normal course of the Company’s business. Some of these suits may purport or may be determined to be class actions and/or involve parties seeking large and/or indeterminate amounts, including punitive or exemplary damages, and may remain unresolved for several years. From time to time, the Company may also be involved in legal proceedings as a plaintiff involving antitrust, tax, contract, intellectual property, and other matters. Gain contingencies, if any, are recognized when they are realized. The results of legal proceedings are often uncertain and difficult to predict, and the costs incurred in litigation can be substantial, regardless of the outcome. The Company does not believe that any of these pending matters, after consideration of applicable reserves and rights to indemnification, will have a material adverse effect on the Company’s condensed consolidated balance sheets. However, substantial unanticipated verdicts, fines, and rulings may occur. As a result, the Company may from time to time incur judgments, enter into settlements, or revise expectations regarding the outcome of certain matters, and such developments could have a material adverse effect on its results of operations in the period in which the amounts are accrued and/or its cash flows in the period in which the amounts are paid.

STOCK-BASED INCENTIVE COMPENSAT

STOCK-BASED INCENTIVE COMPENSATION	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
STOCK-BASED INCENTIVE COMPENSATION	STOCK-BASED INCENTIVE COMPENSATION Equity Incentive Plans — Under the Company’s 2018 Equity Incentive Plan (the “2018 Plan”), approved at the annual meeting by the BioScrip, Inc. (“BioScrip”) stockholders on May 3, 2018 and amended and restated on May 19, 2021 and May 15, 2024, the Company may issue, among other things, incentive stock options, non-qualified stock options, stock appreciation rights, restricted stock units, stock grants, and performance units to key employees and directors. The 2018 Plan is administered by the Company’s Compensation Committee, a standing committee of the Company’s Board of Directors. As of May 2021, a total of 9,101,734 shares of common stock were authorized for issuance under the 2018 Plan. In May 2024, an additional 4,000,000 shares were authorized for issuance under the 2018 Plan, resulting in a total of 13,101,734 shares of common stock authorized for issuance. The Company had stock options, restricted stock units and performance stock units outstanding related to the 2018 Plan as of September 30, 2024 and 2023. During the three and nine months ended September 30, 2024, total stock-based incentive compensation expense recognized by the Company related to the 2018 Plan was $10.4 million and $27.6 million, respectively. During the three and nine months ended September 30, 2023, total stock-based incentive compensation expense recognized by the Company related to the 2018 Plan was $9.2 million and $22.9 million, respectively.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
STOCKHOLDERS’ EQUITY	STOCKHOLDERS’ EQUITY 2017 Warrants — During the three and nine months ended September 30, 2024, warrant holders did not elect to exercise any warrants to purchase shares of common stock. During the three and nine months ended September 30, 2023, warrant holders elected to exercise 188,350 warrants to purchase shares of common stock. As of September 30, 2024 and December 31, 2023, the remaining warrant holders are entitled to purchase 51,838 shares of common stock. 2015 Warrants — During the three and nine months ended September 30, 2024, warrant holders exercised an immaterial number of warrants to purchase shares of common stock. During the three and nine months ended September 30, 2023, warrant holders exercised an immaterial number of warrants to purchase shares of common stock. As of September 30, 2024 and December 31, 2023, the remaining warrant holders are entitled to purchase 11,775 and 13,888 shares of common stock, respectively. Share Repurchase Program — The Company’s Board of Directors approved a share repurchase program of up to an aggregate $500.0 million of common stock of the Company. Under the share repurchase program, repurchases may occur in any number of methods depending on timing, market conditions, regulatory requirements, and other corporate considerations. The share repurchase program has no specified expiration date. During the three and nine months ended September 30, 2024, the Company purchased 1,399,674 and 5,317,183 shares of common stock for an average share price of $29.97 and $30.09, totaling $41.9 million and $160.0 million, respectively. During the three and nine months ended September 30, 2023, the Company purchased 2,913,520 and 5,388,686 shares of common stock for an average share price of $34.32 and $32.48, totaling $100.0 million and $175.0 million, respectively. All repurchased shares became treasury stock. As of September 30, 2024, the Company is authorized to repurchase up to a remaining $90.0 million of common stock of the Company. Shares Outstanding — The following table shows the Company’s changes in shares of common stock for the three and nine months ended September 30, 2024 and 2023 (in thousands): 2024 2023 Balance, beginning of the year 174,576 181,958 Equity award issuances 492 274 Share repurchases (1,252) (2,475) Balance March 31, 173,816 179,757 Equity award issuances 261 114 Share repurchases (2,666) — Balance June 30, 171,411 179,871 Equity award issuances 135 172 Share repurchases (1,400) (2,914) Balance September 30, 170,146 177,129

RELATED-PARTY TRANSACTIONS

RELATED-PARTY TRANSACTIONS	9 Months Ended
	Sep. 30, 2024
Related Party Transactions [Abstract]
RELATED-PARTY TRANSACTIONS	RELATED-PARTY TRANSACTIONS Transactions with Equity-Method Investees — The Company provides management services to its joint ventures such as accounting, invoicing and collections in addition to day-to-day managerial support of the operations of the businesses. The Company recorded management fee income of $1.6 million and $4.5 million for the three and nine months ended September 30, 2024, respectively. The Company recorded management fee income of $1.3 million and $3.9 million for the three and nine months ended September 30, 2023, respectively. Management fees are recorded in net revenues in the accompanying unaudited condensed consolidated statements of comprehensive income. During the three and nine months ended September 30, 2024, the Company received distributions from the investees of $0.5 million and $1.3 million, respectively. During the three and nine months ended September 30, 2023, the Company received distributions from the investees of $1.5 million and $4.0 million, respectively. The Company had amounts due from its joint ventures of $0.6 million and due to its joint ventures of $0.8 million as of September 30, 2024. The Company had amounts due from its joint ventures of $0.1 million and due to its joint ventures of $0.5 million as of December 31, 2023. Receivables were included in prepaid expenses and other current assets in the accompanying condensed consolidated balance sheets. Payables were included in accrued expenses and other current liabilities in the accompanying condensed consolidated balance sheets. These balances primarily relate to cash collections received by the Company on behalf of the joint ventures, offset by certain pharmaceutical inventories and other expenses paid for by the Company on behalf of the joint ventures.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net income	$ 53,856	$ 53,043	$ 44,791	$ 56,302	$ 114,403	$ 39,208	$ 151,690	$ 209,913

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation — The accompanying unaudited condensed consolidated financial statements have been prepared in conformity with generally accepted accounting principles (“GAAP”) in the United States and contain all adjustments, including normal recurring adjustments, necessary to present fairly the Company’s financial position, results of operations and cash flows for interim financial reporting. The results of operations for the interim periods presented are not necessarily indicative of the results of operations for the entire year. These unaudited condensed consolidated financial statements do not include all of the information and notes to the financial statements required by GAAP for complete financial statements and should be read in conjunction with the 2023 audited consolidated financial statements, including the notes thereto, as presented in our Form 10-K.
Principles of Consolidation	Principles of Consolidation — The Company’s unaudited condensed consolidated financial statements include the accounts of Option Care Health, Inc. and its subsidiaries. All intercompany transactions and balances are eliminated in consolidation.
Cash and Cash Equivalents	Cash and Cash Equivalents — The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. As of September 30, 2024, cash equivalents consisted of money market funds.
Equity -Method Investments	Equity-Method Investments — The Company’s investments in certain unconsolidated entities are accounted for under the equity method. The balance of these investments is included in other noncurrent assets in the accompanying condensed consolidated balance sheets. As of September 30, 2024 and December 31, 2023, the balance of the investments was $23.6 million and $20.9 million, respectively. The balance of these investments is increased to reflect the Company’s capital contributions and equity in earnings of the investees. The balance of these investments is decreased to reflect the Company’s equity in losses of the investees and for distributions received that are not in excess of the carrying amount of the investments. The Company’s proportionate share of earnings or losses of the investees is recorded in equity in earnings of joint ventures in the accompanying unaudited condensed consolidated statements of comprehensive income. The Company’s proportionate share of earnings was $1.4 million and $3.9 million for the three and nine months ended September 30, 2024, respectively. The Company’s proportionate share of earnings was $1.3 million and $4.1 million for the three and nine months ended September 30, 2023, respectively. Distributions from the investees are treated as cash inflows from operating activities in the unaudited condensed consolidated statements of cash flows. During the three and nine months ended September 30, 2024, the Company received distributions from the investees of $0.5 million and $1.3 million, respectively. During the three and nine months ended September 30, 2023, the Company received distributions from the investees of $1.5 million and $4.0 million, respectively. See Note 15, Related-Party Transactions , for discussion of related-party transactions with these investees.
Concentrations of Business Risk	Concentrations of Business Risk — The Company generates revenue from managed care contracts and other agreements with commercial third-party payers. Revenue related to the Company’s largest payer was approximately 15% for the three and nine months ended September 30, 2024. Revenue related to the Company’s largest payer was approximately 14% for the three and nine months ended September 30, 2023. There were no other managed care contracts that represent greater than 10% of revenue for the periods presented. For the three and nine months ended September 30, 2024, approximately 11% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. For the three and nine months ended September 30, 2023, approximately 11% and 12%, respectively, of the Company’s revenue was reimbursable through direct government healthcare programs, such as Medicare and Medicaid. As of September 30, 2024 and December 31, 2023, approximately 10% and 12%, respectively, of the Company’s accounts receivable was related to these programs. Governmental programs pay for services based on fee schedules and rates that are determined by the related governmental agency. Laws and regulations pertaining to government programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change in the near term. The Company does not require its patients or other payers to carry collateral for any amounts owed for goods or services provided. Other than as discussed above, concentration of credit risk relating to trade accounts receivable is limited due to the Company’s diversity of patients and payers. Further, the Company generally does not provide charity care; however, Option Care Health offers a financial assistance program for patients that meet certain defined hardship criteria. For the three and nine months ended September 30, 2024, approximately 68% and 67%, respectively, of the Company’s pharmaceutical and medical supply purchases were from four vendors. For the three and nine months ended September 30, 2023, approximately 73% of the Company’s pharmaceutical and medical supply purchases were from four vendors. Although there are a limited number of suppliers, the Company believes that other vendors could provide similar products on comparable terms. However, a change in suppliers could cause delays in service delivery, losses in revenue or decreased gross profit dollars, which could adversely affect the Company’s financial condition or operating results.
Fair Value Measurements	FAIR VALUE MEASUREMENTS Fair value measurements are determined by maximizing the use of observable inputs and minimizing the use of unobservable inputs. The hierarchy places the highest priority on unadjusted quoted market prices in active markets for identical assets or liabilities (Level 1 measurements) and gives the lowest priority to unobservable inputs (Level 3 measurements). The categories within the valuation hierarchy are described as follows: • Level 1 — Inputs to the fair value measurement are quoted prices in active markets for identical assets or liabilities. • Level 2 — Inputs to the fair value measurement include quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, and inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. • Level 3 — Inputs to the fair value measurement are unobservable inputs or valuation techniques. While the Company believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies or assumptions to determine the fair value of certain financial instruments could result in a different fair value measurement at the reporting date. First Lien Term Loan : The fair value of the First Lien Term Loan is derived from a broker quote on the loans in the syndication (Level 2 inputs). See Note 9, Indebtedness , for further discussion of the carrying amount and fair value of the First Lien Term Loan. Senior Notes: The fair value of the Senior Notes is derived from a broker quote (Level 2 inputs). See Note 9, Indebtedness , for further discussion of the carrying amount and fair value of the Senior Notes. Interest Rate Cap: The fair value of the interest rate cap is derived from the interest rates prevalent in the market and future expectations of those interest rates (Level 2 inputs). The Company determines the fair value of the investments based on quoted prices from third-party brokers. See Note 10, Derivative Instruments , for further discussion of the fair value of the interest rate cap. Money Market Funds: The fair value of the money market funds is derived from the closing price reported by the fund sponsor and classified as cash and cash equivalents on the Company’s condensed consolidated balance sheets (Level 1 inputs). There were no other material assets or liabilities measured at fair value at September 30, 2024 and December 31, 2023.

REVENUE (Tables)

REVENUE (Tables)	9 Months Ended
	Sep. 30, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Net Revenue Earned by Category of Payer	The following table sets forth the net revenue earned by category of payer for the three and nine months ended September 30, 2024 and 2023 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Commercial payers $ 1,109,971 $ 957,601 $ 3,160,490 $ 2,765,513 Government payers 147,005 124,122 424,033 370,648 Patients 21,570 11,291 67,261 41,773 Net revenue $ 1,278,546 $ 1,093,014 $ 3,651,784 $ 3,177,934

EARNINGS PER SHARE (Tables)

EARNINGS PER SHARE (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following table presents the Company’s common stock equivalents that were excluded from the calculation of earnings per share as they would be anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Stock option awards 779,876 984,567 855,323 1,180,376 Restricted stock awards 324,877 16,564 365,835 569,831 Performance stock unit awards — — 257,735 288,680
Schedule of Basic and Diluted Earnings Per Share	The following table presents the Company’s basic earnings per share and shares outstanding (in thousands, except per share data): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Numerator: Net income (1) $ 53,856 $ 56,302 $ 151,690 $ 209,913 Denominator: Weighted average number of common shares outstanding 170,636 178,826 172,490 179,956 Earnings per common share: Earnings per common share, basic $ 0.32 $ 0.31 $ 0.88 $ 1.17 (1) Net income for the nine months ended September 30, 2023 includes $62.8 million related to the termination payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses and taxes. The following table presents the Company’s diluted earnings per share and shares outstanding (in thousands, except per share data): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Numerator: Net income (1) $ 53,856 $ 56,302 $ 151,690 $ 209,913 Denominator: Weighted average number of common shares outstanding 170,636 178,826 172,490 179,956 Effect of dilutive securities 1,305 1,702 1,358 1,330 Weighted average number of common shares outstanding, diluted 171,941 180,528 173,848 181,286 Earnings per common share: Earnings per common share, diluted $ 0.31 $ 0.31 $ 0.87 $ 1.16 (1) Net income for the nine months ended September 30, 2023 includes $62.8 million related to the termination payment received on behalf of Amedisys, under the terms of the Mutual Termination Agreement, net of merger-related expenses and taxes.

LEASES (Tables)

LEASES (Tables)	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
Schedule of Maturities of Lease Liabilities, Operating	Operating leases mature as follows (in thousands): Fiscal Year Ended December 31, Minimum Payments 2024 $ 7,464 2025 28,646 2026 25,880 2027 20,554 2028 13,517 Thereafter 43,813 Total lease payments 139,874 Less: interest (29,982) Present value of lease liabilities $ 109,892

PROPERTY AND EQUIPMENT (Tables)

PROPERTY AND EQUIPMENT (Tables)	9 Months Ended
	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment was as follows as of September 30, 2024 and December 31, 2023 (in thousands): September 30, 2024 December 31, 2023 Infusion pumps $ 36,476 $ 36,943 Equipment, furniture and other 30,124 23,593 Leasehold improvements 117,827 99,725 Computer software, purchased and internally developed 52,513 50,572 Assets under development 26,007 33,668 262,947 244,501 Less: accumulated depreciation (137,036) (123,871) Property and equipment, net $ 125,911 $ 120,630 Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Depreciation expense in cost of revenue $ 568 $ 616 $ 1,735 $ 2,006 Depreciation expense in operating expenses 6,063 6,365 18,485 18,665 Total depreciation expense $ 6,631 $ 6,981 $ 20,220 $ 20,671

GOODWILL AND OTHER INTANGIBLE_2

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Carrying Amount and Accumulated Amortization of Intangible Assets	The carrying amount and accumulated amortization of intangible assets consist of the following as of September 30, 2024 and December 31, 2023 (in thousands): September 30, 2024 December 31, 2023 Gross intangible assets: Referral sources $ 514,388 $ 514,388 Trademarks/names 39,136 39,136 Other amortizable intangible assets 985 995 Total gross intangible assets 554,509 554,519 Accumulated amortization: Referral sources (222,549) (199,084) Trademarks/names (21,874) (19,698) Other amortizable intangible assets (479) (341) Total accumulated amortization (244,902) (219,123) Total intangible assets, net $ 309,607 $ 335,396

INDEBTEDNESS (Tables)

INDEBTEDNESS (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Debt	Long-term debt consisted of the following as of September 30, 2024 (in thousands): Principal Amount Discount Debt Issuance Costs Net Balance Revolver Facility $ — $ — $ — $ — First Lien Term Loan 633,244 (5,885) (8,030) 619,329 Senior Notes 500,000 — (7,711) 492,289 $ 1,133,244 $ (5,885) $ (15,741) 1,111,618 Less: current portion (6,512) Total long-term debt $ 1,105,106 Long-term debt consisted of the following as of December 31, 2023 (in thousands): Principal Amount Discount Debt Issuance Costs Net Balance Revolver Facility $ — $ — $ — $ — First Lien Term Loan 588,000 (6,974) (9,678) 571,348 Senior Notes 500,000 — (8,698) 491,302 $ 1,088,000 $ (6,974) $ (18,376) 1,062,650 Less: current portion (6,000) Total long-term debt $ 1,056,650
Schedule of Long-term Debt Maturities	Long-term debt matures as follows (in thousands): Fiscal Year Ended December 31, Minimum Payments 2024 $ 1,628 2025 6,512 2026 6,512 2027 6,512 2028 612,080 Thereafter 500,000 Total $ 1,133,244
Schedule of Estimated Fair Values of Debt Obligations	The following table presents the estimated fair values of the Company’s debt obligations as of September 30, 2024 (in thousands): Financial Instrument Carrying Value as of September 30, 2024 Markets for Identical Item (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) First Lien Term Loan $ 619,329 $ — $ 634,827 $ — Senior Notes 492,289 — 475,000 — Total debt instruments $ 1,111,618 $ — $ 1,109,827 $ —

DERIVATIVE INSTRUMENTS (Tables)

DERIVATIVE INSTRUMENTS (Tables)	9 Months Ended
	Sep. 30, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Amount and Location of Derivatives in the Balance Sheet	The following table summarizes the amount and location of the Company’s derivative instruments in the condensed consolidated balance sheets (in thousands): Fair Value - Derivatives in Asset Position Derivative Balance Sheet Caption September 30, 2024 December 31, 2023 Interest rate cap designated as cash flow hedge Prepaid expenses and other current assets $ 7,223 $ 9,746 Interest rate cap designated as cash flow hedge Other noncurrent assets 5,446 10,183 Total derivative assets $ 12,669 $ 19,929
Schedule of Pre-tax Gains (Losses) Recognized in the Statements of Comprehensive Income (Loss)	The following table presents the pre-tax (loss) gain from derivative instruments recognized in other comprehensive (loss) income in the Company’s unaudited condensed consolidated statements of comprehensive income (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Derivative 2024 2023 2024 2023 Interest rate cap designated as cash flow hedge $ (8,125) $ 45 $ (7,260) $ (156) The following table presents the amount and location of pre-tax income recognized in the Company’s unaudited condensed consolidated statements of comprehensive income related to the Company’s derivative instruments (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Derivative Income Statement Caption 2024 2023 2024 2023 Interest rate cap designated as cash flow hedge Interest expense, net $ 3,056 $ 2,931 $ 9,005 $ 8,002

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Schedule of Changes in Shares of Common Stock	The following table shows the Company’s changes in shares of common stock for the three and nine months ended September 30, 2024 and 2023 (in thousands): 2024 2023 Balance, beginning of the year 174,576 181,958 Equity award issuances 492 274 Share repurchases (1,252) (2,475) Balance March 31, 173,816 179,757 Equity award issuances 261 114 Share repurchases (2,666) — Balance June 30, 171,411 179,871 Equity award issuances 135 172 Share repurchases (1,400) (2,914) Balance September 30, 170,146 177,129

NATURE OF OPERATIONS AND PRES_2

NATURE OF OPERATIONS AND PRESENTATION OF FINANCIAL STATEMENTS (Details)	9 Months Ended
	Sep. 30, 2024 suite segment pharmacy
Business Acquisition [Line Items]
Number of service locations | pharmacy	92
Number of infusion sites | suite	93
Number of operating segments | segment	1
Legacy Health Systems
Business Acquisition [Line Items]
Ownership interest (as a percent)	50%

SUMMARY OF SIGNIFICANT ACCOUN_3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Concentration Risk [Line Items]
Rebate receivable	$ 45,900		$ 45,900		$ 52,000
Investments in equity-method investees	23,600		23,600		$ 20,900
Proportionate share of earnings in equity-method investees	$ 1,400	$ 1,300	3,921	$ 4,107
Distributions received from the investees			$ 1,250	$ 4,000
Revenue from Contract with Customer Benchmark | Governmental Healthcare Programs | Government Healthcare Programs
Concentration Risk [Line Items]
Concentration ​risk (as a percent)	11%	11%	12%	12%
Accounts Receivable, Benchmark | Governmental Healthcare Programs | Government Healthcare Programs
Concentration Risk [Line Items]
Concentration ​risk (as a percent)			10%		12%
Cost of Goods and Service, Product and Service Benchmark | Medical Supply Vendors | Four Vendors
Concentration Risk [Line Items]
Concentration ​risk (as a percent)	68%	73%	67%	73%
Largest Payer | Revenue from Contract with Customer Benchmark | Company's Largest Payer
Concentration Risk [Line Items]
Concentration ​risk (as a percent)	15%	14%	15%	14%
Joint Venture
Concentration Risk [Line Items]
Distributions received from the investees	$ 500	$ 1,500	$ 1,300	$ 4,000

REVENUE - Net Revenue Earned by

REVENUE - Net Revenue Earned by Category of Payer (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Disaggregation of Revenue [Line Items]
Net revenue	$ 1,278,546	$ 1,093,014	$ 3,651,784	$ 3,177,934
Commercial payers
Disaggregation of Revenue [Line Items]
Net revenue	1,109,971	957,601	3,160,490	2,765,513
Government payers
Disaggregation of Revenue [Line Items]
Net revenue	147,005	124,122	424,033	370,648
Patients
Disaggregation of Revenue [Line Items]
Net revenue	$ 21,570	$ 11,291	$ 67,261	$ 41,773

INCOME TAXES (Details)

INCOME TAXES (Details) - USD ($) $ in Thousands		1 Months Ended	3 Months Ended		9 Months Ended
	Jun. 26, 2023	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Examination [Line Items]
Income tax expense			$ 19,698	$ 13,783	$ 50,860	$ 69,904
Effective tax rate (as a percent)			26.80%	19.70%	25.10%	25%
Termination fee income						$ 22,100
Amedisys
Income Tax Examination [Line Items]
Termination fee	$ 106,000					$ 62,800
State Jurisdiction
Income Tax Examination [Line Items]
Release of valuation allowance		$ 5,800			$ 2,200
Valuation allowance			$ 4,200		$ 4,200

EARNINGS PER SHARE - Antidiluti

EARNINGS PER SHARE - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Stock option awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	779,876	984,567	855,323	1,180,376
Restricted stock awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	324,877	16,564	365,835	569,831
Performance stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded (in shares)	0	0	257,735	288,680

EARNINGS PER SHARE - Schedule o

EARNINGS PER SHARE - Schedule of Basic and Diluted Earnings (Loss) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands		3 Months Ended						9 Months Ended
	Jun. 26, 2023	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Numerator:
Net income		$ 53,856	$ 53,043	$ 44,791	$ 56,302	$ 114,403	$ 39,208	$ 151,690	$ 209,913
Denominator:
Weighted average number of common shares outstanding (in shares)		170,636			178,826			172,490	179,956
Effect of dilutive securities (in shares)		1,305			1,702			1,358	1,330
Weighted average number of common shares outstanding, diluted (in shares)		171,941			180,528			173,848	181,286
Earnings per common share, basic
Earnings per common share, basic (in dollars per share)		$ 0.32			$ 0.31			$ 0.88	$ 1.17
Earnings per common share, diluted
Earnings per common share, diluted (in dollars per share)		$ 0.31			$ 0.31			$ 0.87	$ 1.16
Amedisys
Earnings per common share, diluted
Termination fee	$ 106,000								$ 62,800

LEASES - Additional Information

LEASES - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Leases [Abstract]
Operating lease cost	$ 8.6	$ 7.8	$ 25.3	$ 22.3
Weighted-average remaining lease term, operating leases (in years)	6 years 6 months		6 years 6 months
Weighted-average discount rate, operating leases (as a percent)	6.49%		6.49%
Increase in operating lease right-of-use asset and lease liabilities			$ 23	$ 26.1

LEASES - Schedule of Operating

LEASES - Schedule of Operating Leases Mature (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Minimum Payments
2024	$ 7,464
2025	28,646
2026	25,880
2027	20,554
2028	13,517
Thereafter	43,813
Total lease payments	139,874
Less: interest	(29,982)
Present value of lease liabilities	$ 109,892

PROPERTY AND EQUIPMENT (Details

PROPERTY AND EQUIPMENT (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 262,947		$ 262,947		$ 244,501
Less: accumulated depreciation	(137,036)		(137,036)		(123,871)
Property and equipment, net	125,911		125,911		120,630
Total depreciation expense	6,631	$ 6,981	20,220	$ 20,671
Depreciation expense in cost of revenue
Property, Plant and Equipment [Line Items]
Total depreciation expense	568	616	1,735	2,006
Depreciation expense in operating expenses
Property, Plant and Equipment [Line Items]
Total depreciation expense	6,063	$ 6,365	18,485	$ 18,665
Infusion pumps
Property, Plant and Equipment [Line Items]
Property and equipment, gross	36,476		36,476		36,943
Equipment, furniture and other
Property, Plant and Equipment [Line Items]
Property and equipment, gross	30,124		30,124		23,593
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	117,827		117,827		99,725
Computer software, purchased and internally developed
Property, Plant and Equipment [Line Items]
Property and equipment, gross	52,513		52,513		50,572
Assets under development
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 26,007		$ 26,007		$ 33,668

GOODWILL AND OTHER INTANGIBLE_3

GOODWILL AND OTHER INTANGIBLE ASSETS - Carrying Amount and Accumulated Amortization of Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	$ 554,509		$ 554,509		$ 554,519
Total accumulated amortization	(244,902)		(244,902)		(219,123)
Total intangible assets, net	309,607		309,607		335,396
Amortization expense for intangible assets	8,600	$ 8,600	25,800	$ 25,600
Referral sources
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	514,388		514,388		514,388
Total accumulated amortization	(222,549)		(222,549)		(199,084)
Trademarks/names
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	39,136		39,136		39,136
Total accumulated amortization	(21,874)		(21,874)		(19,698)
Other amortizable intangible assets
Finite-Lived Intangible Assets [Line Items]
Total gross intangible assets	985		985		995
Total accumulated amortization	$ (479)		$ (479)		$ (341)

INDEBTEDNESS - Schedule of Debt

INDEBTEDNESS - Schedule of Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2024	May 08, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Principal Amount	$ 1,133,244		$ 1,088,000
Discount	(5,885)		(6,974)
Debt Issuance Costs	(15,741)		(18,376)
Net Balance	1,111,618		1,062,650
Less: current portion	(6,512)		(6,000)
Total long-term debt	1,105,106		1,056,650
Senior Notes | First Lien Term Loan
Debt Instrument [Line Items]
Principal Amount	633,244		588,000
Discount	(5,885)		(6,974)
Debt Issuance Costs	(8,030)	$ (100)	(9,678)
Net Balance	619,329		571,348
Senior Notes | Senior Notes
Debt Instrument [Line Items]
Principal Amount	500,000		500,000
Discount	0		0
Debt Issuance Costs	(7,711)		(8,698)
Net Balance	492,289		491,302
Revolver Facility | Senior Notes
Debt Instrument [Line Items]
Principal Amount	0		0
Discount	0		0
Debt Issuance Costs	0		0
Net Balance	$ 0		$ 0

INDEBTEDNESS - Additional Infor

INDEBTEDNESS - Additional Information (Details) - USD ($)			3 Months Ended		9 Months Ended
	May 08, 2024	May 07, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023	Dec. 07, 2023
Debt Instrument [Line Items]
Repayment of debt					$ 4,756,000	$ 4,500,000
Cash outflow from financing activities					(122,827,000)	(187,298,000)
Debt issuance costs			$ 15,741,000		15,741,000		$ 18,376,000
Proceeds from issuance of debt					49,959,000	0
Loss on extinguishment of debt					377,000	$ 0
Senior Notes | Revolver Facility
Debt Instrument [Line Items]
Debt issuance costs			0		0		$ 0
First Lien Credit Agreement, Third Amendment | Senior Notes | Revolver Facility
Debt Instrument [Line Items]
Undrawn letters of credit issued and outstanding			$ 4,100,000		$ 4,100,000
First Lien Credit Agreement, Third Amendment | First Lien Term Loan | Senior Notes
Debt Instrument [Line Items]
Debt instrument, basis spread (as a percent)	2.25%	2.75%
Debt instrument, face amount	$ 50,000,000
Effective rate on term loans at end of period (as a percent)			7.50%		7.50%		8.21%
Weighted average interest rate paid on term loans during period (as a percent)			7.56%	8.11%	7.84%	7.71%
First Lien Credit Agreement, Third Amendment | Second Lien Term Loan | Senior Notes
Debt Instrument [Line Items]
Effective rate on term loans at end of period (as a percent)			4.375%		4.375%		4.375%
Weighted average interest rate paid on term loans during period (as a percent)			4.375%	4.375%	4.375%	4.375%
First Lien Term Loan | Senior Notes
Debt Instrument [Line Items]
Cash outflow from financing activities					$ 50,000,000
Legal fees	1,600,000
Debt issuance costs	$ 100,000		$ 8,030,000		8,030,000		$ 9,678,000
Proceeds from issuance of debt					50,000,000
Loss on extinguishment of debt					400,000
First Lien Term Loan | First Lien Term Loan | Senior Notes
Debt Instrument [Line Items]
Repayment of debt					400,000
Second Lien Credit Agreement | Senior Notes | Revolver Facility
Debt Instrument [Line Items]
Debt instrument, face amount								$ 400,000,000
Available borrowing capacity			$ 395,900,000		$ 395,900,000

INDEBTEDNESS - Schedule of Long

INDEBTEDNESS - Schedule of Long Term Debt Maturities (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Debt Disclosure [Abstract]
2024	$ 1,628
2025	6,512
2026	6,512
2027	6,512
2028	612,080
Thereafter	500,000
Total	$ 1,133,244	$ 1,088,000

INDEBTEDNESS - Schedule of Esti

INDEBTEDNESS - Schedule of Estimated Fair Values of Debt Obligations (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Debt Instrument [Line Items]
Total debt instruments	$ 1,111,618
Markets for Identical Item (Level 1)
Debt Instrument [Line Items]
Total debt instruments	0
Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	1,109,827
Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes
Debt Instrument [Line Items]
Total debt instruments	492,289
Senior Notes | First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	619,329
Senior Notes | Markets for Identical Item (Level 1)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes | Markets for Identical Item (Level 1) | First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes | Significant Other Observable Inputs (Level 2)
Debt Instrument [Line Items]
Total debt instruments	475,000
Senior Notes | Significant Other Observable Inputs (Level 2) | First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	634,827
Senior Notes | Significant Unobservable Inputs (Level 3)
Debt Instrument [Line Items]
Total debt instruments	0
Senior Notes | Significant Unobservable Inputs (Level 3) | First Lien Term Loan
Debt Instrument [Line Items]
Total debt instruments	$ 0

DERIVATIVE INSTRUMENTS - Additi

DERIVATIVE INSTRUMENTS - Additional Information (Details) - First Lien Term Loan - Interest rate cap designated as cash flow hedge - Designated as Hedging Instrument - Senior Notes	1 Months Ended
	Oct. 31, 2021 USD ($)
Derivative [Line Items]
Notional amount of derivative	$ 300,000,000
Derivative, term of contract (in years)	5 years

DERIVATIVE INSTRUMENTS - Schedu

DERIVATIVE INSTRUMENTS - Schedule of Amount and Location of Derivatives in the Balance Sheet (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Derivative [Line Items]
Total derivative assets	$ 12,669	$ 19,929
Designated as Hedging Instrument | Prepaid expenses and other current assets | Interest rate cap designated as cash flow hedge
Derivative [Line Items]
Total derivative assets	7,223	9,746
Designated as Hedging Instrument | Other noncurrent assets | Interest rate cap designated as cash flow hedge
Derivative [Line Items]
Total derivative assets	$ 5,446	$ 10,183

DERIVATIVE INSTRUMENTS - Sche_2

DERIVATIVE INSTRUMENTS - Schedule of Pre-tax Gain (Loss) on Derivative Instruments (Details) - Interest rate cap designated as cash flow hedge - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Derivative [Line Items]
Interest rate cap designated as cash flow hedge	$ (8,125)	$ 45	$ (7,260)	$ (156)
Interest expense, net
Derivative [Line Items]
Interest rate cap designated as cash flow hedge	$ 3,056	$ 2,931	$ 9,005	$ 8,002

STOCK-BASED INCENTIVE COMPENS_2

STOCK-BASED INCENTIVE COMPENSATION (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended		9 Months Ended
	May 31, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	May 31, 2021
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)	13,101,734
2018 Plan
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Number of shares authorized (in shares)						9,101,734
Number of additional shares authorized (in shares)	4,000,000
2018 Plan | HC I Incentive Units
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based compensation expense		$ 10.4	$ 9.2	$ 27.6	$ 22.9

STOCKHOLDERS' EQUITY - Addition

STOCKHOLDERS' EQUITY - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Class of Warrant or Right [Line Items]
Treasury stock, shares, acquired (in shares)	1,399,674	2,913,520	5,317,183	5,388,686
Treasury stock acquired, average cost per share (in dollars per share)	$ 29.97	$ 34.32	$ 30.09	$ 32.48
Shares repurchased	$ 41.9	$ 100	$ 160	$ 175
Stock repurchase program, authorized amount	$ 90		$ 90
Common Stock Repurchase Program
Class of Warrant or Right [Line Items]
Number of shares authorized to be repurchased (in shares)	500,000,000		500,000,000
2017 Warrants | Common Stock
Class of Warrant or Right [Line Items]
Number of warrants exercised (in shares)	0	188,350	0	188,350
Class of warrant or right, outstanding (in shares)	51,838		51,838		51,838
2015 Warrants | Common Stock
Class of Warrant or Right [Line Items]
Number of warrants exercised (in shares)	0	0	0	0
Class of warrant or right, outstanding (in shares)	11,775		11,775		13,888

STOCKHOLDERS' EQUITY - Schedule

STOCKHOLDERS' EQUITY - Schedule of Changes in Shares of Common Stock (Details) - shares	3 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Balance, beginning of the year			174,575,537
Balance, end of the period	170,146,331
Common Stock
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Balance, beginning of the year	171,411,000	173,816,000	174,576,000	179,871,000	179,757,000	181,958,000
Equity award issuances	135,000	261,000	492,000	172,000	114,000	274,000
Share repurchases	(1,400,000)	(2,666,000)	(1,252,000)	(2,914,000)	0	(2,475,000)
Balance, end of the period	170,146,000	171,411,000	173,816,000	177,129,000	179,871,000	179,757,000

RELATED-PARTY TRANSACTIONS (Det

RELATED-PARTY TRANSACTIONS (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Related Party Transaction [Line Items]
Management fee income	$ 1,278,546	$ 1,093,014	$ 3,651,784	$ 3,177,934
Distributions received from the investees			1,250	4,000
Joint Venture
Related Party Transaction [Line Items]
Management fee income	1,600	1,300	4,500	3,900
Distributions received from the investees	500	$ 1,500	1,300	$ 4,000
Due from joint ventures	600		600		$ 100
Due to joint ventures	$ 800		$ 800		$ 500