Concentra Group Holdings Parent (NYSE:CON) reported fourth-quarter and full-year 2025 results that management said finished “an overall solid year,” with revenue and Adjusted EBITDA exceeding the high end of the company’s previously issued guidance ranges and leverage coming in better than expected. Chief Executive Officer Keith Newton and President and Chief Financial Officer Matthew DiCanio also reiterated the company’s fiscal 2026 outlook and discussed de novo expansion, bolt-on M&A, and reimbursement developments that could influence longer-term growth opportunities.
Validation studies highlight workers’ comp outcomes
Newton said Concentra recently completed additional validation studies on workers’ compensation claims, which he described as consistent with the company’s previously published findings. With the newly added results, the company said it has reviewed and analyzed more than 550,000 claims from 2020 to 2025 in partnership with employers and payers.
- Average total workers’ compensation claims cost for those treated by Concentra was 25% lower than non-Concentra providers.
- Average claim duration was 65 fewer days when treated by Concentra.
Management attributed the outcomes to a specialized clinical approach and an integrated medical model, alongside nationwide access and technology capabilities. Newton also said patient satisfaction metrics are at all-time highs.
Q4 and full-year 2025 performance
For the fourth quarter of 2025, Concentra reported total revenue of $539.1 million, up from $465.0 million in the year-ago quarter, representing 15.9% year-over-year growth. Excluding contributions from the Nova and Pivot acquisitions, revenue was $493.8 million, up 6.2% from the prior year period.
For the full year, revenue was $2.2 billion, up from $1.9 billion in 2024, a 13.9% increase despite one fewer revenue day, the company said. Excluding Nova and Pivot, full-year revenue was $2.0 billion, up 6.4% year-over-year, or 6.8% on a per-day basis.
Volume trends remained positive in the quarter despite seasonal headwinds, with total patient visits up 9% to more than 51,000 visits per day. Workers’ compensation visits per day increased 9.1% and employer services visits per day increased 9.4%. Excluding Nova, total visits per day increased 2.6%, with workers’ comp visits up 3.4% and employer services visits up 2.3%.
Newton noted the company was “largely unimpacted by the government shutdown during the quarter,” citing limited exposure to federal government customers.
Pricing also improved. Revenue per visit increased 3.1% in Q4, driven by a 4.1% increase in workers’ compensation revenue per visit and a 1.2% increase in employer services revenue per visit. Management said employer services rate growth slowed versus earlier quarters primarily due to a mix shift between lower-dollar drug screens and higher-dollar physicals.
Adjusted EBITDA for the quarter rose to $95.3 million from $77.5 million, up 22.9%, and Adjusted EBITDA margin improved to 17.7% from 16.7%. For the full year, Adjusted EBITDA was $431.9 million compared to $376.9 million in 2024, up 14.6%, and Adjusted EBITDA margin increased to 20.0% from 19.8%.
On profitability measures, adjusted net income attributable to the company was $36.1 million in Q4 and adjusted EPS was $0.28, compared with $22.2 million and $0.17 in the prior-year quarter. For full-year 2025, adjusted net income attributable to the company was $176.0 million and adjusted EPS was $1.37, compared with $168.5 million and $1.48 in 2024.
Segment results: centers, onsite clinics, and other businesses
DiCanio said occupational health centers generated $490.6 million of revenue in Q4, up 12.2% year-over-year, supported by the 9% increase in visits per day and higher revenue per visit. Within that segment:
- Workers’ compensation revenue was $328.5 million, up 13.6%.
- Employer services revenue was $151.9 million, up 10.7%.
Excluding Nova, occupational health center revenue increased 5.7% to $461.9 million in Q4, with workers’ comp revenue up 7.2% and employer services revenue up 3.7%.
On-site health clinics revenue rose to $36.2 million in Q4, up 112%, driven largely by the Pivot Onsite Innovations acquisition completed in Q2 2025. Excluding Pivot, the company said onsite revenue grew 14.6% year-over-year in Q4, marking the third consecutive quarter of double-digit organic growth. For full-year 2025, onsite revenue was $110.2 million, up 72%, and up 11.6% organically excluding Pivot. DiCanio said the company expects continued organic sales growth in 2026, highlighting traction in its Advanced Primary Care offering.
Other businesses generated $12.3 million in Q4 revenue, up 12.6%. For the full year, other businesses grew 8.7%.
Costs, cash flow, capital allocation, and separation progress
Cost of services was $398.4 million, or 73.9% of revenue in Q4, improving from 74.2% in the year-ago quarter. For the full year, cost of services was 71.7% of revenue, down from 72.2% in 2024. DiCanio said the improvement reflected staffing efficiencies, even with more than $2 million of one-time Nova integration costs incurred during the year.
Total G&A expenses were $50.8 million in Q4, or 9.4% of revenue, compared with 9.8% in the year-ago quarter. Excluding adjustments used in the company’s Adjusted EBITDA calculation, G&A was $45.8 million, or 8.5% of revenue, compared with 9.4% in the prior-year quarter. For full-year 2025, total G&A was 9.4% of revenue versus 8.2% in 2024, with the increase largely attributed to costs tied to separating from Select Medical and operating as a standalone public company following the July 2024 IPO.
Concentra generated $118.7 million of operating cash flow in Q4, compared with $93.7 million in Q4 2024. For the full year, operating cash flow was $279.4 million, slightly higher than $274.7 million in 2024 despite higher cash interest expense tied to the IPO recap.
Free cash flow (as defined by the company) totaled $98.6 million in Q4, up from $77.0 million a year earlier, and $197.8 million for full-year 2025. Free cash flow conversion was 114% for the year, consistent with the company’s five-year average, management said.
In the quarter, financing activities included repayment of the remaining $35 million on the credit facility, repurchase of 1.1 million shares for $22.4 million, and $8 million in dividends. For the year, the company made $92.1 million in principal payments on senior debt, repurchased $22.4 million in shares, and paid $32.1 million in dividends. At quarter-end, Concentra had $1.57 billion of total debt and $79.9 million in cash, with a net leverage ratio of 3.4x. DiCanio said the company intends to work toward approximately 3.0x leverage by the end of 2026, while remaining opportunistic with share repurchases; about $80 million remained authorized under the buyback program.
Management also provided an update on its separation from Select Medical, stating it has hired more than 80% of the expected FTEs, including all senior-level roles. DiCanio said the company expects transition services agreement (TSA) costs to ramp down close to zero by mid-year 2026, with some incremental costs in the first half of 2026 as additional hires are completed.
Expansion plans, New York fee schedule, and 2026 guidance
Concentra opened two de novo sites in Q4 (Southern California and Miami), bringing total 2025 de novos to seven. Newton said the company had already opened another new location outside Atlanta in January, executed leases for five additional locations across Arizona, Florida, Missouri, and Idaho (a new state for Concentra), and identified other potential sites that could bring 2026 de novos into the high single digits. DiCanio later said the company is targeting 7 to 9 de novos in 2026 and “potentially double-digit” new sites in 2027, with typical payback in under three years.
On M&A, management said it will continue pursuing smaller bolt-on deals and is not anticipating larger acquisitions in the near term. The company referenced a January acquisition of three net incremental centers in California and said it finalized the Reliant acquisition from MBI in January, which was included in guidance.
Management also discussed developments in New York’s workers’ compensation fee schedule. Concentra has no centers in the state due to historically low reimbursement, but DiCanio said the state published revised rates in mid-January that increased evaluation and management codes by about 50%. Management characterized the change as a “good first step,” while noting that both proposed evaluation and management and physical therapy codes remain below levels the company would need to commit capital. The public comment period runs through mid-March, and DiCanio said the company expects new rates could be implemented around January 1, 2027. Newton said Concentra believes it could move quickly if conditions became attractive, potentially through de novos and/or transactions.
For full-year 2026, Concentra reiterated guidance issued in late January, calling for:
- Revenue of $2.25 billion to $2.35 billion
- Adjusted EBITDA of $450 million to $470 million
- CapEx of $70 million to $80 million
- Free cash flow of $200 million to $225 million
- Year-end 2026 leverage of approximately 3.0x
DiCanio said assumptions include about 3% rate growth in occupational health centers and low single-digit visit growth excluding Nova, noting that many key states have finalized 2026 fee schedules. Management expects cost-of-services as a percentage of revenue to remain relatively consistent with 2025, while overhead will reflect incremental separation costs in 2026. The company expects Adjusted EBITDA margin to remain around 20% in 2026, with potential for additional expansion once separation activities are fully complete. CapEx is expected to decline year-over-year as roughly $15 million of one-time Nova integration spend rolls off.
The company also announced a quarterly cash dividend of $0.0625 per share, declared February 25, 2026, payable on or about March 19, 2026, to stockholders of record as of March 12, 2026.
About Concentra Group Holdings Parent (NYSE:CON)
Concentra Group Holdings Parent (NYSE:CON) is a Canada-based financial services holding company that specializes in serving Canadian credit unions and their members. Through its operating subsidiaries, the group provides wholesale funding, lending solutions and investment management services tailored to the unique needs of cooperative financial institutions. Concentra’s broad suite of offerings includes trust and custody services, mortgage investment products and equipment financing, all designed to support credit-union growth and stability.
In addition to wholesale funding and lending, Concentra Group Holdings Parent distributes life and general insurance products through affiliated insurance brokers and credit-union channels.
