Alternate site health provider Option Care Health (NASDAQ: OPCH) met Wall Street’s revenue expectations in Q4 CY2025, with sales up 8.8% year on year to $1.47 billion. On the other hand, the company’s full-year revenue guidance of $5.9 billion at the midpoint came in 1.4% below analysts’ estimates. Its non-GAAP profit of $0.46 per share was in line with analysts’ consensus estimates.
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Option Care Health (OPCH) Q4 CY2025 Highlights:
- Revenue: $1.47 billion vs analyst estimates of $1.46 billion (8.8% year-on-year growth, in line)
- Adjusted EPS: $0.46 vs analyst estimates of $0.47 (in line)
- Adjusted EBITDA: $126 million vs analyst estimates of $125.5 million (8.6% margin, in line)
- Adjusted EPS guidance for the upcoming financial year 2026 is $1.87 at the midpoint, in line with analyst estimates
- EBITDA guidance for the upcoming financial year 2026 is $492.5 million at the midpoint, in line with analyst expectations
- Operating Margin: 6.2%, in line with the same quarter last year
- Free Cash Flow Margin: 1.5%, similar to the same quarter last year
- Market Capitalization: $5.73 billion
Company Overview
With a nationwide network of 177 locations serving 43 states and a team of over 4,500 clinicians, Option Care Health (NASDAQ: OPCH) is the largest independent provider of home and alternate site infusion services, delivering medications and clinical support to patients across the United States.
Revenue Growth
A company’s long-term sales performance can indicate its overall quality. Even a bad business can shine for one or two quarters, but a top-tier one grows for years. Thankfully, Option Care Health’s 13.3% annualized revenue growth over the last five years was solid. Its growth beat the average healthcare company and shows its offerings resonate with customers.
We at StockStory place the most emphasis on long-term growth, but within healthcare, a half-decade historical view may miss recent innovations or disruptive industry trends. Option Care Health’s annualized revenue growth of 14.6% over the last two years is above its five-year trend, suggesting its demand was strong and recently accelerated. 
This quarter, Option Care Health grew its revenue by 8.8% year on year, and its $1.47 billion of revenue was in line with Wall Street’s estimates.
Looking ahead, sell-side analysts expect revenue to grow 5.7% over the next 12 months, a deceleration versus the last two years. Despite the slowdown, this projection is above the sector average and indicates the market sees some success for its newer products and services.
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Operating Margin
Operating margin is a key measure of profitability. Think of it as net income - the bottom line - excluding the impact of taxes and interest on debt, which are less connected to business fundamentals.
Option Care Health’s operating margin might fluctuated slightly over the last 12 months but has generally stayed the same, averaging 6.3% over the last five years. This profitability was mediocre for a healthcare business and caused by its suboptimal cost structure.
Looking at the trend in its profitability, Option Care Health’s operating margin of 6% for the trailing 12 months may be around the same as five years ago, but it has decreased by 1.3 percentage points over the last two years.
In Q4, Option Care Health generated an operating margin profit margin of 6.2%, in line with the same quarter last year. This indicates the company’s overall cost structure has been relatively stable.
Earnings Per Share
We track the long-term change in earnings per share (EPS) for the same reason as long-term revenue growth. Compared to revenue, however, EPS highlights whether a company’s growth is profitable.
Option Care Health’s EPS grew at an astounding 62.9% compounded annual growth rate over the last five years, higher than its 13.3% annualized revenue growth. However, this alone doesn’t tell us much about its business quality because its operating margin didn’t improve.
We can take a deeper look into Option Care Health’s earnings quality to better understand the drivers of its performance. A five-year view shows that Option Care Health has repurchased its stock, shrinking its share count by 10.4%. This tells us its EPS outperformed its revenue not because of increased operational efficiency but financial engineering, as buybacks boost per share earnings. 
In Q4, Option Care Health reported adjusted EPS of $0.46, up from $0.37 in the same quarter last year. Despite growing year on year, this print slightly missed analysts’ estimates, but we care more about long-term adjusted EPS growth than short-term movements. Over the next 12 months, Wall Street expects Option Care Health’s full-year EPS of $1.72 to grow 9%.
Key Takeaways from Option Care Health’s Q4 Results
We struggled to find many positives in these results. Its full-year revenue guidance slightly missed and its EPS was in line with Wall Street’s estimates. Overall, this was a weaker quarter. The stock traded down 3.9% to $34.70 immediately following the results.
Option Care Health didn’t show it’s best hand this quarter, but does that create an opportunity to buy the stock right now? What happened in the latest quarter matters, but not as much as longer-term business quality and valuation, when deciding whether to invest in this stock. We cover that in our actionable full research report which you can read here (it’s free).
