Free cash flow volatility remains a primary concern, with margins swinging from 15.1% in 2024Q2 to a negative 0.9% in 2026Q1, exacerbated by erratic working capital fluctuations.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 | Dec'99 | Dec'98 | Dec'97 | Dec'96 |
|---|
| Cash from Operations | 253.55M | 258.45M | 323.39M | 371.3M | 267.55M | 208.57M | 127.39M | 39.47M | -20.1M | -1.05M | -35.2M | -64.74M | -31.42M | -54.58M | 26.88M | 26.97M | -21.42M | 22.75M | -8.75M | 24.19M | -29.86M | -6.42M | 3.29M | 14.34M | 20.8M | 10.93M | 11.33M | 12.9M | -16.4M | -3.1M | -7.6M |
| Operating CF Margin % | - | 4.57% | 6.47% | 8.63% | 6.78% | 6.07% | 4.2% | 1.71% | -1.04% | -0.13% | -3.76% | -6.59% | -3.4% | -7.84% | 4.53% | 4.86% | -4.97% | 1.71% | -0.62% | 2.02% | -2.59% | -0.6% | 0.52% | 2.44% | 3.61% | 2.39% | 3.35% | 3.68% | -3.64% | -1.28% | -2.68% |
| Operating CF Growth % | -135.41% | -20.08% | -12.9% | 38.78% | 28.28% | 63.72% | 222.78% | 296.31% | -1811.03% | 97.01% | 45.63% | -106.08% | 42.44% | -303.02% | -0.32% | 225.91% | -194.17% | 360.06% | -136.16% | 181% | -365% | -294.96% | -77.03% | -31.05% | 90.38% | -3.6% | -12.11% | 178.63% | -429.03% | 59.21% | - |
| Net Income | 206.19M | 207.59M | 211.82M | 267.09M | 150.56M | 139.9M | -8.08M | -75.92M | -51.59M | -61.28M | -34.37M | -303.43M | -143.38M | -53.61M | -8.34M | 7.87M | -69.14M | 54.1M | -74.03M | 3.32M | -38.29M | -23.85M | 7.03M | 9.13M | 18.68M | 14.2M | -1.82M | -3.79M | 4.3M | -13.5M | -31.8M |
| Depreciation & Amortization | 69.97M | 70.69M | 63.5M | 62.2M | 65.43M | 68.8M | 77.9M | 57.87M | 23.6M | 26.31M | 21.55M | 22.74M | 22.94M | 20.23M | 12.47M | 15.88M | 12.33M | 5.03M | 6.39M | 7.09M | 10.85M | 35.08M | 5.02M | 5.08M | 6.06M | 6.36M | 4.88M | 3.22M | 1.7M | 1.1M | 800K |
| Stock-Based Compensation | -232K | 39.96M | 36.14M | 30.48M | 16.78M | 9.57M | 2.92M | 4.17M | 4.17M | 2.36M | 1.96M | 4.51M | 8.57M | 9.45M | 6.12M | 4.47M | 3.32M | 3.42M | 3.79M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Deferred Taxes | 0 | 8.44M | 12.66M | 12.77M | 49.19M | -30.37M | 1.2M | -4.61M | 66K | -3.15M | 2.04M | -20.09M | 12.32M | 4.82M | -4K | 1.16M | 47.34M | -40.52M | -12.22M | 2.81M | 20.3M | -6.03M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Non-Cash Items | -10.6M | 31.52M | 19.52M | 20.2M | 15.36M | 32.03M | 46.33M | 19.38M | 20.35M | 17.01M | -14.96M | 252.81M | -7.61M | -3M | -21.56M | 1.46M | 11.72M | 8.52M | 98.55M | 8.12M | 15.43M | 13.87M | 2M | 2M | 487K | -1.06M | 2.9M | 6.54M | -100K | 500K | 27.6M |
| Working Capital Changes | -11.78M | -99.75M | -20.25M | -21.45M | -29.78M | -11.37M | 7.13M | 38.58M | -16.71M | 17.71M | -11.44M | -21.29M | 75.74M | -32.46M | 38.2M | -3.86M | -26.99M | -7.8M | -31.23M | 2.85M | -38.39M | -25.49M | -10.76M | -1.87M | -4.43M | -8.57M | 5.38M | 6.92M | -22.4M | 8.8M | -4.2M |
| Change in Receivables | -40.67M | -54.59M | -32.08M | 224K | -36.89M | -4.27M | -3.92M | 82.28M | -29.34M | 23.56M | -2.5M | 16.45M | 30.65M | -31.86M | 101.23M | -83.67M | -69.05M | -90.45M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Inventory | -47.8M | -81.47M | -114.13M | -51M | -41.01M | -22.7M | -42.73M | -12.85M | 11.36M | -1.77M | 10.02M | -5.77M | -2.95M | 4.94M | -15.25M | 9.78M | -11.02M | -6.03M | -11.63M | -127K | -7.11M | -3.56M | -2.56M | 767K | -2.04M | -1.11M | -1.01M | 410K | -400K | 0 | 0 |
| Change in Payables | 14.38M | 19.52M | 183.4M | 47.7M | 98.89M | -10.38M | 59.22M | -30.86M | 1.06M | -2.54M | -20.52M | -24.13M | 26.02M | 22.14M | -48.2M | -1.66M | 2.94M | -2.4M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -43.71M | -161.08M | -36.47M | -56.51M | -108.05M | -111.54M | -26.33M | -727.83M | -13.52M | -13.34M | -72.98M | 13.02M | 44.26M | -302.34M | 93.88M | -9.91M | -108.55M | -5.74M | -7.46M | -5.53M | -18.41M | 3.12M | -17.08M | -981K | -33.27M | -3.65M | -22.56M | 2.57M | 7.8M | 10.9M | -38.9M |
| Capital Expenditures | -9.1M | -41.31M | 0 | -41.87M | -35.36M | -25.63M | -26.88M | -28.29M | -13.88M | -8.39M | -9.64M | -11.54M | -13.83M | -25.62M | -10.99M | -9.44M | -11.11M | -5.74M | -7.46M | -5.53M | -5.44M | -5.13M | -1.06M | -961K | -2.1M | -2.63M | -6.63M | -2.18M | -2.2M | -1.6M | -900K |
| CapEx % of Revenue | 0.16% | 0.73% | 0.71% | 0.97% | 0.9% | 0.75% | 0.89% | 1.22% | 0.72% | 1.03% | 1.03% | 1.18% | 1.5% | 3.68% | 1.85% | 1.7% | 2.58% | 0.43% | 0.53% | 0.46% | 0.47% | 0.48% | 0.17% | 0.16% | 0.36% | 0.58% | 1.96% | 0.62% | 0.49% | 0.66% | 0.32% |
| Acquisitions | 75K | -117.25M | 0 | -12.49M | -87.36M | -85.91M | 0 | -700.17M | 360K | 0 | -63.34M | 0 | 398K | -274.36M | -13.59M | 0 | 0 | 0 | 0 | 0 | -13.1M | 0 | -14.26M | 0 | -34.85M | -2.19M | -19.64M | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -34.69M | -2.53M | -36.47M | -2.15M | 14.67M | 0 | 541K | 636K | 360K | -4.95M | -63.34M | 24.57M | 56.84M | -2.36M | 118.45M | -463K | -97.43M | 0 | 0 | 0 | 125K | 8.25M | -1.76M | -20K | 3.69M | 1.16M | -1.32M | -1.91M | -900K | 400K | -1M |
| Cash from Financing | -203.89M | -277.31M | -218.21M | -265.13M | 15.27M | -76.87M | -68.85M | 719.02M | 8.07M | 44.28M | 109.74M | 66.56M | -13.1M | 295.82M | -58.66M | -17.06M | 129.97M | -17.01M | 16.21M | -18.66M | 46.75M | 1.86M | 7.31M | -9.69M | 5.73M | 3.92M | -2.79M | -4.65M | 3.5M | -100K | 46.5M |
| Debt Issued (Net) | 49.16M | 40.9M | 43.58M | -6M | -6M | -76.84M | -183.25M | 752.24M | -4.15M | 23.38M | 26.68M | 9.61M | -14.2M | 174.89M | -67.1M | -20.07M | 126.98M | -20.02M | 16.63M | -19.13M | 45.37M | 89K | 6.44M | -5.24M | 4.05M | -753K | -3.12M | -4.32M | 3.5M | -200K | -300K |
| Equity Issued (Net) | -209.73M | -309.95M | -252.73M | -250.26M | 0 | -32K | 118.93M | 0 | 0 | 20.78M | 83.27M | 59.69M | 0 | 118.38M | 0 | 0 | 3.99M | 3.02M | -424K | 1.87M | 0 | 1.78M | 876K | -4.45M | 1.68M | 4.68M | 333K | -333K | 0 | 100K | 46.8M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -2M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -227.27M | -309.95M | -252.73M | -250.26M | 0 | -32K | 0 | -2.5M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -128K | -119K | -889K | -1.4M | 0 | 0 | 0 | -5.07M | 0 | -2.6M | 0 | -338K | 0 | 0 | 0 |
| Other Financing | -43.33M | -8.25M | -9.05M | -8.87M | 21.27M | 0 | -4.53M | -31.21M | 0 | 120K | -202K | -2.74M | 1.1M | 2.55M | 8.44M | 3.01M | -1M | 1K | 0 | -1.4M | 1.38M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Net Change in Cash | 5.95M | -179.94M | 68.72M | 49.66M | 174.76M | 20.16M | 32.21M | 30.66M | -25.55M | 29.89M | -6.01M | 14.84M | -261K | -61.1M | -58.66M | 0 | 0 | 0 | 0 | 0 | 46.75M | -1.44M | -6.47M | 3.68M | -6.74M | 11.2M | -14.02M | 10.81M | 3.5M | -100K | 0 |
| Free Cash Flow | 244.46M | 258.45M | 287.79M | 329.43M | 232.19M | 182.94M | 100.52M | 11.18M | -33.98M | -9.44M | -44.84M | -76.29M | -45.24M | -80.2M | 15.9M | 17.52M | -32.53M | 17.01M | -16.21M | 18.66M | -35.3M | -11.55M | 2.24M | 13.38M | 18.7M | 8.29M | 4.7M | 10.72M | -18.6M | -4.7M | -8.5M |
| FCF Margin % | 4.31% | 4.57% | 5.76% | 7.66% | 5.89% | 5.32% | 3.31% | 0.48% | -1.75% | -1.16% | -4.79% | -7.77% | -4.9% | -11.51% | 2.68% | 3.16% | -7.55% | 1.28% | -1.16% | 1.56% | -3.06% | -1.08% | 0.35% | 2.27% | 3.24% | 1.82% | 1.39% | 3.06% | -4.12% | -1.94% | -3% |
| FCF Growth % | -29.31% | -10.19% | -12.64% | 41.88% | 26.92% | 82% | 799.48% | 132.89% | -259.87% | 78.95% | 41.21% | -68.61% | 43.58% | -604.44% | -9.28% | 153.87% | -291.3% | 204.92% | -186.86% | 152.87% | -205.58% | -616.59% | -83.29% | -28.44% | 125.46% | 76.47% | -56.14% | 157.61% | -295.74% | 44.71% | - |
| FCF per Share | 1.55 | 1.58 | 1.66 | 1.83 | 1.28 | 1.01 | 0.56 | 0.07 | -1.06 | -0.31 | -1.91 | -4.44 | -2.64 | -4.97 | 1.13 | 1.29 | -2.58 | 1.71 | -1.69 | 1.94 | -3.78 | -1.35 | 0.39 | 2.36 | 3.17 | 1.50 | 0.93 | 2.26 | -4.50 | -1.49 | -3.56 |
| FCF Conversion (FCF/Net Income) | 1.19x | 1.25x | 1.53x | 1.39x | 1.78x | 1.49x | -15.77x | -0.52x | 3.29x | 0.02x | 0.82x | 0.22x | 0.21x | 0.78x | 0.42x | 3.43x | 0.31x | 0.42x | 0.12x | 7.29x | 0.78x | 0.27x | 0.47x | 1.57x | 1.11x | 0.77x | -6.22x | -3.41x | -3.81x | 0.23x | 0.24x |
| Interest Paid | 21.76M | 0 | 71.55M | 69.8M | 50.37M | 60.92M | 97.64M | 50.81M | 47.17M | 45.38M | 34.7M | 34.3M | -34.13M | 25.59M | 27.53M | 27.53M | 20.12M | 1.92M | 4.01M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 38.6M | 0 | 64.52M | 75.24M | 13.44M | 5.71M | 2.88M | 2.4M | 1.6M | 649K | 372K | 114K | -1.65M | 3.14M | 1.04M | 1.04M | 2.56M | 741K | 382K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Working capital volatility
As reported in recent financial statements, Option Care Health's OCF/NI ratio has fluctuated wildly, reaching a negative 0.27 in 2026Q1, which suggests that reported net income is frequently decoupled from actual cash generation due to the inherent complexities of the buy-and-bill reimbursement model.
The significant divergence between net income and operating cash flow indicates that accounting profits are heavily reliant on non-cash accruals and timing differences in insurance collections. Investors should monitor whether this disconnect reflects structural delays in reimbursement or an inability to convert service delivery into timely cash inflows.
Based on the company's reported figures, free cash flow margins have swung from a peak of 15.1% in 2024Q2 to a negative 0.9% in 2026Q1, illustrating a highly inconsistent ability to generate surplus cash after accounting for necessary capital expenditures and working capital requirements.
This erratic trajectory suggests that the business model is highly sensitive to operational disruptions and working capital cycles. The inability to maintain positive free cash flow in recent periods raises questions about the sustainability of the company's current capital allocation strategy.
According to recent SEC filings, working capital changes have been a primary driver of cash flow volatility, with swings as large as negative $150 million in 2024Q1, indicating that the company's cash position is highly vulnerable to the timing of payor reimbursements and inventory management.
The extreme variance in working capital suggests that the company lacks a stable cash conversion cycle, likely due to the administrative burden of managing complex insurance claims. This volatility makes it difficult to forecast underlying cash generation and may mask underlying operational inefficiencies.
As evidenced by financial data, the company has consistently prioritized share repurchases, including $95.1 million in 2025Q4, even during periods of negative operating cash flow, which suggests a capital allocation strategy that may be disconnected from the reality of its internal cash generation capabilities.
Prioritizing shareholder returns while operating cash flow remains inconsistent warrants further investigation into the company's long-term liquidity planning. This approach may limit the financial flexibility required to navigate potential reimbursement headwinds or future operational investments.
Based on reported figures, the company's cash flow statement is frequently impacted by stock-based compensation adjustments and acquisition-related outflows, which complicate the assessment of true recurring cash generation and suggest that headline figures may overstate the company's underlying financial health.
The reliance on non-cash adjustments to bolster reported metrics may obscure the true cost of operations and the impact of past M&A activity. Analysts should be cautious of these adjustments, as they may hide the true cash impact of maintaining the company's specialized clinical workforce.
Quick answers to the most common questions about buying OPCH stock.
Option Care Health, Inc. (OPCH) generated $258.4M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Option Care Health, Inc. (OPCH) generated $258.4M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Option Care Health, Inc. (OPCH) spent $41.3M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Option Care Health, Inc. (OPCH) spent $310.0M on share repurchases. This shows the company's commitment to returning capital to its equity investors.