NUTX

Greetings, welcome to the Nutex Health 2026 first quarter conference call. At this time, all participants are in a listen-only mode. A brief question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Jennifer Rodriguez, Investor Relations Manager. Thank you. You may begin.

Good morning, everyone, and welcome to Nutex Health Inc.'s first quarter 2026 earnings call. My name is Jennifer Rodriguez, and I'm happy to serve as your moderator today. We're truly grateful for your participation and your continued interest in our company as we share the highlights of another exceptional quarter. Please note that this call is being recorded for future reference. Joining me this morning are some of the key leaders driving Nutex Health forward. Our Chairman and CEO, Dr. Tom Vo, our Chief Financial Officer, Jon Bates, our President, Dr. Warren Hosseinion, and our Chief Operating Officer, Wesley Bamburg. Together, they'll provide prepared remarks to give you a comprehensive view of our performance, strategies, and vision, after which we'll open the floor for your questions. Before I turn things over to Dr. Vo, I'd like to take a moment to address a few important points.

Today's discussion may include forward-looking statements which reflect management's current expectations about our future performance. These statements are based on what we know today, but they're subject to risks, uncertainties, and other factors that could cause our actual results to differ from what we'll share. For a deeper dive into these forward-looking statements and the factors that might influence them, I encourage you to review the press release and Form 10-Q filed earlier this week, as well as our various SEC filings. You'll find all the details there. Additionally, we may reference non-GAAP financial measures, such as adjusted EBITDA, during the call. For those interested in how these metrics reconcile to GAAP standards, please refer to the press release and Form 10-Q, where we've included that information.

With those housekeeping items out of the way, it's my pleasure to hand the call over to Dr. Tom Vo, our Founder and Chief Executive Officer. Dr. Vo, the floor is yours.

Thank you, Jen, and good morning, everyone. It's a pleasure to be with you as we review Nutex Health's first quarter 2026 results. This first quarter has been one of renewed energy and vigor as we continue our mission of delivering high-quality, concierge-level, accessible healthcare to the communities we serve. Let's first discuss the first quarter of 2026 financial and operational performance. Total revenue reached $216.5 million, a 2% increase from $211.8 million in Q1 2025. Net income increased to $46.8 million compared to $21.2 million in Q1 2025. Adjusted EBITDA dropped to $57.6 million, down 21%, and discuss more, but this has to do with the timing of recognition for IDR expenses in the first quarter of 2025 compared to the same period in 2026.

On the volume side, our hospital recorded 49.7 thousand, Total patient visits, up 3.1% from 48.3 thousand patients in Q1 2025. 0.6% of that growth came from same hospitals, demonstrating their resilience and continued relevance in their markets. Please note that this year's flu season was much milder compared to 2025's flu season. On the balance sheet, net long-term debt decreased from $29.2 million at December 31, 2025 to $24.3 million at the end of Q1 2026. Very low relative to our revenue and expansion base. Net cash from operating activities was $75.5 million for Q1 2026 compared to $51 million in 2025, a 48% increase.

Cash on hand grew to $207.3 million as of March 31, 2026, up from $185.6 million at year-end 2025. In the first quarter of 2026, we completed our inaugural $25 million share repurchase program, retiring approximately 119,000 shares. We also initiated a second $25 million share repurchase program during the quarter, reflecting our continued confidence in the intrinsic value of Nutex Health. Our share repurchase activity underscores management's strong conviction in the long-term intrinsic value of Nutex Health and our disciplined approach to capital allocation. Operationally, we continue to invest in infrastructure that will support sustained growth in both emergency room and inpatient volumes. These investments are focused on scalability, efficiency, and long-term operating leverage.

We are also strengthening our leadership team with targeted additions in business development, IT, AI to support our next phase of growth. On the business development side, our focus is increasing community awareness and engagement, ensuring patients and physicians clearly understand the differentiated and unique care delivered at Nutex's hospitals. From a technology standpoint, we are investing in both AI and IT to enhance patient care, streamline clinical workflows, and enable innovation within our micro-hospital model. While preserving the personalized, concierge-level experience that defines Nutex's. Technology is advancing at an unprecedented pace, we believe Nutex is exceptionally well-positioned to harness these innovations to meaningfully improve patient outcomes while driving sustainable patient volume growth across our platform. As a smaller, more agile organization, we are able to adapt quickly and deploy new technologies far more efficiently than larger, more bureaucratic healthcare systems.

In parallel, we continue to develop and grow new service lines, including medical detox programs, behavioral health services, outpatient imaging, outpatient procedures, personal injury services. Wes will add more on his operational report. With respect to our de novo pipeline, a significant development this quarter was the board's approval for Nutex to begin directly investing in the development and construction of new hospital facilities. Historically, real estate development was undertaken by third-party developers alongside local physician partners. By internalizing this capability, Nutex can build a more secure, cost-efficient, and scalable development pipeline while reducing reliance on external credit markets and alleviating the financial burden historically placed on physician partners. Nutex does not intend to hold these real estate assets on a long-term basis.

Our strategy is to invest capital upfront to develop and construct the facilities, and once a hospital is completed or has reached operational stabilization, we expect to monetize the asset through a sale-leaseback transaction with a third-party owner, such as a real estate investment trust or REIT. While a specific REIT partner has not yet been identified, proceeds from these transactions are expected to be recycled into future developments, allowing us to efficiently redeploy capital and continue to expand our footprint in a disciplined and capital-efficient manner. On the IPA front, we are expanding internal resources to bring additional management functions in-house, further reducing our dependence on third-party service providers and improving operational control and efficiency. Warren will discuss more on this later. From a payer strategy perspective, we continue to carefully evaluate all in-network contract opportunities.

Each proposal is assessed against our existing reimbursement outcome under the IDR process. Our objective remains consistent. We are not seeking to collect more than pure hospitals offering similar services. We simply aim to receive comparable reimbursement for comparable care. Our goal is not to increase costs to insurers, but to ensure fair and equitable payments. On the legislative front, we continue to closely monitor development related to the Murphy Bill, formerly known as the No Surprises Act Enforcement Act, and we will adjust our strategy as appropriate as that process evolves. More broadly, we are actively monitoring legislative and legal developments nationwide that could impact our business. We have seen several recent court decisions in states such as California, Florida, and Pennsylvania that may be constructive for providers like Nutex's.

While these matters remain fluid, we believe these developments reinforce the importance of staying engaged in the regulatory and legal landscape, and we will continue to evaluate their potential implications for the company. Today, Nutex Health operate 27 hospital facilities across 12 states. In 2026, we remain on track to open three additional hospitals in the third and fourth quarter, located in San Antonio, Texas, Jacksonville, Florida, and West Little Rock, Arkansas. Demand for the Nutex's health model remains strong. Physicians and community leaders across the country continue to approach us weekly with requests to bring new Nutex facilities to their markets. With that, I'll turn it over to Jon Bates, our CFO, to walk through the financials in more detail. Jon?

Thanks, Tom, and good morning, everyone. I'm gonna provide a little more color on the financials for Nutex Health's first quarter of 2026, another strong quarter where we are continuing to grow the business and prove our micro-hospital model while we build the infrastructure to handle that growth each year-over-year. Now, Tom's given you a little bit of the big picture, and I'm gonna attempt to provide a little more detail. Going forward, when we do talk about comparisons between periods for metrics like visits and revenue, I wanted to bring to your attention, we're gonna begin using the term same hospital in our analytics, which basically means that the hospital data being compared period-to-period will have been fully opened in both periods presented.

In this case, hospitals in each period being compared under the same hospital definition were fully opened by December 31st of 2024. Starting with revenue. Total revenue for Q1 of 2026 increased by 2.2% or $4.7 million to $216.5 million versus $211.8 million for the first quarter of 2025, with the hospital division revenue being $207.6 million in 2026. Of the total revenue increase, hospital division revenue grew 1.8% to $207.6 million from $203.9 million, while same hospitals increased their revenue by 0.2% for the first quarter of 2026 compared to the same period in 2025.

Hospital division visits increased by 3.1% or 1,473 visits to 49,742 visits in Q1 2026 versus 48,269 visits in the same period in 2025, with same hospital visits growing at 0.6% over the same period. With regard to the population health division, it had revenue growth of approximately 14% to $8.9 million for Q1 2026 versus $7.8 million for the same period in 2025. In addition to the revenue and visit growth noted above, facility and operating level costs also showed improvement for the first quarter of 2026 compared to the same period in 2025.

Total facility level operating costs and expenses increased $31.3 million during the period, representing 57.6% or $124.8 million of the total revenue for Q1 2026 versus 44.1% or $93.5 million for the same period in 2025. Of the $31.3 million increase for the period, $19.8 million of it related to arbitration costs for additional arbitration revenue recorded during the period. An increase in these costs is primarily due to less settlement in open negotiations in the prior period as the company was increasing its IDR submissions beginning in the first quarter 2025. Regarding arbitration level revenue, we've continued to submit between 50%-60% of our claims through the IDR process.

When an award determination is made, we currently prevail in over 85% of those determinations, and we currently have an average collection rate of over 80% on those determination wins. Regarding arbitration costs, we do anticipate we ultimately will finalize around 24%-26% of the overall revenue realized. As a reminder, we currently are recording 100% of the anticipated cost of the arbitration effort, but only are recording revenue based upon our current 80%+ collection rate. During the current period, these costs approximated a higher % of 35% of the arbitration-related revenue, which we anticipate in moving back to our lower averages in future periods.

Total stock compensation expense for the three months ended March of 2026 was a $3.9 million gain compared to a $27.6 million expense for the same period in 2025, which was a $31.6 million increase in Q1 of 2026. We did finalize one hospital earn-out at March 31, 2026, and have two more facilities currently in their measurement periods, with both of them completing their measurement period in the fourth quarter of 2026.

Gross profit for the three months ended March 31st of 2026 was $91.7 million or 42.4% of total revenue as compared to $118.3 million or 55.9% of total revenue in the same period in 2025. A 13.5% decrease for the three months ended March of 2026 versus 2025. From a corporate and other cost perspective, the general and administrative expenses as a percentage of total revenue for the three months ended March of 2026 increased at 6.6% or $14.4 million from 4.7% or $10 million for the same period in 2025.

Operating income for the three months ended March of 2026 was $81.3 million compared to $80.7 million for the same period in 2025, an increase of $0.6 million. Net income attributable to Nutex Inc was $46.8 million for 2026 compared to net income of $21.2 million for the period in 2025, which was an increase of $25.6 million. Adjusted EBITDA attributable to Nutex decreased $15.3 million or 21% from $72.8 million in Q1 of 2025 to $57.6 million in Q1 of 2026.

Looking at our balance sheet, it remains very strong with cash and cash equivalents at March 31, 2026 of $207.3 million, up $21.8 million or 11.7% from the $185.6 million we had at the end of December 2025. Additionally, accounts receivable increased by $20.2 million-$339.6 million at March 31, 2026 from $319.4 million at December 31, 2025. We had another strong collection quarter which provides us continued confidence in this increase.

Regarding cash flow, net cash from operating activities increased by $24.6 million for the three months ended March 31, 2026 to $75.5million as compared to $51 million for the same period in 2025. As Tom had mentioned earlier, on the liability side, our total bank equity type debt decreased by $2.1 million to $41.3 million at December 31, 2026. Excuse me, at March 31, 2026 from $43.5 million at December 31, 2025. With the majority of that debt, as we've talked about before, relating to equipment loans at our hospitals for such items as our MRIs, X-rays, ultrasounds, and CT machines.

With all that said, our balance sheet remains very solid. We have provided our company the flexibility to execute on our growth plan in 2026 and beyond. With that, on to Warren Hosseinion, our President, for a population health update. Warren?

Thank you, Jon, and good morning, everyone. It's great to be with you today to discuss how Nutex Health is advancing population health management. In the first quarter of 2026, we continued to make strides in this area. This morning, I would like to again focus on our strategy and our upcoming goals. Let's start with where we are today. Our population health management division now oversees a diverse group of almost 40,000 patients across our platform, including a mix of Medicare Advantage, commercial, and Medicaid managed care members. Revenue for the division was $8.9 million in Q1, up from $7.8 million in Q1 2025. Our strategy revolves around physician networks. Our IPAs, or Independent Practice Associations, are comprised of networks of contracted and credentialed primary care physicians and specialists located around our facilities.

Building strong partnerships with local doctors is critical. By forming these IPAs, we are building awareness of our hospitals among the local community doctors and their patients. Why do physicians join our IPA? We offer these physicians ownership in our IPA entities of the IPA. We offer them to get on the staff of our hospital so they can admit and follow their own patients if they choose to. We also incentivize the physicians to achieve high-quality metrics. We believe that over time, these relationships will not only increase the volume of both IPA and non-IPA patients to our hospitals, but also create a web of care that's seamless for patients. Our vision is that our hospitals and IPAs will work hand in hand to amplify our reach and effectiveness. We are fostering collaboration, sharing best practices, and ensuring every provider is aligned with our patient-first culture.

We're growing our IPA strategically, focusing on areas near our hospitals to leverage existing relationships and infrastructure. Going forward, our growth strategy focuses on three areas. One, provider network expansion by partnering with primary care physicians and specialists. Second, value-based contract growth by increasing the number of covered lives under management. Three, technology scaling by enhancing our analytics and care management platform. With that, I'll turn it over to Wesley Bamburg, our Chief Operating Officer.

Thank you, Warren. I'll focus my remarks on the operational drivers behind our first quarter performance and how we continue to balance growth, efficiency, and execution as we scale the platform. Operationally, overall hospital visits increased year-over-year, reflecting continued demand across our markets and steady contributions from both newer and more established facilities. More importantly, we continue to improve patient acuity and drive a higher mix of observation and inpatient patients. On the care delivery side, we continue to strengthen coordination across clinical and care management teams. These actions are improving patient retention, supporting stronger clinical outcomes, and reinforcing the operating leverage built into our model. From a cost management perspective, operating expenses increased during the quarter, driven primarily by higher patient volumes, increasing acuity, and intentional staffing investments.

Labor cost increased to $41.4 million for the quarter, representing approximately 19.1% of net revenue. This reflects deliberate staffing decisions tied directly to demand, including expanded clinical coverage and support resources required to manage higher acuity observation and inpatient services. As in prior periods, our focus remains on aligning staffing models with real-time volume rather than fixed assumptions, supported by centralized analytics, scheduling discipline, and cross-training. Medical supply costs increased modestly to approximately $4 million or 5% during the quarter, reflecting higher utilization rather than pricing pressure. Over the past year, we have continued to benefit from vendor standardization and group purchasing initiatives, which have created a more stable and controlled supply cost foundation. As facilities continue to develop and utilization patterns normalize, we expect these efforts to continue supporting operating leverage and margin stability.

In parallel, we remain focused on targeted technology investments that enhance operational efficiency and scalability. These include tools designed to improve patient access, documentation efficiency, coding accuracy, and workforce productivity. What does this all mean for the patient? During the quarter, we received over 2,400 patient reviews, delivering an average Google rating of 4.8 out of five. This feedback underscores the distinct experience we deliver. One defined by minimal to no emergency room wait times, high touch service, and personalized care. These patient-centric principles remain core to our mission and a key differentiator for Nutex's. In summary, the first quarter reflects continued progress in executing on our operating strategy and reinforcing the scalability of the micro-hospital model. We remain focused on reliability, standardization, and consistent execution, ensuring that every Nutex's facility delivers high quality, patient-centered care that supports long-term value creation. Thank you for your time.

Back to you, Jen.

Thank you, Wes and team, for those updates. I will now turn it over to our operator, who will begin the Q&A portion of the call.

Thank you, we will now conduct the question and answer session, if you would like to ask a question please press star one on your telephone keypad, a confirmation tone indicate your line in the question que. You may press star, two if you would like to remove your question from the que. For participative-equipments it may be necessary to take the headset before pressing the stay keys. One moment please as we poll for questions. Thank you.

Our first question comes from the line of Bill Sutherland with The Benchmark Company. Please proceed with your question.

Thank you. Hey, good morning, everybody. Exciting news, Tom, about taking on the hospital development internally. When will that probably initiate? How should we think about the balance sheet impact as you get into that?

Hi, Bill. Thanks for asking, and great to have you on the call. Yes, the process has already started with the three new projects in Florida. Typically, these project takes roughly 18-24 months to develop and open. In other words, even if we start today, we may not open these for another two years. Once the facility opens, at that time, we will then flip it to a REIT.

Mm-hmm

Like I mentioned, or some kind of a long-term real estate vehicle. As far as the balance sheet, change, Jon Bates could probably chime in, but each of these project costs roughly $20 million-$30 million to build. Our thought is to have Nutex's invest the down payments, get a financing vehicle of some type, and then once we flip it, get all that reimbursement back. Jon Bates, any further thoughts on the balance sheet question?

Yeah, I mean, It's a great question, Bill. I mean, obviously, when you have the asset on the books, at the point you have it on the books, you're gonna have the land and the building, and you'll have a mortgage of some kind or whatever it costs to potentially finance it. Outside of that.

Mm-hmm

Then we'll decide and move on to the REIT concept, and there'll be some, you know, slight changes there. But the main point at the start is gonna be your asset and, of course, the mortgage.

Tom, thanks to that. The current state of development, obviously, they're financed externally. The ones for planned for 27, would that include Florida? No. That would be too soon, right?

Yes. For the ones that are opening this year in 2026, those all have been financed externally. You're correct. In 2027, we have roughly four to five new projects, and I would say half of those were financed externally, and we're still working on one or two that will be financed by Nutex's.

Okay.

Some of the 2027 projects have been in development for roughly six to 12 months now.

Mm-hmm

Getting to a point of starting construction. The project in 2027 is essentially starting construction now. We have a peer-up window so that Nutex's could start investing in those.

Got it. The court cases, et cetera, I'm not sure what the status is of the Murphy bill is, but it seems like insurance, the, you know, the payer side is not getting any wins, basically. I'm just curious if there's a change in, you know, as you guys approach the negotiating process prior to arbitration, or even just discussions outside of that, any change in you feel like how they wanna approach this whole process and maybe even being more realistic about what in-network should look like for you?

Yeah. The answer is that we are constantly and always looking at new contracts that are submitted by payers. We are always trying to get in-network if possible. You are correct that recently we've had three very positive court cases that are pro providers in California, Florida, and Pennsylvania. Those are all fantastic news for us. However, it is a long war, so to speak. We just won a few battles, but this will be a continuing process as insurance company are always trying to fight back. This is consistent with our experience with insurance company for the past 15 years. That's always been the case. That will not change anytime soon.

Having said that, however, the good news is that, we are seeing more.

I would say better offer from the insurance company, and we are looking at all of them.

Okay. One housekeeping question, if I might, on the stock-based comp. Yeah, just trying to understand You know, what's in that number, right? You probably discussed it in the queue, I just haven't gotten there yet.

Yes. Bill, your question is how is the makeup of that number for the quarter?

Yeah. It's, you know, it's a negative number, and 4Q was as well.

Yeah. Yeah.

Anyway, if you-

If you recall. Yeah, the detail is in the queue. More than happy to talk more about it. Effectively, what we do is, remember, we do the math on, along the way, what the earnings in the last 12 months is of each of those facilities that are in an earn-out.

Mm-hmm.

Then there's a multiplier on that based on the share price at the time and the value of their business.

Yeah.

It can go up or down based on where their EBITDA is and/or, you know, the price at the time.

Yeah.

That we accrue that along the way. Like in this case, in March, we actually had one that finalized. It actually then gets resolved to exactly what the number is. Whatever that change is, could be up or down, runs through the stock-based comp and ultimately through equity.

Mm-hmm.

That's what that is. Just so happens it just went down slightly cumulatively based on those factors and pushed through in the current period.

Yeah.

Does that answer your question?

Yeah, yeah, it does. Thank you. How should we think about the effective tax rate for the rest of the year on that front?

Yeah, actually, it's a great question. I think as you look at the first quarter, to me, it's probably more in line with what I would expect. There's some, you know, ups and downs in that. Generally, I think this first quarter is probably more representative of what we would see. Somewhere in that high teens to 20% from an effective rate.

Mm-hmm.

Then we'll watch it as we go. Some of the variables that sort of swung it from previous years' higher numbers, there were some permanent differences from, not to get into too much detail, but the way it works in taxing. Permanent differences that were making that a little bit higher, and now those have resolved themselves a lot. A big piece of that was actually impacting the stock comp expense, kind of now finalizing and becoming much less of an impact as we move forward. I think where we're at is not a bad way to start, somewhere in that high teens to 20%.

Thank you, Bill.

Our next question comes from the line of Thomas McGovern with Maxim. Please proceed with your question.

Hey, guys. Thanks for taking the time to answer my questions here. First on the arbitration cost rate increase to 35%. You know, historically, it's been that mid 20% range. Jon, you know, you indicated that you expected to return to that, you know, 24%-26% range. Just curious, you know, what gives you confidence in that, in it returning back down to the lower levels? You know, do you have an internal timeline on when you expect these, you know, these figures to return back to stable levels? Also, if you could talk about what drove the increase in the quarter, that'd be appreciated.

Yeah, sure. No problem. I mean, it's just a one slice in time on that piece. As we talk about in my earlier discussions, and we talked about before, revenues on accrual base based on collection basis, our costs because of the way we're laid out are we record 100%. Technically, when that calculation comes out at being slightly higher in our financials, when the realization happens, cash ultimately goes out. It will only be going out at the point at which there's a win. Right now, we're anticipating 100% of every single win on the cost side, but only whatever our average collection rate is on the revenue side. That inherently brings that percentage up.

I think if you look back over the last four or five quarters, it actually, it's averaging in that mid to high 20%, which is where I think it will ultimately land when the dust settles on realization. That's kind of the technical the answer. I do think over the second, third, and fourth quarter, you'll see, you know, it'll start probably working its way back into that area we were talking about. I think just for this 1 period, just with the math on where the costs are, just getting everything kind of in line and recorded in the quarter relative to revenue is slightly higher. That's not. I don't anticipate that being the case as we move forward.

Another quarter or two, and we'll look at it over the last, you know, three, four quarters, I think you're gonna see that it's gonna resolve itself back into that lower number. Great question, Thomas.

Understood. Appreciate that. Yeah, then also wanna take a look at revenue per visit. Declined again this quarter, you know, slightly, but just still notable. You know, is that just a function of the IDR award dynamics, or are we seeing something with payer mix, patient acuity? Just, you know, if we look forward at 2026, how do you expect this metric to trend over time? You know, I know you guys had some initiatives to, you know, hopefully drive this, but just kind of curious if we can get an update on that front. You know, will the new service offerings play a role, or are you mostly just looking to increase the inpatient visit rate? Thanks.

Yeah, no, good question as well, D. We talked about this before. Remember, 2025 had more of, you know, an aggregation of the beginning of the IDR process. End of 2024 was kind of the first piece. As you know, collection percentages increased throughout each period, which is what we're using to accrue revenue in 2025. It's gotten to a pretty solid rate now.

There was a lot more, if you look at just pure revenue per visit in 2025, which makes that, you know, that piece look a little bit higher when probably some of that, if you look back and say, okay, if you would had the higher percentage collection rate at the end of 2024, which ultimately resolved itself, then we would've had more revenue back then, which would've shifted some of the kinda net revenue per visit in those periods and evened this out a little bit more. I think we talked about at year-end, that if you looked at the rate per visit from when we really started the arbitration process back in July of 2024, it was averaging right around in that, you know, between the $4,000-$4,200 range.

That's I think that's where the normalization really is on a steady state. I know we're working in a lot of areas on acuity and improving in those areas. I know Wes mentioned earlier about the observation and inpatient piece. That's happening. I think the rate that we're seeing, even look back, you know, the six quarters prior to December of 2025, and then add this one in, another seventh quarter, I think you're looking at kinda where we're at on the steady state, assuming the same types of visits walk in the door yesterday that they do tomorrow.

I think the rate's probably in a pretty good spot there, and we're gonna continue to work in the efforts that were mentioned earlier on, you know, finding ways to get some higher acuity and improving also on the realization side as we work hard with the payers, whether it's through the IDR process or just in normal negotiations. Making sure we're getting paid fairly, which I think things are improving in that area, as we move through this year, I do think some positive things will happen and, you know, reimbursement should continue to stay pretty strong.

Got it. Appreciate that response. Final question from me. It's gonna be on the selective self-development of some of these de novo facilities. Just curious, you know, do you guys have an internal target for the mix of how many of these facilities will be invested in by Nutex's versus, you know, having the real estate partner? Does this impact how you guys look at long-term expansion strategies? Does this open the door for more rapid expansion, more selective expansion in particular markets or anything on that front?

Yeah, Thomas, great question. By the way, thank you for joining the call. The answer is that, yes, we are looking at each location selectively on a one-by-one case-by-case basis. We're gonna essentially develop based on what we think will bring the most value to our shareholders. Having said that, there will be an option for other developers to come in and invest with us, and so all that is still open at this point. The whole reason we're doing this, once again, is to, number 1, ensure a steady pipeline, as well as decrease costs and ensure that the pipeline remains robust, so that we consistently could still do 3 to 5 per year.

Great. I appreciate you guys answering all my questions so thoroughly. I'll hop out of here.

Thank you, Thomas.

Our next question comes from the line of Gene Mannheimer with Freedom Capital Markets. Please proceed with your question.

Thank you. Good morning. Congrats on a good start to the quarter and year. I wanted to ask a little bit about patient volumes. The 3% growth year-on-year seems a little modest to me, you know, considering that you opened three hospitals last year. I'm just wondering, you know, was it that the openings were skewed toward year-end, which is why we didn't see more throughput there on the volume side?

Yeah. Hi, Gene. Thanks for joining us. The answer is multifold, but yes, you're correct in the sense that the three openings were earlier this year, and in fact, two of them opened, I would say, in late December of 2025, and the last one opened in January. They are still developing. They are growing. They are, in that sense, growing as projected, but they are fairly new. I think that was one of the reason why volume has been a little bit flattish. The second reason is last year we had a very robust and I would say, very heavy flu season compared to this year.

The flu season just didn't hit as hard as we thought it would be, and so hence are leading to a slightly flatter volume. Having said that, it's still growing. We're still developing internal processes so that we could accommodate more patients. It's a never-ending job to increase volume and increase acuity.

Yep. No, that makes a lot of sense, Tom. Thank you. I wanted to ask, I guess, the prior question a different way on the IDR process. Do you or can you still quantify the revenue from IDR in the quarter? How about that pivot toward higher acuity, is that manifesting in the numbers today?

Jon, you wanna take that?

Yeah, yeah. I can talk to some of that. I mean, we talk about we're submitting 50%-60% of our claims going through there. I think that's a pretty good idea of the piece of it. I mean, we look at this as part of our overall business now, we don't break it out as much as we used to because of the day-to-day. To your point of, yeah, it's certainly in the acuity is certainly in our numbers when it comes to the revenue side of it. As you can see in the reimbursement rate, it's stayed relatively consistent with kinda where we looked at from almost inception of July of 2024 all the way through even December of 2025, kinda reimbursement rate.

Pretty close to what it is now when you go into the first quarter of this year. I think that will continue, and I think there's opportunity for that to improve based on some of the initiatives that we have.

Great. Thank you, Jon. I have one last one, if I could. I don't wanna exclude Warren from the discussion. Growth in the population health segment, I mean, Q1 was strong at 14% year-on-year, but revenues have been very lumpy there. It seems like that you're most profit around it. I'm just wondering, how do we think about this population segment longer term in terms of growth and, you know, of both lives and contracted physicians? Thank you.

Hi, Gene. Thanks for that question. Actually, in 2025, each of our IPAs, in Southern California, in Houston, and in Southern Florida, they generated cash on a standalone basis. Just want to start with that. You know, our goal, again, is to build these networks of physicians around our facilities, and it's not just to, you know, bring IPA volume, but once these doctors join our IPAs, they're aware of our facilities, our services. Some of them become owners in the IPA medical entities. You know, they, you know, we have seen anecdotally that they send their non-IPA, you know, PPO/commercial patients to our ER. You know, the goal is not to build the largest IPA.

It's to just, you know, build these networks, build awareness, and take really good care of our patients, bring volume, both IPA, non-IPA volume to our facilities. Really, you know, that's the goal.

Got it. Okay. Thanks very much.

Yeah. Bill, I wanna add that the L.A. IPA is our most mature and our most established, that's one reason why they're more profitable than the others. Houston and Phoenix are coming along nicely. Like Warren said, they are profitable. We do have hospitals around both of those. The Miami location is also slightly profitable. We do have a hospital opening in the Hallandale area in 2027 that would complement that nicely, as well as West Palm Beach, a hospital that will also complement the South Miami. We're also expanding to both Dallas and San Antonio, where we have planned hospitals opening. The strategy is to surround the hospital with a network of primary care and specialist physicians.

Perfect. Thank you, and congrats again.

Thank you, Gene.

Thank you. We have reached the end of the question and answer session. Ms. Rodriguez, I'd like to turn the floor back over to you for closing comments.

Thank you all for those valuable questions and answers. For all those joining us today, if you have more questions, please email us at [email protected], and we'll get back to you promptly. On behalf of the Nutex Health management team, thank you all for joining us for our first quarter 2026 earnings call. We've covered a lot, growth, strategy, challenges, and our vision, and we appreciate your time and interest. A recording of this call will be available on our website for a limited time, so feel free to revisit it there. Take care, everyone, and we look forward to keeping you updated on our journey.

Ladies and gentlemen, this does conclude today's teleconference. You may disconnect your lines at this time. Thank you for your participation, and have a wonderful day.