コンセントラ（CON）2026年第3四半期決算説明会：EBITDAが17.9%増でガイダンス引き上げ

要点

• コンセントラ・グループ・ホールディングス・ペアレント（Concentra Group Holdings Parent, Inc.、NYSE: CON）が発表した2026年第3四半期決算は、来院患者数および来院1回当たり売上高の増加により、売上高が前年同期比8.6%増の6億2,210万ドルとなった。
• 調整後EBITDAは17.9%増の1億4,020万ドルに達した。患者数の増加、価格改定、人員配置の効率化、およびコスト管理の徹底に支えられ、調整後EBITDAマージンは170ベーシスポイント改善して22.5%に拡大した。
• 労働衛生センター（Occupational Health Center）の来院数は4.9%増となり、1日当たり5万8,000件を超えた。労災補償（Workers’ Compensation）関連の来院数は4.2%増加し、雇用主向けサービス（Employer Services）の来院数は5.8%増加した。
• 経営陣は2026年通期の売上高ガイダンスを23億6,000万〜23億8,000万ドルに、調整後EBITDAガイダンスを5億500万〜5億1,000万ドルにそれぞれ引き上げた。フリーキャッシュフローおよび設備投資額のガイダンスは据え置かれた。
• 同社は四半期末後、新たに2億5,000万ドルの自社株買いプログラムを承認した。第3四半期末時点の純レバレッジ比率は2.90倍となり、経営陣は長期目標である2.5倍を維持している。
• コンセントラは、完了した買収と新規開設により2026年に15拠点が追加されると見込んでおり、現時点では2027年に10拠点台前半の新規開設を予想している。

主要財務業績

サービス原価の売上高比率は、営業レバレッジおよび拠点での人員配置の効率化を反映し、前年同期の70.8%から68.6%に低下した。調整後一般管理費（G&A）は5,640万ドル、売上高比率は9.1%となり、2025年第3四半期の8.5%から上昇した。

事業および営業実績

労働衛生センターの売上高は8.3%増の5億6,970万ドルとなった。労災補償の売上高は7.9%増の3億7,050万ドル、雇用主向けサービスの売上高は10%増の1億9,050万ドルとなった。

来院1回当たり売上高は3.3%増加した。労災補償の来院1回当たり売上高は、主に診療報酬規定（fee schedule）の改定を反映して3.5%増加した。雇用主向けサービスの来院1回当たり売上高は、薬物スクリーニング検査に比べて高単価な健康診断の割合が増加したことなどが寄与し、4.0%増加した。

経営陣によると、全6地域および大半のエンドマーケットで広範な成長が見られた。薬物スクリーニング検査や健康診断などの採用関連サービスは、運輸・物流、製造、建設分野の顧客を中心に特に好調だった。顧客維持率は過去数年間の高水準を維持し、年初来の新規案件獲得の動きは2025年の水準を上回った。

オンサイト事業の売上高は10%増の3,840万ドルとなった。経営陣は、営業パイプライン、医療費抑制に対する雇用主の関心の高さ、およびPivotの統合効果が同事業の追い風になり続けていると述べた。遠隔医療や調剤業務を含むその他の事業は、18.4%増となる1,410万ドルの売上高を計上した。

コンセントラは第3四半期中にミネソタ州の医療センター4拠点を買収し、3拠点を新規開設した。四半期末後にも2拠点を追加開設しており、経営陣は年末までにさらに1拠点を開設する予定である。同社は、M&Aパイプラインは引き続き活発であるものの、未発表の案件は社内予想に含めていないと説明した。

業績ガイダンス

経営陣は、2027年の雇用主向けサービスの単価上昇率について、長期予想である約3%とおおむね一致した推移が続くと見込んでいる。労災補償の明確な価格見通しを示すには各州からの診療報酬規定の追加発表を待つ必要があるものの、現時点では全体の単価上昇率が長期予想と大きく乖離すると見込む理由はないとしている。

経営陣は現在のマージン水準は維持可能であるとしつつも、2027年の前年比マージン拡大幅は2026年と同等の規模にはならないと予想している。中長期的なマージン改善要因としては、拠点の効率化や、分社化費用の解消に伴う一般管理費（G&A）レバレッジの向上が挙げられる。

リスクと注視項目

• 2027年の州労災補償診療報酬規定の大半はまだ確定していない。経営陣は、電話会議から45〜60日以内に約20〜25の州が改定内容を発表すると見込んでいる。
• 雇用主向けサービスの来院数が5.8%増加したことは、将来的な労災補償の力強い推移を示唆している可能性があるものの、経営陣はこれが単一四半期のデータにすぎないとして慎重な見方を示した。
• 第3四半期の営業キャッシュフローが減少したのは、運転資本の計上時期のズレや、前年の特定税制優遇措置の終了に伴う現金納税額の増加が主因である。
• データセンター建設関連は拡大しているものの、事業全体に占める割合は依然として軽微である。また経営陣は、リショアリング（製造業の国内回帰）による恩恵の規模を判断するのは時期尚早であると述べた。
• ニューヨーク州で提案されている規制変更は施行日が確定していないものの、経営陣は2027年初頭に施行される可能性があると見込んでいる。

アナリスト質疑応答（Q&A）の要点

来院数の伸び：経営陣によると、第3四半期の患者数増加は、症例の複雑化や再診の増加だけでなく、主に労働災害の初診患者の堅調な推移が牽引した。また、平均を上回る成長の要因として、顧客維持、新規案件獲得、業務遂行力、市場シェアの拡大、および良好なブルーカラー雇用の動向が複合的に寄与したと説明した。

長期成長フレームワーク：コンセントラは、来院数の1桁台前半の伸び、約3%の単価上昇、コア事業における1桁台前半のセミオーガニック成長という枠組みを維持した。経営陣は、来院数の伸びが5〜6四半期にわたりこの枠組みを上回っていることを認めたものの、この力強いサイクルがいつまで続くかは予測できないとした。

マージンと一般管理費（G&A）：第3四半期には一時的とされる費用が複数含まれていたため、経営陣は正常化されたG&Aの年換算ランレートが第2四半期と第3四半期の間の水準になると予想している。また、人員配置の効率化や分社化費用の解消がマージンを下支えすると見込んでいる。

資本配分：買収や新規拠点の開設を含む成長投資が、引き続き資本使途の最優先事項である。債務削減と自社株買いは追加の優先事項として同等の位置付けとなっており、経営陣は今後12カ月間でレバレッジ比率2.5倍を達成することを目標としている。

新規開設拠点の採算性：コンセントラは拠点開設に先立ち、市場の出店密度、診療報酬規定、および不動産を評価している。新設拠点は市場環境に応じて1日当たり約25〜50件の来院数からスタート可能であり、経営陣は設備投資を含めて2〜3年の投資回収期間を引き続き目標としている。

決算説明会トランスクリプト全文

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決算説明会の完全なトランスクリプト

経営陣による説明

Operator

Good morning, and thank you for joining us today for the Concentra Group Holdings Parent, Inc. earnings conference call to discuss the third quarter 2026 results. Speaking today are the company's Executive Chairman, Keith Newton; the company's President and Chief Executive Officer, Matt DiCanio; and the company's Executive Vice President and Chief Financial Officer, Tanner Newton. Management will give you an overview and then open the call for questions.

Before we get started, we would like to remind you that this conference call may contain forward-looking statements regarding future events or the future financial performance of the company, including, without limitation, statements regarding operating results, growth opportunities and other statements that refer to Concentra's current plans, expectations, strategies, intentions and beliefs. You are hereby cautioned that these forward-looking statements may be affected by the important factors, among others, set forth in Concentra's earnings release and the reports that are filed or furnished to the SEC. Consequently, actual operations and results may differ materially from those discussed in the forward-looking statements. These forward-looking statements are based on the information available to management of Concentra today, and the company assumes no obligation to update these statements as circumstances change. Additionally, during today's call, we may reference measures such as adjusted EBITDA, adjusted EBITDA margin and free cash flow, which are non-GAAP financial measures. The definitions of adjusted EBITDA, adjusted EBITDA margin and free cash flow and the tables reconciling those metrics to the corresponding GAAP measures are provided in the earnings release.

At this time, I'll turn the conference over to Mr. Keith Newton, Mr. Matt DiCanio, and Mr. Tanner Newton.

Keith Newton

Thank you, and good morning. This is our first earnings call following our leadership transition, and I'd like to begin by congratulating Matt on his assumption of the Chief Executive Officer role and Tanner on his assumption of the Chief Financial Officer role effective as of November 1. These appointments reflect a thoughtful succession process and the strength of the leadership team we have built over many years.

Concentra enters in this next chapter from a position of considerable strength. We have a differentiated market position, a proven strategy, strong operational execution and a talented, very experienced team serving our patients, employer customers and partners every day. I am confident that Matt, Tanner and the broader leadership team are exceptionally well-positioned to build on the momentum we've established and continue to create long term value for our stakeholders.

While my role has changed, my commitment to Concentra remains the same. As Executive Chairman, I'll continue to partner very closely with Matt, the Board, and the leadership team to support our strategic priorities and ensure a seamless and successful transition. I'm very excited about the opportunities ahead and the future of the company.

With that, I'll turn the call over to Matt.

Matthew DiCanio

Thank you, Keith, and good morning. I appreciate your leadership and look forward to continuing our partnership in your role as Executive Chairman. I also want to welcome Tanner to his first earnings call as Chief Financial Officer. We had a great third quarter with strong visit volume, higher revenue per visit and disciplined cost management driving significant earnings growth.

Let's jump into some of the highlights. Total revenue increased 8.6% year-over-year to $622.1 million. Net income was $67.8 million, up 36% from a year ago, and adjusted EBITDA was $140.2 million, up 17.9% from a year ago. Tanner will walk through the financial details, but I want to spend a few minutes on what we saw across the business and where we are focused.

Total Occupational Health Center patient visits increased 4.9% to an average of more than 58,000 visits per day in the third quarter. Our Workers' Compensation visits per day increased 4.2% and Employer Services visits per day increased 5.8% relative to prior year. We believe this performance reflects a combination of favorable labor market conditions in many of the blue-collar sectors we serve and continued market share gains.

Growth was broad-based across all 6 of our regions and most end markets. Recent activity in our Employer Services business remains particularly encouraging with strong increases in hiring-related services such as drug screens and physicals across transportation and logistics, manufacturing, construction-oriented customers and other industries as well. The activity we are seeing among customers in these sectors continues to indicate healthy workforce demand.

We believe our ongoing investments in sales execution, account management and technology continue to strengthen our competitive position and support market share gains. Customer retention remains at multiyear highs. while year-to-date new business activity is tracking ahead of 2025 levels.

Turning to our Occupational Health Center rate. Revenue per visit increased 3.3% year-over-year in the third quarter. This growth was driven by a 3.5% increase in Workers' Compensation and a 4.0% increase in Employer Services revenue per visit. Employer Services revenue per visit was slightly elevated this quarter, in part due to a shift in the mix with services comprising a larger percentage of higher revenue per visit physicals relative to drug screens.

During the third quarter, we acquired 4 medical centers in Minnesota. We also opened 3 de novo centers in Kansas City, Missouri, Boise, Idaho, and Daytona Beach, Florida, with the latter 2 representing new markets for Concentra. Following quarter-end, we opened 2 additional centers near Pensacola, Florida, and Washington, D.C. We expect to open one more center before the end of this year. In total, completed acquisitions and de novo development are expected to add 15 new centers during 2026. We are currently anticipating low double-digit de novo openings in 2027.

Our M&A pipeline remains strong with multiple bolt-on transactions progressing well. We see attractive opportunities to continue expanding the business through both acquisitions and de novo development, and we will remain disciplined in evaluating returns and executing on those opportunities.

Within the onsite business, fundamentals remain strong, supported by employers' continued focus on managing their rising health care costs, a growing sales pipeline, and strong operational execution as we capture the benefits of the Pivot integration.

I'll now turn the call over to Tanner, to review our financial results in more detail.

Tanner Newton

Thank you, Matt, and good morning. I'm pleased to join you in my new role and look forward to continuing to work with our leadership team and the investment community. I'll begin with our consolidated results, then review operating segment performance, expenses, cash flow, and the balance sheet.

Total company revenue was $622.1 million in Q3 2026, compared to $572.8 million in Q3 of the prior year, representing 8.6% growth year-over-year. We saw a slight acceleration in year-over-year organic revenue growth compared to Q2, which grew at 8%. Net income attributable to the company in Q3 2026, was $65.9 million or $0.52 per share compared to $48.3 million and $0.38 per share, respectively, in Q3 2025.

Adjusted net income attributable to the company in Q3 2026, was $66.1 million and adjusted earnings per share was $0.52 compared with $49.9 million and $0.39 per share, respectively, in Q3 2025, reflecting growth of 33.3% in adjusted earnings per share year-over-year. Adjusted EBITDA increased 17.9% to $140.2 million and adjusted EBITDA margin expanded 170 basis points to 22.5%.

Sequentially, relative to Q2, margin was affected by 1 additional expense day in Q3 compared with the second quarter. More broadly, the year-over-year improvement reflects strong volume and rate growth, disciplined execution and operating efficiencies across the business.

Next, breaking down revenue by segment. Total Occupational Health Center revenue increased 8.3% year-over-year to $569.7 million. Workers' Compensation revenue increased 7.9% to $370.5 million, while Employer Services revenue increased 10% to $190.5 million. Onsite revenue increased 10% year-over-year to $38.4 million. Organic growth moderated versus Q2 as Pivot entered the organic calculation following the acquisition anniversary with Pivot's relatively modest year-over-year growth diluting stronger growth in the core business.

Finally, other businesses, which include telemedicine, pharmacy operations, and other occupational health-related services generated revenue of $14.1 million, an increase of 18.4% year-over-year.

Moving on to expenses. Cost of services was $426.7 million or 68.6% of revenue in Q3 2026, an improvement from 70.8% of revenue for the same quarter of the prior year. The drivers were consistent with the first half of the year with strong flow-through from visit and rate growth, together with favorable staffing efficiencies across our centers.

Our total general and administrative expenses were $60.9 million or 9.8% of revenue in Q3 2026, compared to 9.2% of revenue in the same quarter of the prior year. Excluding items that are added back for the purposes of calculating adjusted EBITDA, including equity compensation expense, onetime select separation costs and M&A transaction costs, G&A expense was $56.4 million for the quarter or 9.1% of revenue compared to 8.5% of revenue in the same quarter of the prior year.

Turning to cash flow. In Q3, we generated $51.9 million of operating cash flow compared to $60.6 million in the third quarter of 2025. The year-over-year decrease was driven primarily by working capital timing and higher cash tax payments following the roll-off of certain tax benefits associated with the OBBBA that we received in the prior year period. Excluding these factors, the underlying cash-generating capacity of the business remains strong and consistent with our expectations.

Investing activities used a net $25.9 million of cash in the third quarter, which includes both acquisition capital related to our Minnesota deal that closed in the quarter and net inflows from the sale of a previously owned building.

Free cash flow or cash flow from operations less cash flow used in investing activity, excluding business combinations, totaled $32.2 million, a decrease from prior year third quarter free cash flow of $40.2 million. The year-over-year decrease was primarily due to the aforementioned lower cash flow from operations in Q3 2026.

Finally, financing activities used $98.2 million of cash during the quarter. We repurchased 1 million shares for $34.65 million and returned an additional $8 million to shareholders through dividends. At September 30, 2026, approximately $19 million remained under the Board's original $100 million repurchase authorization.

Subsequent to quarter-end, the Board authorized a new $250 million share repurchase program with no expiration date. The authorization provides additional flexibility to return capital while continuing to invest in organic growth, acquisitions and de novos and debt reduction. The Board also declared a quarterly cash dividend of $0.0625 per share payable on or about December 4, 2026, to shareholders of record as of November 19, 2026.

During the quarter, we repaid $52.4 million on our Term Loan B, comprised of both mandatory amortization and a $50 million discretionary prepayment. We ended the quarter with a total debt balance of $1.52 billion and a cash balance of $85.8 million. Our net leverage ratio per our credit agreement at the end of September was 2.90x.

We were also pleased to receive a ratings upgrade from S&P Global in August with our corporate rating improving from BB minus to BB. In mid-October, Moody's also revised its outlook from stable to positive.

Now I'll turn it back over to Matt, to close this out with some comments on separation activity as well as our updated guidance.

Matthew DiCanio

Thanks, Tanner. As discussed last quarter, separation activities are substantially complete and will conclude with the expiration of the TSA with Select Medical at the end of this month. This marks the successful completion of a multiyear separation process. I'd like to recognize and thank both our Concentra team and the Select Medical team for their tremendous efforts and partnership throughout this entire process. Their work has been instrumental in achieving a smooth and successful transition, and we are pleased to have this milestone behind us.

Now with respect to our updated guidance, we are raising our 2026 outlook as follows. We are increasing the low end of our revenue range by $35 million and the high end of our revenue range by $5 million, resulting in a revised range of $2.36 billion to $2.38 billion. We are increasing the low end of our adjusted EBITDA range by $20 million and the high end of our adjusted EBITDA range by $15 million, resulting in a revised range of $505 million to $510 million. Our free cash flow range of $220 million to $240 million and our capital expenditure range of $70 million to $80 million remains unchanged.

The business continues to perform well, and we expect to close out the year on strong footing. As in prior years, we expect to provide formal 2027 guidance early next year when we have greater visibility into the economic and reimbursement environment. At this stage, we expect Employer Services rate growth to remain generally consistent with our long-term expectation of approximately 3%.

It is too early to provide a definitive outlook for Workers' Compensation rates because most states have not yet announced changes to their fee schedules. Based on the information currently available, however, we have no reason to expect aggregate Workers' Compensation rate growth to differ materially from our long-term expectations.

That concludes our prepared remarks. We thank everyone for the time today. We'll turn it back to the operator to open the call for questions.

Operator

[Operator Instructions] Your first question is coming from Ann Hynes from Mizuho.

質疑応答

Ann Hynes

So I just want to break down the strength just in the visits. So I know you give visits per day. What is the trend with visits per patient? What does that typically average? And is that growing per patient? Or are you seeing absolutely new patients?

Matthew DiCanio

Ann, it's Matt DiCanio. Thanks for the question. So we don't really break down our visits beyond what we disclosed publicly, but I'll add some comments on your question. We've talked about complexity of cases, severity, things like that, that have been trending higher over recent years. We saw a little bit of that in Q3, but Q3 visits were really driven primarily by stronger initial injury visit volumes, which is the start of the patient cycle within Concentra.

Ann Hynes

Okay. Great. I want to say congratulations to everyone before my questions on your new positions. And then when I head into 2027, can you remind us how much MA EBITDA contribution that was in 2026? And when we do our models, should we put kind of some unannounced M&A in our models? Or would you prefer just like organic models?

Tanner Newton

Yes. Ann, this is Tanner. I'd say the way we think about it is until we've got deals definitively done, we don't bake that into our internal projections. So I would expect our analyst community to follow along or follow in suit from that standpoint.

Operator

Your next question is coming from Justin Bowers from Deutsche Bank.

Justin Bowers

Matt, we've continued to get constructive feedback from your customers, and you talked about new business development trending very well this year as well. So longer term, how should we think about market share gains relative to the historical algo of volume plus price? And then part 2 would be, again, for Matt and/or Tanner. Any updates on New York and some of the developments there?

Matthew DiCanio

Yes, sure. I'll take the first one. Tanner, you can hit the second one on New York. As far as market share gains, similar to what we've said in prior quarters, our teams out there managing the centers and the visit volumes are doing a tremendous job. Retention is up across the board. Our KPIs are at or near all-time highs and anything we measure, whether it's turnaround times, patient satisfaction scores, things like that.

So our job on a go-forward basis will be to continue that. And we've got some technology enhancements that we'll look to continue to roll out to help support the center colleagues so we can continue to drive that great experience. And as we continue to add dots on the map and do what we're doing at our existing centers, that is our goal to continue our market share gains across the board.

Tanner Newton

Yes. Justin, with respect to New York, there's not a substantive update at this time. We got through the public comment period. The regulator basically said, hey, take your comments, understand them, but we're going to stick with our existing proposal for now. We're not exactly sure when that's going to go into effect. They haven't provided guidance around that. We're still thinking sometime early 2027, hopefully.

That being said, we do think that the level that they have increased the E&M codes within the state, have made it attractive enough for us to at least explore entry either via de novo or small bolt-on acquisitions. So we're going to be looking at that in pretty heavy detail.

Operator

Your next question is coming from Ben Rossi from JPMorgan.

Benjamin Rossi

I guess across segments, rates held up pretty steadily from 2Q despite the sequential step-up in volume growth. To what extent did rates reflect this underlying fee schedule and contract pricing versus some of the service line mix and market share gains? And then looking ahead to 2027, you mentioned consistency with rate trends in your 3% long-term guide. Are there any specific states to call out regarding fee schedule refreshes for next year?

Matthew DiCanio

Ben, thanks for the question. So from a rate standpoint, 3.5% Work Comp rate year-over-year in the quarter, 4% from Employer Services. We did call out there was some visit mix that drove the Employer Services rate slightly higher than our long-term average of 3%. So a little bit of visit mix. But from a Work Comp standpoint, most of that is just straight fee schedule gains year-over-year.

As far as '27 rates, I think that was the second half of your question. We have -- we are about to find out a number of states. I think in the next 45 to 60 days, there's about 20 to 25 states that release their fee schedules for next year. So we'll have a lot more information. Most of those states release in December. Most are effective January 1. We have some pretty good insight, but obviously, would like to wait the next 30, 45 days and get the full data set.

Keith Newton

This is Keith. I'd say the only thing to add to what Matt just said, specific more to Employer Services, the Work Comp is that pretty much in the finalization stages of sticking a stake in the ground on that, communicating it to the employers relative to our Jan 1 price increases that we typically do every year. As we've talked to you guys in the past, we will evaluate that typically October, November time frame, communicate to the employers what we're doing in a generic letter and put that into play on January 1 for everybody, and that has historically gone very well for us, and we anticipate that to do the same and be basically in line with what we've been seeing.

Benjamin Rossi

Great. I appreciate the added details there. Just as a follow-up, some of the initial contributions you described from things like onshoring and the data center build-out, you just refresh us on how these trends have shown across your footprint and maybe some of the specific indicators from either your customers or screening data that can help us get a feel for whether this is a sustained demand driver?

Tanner Newton

Yes. Ben, Tanner here. Yes, it's a great question. It's something that we're spending a lot of time trying to dive into our internal data on and parse out some -- derive some responses from. So what I would say there is with respect to data centers, it's a really small -- it's growing part of our business, but still a relatively small and immaterial part of the overall book of business. We're tracking all 300-plus projects across our sales team, both onsite and our core brick-and-mortar sales teams.

I think there is going to be more opportunity going forward on the onsite, just given the nature of the construction projects there that are -- and the size of those construction projects that we're going to be tracking. But I wouldn't say that it's a huge contributor right now.

On the overall reshoring trend, just given the data that we're seeing with respect to things like manufacturing and construction growth and particularly within the Employer Services book of business, which as we always talk about as kind of a leading indicator, we are optimistic and hopeful that, that is a sign of a growing reshoring trend. But again, I think we've talked about this in the past. It's still a little bit too early to definitively say that one way or the other.

Benjamin Rossi

Congrats again on the new roles to Matt & Tanner.

Operator

Your next question is coming from Ben Hendrix from RBC.

Michael Murray

This is Michael Murray on for Ben. Just kind of building on the last question. Just wanted to hear your initial results on the election results or your initial thoughts on the election results and if that has changed your long-term perspective on the tailwinds from the data center build-outs and the manufacturing reshoring.

Matthew DiCanio

Yes. It's Matt. Michael, thanks for the question. Here's what I'd say, just to add on to Tanner's comments too about reshoring and the data center build-out. If you look at our results and what's driving the visit volumes, it is very broad-based. And we are very diversified across the country, across industries, across geographies, across employer sizes. And what we have been seeing is strength across pretty much every industry and every geography.

So we don't really have a view on the election results and the potential impact on our business. We're continuing to monitor the day-to-day visit volumes. And it's not one industry that's driving what we're seeing right now. That's really my main point.

Michael Murray

Okay. That's helpful. And then just a quick follow-up. It looks like adjusted G&A ratio was up a bit year-over-year even with the strong revenue growth. So is this the right run rate moving forward?

Tanner Newton

Yes. I would say in Q3, we had a few additional expenses that I would characterize as more onetime in nature. And so we had a slight uptick relative to Q2 G&A. I think the run rate is probably somewhere in between Q2 and Q3 G&A is how I would look at it on a go-forward basis.

Operator

Your next question is coming from Jack Slevin from Jefferies.

Unknown Analyst

This is Brett on for Jack. Just wanted to touch on the margin progress you guys have made and kind of get a look into once you lap the separation costs moving forward into '27, how we should be thinking about the margin expansion and maybe the levers you can pull upon.

Tanner Newton

Yes. So we've had really strong margin expansion in 2026. I think that we feel pretty confident that we're going to be able to sustain that level of margin going forward. Staffing efficiencies in our centers have been great. We're getting -- starting to get more leverage off of our G&A as we start to run rate the separation costs.

So I think that over a long period of time or a medium period of time, there's still opportunity for margin expansion, particularly as we continue to invest in centers and efficiencies within the centers. But would I expect to see the same level of margin expansion year-over-year that we saw in 2026 relative to 2025? Probably not. But I do think that we can sustain the current level of margin going forward.

Matthew DiCanio

Yes. I would just add to that. It's really a combination of strong rate, strong visits. We've done a nice job with cost control, and we've obviously been very active from a growth standpoint. So that's our strategy. We're going to continue that into 2027. And what you're seeing now with -- from a margin expansion standpoint is very much in line with how we've talked about the business for the last 2, 3 years since the IPO. As soon as we get through the separation costs, digest some of the M&A, we expected margin expansion, and that's pretty much exactly what we're seeing right now.

Unknown Analyst

Great. That's super helpful. Maybe just for a quick follow-up on the capital allocation front. I know you have the new buyback authorization and obviously, with leverage coming down below 3x now. How should we be thinking about moving forward, capital allocation appetite for further M&A and de novo growth as well?

Tanner Newton

So the new authorization is really a product of the fact that we are almost through the original authorization that we got put in place in the latter part of 2025. So we size this appropriately relative to our market cap and really think that this provides a tremendous amount of flexibility as we go forward from an overall capital allocation standpoint, our first priority is always going to be good, accretive growth opportunities, both organic capital being spent and inorganic capital being spent. We think that's our highest returning use of capital.

Beyond that, we have a long-term debt target -- leverage target of 2.5x, which we think we're going to continue to work down towards over the course of the next 12 months. And that has historically been priority, call it, 1B. I think now that we are below 3x leverage and working down towards 2.5, we are able to elevate share repurchases into the category of 1B, 1C alongside debt paydown. So I think given the nature of our free cash flow and the strength of that, we're able to do all three of those things simultaneously.

Operator

Your next question is coming from Scott Fidel from Goldman Sachs.

Sarah Conrad

Sarah Conrad on for Scott. Keith, last quarter, you described Employer Services as a leading indicator that ultimately yields future Workers' Comp visits. With the acceleration in Employer Services visit growth in the third quarter, does that give you greater confidence into continued Workers' Comp strength into 2027? And can you also help us think about the typical lag between the strength in Employer Services and the Workers' Comp volumes?

Matthew DiCanio

Yes. Sarah, it's Matt. I can take that and Keith or Tanner jump in as well. Yes, we have historically seen when there is a pickup in Employer Services, there is a subsequent pickup in Work Comp. What I would say here is it's 1 quarter of data. We've got to continue to monitor Employer Services. We've been trending in the 1% to 2% growth rate range for Employer Services. Obviously, saw a nice pickup to 5.8% here. But when you look at our 40-, 45-year history of visit data, it is an early indicator of economic activity. But obviously, we need to see more than 1 quarter worth of that activity.

Keith Newton

Yes. I'd say it is definitely positive when we're seeing this. And again, as Matt said, it's early. But historically, that's what it tended to reflect is that Workers' Comp follows it. But -- so that's -- yes, that's really what I would add to it.

Sarah Conrad

Great. And then can you give us -- can you update us on wage inflation, turnover, and clinician availability? Just given all of the volume strength you've been seeing, how are you thinking about the incremental hiring needs and labor unit costs as you move into 2027?

Matthew DiCanio

Sure. Yes. What we're seeing right now is pretty consistent with what we've seen over a long period of time, right around 3% wage inflation. Turnover is stable and in certain areas is improving slightly. So obviously, the visit volumes are strong. Our efficiencies at the center level are improving, but we've been able to do a nice job from a recruiting standpoint and retention standpoint, but something we're focused on heavily, and we're reinvesting in our colleagues, and we'll continue to monitor that as we go forward.

Operator

Your next question is coming from Jared Haase from William Blair.

Jared Haase

You've had a little bit of favorability on mix supporting your revenue per visit, both in Workers' Comp and then this quarter in Employer Services, it sounds like. I'm wondering, is that something that you would say is becoming more in your control structurally such that mix could be a little bit of a rate tailwind on a more durable basis going forward above and beyond what you get from a fee schedule perspective? Or do you still feel like that's sort of more just the reality of what's going on in the market?

Matthew DiCanio

Jared, what I would say on that is the visit mix, that bounces around a decent bit. There's been no real consistent theme. So some quarters will have physical slightly higher than drug screens. Some quarters will be slightly the reverse of that. So there really has been no consistent theme in Employer Services or Work Comp.

Jared Haase

Okay. That's helpful. And then you mentioned a couple of the de novos that you opened up recently, a couple of them in new markets. Could you just kind of remind us what the motion looks like for opening a center in a new market or some of the start-up or ramp-up activities involved with that? And then really how do you go about building relationships in the community, building brand awareness for Concentra with employers and ultimately with employees?

Tanner Newton

Sure. Yes. So just as we think about opening and developing de novos in center, it starts with looking at entry density in any given market. It looks -- involves looking at the fee schedules in any given market, and it involves looking at real estate in any given market. You really need all three of those things, those factors playing together to have a successful de novo.

And when we go into a market, particularly a new market, we lead with our sales and marketing team months and months in advance. We're doing open houses. We're visiting different workplace sites. We're doing marketing blitzes in the community such that they're getting familiarity with Concentra. And so by the time the de novo actually opens, we're driving solid visits day 1.

So in some cases, that's -- it could be 25 visits a day in the first week. In some cases, that's upwards of 50 visits a day, just depending on the market. But in terms of the overall economics of a de novo, we still look at that and view the payback and the overall payback inclusive of capital spend in the 2- to 3-year range.

Keith Newton

Yes. I'm just going to add to that. We've got a large footprint now. We've gotten so much more sophisticated and better at these de novos. And our sales force is typically segregated for certain sized employers out there. So when we open up in Jacksonville, our first center, we've got a national sales force that is handling the UPSs and the Amazons and the large national employers that use us elsewhere.

So the first thing they're doing is communicating to their corporate contacts about this new center, and the local UPS or Amazon or FedEx terminals, wherever they may be, finding out who they're using and just making them aware that we're opening up. And pretty quickly, we've gotten really good at making those switches. So those anchor accounts pretty quickly go in there.

And then we've got the ground level folks that are knocking on the doors within a 5- to 10-minute drive time of those particular clinics and meeting with the local municipalities, which, again, those local municipalities, the cities, the schools and all that, that are in a short area time frame from those centers.

There's been a real need in a lot of these smaller municipalities that we've opened up and just communicating way ahead of time, doing, as Tanner mentioned, the open houses and inviting them in for tours. And it's really -- I think the recipe book has really progressed dramatically over the last few years. We're very successful at ramping them up very quickly.

Matthew DiCanio

Jared, the only thing just quickly that I would add to that, definitely sales and marketing, but just a shout out to our medical therapy and operations team that obviously, play a big role in those center openings as well. And it's truly a team effort that all those teams come together to help drive the success.

Operator

Your next question is coming from Stephen Baxter from Wells Fargo.

Stephen Baxter

I was curious if you have a perspective on what industry-level workers' comp volumes are doing. I'm trying to put your volume outperformance this year into that context. Maybe how much you think is driven by maybe the better industry overall, maybe has to do with your market selection or maybe it's better-than-expected share gains. I guess how are you thinking about that at this point based on what you know?

Matthew DiCanio

Thanks for the question, Steve. So we -- there is some publicly available data through the VLS on injuries, but it's typically almost a year in arrears. So we don't have that data yet. But we do monthly financial calls with all the regions. We know that our retention is higher than previous years. We've got a decent bit of anecdotes of us picking up market share. So it's hard to know exactly the split between market share gains and new customers and how that compares to the overall growth in the marketplace. But we definitely think there's macro trends that are helping, but everything I talked about earlier on the call is helping us drive market share gains as well.

Keith Newton

Yes. And total blue collar, which is a big driver of the injuries, employment has continued to increase.

Stephen Baxter

Got it. And then I think when we went back to some of the education process, I think historically, you guys have spoken about something like 60% of injuries in the workplace are dealt with in places like ER, urgent care, primary care and then more like 40% ultimately land in the Workers' Comp arena. I guess I'm curious if you think there's been any change to that? Or if you potentially look back to periods where you've seen some economic pressure, whether there tends to be maybe more migration out of settings where people are going to have exposure to cost sharing and things like that from their health benefits and into the Workers' Comp. Wondering if that's something you've seen in the past or something that you feel like you might be seeing now?

Matthew DiCanio

No, I don't think we're seeing any shifts there. Obviously, you have Concentra with our market share, you have hundreds of smaller occupational medicine practices that make up the number you talked about. And then you have a wide range of urgent cares, health systems, family medicine offices. So we have not seen a shift in where the occupational health visits are going. There's a lot of players that see occupational health across the entire country.

Operator

[Operator Instructions] Your next question is coming from Joanna Gajuk from Bank of America.

Joanna Gajuk

I don't know maybe I missed it, but did you talk about the acceleration in volumes in the context of variation by maybe geography or industry to industry? Or is this kind of broad-based?

Tanner Newton

Yes. Joanna, we did comment on that and basically said that the acceleration is pretty broad-based across all of our regions, across most of our industries. And so that's what gives us comfort that we're really seeing a solid -- we're on solid footing really across the country. And I think we can hopefully sustain that for a decent period of time.

Joanna Gajuk

I guess that was my actual question in terms of, yes, when I look at the volume growth numbers, Workers' Comp up 4% and Employee Services almost 6%. And historically, you kind of talk about the length -- the long-term framework more in the low single digits range. So does that kind of change how we should think about the growth going forward, especially you might not be prepared to talk about '27, but just as you exit this year, it sounds like you're having like a higher level of growth versus where you started the year.

Matthew DiCanio

Yes. I'll add some comments to that. We always point over a long period of time back to our long-term growth algorithm, which is low single-digit visit growth volumes, 3% rate, and then low single digits on core semi-organic growth rate. We've obviously had 5, 6 quarters here where our visits are above that long-term algorithm.

And looking back over 40, 45 years, there are periods of time where we'll see growth rates in excess of that long-term average. We're right in the middle of that right now. So we can't really predict how long the cycle will last, but it's a contribution or a combination of all the things we've talked about: our operating metrics, our retention stats, our sales technologies. We acquired a competitor. We've got a growing blue-collar labor force. We've got the reshoring trends we've talked about. So there's a combination of things that we believe are all adding up to these growth rates that are above long-term averages.

Joanna Gajuk

And if I may, on the outlook into next year in terms of pricing. So I think last quarter, you said you should do more about the fee schedules for '27. Anything to call out that you know right now and that we should think about when it comes to 2027 Workers' Comp pricing environment?

Matthew DiCanio

The only thing I'd add there, we'll give formal guidance in the first couple of months of next year. As I mentioned earlier, we're going to wait the next 30, 45 days and get the full data set on Work Comp fee schedules. As Keith mentioned, our Employer Services price increase will be in the same range as it's historically been. So more information to come, but no, we don't expect any material differences from our long-term algorithm.

Operator

Your next question is coming from Raj Kumar from Stephens.

Raj Kumar

Maybe just on the onsite clinic business. I know overall smaller portion of the business, but just kind of given the expansion there, I just want to know if you guys have been seeing any maybe incremental referrals to your Occupational Health Centers for some of the more higher severity cases from the onsite clinic business and whether there's a kind of meaningful opportunity on that front longer term?

Keith Newton

Yes. This is Keith. Historically, it all depends on where the onsite clinics are relative to the bricks-and-mortar clinic. And in many instances, they're not really convenient for that, a lot of our onsite clinics. But where they are, certainly, there is a collaboration between the two.

I wouldn't say we've seen more relative to what we've seen in the past when we do have the opportunity to do that. But I think as we continue to expand our footprint from -- across the United States with our onsite group and as we have more onsites that are closer in proximity to allow that, certainly, I think we will -- our bricks and mortar will benefit at some point in time. But at this point in time, no real fluctuation.

Operator

Thank you. That completes our Q&A session. Everyone, this concludes today's event. You may disconnect at this time and have a wonderful day. Thank you for your participation.