The Ledger

Nutex Health, which runs 28 hospitals in 12 states, reported third quarter revenue down 18.7% to $217.6 million even as hospital visits rose 18.1%. In its Form 8-K earnings release dated November 5, the company said net income attributable to Nutex fell to $40.2 million from $55.4 million, and adjusted EBITDA (earnings before interest, taxes, depreciation and amortization) fell to $63.9 million from $98.5 million. Same-hospital visits rose 12.4% while same-hospital revenue fell 20.1%, so by our arithmetic revenue per visit dropped sharply. Nutex attributes the decline to factors that boosted 2025 revenue: extra collection data that raised estimates for 2024 services, and a fourth quarter 2025 cleanup of ineligible charts. The release says roughly 50% to 60% of billable visits go through the federal independent dispute resolution (IDR) process under the No Surprises Act, that Nutex prevailed in over 80% of determinations in the last nine months, and that cost of arbitration fell to $27.8 million from $41.9 million. Nine-month net income of $152.9 million, up from $59.0 million, includes a $52.3 million non-cash cut to contract services expense after a June 30 amendment to its agreement with HaloMD, its arbitration vendor, and a lower CMS administrative fee. Cash was $249.9 million, and the release gives no numeric guidance. Who it hits: insurers paying out-of-network arbitration awards, and emergency-focused hospital operators whose revenue leans on those awards. So what: volume is growing, but revenue rests on estimates of what arbitration will collect, and those estimates just moved. The release lists lawsuits by health insurers against its third-party arbitration provider as a risk. Confidence: High on the figures, which come from the filing; Med on our reading of per-visit revenue.

UPDATE: Redeemer Health, the Pennsylvania hospital system that filed Chapter 11 on November 1, faces a sale deadline of about November 15, and its budget depends on freeing $17.2 million of board-designated funds. This updates our November 3 coverage. According to Bondoro’s summary of the case filings, dated November 5, the debtors must file a bid procedures motion acceptable to the bond trustee within 14 days of the petition date, and missing that milestone is a termination event on five business days’ notice. Four health systems have signed nondisclosure agreements and are in diligence, none confirmed publicly, and the trustee holds a right to credit bid. The 13-week budget projects about $14.1 million of ending cash in January only if the $17.2 million release is approved; without it, ending cash is about negative $3 million. Bondoro puts bondholder liens at about $77 million, a different measure from the $119 million of long-term debt we reported November 3, and says the trustee filed a limited objection on November 3 to the adequate protection offered for cash use. Who it hits: bondholders, the Abington hospital’s 239 licensed beds, and rival systems eyeing its patients. So what: the lenders control the clock, and a sale also needs Pennsylvania Department of Health notice and attorney general consent. Confidence: Med. We read a secondary summary, not the court docket.

A note on today’s scan: it is a weekend. We found no earnings, rating actions or transactions dated November 7 or 8, so this issue leads with Thursday’s filing we had not yet covered.

THE DEAL SHEET

No new transactions spotted in the last 24 hours. Previously reported pending deals, including the Option Care Health and Definitive Healthcare proposals, showed no new terms in our scan.