Envision Healthcare Holdings, Inc. (Envision or Company) (NYSE: EVHC) reports results from operations for the three months and nine months ended September 30, 2016. All comparisons included in this release are for the 2016 periods to the comparable 2015 periods, unless otherwise noted.

Highlights:

  • Net revenue of $1.64 billion, an increase of 19.8%;
  • Net income of $25.9 million, an increase of 50.2%;
  • Adjusted EBITDA of $180.7 million, an increase of 26.8%;
  • GAAP diluted earnings per share (EPS) was $0.13, an increase of 44.4%; and
  • Adjusted diluted EPS was $0.36, an increase of 20.0%.

“In spite of lower sector volume growth in the period, our third quarter reflects strong operating results at EmCare, including encouraging progress at Evolution Health, and performance improvement at AMR’s Rural Metro operations,” said William A. Sanger, chairman, president and chief executive officer of Envision. “Rural Metro’s margins improved, driven by continued integration into AMR’s operations and technology platforms. Our results at Evolution Health improved as we realized benefits from our participation in bundled payment models and medical cost savings from our contract with a Florida health plan.

“The strategic investments we have made at Envision to expand our scale and scope continue to provide unique opportunities for the company and our stakeholders. We believe these investments will be further enhanced by the merger between Envision and AMSURG Corp., which is expected to be completed this year.”

Results of Operations for the Third Quarter of 2016

Envision generated net revenue of $1.64 billion, an increase of 19.8%, driven by contributions from acquisitions of 16.1%, and organic growth of 3.7%. Net income was $25.9 million and Adjusted EBITDA was $180.7 million. Envision earned $0.13 per diluted share on a GAAP basis and Adjusted diluted EPS for the quarter was $0.36.

Segment Results for the Third Quarter of 2016

Envision operates two business segments: EmCare Holdings (EmCare), the Company’s facility-based and post-acute care physician-led services segment and American Medical Response (AMR), the Company’s medical transportation services segment.

EmCare

EmCare’s net revenue for the third quarter of 2016 was $1.06 billion, an increase of 13.0% from the prior-year period.

Revenue from acquisitions completed during the past 12 months contributed growth of 9.0%. Organic revenue growth of 4.0% consisted of same-store contributions of 5.1% while revenue from net new contracts declined by 1.1%. Revenue from net new contracts increased at Evolution Health and was offset by contract terminations, net of new contracts started at EmCare, during the last 12 months.

EmCare’s same-store revenue, when calculated from the comparable contract base for both periods, grew by 6.0% and included rate growth of 4.3%, driven by an increase in yield in all service lines, as well as same-contract growth at Evolution Health. Same-store revenue growth from patient volume was 1.7% overall, with 1.1% from emergency department volume growth.

EmCare’s income from operations was $73.6 million, or 7.0% of revenue, which compares with $28.9 million, or 3.1% of revenue, and includes changes in restructuring and transaction costs in comparable periods. Adjusted EBITDA of $113.9 million was 10.8% of revenue, which compares with $86.4 million, or 9.2% of revenue. EmCare’s results were impacted by Evolution Health, which generated revenue of $120.5 million in the third quarter and contributed Adjusted EBITDA of $1.7 million.

American Medical Response

AMR’s net revenue was $583.6 million and grew by 34.6% from the prior-year period. Acquisition-related growth was 31.4%. Growth from organic revenue sources was 3.2% and included net new contract growth of 2.2% and same-market growth of 1.0%. When calculated on a comparable same-market basis, revenue growth was 1.2% and consisted of volume growth of 1.8%, offset by a 0.6% decline related to rate. AMR’s same-market rate included contributions from improved commercial rates, offset by lower managed transportation revenue.

AMR’s income from operations was $9.7 million, or 1.7% of revenue, which compares with $31.1 million, or 7.2% of revenue. The change in income from operations was driven primarily by higher transaction costs and depreciation and amortization expense. Adjusted EBITDA was $66.8 million, or 11.4% of revenue, compared with $56.1 million, or 12.9% of revenue.

Envision Cash Flows for the Third Quarter of 2016

Envision generated cash flow from operations of $93.2 million. This compares with cash flow from operations of $34.0 million. Adjusted Free Cash Flow, a non-GAAP financial measure, was $47.7 million and was impacted primarily by expected higher capital expenditures, largely related to acquisition and new contract growth at AMR. At the end of the quarter, Envision completed two acquisitions for net consideration of $66.1 million. See “Non-GAAP Financial Measures Description and Reconciliation” below for a definition and reconciliation of Adjusted Free Cash Flow to Cash Flows from Operating Activities.

Results of Operations for the Nine Months Ended September 30, 2016

Envision’s net revenue was $4.88 billion, net income was $81.2 million, and Adjusted EBITDA was $504.2 million. Envision generated cash flow from operations of $252.4 million, or $278.4 million when excluding certain non-recurring payments earlier in 2016, and Adjusted Free Cash Flow was $173.4 million.

Segment Results for the Nine Months ended September 30, 2016

Net revenue at EmCare was $3.12 billion, operating income was $198.9 million and Adjusted EBITDA was $305.0 million.

Net revenue at AMR was $1.76 billion, operating income was $60.7 million and Adjusted EBITDA was $199.2 million.

Merger Update

The previously announced merger between Envision and AMSURG remains on track for completion during the fourth quarter of 2016. Both Envision and AMSURG mailed the definitive proxy statement/prospectus on October 21, 2016, and special meetings of shareholders of AMSURG and stockholders of Envision will be held on November 28, 2016, to vote on the merger proposals.

2016 Outlook

Envision Healthcare is updating its financial outlook for 2016. Envision now expects to generate Adjusted EBITDA of $705 million to $715 million and Adjusted EPS of $1.39 to $1.42. Envision’s outlook anticipates that lower volume growth at both EmCare and AMR will continue into the fourth quarter.

Envision is not providing a reconciliation of its forward-looking 2016 Adjusted EBITDA and Adjusted EPS because the Company is not able to accurately estimate the variables and individual adjustments for these items, including normal variability in income tax expense, equity compensation and transaction costs related to acquisition activities. Envision believes that the variability of these items could have an impact on its GAAP financial results.

Conference Call

Envision management will host a conference call today, Tuesday, November 1, 2016, at 8:30 a.m. Eastern Time, to discuss the Company’s financial results. Interested participants may listen to the call by dialing 800-857-6175, or 517-623-4852 for international callers, and referencing participant code 909712. A replay will be available approximately one hour after the call ends through December 1, 2016. To access the replay, dial 866-441-1048, or 203-369-1056 for international callers. An audio file will also be archived for 30 days on the investor relations section of the Company’s website: investor.evhc.net.

About Envision Healthcare Holdings, Inc.

Envision Healthcare Holdings, Inc., offers an array of physician-led healthcare-related services to consumers, hospitals, healthcare systems, health plans and local, state and national government entities. The organization provides care across a broad patient continuum via American Medical Response, Inc. (AMR), EmCare Holdings, Inc. (EmCare) and Evolution Health, LLC (Evolution Health). AMR provides community-based medical transportation services, including emergency (‘911’), non-emergency, managed transportation, air ambulance and disaster response. EmCare’s integrated facility-based physician services include emergency, anesthesiology, hospitalist/inpatient care, radiology, tele-radiology and surgery. Evolution Health’s innovative and comprehensive care coordination solutions result in improved patient care delivery across a number of healthcare settings. Envision Healthcare is headquartered in Greenwood Village, Colorado. For additional information, visit www.evhc.net.

Forward-Looking Statements

Certain statements and information in this press release may be deemed to be “forward-looking statements” within the meaning of the Federal Private Securities Litigation Reform Act of 1995. Forward-looking statements may include, but are not limited to, statements relating to our 2016 Adjusted EBITDA and Adjusted EPS guidance, objectives, plans and strategies, and all statements (other than statements of historical facts) that address activities, events or developments that we intend, expect, project, believe or anticipate will or may occur in the future. Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking statements are described in our filings with the Securities and Exchange Commission from time to time, including in the section entitled “Risk Factors” in our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q. Factors that could cause future results to differ materially from those provided in this press release include, but are not limited to: decreases in our revenue and profit margin under our fee-for-service contracts; failure to implement our business strategies, the loss of existing contracts; failure to accurately assess costs under new contracts; our ability to integrate acquisitions; competition in markets we serve; the cost of required capital expenditures; retention of our senior management; our ability to maintain or implement information systems; the impact of labor union representation; failure to comply with extensive and complex government regulation of our industry, including oversight of state and federal healthcare programs; the impact of changes in the healthcare sector; our ability to service our debt obligations; risks associated with the ability to consummate the previously announced business combination between Envision and AMSURG Corp. (“AMSURG”) and the timing of the closing of the business combination; the ability to successfully integrate Envision’s and AMSURG’s operations and employees; the ability to realize anticipated benefits and synergies of the business combination; the potential impact of announcement of the business combination or consummation of the transaction on relationships, including with employees, customers and competitors, and other factors discussed in our filings with the Securities and Exchange Commission. Any forward-looking statements herein are made as of the date of this press release, and we undertake no duty to update or revise any such statements. Forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties.

Non-GAAP Financial Measures Description and Reconciliation

This press release includes presentations of Adjusted EBITDA, Adjusted Free Cash Flow and Adjusted EPS. These are financial measures that are not calculated and presented in accordance with generally accepted accounting principles in the United States of America (GAAP). These non-GAAP measures may not be comparable to similarly titled measures of other companies.

Adjusted EBITDA is defined as net income (loss) before equity in earnings of unconsolidated subsidiary, income tax benefit (expense), loss on early debt extinguishment, other income (expense), net, realized gains (losses) on investments, interest expense, net, equity-based compensation expense, transaction costs related to acquisition activities, restructuring and other charges, adjustment to net loss (income) attributable to non-controlling interest due to deferred taxes, and depreciation and amortization expense. Adjusted Free Cash Flow is defined as cash flow from operations adjusted for cash used in non-acquisition related investing activities and certain out-of-period or non-recurring cash payments. Adjusted EPS is defined as diluted earnings per share adjusted for expenses related to the Company’s secondary offerings, amortization expense, equity-based compensation expense, restructuring and other charges, severance and related costs, loss on early debt extinguishment, and transaction costs related to acquisition activities, net of an estimated tax benefit.

Adjusted Free Cash Flow is a non-GAAP measures used by management as a liquidity indicator. Adjusted EBITDA and Adjusted EPS are non-GAAP measures used by management solely as performance measures. The items excluded from these non-GAAP measures are important in understanding the Company’s financial performance, and should not be considered in isolation of, or as an alternative to, GAAP financial measures. Reconciliations of non-GAAP financial measures are provided in the tables included in this press release.

       
Envision Healthcare Holdings, Inc.
Consolidated Statements of Operations and Other Information
(unaudited; in thousands, except shares, per share data and other information)
 
 
Three months ended September 30, Nine months ended September 30,
  2016     2015     2016     2015  
 
Net revenue $ 1,638,750   $ 1,367,370   $ 4,877,326   $ 3,966,130  
Compensation and benefits 1,159,244 997,213 3,427,921 2,874,328
Operating expenses 256,481 165,099 772,877 472,954
Insurance expense 35,925 41,091 108,799 114,783
Selling, general and administrative expenses 42,753 29,463 122,336 87,161
Depreciation and amortization expense 60,886 44,547 178,075 129,364
Restructuring and other charges   164     30,000     7,726     30,000  
Income from operations 83,297 59,957 259,592 257,540
Interest income from restricted assets 283 149 749 442
Interest expense, net (39,300 ) (27,579 ) (117,751 ) (82,360 )
Realized gains (losses) on investments (151 ) - (191 ) (34 )
Other income (expense), net   756     (221 )   743     (593 )
Income (loss) before income taxes and equity in
earnings of unconsolidated subsidiary 44,885 32,306 143,142 174,995
Income tax benefit (expense) (16,057 ) (13,795 ) (53,611 ) (69,009 )
Equity in earnings of unconsolidated subsidiary   123     59     1,758     202  
Net income (loss) 28,951 18,570 91,289 106,188
Less: Net (income) loss attributable to noncontrolling interest   (3,062 )   (1,334 )   (10,118 )   (3,161 )
Net income (loss) attributable to Envision Healthcare Holdings, Inc.   25,889     17,236     81,171     103,027  
 
Basic earnings per common share $ 0.14 $ 0.09 $ 0.43 $ 0.56
Diluted earnings per common share $ 0.13 $ 0.09 $ 0.42 $ 0.54
 
Weighted average common shares outstanding, basic 187,188,118 185,969,475 187,123,581 185,214,021
Weighted average common shares outstanding, diluted 192,045,426 191,769,107 191,998,390 191,373,606
 
Other Information
EmCare weighted patient encounters 4,803,721 4,585,390 14,420,261 13,394,015
AMR weighted transports 1,183,962 848,688 3,543,061 2,503,731
 
 
Earnings Per Share Reconciliation
 
Three months ended September 30, Nine months ended September 30,
  2016     2015     2016     2015  
Weighted average common shares outstanding, diluted 192,045,426 191,769,107 191,998,390 191,373,606
 
Net income (loss) attributable to Envision Healthcare Holdings, Inc. stockholders $ 25,889 $ 17,236 $ 81,171 $ 103,027
Net income (loss) allocated to participating securities   140     -     359     -  
Net income (loss) attributable to Envision Healthcare Holdings, Inc. common
stockholders $ 25,749 $ 17,236 $ 80,812 $ 103,027

Adjustments:

Other expense related to secondary offering/other filings - 154 - 526
 
Amortization expense 30,838 26,697 95,192 76,276
 
Equity-based compensation expense 3,353 1,761 9,290 4,786
 
Restructuring and other charges 164 30,000 7,726 30,000
 
Severance and related costs 3,381 863 7,953 3,426
 
Transaction costs related to acquisition activities 32,348 6,535 50,973 11,708
         
Total pre-tax adjustments 70,084 66,010 171,134 126,722
 
Tax impact of adjustments (26,702 ) (25,022 ) (65,202 ) (50,494 )
         
Total adjustments, net   43,382     40,988     105,932     76,228  
Net income (loss) attributable to Envision Healthcare Holdings, Inc., adjusted $ 69,131   $ 58,224   $ 186,744   $ 179,255  
Adjusted EPS $ 0.36 $ 0.30 $ 0.97 $ 0.94
 
Envision Healthcare Holdings, Inc.
Reconciliation of Adjusted EBITDA to Net Income (Loss)
(unaudited; in thousands)
       
 
Three months ended September 30, Nine months ended September 30,
Envision   2016     2015     2016     2015  
 
Adjusted EBITDA $ 180,650 $ 142,478 $ 504,240 $ 434,105
Depreciation and amortization expense (60,886 ) (44,547 ) (178,075 ) (129,364 )
Restructuring and other charges (164 ) (30,000 ) (7,726 ) (30,000 )
Interest income from restricted assets (283 ) (149 ) (749 ) (442 )
Transaction costs (32,348 ) (6,535 ) (50,973 ) (11,708 )
Severance and related costs (3,381 ) (863 ) (7,953 ) (3,426 )
Equity-based compensation expense (3,353 ) (1,761 ) (9,290 ) (4,786 )
Net income (loss) attributable to noncontrolling interest   3,062     1,334     10,118     3,161  
Income from operations 83,297 59,957 259,592 257,540
Interest income from restricted assets 283 149 749 442
Interest expense, net (39,300 ) (27,579 ) (117,751 ) (82,360 )
Realized gains (losses) on investments (151 ) - (191 ) (34 )
Other income (expense), net 756 (221 ) 743 (593 )
Income tax benefit (expense) (16,057 ) (13,795 ) (53,611 ) (69,009 )
Equity in earnings of unconsolidated subsidiary 123 59 1,758 202
Net (income) loss attributable to noncontrolling interest   (3,062 )   (1,334 )   (10,118 )   (3,161 )
 
Net income (loss) attributable to Envision Healthcare Holdings, Inc. $ 25,889   $ 17,236   $ 81,171   $ 103,027  
 
Envision Healthcare Holdings, Inc.
Reconciliation of Segment Adjusted EBITDA to Income from Operations
(unaudited; in thousands)
       
 
Three months ended September 30, Nine months ended September 30,
  2016     2015     2016     2015  
EmCare
Net revenue $ 1,055,156 $ 933,941 $ 3,118,613 $ 2,688,117
Compensation and benefits 816,349 758,379 2,420,857 2,175,715
Operating expenses 92,687 46,417 278,161 124,638
Insurance expense 22,026 28,511 64,021 77,645
Selling, general and administrative expenses 23,028 17,032 67,005 50,324
Interest income from restricted assets (172 ) (38 ) (416 ) (109 )
Transaction costs (12,799 ) (2,820 ) (17,955 ) (7,288 )
Severance and related costs (1,287 ) (448 ) (3,574 ) (2,480 )
Equity-based compensation expense (1,608 ) (793 ) (4,644 ) (2,154 )
Net income (loss) attributable to noncontrolling interest   3,062     1,334     10,118     3,161  
Adjusted EBITDA 113,870 86,367 305,040 268,665
Depreciation and amortization expense (27,317 ) (24,744 ) (81,964 ) (70,831 )
Restructuring and other charges (164 ) (30,000 ) (7,726 ) (30,000 )
Interest income from restricted assets (172 ) (38 ) (416 ) (109 )
Transaction costs (12,799 ) (2,820 ) (17,955 ) (7,288 )
Severance and related costs (1,287 ) (448 ) (3,574 ) (2,480 )
Equity-based compensation expense (1,608 ) (793 ) (4,644 ) (2,154 )
Net income (loss) attributable to noncontrolling interest   3,062     1,334     10,118     3,161  
Income from operations $ 73,585   $ 28,858   $ 198,879   $ 158,964  
 
AMR
Net revenue $ 583,594 $ 433,429 $ 1,758,713 $ 1,278,013
Compensation and benefits 342,895 238,834 1,007,064 698,613
Operating expenses 163,794 118,682 494,716 348,316
Insurance expense 13,899 12,580 44,778 37,138
Selling, general and administrative expenses 19,725 12,431 55,331 36,837
Interest income from restricted assets (111 ) (111 ) (333 ) (333 )
Transaction costs (19,549 ) (3,715 ) (33,018 ) (4,420 )
Severance and related costs (2,094 ) (415 ) (4,379 ) (946 )
Equity-based compensation expense   (1,745 )   (968 )   (4,646 )   (2,632 )
Adjusted EBITDA 66,780 56,111 199,200 165,440
Depreciation and amortization expense (33,569 ) (19,803 ) (96,111 ) (58,533 )
Interest income from restricted assets (111 ) (111 ) (333 ) (333 )
Transaction costs (19,549 ) (3,715 ) (33,018 ) (4,420 )
Severance and related costs (2,094 ) (415 ) (4,379 ) (946 )
Equity-based compensation expense   (1,745 )   (968 )   (4,646 )   (2,632 )
Income from operations $ 9,712   $ 31,099   $ 60,713   $ 98,576  
 
Envision
Net revenue $ 1,638,750 $ 1,367,370 $ 4,877,326 $ 3,966,130
Compensation and benefits 1,159,244 997,213 3,427,921 2,874,328
Operating expenses 256,481 165,099 772,877 472,954
Insurance expense 35,925 41,091 108,799 114,783
Selling, general and administrative expenses 42,753 29,463 122,336 87,161
Interest income from restricted assets (283 ) (149 ) (749 ) (442 )
Transaction costs (32,348 ) (6,535 ) (50,973 ) (11,708 )
Severance and related costs (3,381 ) (863 ) (7,953 ) (3,426 )
Equity-based compensation expense (3,353 ) (1,761 ) (9,290 ) (4,786 )
Net income (loss) attributable to noncontrolling interest   3,062     1,334     10,118     3,161  
Adjusted EBITDA 180,650 142,478 504,240 434,105
Depreciation and amortization expense (60,886 ) (44,547 ) (178,075 ) (129,364 )
Restructuring and other charges (164 ) (30,000 ) (7,726 ) (30,000 )
Interest income from restricted assets (283 ) (149 ) (749 ) (442 )
Transaction costs (32,348 ) (6,535 ) (50,973 ) (11,708 )
Severance and related costs (3,381 ) (863 ) (7,953 ) (3,426 )
Equity-based compensation expense (3,353 ) (1,761 ) (9,290 ) (4,786 )
Net income (loss) attributable to noncontrolling interest   3,062     1,334     10,118     3,161  
Income from operations $ 83,297   $ 59,957   $ 259,592   $ 257,540  
 
Envision Healthcare Holdings, Inc.
Condensed Consolidated Balance Sheets
(in thousands)
   
     
September 30, 2016 December 31, 2015
(Unaudited) (Audited)
Assets
Current assets:
Cash and cash equivalents $ 190,033 $ 141,677
Trade and other accounts receivable, net 1,341,202 1,257,021
Other current assets   172,650   199,729
Total current assets 1,703,885 1,598,427
Non-current assets:
Property, plant and equipment, net 383,947 335,869
Goodwill and intangible assets, net 4,448,663 4,323,564
Other long-term assets   119,313   95,712
Total assets $ 6,655,808 $ 6,353,572
 
Liabilities and Equity
Current liabilities $ 757,384 $ 705,980
Long-term debt and capital lease obligations 3,055,440 2,958,481
Deferred income taxes 388,661 369,110
Insurance reserves and other long-term liabilities   322,620   318,560
Total liabilities 4,524,105 4,352,131
Total equity   2,131,703   2,001,441
Total liabilities and equity $ 6,655,808 $ 6,353,572
 

Note: Certain prior period balances in the consolidated balance sheets have been reclassified to conform to the current year
presentation. Such reclassifications had no impact on the results of operations or cash flows previously reported

 
Envision Healthcare Holdings, Inc.
Condensed Consolidated Statements of Cash Flows and Reconciliation of Net Cash Provided by (Used in)
Operating Activities to Adjusted Free Cash Flow
(unaudited; in thousands)
       
Three months ended September 30, Nine months ended September 30,
  2016     2015     2016     2015  
Cash Flows from Operating Activities
Net income (loss) $ 28,951 $ 18,570 $ 91,289 $ 106,188
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation, amortization and other 67,219 48,371 195,573 140,920
Excess tax benefits from equity-based compensation (105 ) (9,575 ) (1,324 ) (34,051 )
Deferred income taxes (1,143 ) 2,403 8,598 3,503
Changes in operating assets/liabilities, net of acquisitions:
Trade and other accounts receivable, net (9,818 ) (45,299 ) (42,014 ) (83,065 )
Parts and supplies inventory (882 ) (324 ) (596 ) (485 )
Prepaids and other current assets 5,401 928 20,924 (3,696 )
Accounts payable and accrued liabilities 11,864 17,468 454 66,296
Insurance reserves (12,578 ) (36 ) (22,448 ) (2,257 )
Other assets and liabilities, net   4,304     1,517     1,977     1,592  
Net cash provided by (used in) operating activities   93,213     34,023     252,433     194,945  
 
Cash Flows from Investing Activities
Purchases of available-for-sale securities (8,651 ) (440 ) (15,459 ) (2,507 )
Sales and maturities of available-for-sale securities 2,421 200 3,869 9,409
Purchases of property, plant and equipment (34,978 ) (22,659 ) (125,738 ) (65,687 )
Proceeds from sale of property, plant and equipment 160 25 202 377
Acquisition of businesses, net of cash received (66,059 ) (69,653 ) (180,867 ) (568,570 )
Net change in insurance collateral (1,104 ) 4,456 33,859 (1,250 )
Other investing activities   (3,462 )   (2,197 )   (3,033 )   (1,226 )
Net cash provided by (used in) investing activities   (111,673 )   (90,268 )   (287,167 )   (629,454 )
 
Cash Flows from Financing Activities
Borrowings under the ABL Facility 80,000 60,000 315,000 365,000
Repayments of the ABL Facility (80,000 ) (55,000 ) (210,000 ) (155,000 )
Repayments of the Term Loan (5,843 ) (3,343 ) (17,529 ) (10,029 )
Debt issuance costs 14 - (709 ) (27 )
Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan 1,073 2,417 2,644 11,767
Excess tax benefits from equity-based compensation 105 9,575 1,324 34,051
Contributions from (distributions to) non-controlling interest, net - - (8,833 ) 100
Other financing activities   399     (119 )   1,193     (358 )
Net cash provided by (used in) financing activities   (4,252 )   13,530     83,090     245,504  
 
Change in cash and cash equivalents (22,712 ) (42,715 ) 48,356 (189,005 )
Cash and cash equivalents, beginning of period   212,745     172,605     141,677     318,895  
Cash and cash equivalents, end of period $ 190,033   $ 129,890   $ 190,033   $ 129,890  
 
Operating and non-acquisition investing cash flow $ 47,599 $ 13,408 $ 146,133 $ 134,061
 

Cash flow adjustments:

Excess tax benefits from equity-based compensation 105 9,575 1,324 34,051
Non-recurring restructuring costs - - 6,500 -
Non-recurring pre-acquisition payroll accrual   -     -     19,486     -  
Adjusted Free Cash Flow $ 47,704   $ 22,983   $ 173,443   $ 168,112