Walgreens Boots Alliance, Inc. (NASDAQ: WBA) Q4 2022 earnings call dated Oct. 13, 2022
Tiffany Kanaga — Vice President, Global Investor Relations
Rosalind Brewer — Chief Executive Officer
James Kehoe — Executive Vice President and Global Chief Financial Officer
John Driscoll — Executive Vice President and President, US Healthcare
Lisa Gill — JPMorgan — Analyst
Good morning, my name is Rob and I’ll be your conference operator today. At this time, I would like to welcome everyone to the Walgreens Boots Alliance Fiscal Year 2022 Earnings Conference Call. All lines have been placed on mute to prevent any background noise. After the speakers’ remarks, there will be a question-and-answer session. [Operator Instructions] Thank you.
Tiffany Kanaga, Vice President, Global Investor Relations, you may begin your conference.
Tiffany Kanaga — Vice President, Global Investor Relations
Good morning. Thank you for joining us for the Walgreens Boots Alliance earnings call for the fourth quarter of fiscal year 2022. I’m Tiffany Kanaga, Vice President of Global Investor Relations. Joining me on today’s call are Ros Brewer, our Chief Executive Officer; James Kehoe, our Chief Financial Officer; and John Driscoll, President of our US Healthcare segment. Rick Gates, Senior Vice President of Pharmacy and Healthcare at Walgreens will participate in Q&A. Today’s call will be approximately two hours in length, including Q&A.
Let me note that we will be referring to our segments by their new name; US Retail Pharmacy, International and US Healthcare. The renaming did not result in any change to the composition of the segments. Additionally, all references to the COVID-19 headwind include US vaccines, drive-through test and OTC tests.
As always during the conference call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results could differ materially due to a number of factors including those listed on slide two and those outlined in our latest Forms 10-K and 10-Q filed with the Securities and Exchange Commission. We undertake no obligation to publicly update any forward-looking statement after this presentation whether as a result of new information, future events, changes in assumptions or otherwise.
You can find our press release and the slides referenced on this call in the Investors section of the Walgreens Boots Alliance website. The slides and the press release also contain further information about non-GAAP financial measures that we will discuss today during this call.
I will now turn the call over to Ros.
Rosalind Brewer — Chief Executive Officer
Thanks, Tiffany, and good morning everyone. It’s great to be with all of you today and it’s hard to believe a whole year has gone by since our Investor Day last October. As I said to you then and I’m deeply committed to being as open and transparent as possible about our business. We have scheduled a longer call this morning to provide a more in-depth update and also to spend additional time on Q&A to hear from you. I’m looking forward to reviewing our execution over the past year. We delivered ahead of our expectations in fiscal year ’22 and are well underway in our transformation to a consumer-centric healthcare company. Today, we’ll also provide much greater visibility to the road ahead.
Our fiscal year ’23 adjusted EPS guidance of $4.45 to $4.65 is down year-over-year, largely due to lapping COVID-19 execution. However, we expect strong 8% to 10% core growth to underpin our results. We are rapidly scaling US healthcare, already raising long-term sales targets with a clear path to achieve profitability, starting in fiscal year ’24. It’s early, but our strategy is working. We are making good progress on each of our four priorities. We’re simplifying and strengthening the company. Our numerous accomplishments this year despite a difficult operating climate bolster our confidence in accelerating to our long-term algorithm of low teens adjusted EPS growth. We have a winning team and winning assets to unlock sustainable shareholder value as we re-imagine local healthcare and wellness for all.
As you’ll remember from last October, we introduced four strategic priorities; first, transform and align the core business; second, build our next growth engine, US Healthcare; third, focus portfolio and optimize capital allocation; and fourth, build a high performance culture and a winning team. Our four key priorities capture value across both core retail pharmacy and growth spaces in healthcare. We are already delivering consumer-centric primary care services, improving the patient experience and health outcomes while lowering costs and leveraging our assets across the care continuum to treat the whole person. We are executing through our unique strengths and our hyper-local footprint, entrusted iconic Walgreens brand. At the same time, we are reinforcing our capabilities for the journey. We have and will continue to take measured and strategic actions to optimize our portfolio. We are also evolving our team with new talent, new skills and fresh ideas, with the singular focus on driving real value for our patients and for communities, our people and our shareholders.
Let me review fiscal year 2022 progress against each strategic priority. First, I’m pleased to say that we broadly exceeded our strategic goals across the core retail pharmacy business despite a challenging macro environment. Our script count is the one soft spot for the year to call-out. I’ll talk more about how we’re addressing that in a moment. However, we still surpassed our US and international adjusted operating income targets with very good execution in the front end. US and Boots UK retail comp sales were both strong with the US up 6% and Boots up 19%. Several of our initiatives are continuing to gain traction. US digital sales grew 37% for the year on top of 74% growth in 2021. myWalgreens membership surged past a big milestone, reaching 102 million customers and I’m encouraged by the innovation and growth happening at our owned brands program. I’m also proud of our significant US retail margin expansion, up over 100 basis points while many other companies like big-box retailers are under pressure because they are more dependent on big-ticket items. We are seeing meaningful contributions from alternative profit streams at $125 million in income for the year including Walgreens advertising group with 25% growth. And you remember that we raised the target for our Transformational Cost Management Program last quarter to $3.5 billion with an expanding funnel of cost savings initiatives.
In the Pharmacy, Walgreens team members have proven that they are highly trusted healthcare resources. We administered 35 million vaccinations in fiscal 2022, well beyond our expectations. With demand for pharmacy services at an all time high due to COVID-19, we have seen a tightening in the labor market for pharmacists and pharmacy technicians. This has unfortunately led to staffing shortages in some of our markets, in turn, creating a headwind for prescription growth. Scripts were up, softer than expected 1.4% in fiscal year 2022. We are focusing investments to return about 3,000 stores to normal operating hours, which I expect will drive script volume recovery as we move through fiscal year 2023, We’re seeing positive staffing trends with 11 straight weeks of net pharmacists headcount increases. We have also opened our eighth automated micro fulfillment center and are now supporting 1,800 total stores. Our pace is somewhat slower than expected in part due to supply side, construction delays, but I’m pleased with the performance of the centers, we do have up and running. These facilities remove routine tasks and excess inventory from the pharmacy which is expected to reduce working capital by over $1 billion over-time.
Let me take a moment to address the historic macro challenges that are affecting our customer. With inflation at four decade highs, consumers are expressing uncertainty about the future and seeking value. At the same time, we know that health and wellness will always be a priority and increasingly so after COVID-19. Our McKinsey study from last month shows that around 50% of US consumers now report wellness as a top priority in their day-to-day lives, a significant rise from 42% just two years ago. We’re leveraging our footprint, our digital capabilities, our consumer insights and our essential services to drive overall retail pharmacy growth. We have a resilient core business with the mix that over-indexes to need now categories and we are better positioned now than we were in prior periods of economic turbulence.
Our execution during the pandemic is just one example of our pharmacy services at the center of our communities and as part of an integrated healthcare experience. In the US, we have administered nearly 72 million COVID-19 vaccinations and completed over 34 million PCR and antigen tests to-date. Second, we’ve improved the customer experience and it’s showing every day through offering strong value, better in-stock conditions and increased service levels. We have been managing inflation and collaborating closely with suppliers. We are maintaining price versus competitors and meeting our customers with robust in-stock levels that are above last year despite supply chain constraints. The products we sell are sourced from a wide variety of domestic and international vendors. The team is also deploying advanced forecasting and replenishment technology including AI. The outcome is a better more dependable shopping experience for our customers during these turbulent times and stronger results for our retail business. Finally, we expect reimbursement pressure on payer contracts to be predictable as fiscal year 2022 was in line with plan. We’ve already locked-in 95% of payer contracts through calendar year 2023.
Turning to our next strategic priority. We’re making important strides and consistent progress in building our next growth engine, the US Healthcare segment. Let me start with CareCentrix. With our announcement on Tuesday that we are accelerating full ownership, we are very well-positioned in the home care market. And if the initial acquisition of a 55% stake had closed in line with our original timeframe, we would have achieved our $3 billion to $3.2 billion sales goal in fiscal year 2022. Next, VillageMD and Shields continue to realize tremendous topline growth, driving pro forma total growth of 75% for the year. We’ve added three strategic partners for Walgreens Health; Blue Shield of California, Clover and Buckeye, bringing the number of lives covered above our calendar 2022 year-end target of $2 million. VillageMD is leading the way in value based care for the nation with over 340 clinics now open, including about 150 co-located with Walgreens, on pace towards 200 by the end of calendar year 2022. Remember that we raised the target from 160 back in January. We’re also adding health corners on schedule, with 70 now on the way to 100 by the end of 2022. Through our accelerated rollout, VillageMD already covers 433,000 lives under value based arrangement, including 161 barrels in Medicare and MA value based lives. At the same time, CareCentrix has 19 million total contracted lives and Shield as partner with 75 health systems.
Our health care strategy is now coming to life. And far from just being in the planning stages, it is well underway and can be seen in our best-in-class assets. We are moving swiftly to implement our vision of consumer-centric tech-enabled health care solutions that improve outcomes and lower cost for patients, providers and payers. Over the course of the past year, we also took several actions to better align our investment portfolio with our strategy. These decisions will fund our continued growth and simplify the business. In addition to building our partnerships with VillageMD, Shields and CareCentrix, we also completed a thorough review of the Boots business. Our decision to pause the process was a reflection of challenging financial market conditions and the Board and I remain confident that the business carries strong fundamental value. We continue to have sufficient access to capital to accomplish, although we need to do as demonstrated by our ability to opportunistically monetize portions of our portfolio. Recent transactions involve Amerisource Bergen, unlocking $900 million, Option Care Health with $360 million in proceeds and GPC at $150 million. There is good financial flexibility through our total portfolio and we are entering fiscal year 2023 on a clear trajectory to a simpler, more streamlined company. Additionally, we increased the dividend for the 47th consecutive year in July and we remain committed to growing the dividend over-time.
Finally, I want to cover our progress on our fourth strategic priority. We have evolved our operating model, expanded expertise on our board, hired new leaders and made critical investments in our winning team. We have restructured our executive committee to align with best practices and health care. In recognition of the central role of technology in health care, we have taken several actions. We reconstituted our Board’s Finance Committee as the Finance and Technology Committee appointed IBM’s Global Chief Data Officer, Inderpal Bhandari to the Board and named our next Chief Information Officer. Beyond that, we have named over 10 senior executives since the start of fiscal 2022, including a new structure for US Retail Pharmacy. It’s always been important to me to prioritize our most meaningful asset which is our team members. I have no doubt that investments in our people will yield large rewards as we recruit and retain the very best talent, which will allow us to recover our script count growth and enhance our customer experience. At the support office level, we’re pleased to announce incremental measures to align compensation with our strategic ambitions and shareholder interests by adopting relative TSR metric in our long-term incentive plan for fiscal year 2023. We are all invested in an accountable for the success of our company.
At our stores, we invested an incremental $190 million dedicated to our pharmacy staff in fiscal year 2022, primarily in premium pay and bonuses. Fiscal year 2023 will include further investments in our pharmacy team of $265 million as we made good progress in returning stores to normal operating hours. As a reminder, this is in addition to the minimum wage increases we announced last year which consistent with prior guidance represent a year-over-year impact of $260 million in fiscal year 2023 building to $450 million over the three-year period.
As we discussed is investments in our team members, let me take a moment here to stop and fully appreciate how important their work is. Just as the crisis level impact of the pandemic has started to subside, we’ve seen tragedy strike with the hurricanes in Florida and Puerto Rico. Our teams as they always do, responded decisively on behalf of their communities and really rose to the occasion. My message to our colleagues on the front lines is, thank you once again from all of us at WBA and we’re still very proud of your leadership.
Now let me go into more detail on the deep and talented bench of leaders at WBA. Most recently we were excited to announce on Tuesday that John Driscoll has joined our team as President of our US Healthcare segment. Our US business is now organized under three leaders; Healthcare under John Driscoll; Pharmacy under Lee Cooper from Shields and Retail under Tracey Brown. John has more than 25 years of expertise including as President of Castlight Health, a health care tech company, Group President for new markets at Medco, a $70 billion PBM that spun-out of Merck and Founder and Chair of the Surescripts ePrescribing Network, the first cross-industry collaborative with competing retail, PBM and health plans. Lee previously served as CEO of GE Healthcare in the US and Canada before leading Shields through rapid expansion. He has demonstrated proven success in driving growth, creating omnichannel customer experiences, establishing high performance cultures and executing with excellence. And already in just one year at WBA, Tracey has made major strides in our customer experience. Tracey’s team is creating highly personalized offerings for our consumers across our digital and physical assets.
We are confident in the road ahead with the right team leading us through hard decisions today. We exceeded expectations in fiscal year 2022, successfully managing our resilient core business. While there are macroeconomic challenges, we are executing well and expecting strong core growth of 8% to 10% in the year ahead. We are scaling our winning assets to accelerate growth and profitability of our US health care business. We are investing in strategic talent and capabilities and we’re taking strong action to simplify our portfolio. Our strategy is working to strengthen the business and build a solid foundation for sustainable shareholder value creation.
With that, I’ll hand it over to James to provide more color on our results and our outlook.
James Kehoe — Executive Vice President and Global Chief Financial Officer
Thank you, Ros and good morning. Overall, we had a good finish to the year. With fourth quarter results slightly ahead of our expectations, we continue to drive strong execution across all of our operating segments and rapidly expand our US healthcare business. As a reminder, we are lapping a very strong prior year when adjusted EPS grew 28%, boosted by COVID-19 vaccinations. Year-over-year comparisons are also impacted by higher investments in the US health care segment, including the acquisition of a majority stake in VillageMD. Sales declined 3.2% on a constant currency basis, excluding the negative impact from AllianceRx and the positive contributions from healthcare M&A. Constant currency sales growth was around 2%, adjusted EPS was $0.80 in the quarter, a constant currency decrease of 30%, entirely driven by the decline in adjusted operating income and partly offset by a lower tax rate.
Solid gross profit performance in US retail and the continued rebound in international were offset by the lapping of peak COVID-19 vaccinations in the year ago quarter and planned growth investments in US healthcare. GAAP earnings per share was a loss of $0.48, which compares to earnings per share of $0.41 last year, mostly due to a $780 million non-cash impairment charge in Boots UK and higher charges related to the Transformational Cost Management Program, reflecting incremental store closures. Please note that the Boots impairment charges were related to trademarks and licenses and were mostly due to the impact of higher discount rates.
Now let’s move to the full year financial highlights. Full year sales increased 1.2% on a constant currency basis. However, if you exclude the 5.5 percentage point negative impact from AllianceRx and positive contributions from US Healthcare M&A activity, core sales growth was a healthy 6%. Adjusted EPS was $5.04, a constant currency increase of 3.4% and above our initial guidance of flat EPS. Furthermore, the result included a 5.5 percentage point headwind from the build-out of the US Healthcare segment. In summary, full year core sales grew by 6% and adjusted EPS increased 3.4%.
Now let’s look at the US Retail Pharmacy segment. Sales decreased 7.2% in the quarter as we lapped a very strong prior-year comp of 8% and we faced a 7.8 percentage point headwind from AllianceRx. Adjusted operating income declined 36%, lapping strong prior year results on AOI grew 16% including significant COVID-19 vaccinations. Strength in US retail and continued cost savings were offset by higher labor investments and lower results in US Pharmacy. For the full year, AOI was up slightly, reflecting solid core sales growth.
Now let’s look in more detail at US Pharmacy. Pharmacy sales declined 8.8% entirely due to a 10.4 percentage point impact from AllianceRx. Comparable pharmacy sales were up 3% despite lapping a very strong 8.9% growth last year. Comp scripts declined 3.5% and excluding immunizations, comp scripts were flat which compares to a 4.2% growth in the prior year. We completed 2.9 million COVID 19 vaccinations in the fourth quarter, well below the 13.5 million vaccinations in the prior year quarter and this trend was generally in line with our expectations. Pharmacy performance in the quarter benefited from improved trends from seasonal scripts and maintenance medications. However, scripts remain challenged by temporary reductions in store operating hours due to staffing shortages. Operating hour limitations impacted scripts by about 270 basis points in the quarter with a full year impact of around 180 basis points. As Ros mentioned, actions have been taken to address the staffing challenges and we are encouraged by the positive hiring trends over the past 11 weeks. This gives us confidence that we can recover script volume as we move into next year. Overall, looking on a three-year stack basis which normalizes for COVID related volatility, comp scripts excluding immunizations increased 7.7%, We administered 3.4 million COVID-19 tests in the quarter compared to 5.2 million last year. Additionally, with payors now reimbursing OTC test, we sold 7.8 million OTC tests through the pharmacy. As a reminder our comp script numbers exclude testing. Finally, pharmacy adjusted gross profit declined, driven by a much lower level of COVID-19 vaccinations and ongoing margin pressure.
Turning next to our US retail business. Overall, we saw a good retail performance as we continue to benefit from our omnichannel and mass personalization initiatives. Comp retail sales decreased 1.9% and this was largely due to lapping a very strong prior-year quarter and sales advanced 6.2%. Overall, our retail business has good underlying momentum with 13% growth on a three-year stack basis. On a full year basis, comp retail sales were up a strong 6%, the highest in nearly two decades with positive contributions from personal care, beauty and cough, cold flu as well as COVID-19 OTC tests which contributed about 3 percentage points of growth. Retail gross margin expanded throughout the year, reflecting the effective margin management, including strategic pricing and promotion optimization and stabilizing shrink levels.
Turning next to the International segment. And as always, I will talk to constant currency numbers. International delivered a strong set of results. Sales increased 6.7%, reflecting growth across all international markets with Boots UK up 6% and Germany wholesale advancing 6.8%. Adjusted operating income was $163 million in the quarter, up 31% versus prior year. The strong finish to the year led to full year sales and adjusted operating income growth of 13% and 65% respectively.
Let’s now look in more detail at Boots UK. Strong retail sales performance more than offset a decline in comp pharmacy sales of 7% as we lap strong demand for COVID-19 services. Comp retail sales advanced 15%, reflecting 20% rebound in footfall with flagship and travel locations showing robust improvement. Market share increased with personal care and health and wellness driving notable gains. Compared to pre-COVID levels, store footfall remains around 15% lower, however, this was more than offset by a 14% increase in store basket size and Boots.com sales that more than doubled. Over 11% of our total UK retail sales came from digital in the quarter, up from around 6% pre-COVID.
Turning next to US Health Care. Segment sales were over $600 million in the quarter with pro forma combined sales growth of 34%. VillageMD grew in line with plan and revenue growth is on track as we launched new clinics, scale existing clinics and increase value based arrangements. Shields delivered another excellent quarter with pro forma sales growth of 48%, driven by annualizing recent contract wins and by expanding the value proposition with existing health system partners. Segment adjusted operating income was a loss of $151 million in the quarter. Organic investments accounted for $45 million. Investments at VillageMD more than offset the profit contribution from Shields and led to a $106 million AOI loss across our majority investments. As the clinic roll-out at VillageMD continues on pace, VillageMD had 334 clinics at the end of the year, an increase of 82 clinics compared to prior year. VillageMD had 433,000 value based patients as of the end of fiscal 2022, up from 326,000 at the end of fiscal 2021. Fiscal 2002 was a peak investment here and the fourth quarter loss is not a good indicator for fiscal 2023 and beyond. VillageMD, Shields and CareCentrix will drive increasingly high contributions as the businesses mature. Additionally investments in the Walgreens Health organic business will be partially offset by positive contributions from clinical trials expansion and integration synergies.
Turning next to cash flow. Operating cash flow was $3.9 billion and free cash flow was $2.2 billion dollars as we cycled through some exceptional headwinds. First, the sales decline of AllianceRx led to the unwinding of a favorable working capital position with the year-over-year impact of $400 million. Secondly, we benefited from COVID-19 government-related support in fiscal 2021 whereas this partially reversed as the deferred FICA payments became due in fiscal 2022. In total, year-over-year impact was around $400 million. Additionally, we executed an inventory pre-buy ahead of an expected strong cough-cold flu and holiday season. And finally, there were some one-time items including legal settlements in the US of $200 million. Free cash flow was also impacted by a $355 million increase in capital expenditures to support our growth initiatives, including the VillageMD clinic expansion, rollout of micro fulfillment centers and continued omnichannel and digital investments. Before moving on I want to reiterate that our full year EPS grew 3% ahead of our original guidance of flat and we made substantial progress against our goals as we build-out our US Healthcare business.
I’ll now turn to our fiscal 2023 guidance and long-term growth outlook. We are guiding fiscal 2023 adjusted EPS of between $4.45 and $4.65 compared to the $5.04 achieved in fiscal 2022. While we expect solid core business growth, looking forward into 2023, we are facing two key challenges. First, we project a much lower level of COVID-19 vaccinations and testing activity and this leads to an earnings headwind of 15% to 17%; second, the dollar has strengthened significantly and is at 2% headwind to EPS in reported currencies. Excluding these two headwinds, we expect core EPS growth of 8% to 10% on a constant currency basis with positive contributions from all segments. This healthy core growth reinforces our confidence in achieving our long-term growth algorithm and today we are providing more clarity and raising our US Healthcare targets. Based on the execution to-date and improved visibility, we are increasing our 2025 sales target for US Healthcare by over 20% and we are now projecting sales of $11 billion to $12 billion by 2025. Furthermore, we expect the US Healthcare segment to generate positive adjusted EBITDA by fiscal 2024. Later, I will provide greater detail on the key drivers.
Let me now walk you through our 2023 guidance in greater detail, starting with WBA. Overall, we expect low single digit sales growth on a constant currency basis. Excluding the COVID-19 headwind, we do expect a sales growth of 2% to 4%. This sales growth is also impacted by 2 percentage point headwind from AllianceRx, which largely cycles-out in the second quarter. So if you strip-out the AllianceRx and COVID-19 impacts, we expect constant currency sales to be up mid-single digit. Adjusted EPS is projected at $4.45 to $4.65, a constant currency decline of 6% to 10%. Excluding the COVID-19 and forex headwinds, adjusted EPS growth is around 8% to 10%.
Let me now walk you through the assumptions and guidance for each of our reporting segments, starting with US Retail Pharmacy. Sales are projected to decline low single digit. A lower sales contribution from vaccinations and testing will reduce the growth by 2 percentage points whereas the low margin AllianceRx business also has an adverse impact of 2 percentage points. In summary, if you strip out these factors, we expect low single digit sales growth. We are projecting 16 million vaccinations in 2023 compared to 35 million in both of the previous years. The 16 million estimate assumes only one booster this year and that around 40% of the population chooses to get one. AOI is projected at $4.5 billion to $4.6 billion including an 18 percentage point headwind from the lower COVID-19 contribution. Excluding this impact, core AOI growth is 10% to 11%.
Let’s walk through some of the key growth drivers. First, we anticipate script volume recovery as we move through the year. Focused labor investments are already leading to positive net staffing trends and over the coming months, will allow more stores to return to normal operating hours. We expect the ongoing rollout of micro fulfillment centers to continue to drive efficiencies in the pharmacy, easing staffing challenges. Additionally, pharmacy will be boosted by increased contributions from pharmacy services and patient acquisition initiatives. We also have good visibility to reimbursement, net of procurement savings. Second, we expect continued momentum from the retail business, driven by our digital and omnichannel offerings, the enhancements we have made to our myWalgreens loyalty program and through innovation and growth in own brands. We are also seeing increasing contribution from alternative profit streams, including financial services and media.
Finally, actions to mitigate shrink are well underway and we are already seeing improved shrink rates. Overall, we expect gross profit to be broadly flat but up around 5% to 6% excluding the COVID headwind. SG&A is expected to increase by around 1% to 2%, reflecting increased investments in team members and technology, offset by continued strong results from the Transformational Cost Management Program.
Turning next to the International segment. International had a very strong year in fiscal 2022 and we expect continued robust growth in 2023. However the strong dollar will negatively impact reported results and represent a headwind to sales and adjusted operating income of around 11% to 12%. Sales are projected to grow 5% to 7% on a constant currency basis with all markets growing. Specifically, we expect the UK to grow 6% and Germany will grow 4%. We expect adjusted operating income of $830 million and $870 million with strong constant currency growth of 26% to 32%. This follows on from 65% growth in 2022. Sales growth, strong cost management discipline and integration related benefits in Germany are the key drivers.
Now let’s turn to US Healthcare. We are very encouraged by our progress as we build-out our next growth engine. We expect sales of around $5 billion including a full year of contribution from prior acquisitions and pro forma sales growth of 45% to 55%. We are introducing an adjusted EBITDA metric for the US Healthcare segment and for fiscal 2023, we expect an adjusted EBITDA loss of $220 million to $240 million. This is an improvement of $70 million to $90 million versus fiscal 2022. We have moved past the fiscal 2022 peak investment period and the team is operating with agility and efficiency and we have clear line of sight to positive adjusted EBITDA in fiscal 2024.
Let’s now take a deeper look at the US Healthcare projections. The US Healthcare segment is scaling to $5 billion in sales and pro forma sales growth of 45% to 50% reflect strong growth across all of our Healthcare businesses. VillageMD sales are projected at $2.8 billion to $3 billion, growing 50% to 60% with the performance driven by growth and value-based patients at existing clinics and continued expansion of their clinic footprint. We anticipate pro forma growth of 20% to 30% at CareCentrix, reaching sales of over $1.4 billion in fiscal 2023. This performance reflects growth across existing and new payer and provider customers and upsell of innovative new home services. Shields is expected to drive pro forma sales growth of 30% to 40% through new health system partners and an expanding value proposition at existing customers. Given the relatively early stage of development, we expect the Walgreens Health organic business to deliver a modest sales contribution of $120 million to $150 million.
Let me now walk you through some of the key corporate assumptions. Our tax rate is expected to be around 16% in fiscal 2023, roughly 50 basis points higher than prior year. However, we do anticipate an increase to around 20% in fiscal 2024, largely consistent with our previous expectations. This step-up will be driven by higher tax rates in the UK and Switzerland and a greater percentage of income from US-based businesses. Interest expense is expected to increase by $100 million due largely to higher interest rates. Our fiscal 2023 guidance assumes only anti-dilutive share repurchase activity as our near-term capital allocation priorities will be primarily focused on growth investments and debt pay-down. However, beyond 2023, we do expect to have flexibility for a sizable new program. Please note that our fiscal 2023 guidance does not assume any acquisitions or divestitures. And finally, corporate costs will decline slightly as we tightly manage central costs.
While we are not providing quarterly EPS guidance, we see a more balanced cadence between the first and second half compared to current consensus which appears more first-half weighted. In the first half, we will be lapping strong COVID-19 the execution and record retail comps, the second half of the year will reflect the pace and timing of script volume recovery and reduced US healthcare losses as the segment scales up.
Let me now turn to our long-term outlook. Looking beyond 2023, we are reconfirming our long-term growth algorithm with mid to high single-digit adjusted EPS growth in 2024, building to low-teens growth in 2025. Additionally, I would highlight that 2024 includes a more modest headwind from COVID-19 and the impact of a higher tax rate. Our transformation to a healthcare company will drive accelerated earnings growth as the faster growth and higher margin US Healthcare business reaches scale. We expect the US Healthcare to contribute over half of the annual adjusted EPS growth over the long term. While we continue to assume moderate growth from the core business and increase returns from capital deployment as we exit 2023 with improved credit metrics.
Looking now at our capital allocation priorities. First, we will continue to prioritize organic investment in our resilient core business and this will drive consistent returns and fast payback. Second, we will prioritize M&A that advances our health care ambitions, evaluating all opportunities through a rigorous strategic and financial lines. We intend to further simplify our portfolio to unlock value and this provides significant flexibility as we execute on our transformation. Third, balance sheet strength is a key focus area for us. We remain committed to maintaining our investment grade rating. Finally, we will return excess capital to shareholders, including a growing dividend. Beyond fiscal 2023, we have potential capacity to resume sizable share repurchases.
Given the rising importance of US Healthcare, I would like to provide increased clarity on the segment goals over the next three years. With our solid execution to-date and greater visibility ahead, we are increasing our fiscal 2025 sales goal from $9 billion to $10 billion previously to $11 to $12 billion and representing a compound annual growth rate of approximately 50% on a pro forma basis. VillageMD is the largest contributor with growth achieved as existing clinics mature and realize more attractive economics and through ongoing expansion of VillageMD’s clinic footprint. We expect continued strong sales growth at Shields, benefiting from rapid growth in the broader specialty pharmacy market and their unique focus on health system enablement. CareCentrix sales will be driven by increased demand to better manage the needs of patients with complex or chronic conditions as they transition-out of the hospital and into other post-acute settings including the home. Finally, we expect the Walgreens Health organic business to scale rapidly as we add new payer and provider partners and increasingly move to value based and delegated risk arrangements. We expect the Walgreens Health organic business to contribute over $1 billion in sales by 2025.
Moving now to our EBITDA projections for US Healthcare. We have a clear path to profitability by fiscal year 2024, building to a target of mid-teens adjusted EBITDA margin. We are projecting adjusted EBITDA of $125 million to $225 million in 2024, rising to $500 to $700 million in 2025. We are confident in this trajectory with several factors expected to drive significant profit growth. Achieving scale across the portfolio is critical, as it enhances our ability to cover central overheads and platform investments, including technology. As you have seen the earlier, sales will scale from $5 billion in fiscal 2023 to $7 billion to $8 billion dollars in 2024 and $11 billion to $12 billion by 2025. [Indecipherable] VillageMD clinic profile is a significant tailwind as a greater percentage of clinics reach positive contribution margin. As a reminder, this typically occurs in year three on a seven-year glide path to very attractive at-scale economics.
Within the Walgreens Health organic business, we continue to have productive discussions with existing and prospective payer partners around the shift to risk arrangements and our margin accretive Shields business is projected to continue to grow strongly. On top of all this, the US Healthcare team has identified sizable synergy opportunities across our various health care assets and they are operating with speed and agility and driving operating efficiencies on a clear path to profitability.
Let me now wrap-up the guidance section. I would like to leave you with three key takeaways as to why we are excited about the near-term and long-term outlook for WBA. First, we expect to drive positive core business momentum in fiscal 2023 as we lap strong COVID-19 execution in 2022. The US Healthcare segment is rapidly approaching positive adjusted EBITDA. The business continues to scale and we have raised our 2025 sales outlook to $11 billion to $12 billion, representing a compound annual growth rate of roughly 50%. Finally we remain confident in our long term growth algorithm and we are reconfirming our goal of low teens EPS growth.
We are committed to our vision and strategy and we have and will take action to simplify the business and unlock shareholder value.
With that let me now pass it back to Ros.
Rosalind Brewer — Chief Executive Officer
Thank you, James. Now we’re going to turn the page and offer more insights into our US Healthcare segment. As I mentioned earlier, we’re very happy to have John Driscoll joining us as our President of US Healthcare. John is an outstanding entrepreneur who has partnered closely with us for some time now in his role as CEO of CareCentrix. He is an incredibly knowledgeable thought leader in health care and has become a confidant and a friend as we work side-by-side during our three-year planning process. I am certain he will be able to hit the ground running overseeing this vitally important part of our business and building on our strong momentum.
John, welcome once again. And now, I’ll turn it over to you.
John Driscoll — Executive Vice President and President, US Healthcare
Thank you, Ros. I’ve spent my career, leading initiatives to re-imagine and reinvent health care solutions that improve outcomes, lower costs and meet patients where they are. I am delighted to join you today as the President of US Healthcare. I believe the Walgreens is uniquely positioned with its pharmacy backbone, as well as the quality of the assets and teams that we have invested in to start the journey at scale to help health plans and patients, lower costs and improve outcomes. Building on our strong foundation in retail and specialty pharmacy, our US healthcare business expands WBA into significantly larger and faster growing profit pools. We’re gaining access to $135 billion in addressable EBITDA profit pools versus $41 billion today. We focus on market segments that are natural extensions of the pharmacy that create value for our payer and provider partners and again, meet consumers where they are. I’m thrilled that WBA has invested in foundational best-in-class assets with VillageMD, Shields and CareCentrix. That together create a platform for us to drive growth in some of the most attractive healthcare markets. Primary care physicians are at the center managing health and wellness of patients and we have a market leading business in VillageMD. As more care moves into the home and the community, we have a natural platform to meet that demand from plans in patients with CareCentrix.
Specialty pharmacy is one of the fastest growing segments in health care and most specialty spend originates in health systems. We also have an industry-leading provider in health system, specialty pharma services in Shields. Simple convenient access to low acuity healthcare services is also a key to managing the health of our consumers. We’re starting to deliver population health services through our health corners to close care gaps and help our payer and provider partners expand their reach. In the end, scale is critical, but healthcare is local. We’re creating a nationally scaled health care business which will leverage our entire portfolio to deliver better care at lower costs. And by focusing our portfolio on these higher growth markets, we will accelerate the return on our investment and our path to profitability in US health care.
Today, most patients and their caregivers are overwhelmed as they try to manage across different health conditions, providers, appointments, bills and medications. They struggle with getting basic access to care and experience a lack of coordination across their health needs. Our consumer-centric tech enabled model will provide care across the full continuum, bringing together products and services across our portfolio. We see significant opportunities for synergies, allowing us to pursue value based care and risk arrangements which will demonstrate the value of an integrated approach.
Our focus is on expanding our risk business, supporting integrated care, expanding our pharmacy value proposition and driving operational efficiencies. Over the past year, we’ve made strategic investments to rapidly expand the breadth and depth of our portfolio, bringing together our current individual assets, which are increasingly working together our US Health care segment now covers over 26 million lives cared for through a network of over 12,000 providers in communities across all 50 states. While the retail pharmacy is not part of our US Healthcare segment, it serves as the bedrock of our healthcare portfolio. We have deep community ties and demand for healthcare services in our stores has never been higher. And it’s not just consumers looking to Walgreens for help with healthcare, federal, state and local jurisdictions are increasingly looking to partner with us because we are close to patients and they know they can count on us to deliver high quality services that are absolutely critical.
Our pharmacy serves 96 million patients through a team of 90,000 care providers. We administered 48 million total vaccines in fiscal year 2022. And importantly, almost half of our pharmacies are in high need underserved areas where we can drive health and vaccine equity. Our front-end business is increasingly relevant to health and wellness as we’ve seen with the sale of COVID OTC tests as well as our trusted selection of OTC medications. Both the retail and pharmacy businesses are serving the consumer across channels. We drove a 117 million visits to the Walgreens app last year.
Lastly, our stores are anchor access points to serve consumers through our Walgreens Health business, which now covers more than 2.3 million lives through three health plan partners. Health advisors in our stores conducted over 200,000 interactions with consumers to tend to their healthcare needs. Being lost in the wilderness of health care is a big challenge for patients and families. Walgreens Health is perfectly positioned to help consumers navigate what can be bewildering experience in US Healthcare.
Now let’s turn to VillageMD. Village is a leading asset in the field of risk taking primary care. Village is uniquely positioned as one of the largest primary care providers in the US. We can now leverage the combined power of the Walgreen stores and our trusted brand with primary care. VillageMD providers touch the lives of over 1.6 million patients, covering over 430,000 value based patients through over 340 clinics in 20 markets. 152 clinics are co-located with Walgreens stores, half of which are in underserved areas. VillageMD has achieved a Medicare stars rating of 4.0 to 5.0 in their mature markets. It generates material Medicare Advantage cost savings of $2,400 per patient per year. We are also very proud to say that we serve patients across all socio-economic statuses and are truly payer agnostic. VillageMD is one of the leaders in the move to value based care. The move to value is increasing and inevitable and we expect very attractive growth ahead. There are a number of companies directly or indirectly competing in the value-based primary care marketplace, but VillageMD is differentiated by faster path to favorable economics, driven by our acceptance of all patient populations and all payer types. We have a unique ability to address all of the ecosystems pinpoints at scale. VillageMD’s payer agnostic model has enabled us to secure value-based contracts with every major national health plan as well as many of the local and regional health plans in the markets we serve. Our integrated primary care and pharmacy model has driven strong results, especially in combating chronic disease in the Medicare population. 23% of VillageMD Medicare patients are on at least 10 medications, Making pharmacists critical members the care teams. And moving forward, we see opportunity for commercial and care delivery synergies with CareCentrix.
Now let me talk about Shields Health Solutions. Shields is not a traditional specialty pharmacy, but instead represents an evolution to the model. Shields participates in the specialty pharmacy space by building and accelerating hospital-owned specialty pharmacy programs that are integrated with care providers at the point of care. The idea is simple. 75% of specialty prescriptions in the US originate in a health system, yet those hospitals retain only 10% of those prescriptions. Shields mission is to help the health system close that gap by driving a 5 times to 7 times higher capture rate of specialty prescriptions for our partners. Today, our network have more than 75 health system partners, represents more than 1,000 hospitals nationwide. Our partners include well-known health systems such as UMass Memorial, NewYork-Presbyterian, Ohio State University and UCHealth.
Our health system enablement model has three core components. First, an integrated clinical model between the pharmacy team and the patient care team; second, centralized infrastructure to remove administrative burdens; and third, proprietary software for end-to-end workflow and operations. Shields benefits the health system, the patient and Walgreens. We expect this business will continue to yield strong topline growth at accretive margins while also providing a balanced approach to the traditional contract pharmacy model. The Shields high-touch model is highly effective, resulting in nearly a 40% reduction in readmission rates. Shields create strong value for every participant in the ecosystem and is well ahead of key market averages. For patients, their need to get on therapy as soon as possible is critical. We get them on therapy in two days versus the market average of 21. Affordability is also critical for patients. The Shields team can help achieve an average co-pay of $8 versus an industry average of more than $100. As I mentioned before, Shields drives a superior specialty capture rate, add up to 2% versus the market average of under 10%. Shields ultimately reduces the total cost of care by about 13% compared to market averages.
Finally, let me turn to CareCentrix, as the only non-payer owned post-acute and home services platform. CareCentrix will help us extend Walgreens pharmacy network and services in the home. CareCentrix provides a national scale, care coordination and actuarial capabilities, along with a deep focus on the customer experience. We cover 19 million lives across the network of 7,500 home supplier locations. In 2022, we will coordinate nearly 6 million home-based services. CareCentrix has externally validated results, showing the total cost of care reductions of up to 20%, delivered with member satisfaction results routinely exceeding 90% and we are already working to integrate CareCentrix across our business, including VillageMD and Shields. For example, together with VillageMD after a hospital discharge, CareCentrix will be able to immediately refer a member to a primary care physician when needed and even schedule an appointment for follow-up care. Analysis has shown that this rapid action can reduce hospital readmission rates by 20%. Collaboration with Walgreens pharmacists can increase the number of successful medication reconciliations after a hospital discharge by 15 to 20%.
When done right these not only lower care costs, but also improve a health plans stars rating to drive sales growth, creating a very attractive value proposition. Relative to the competition, CareCentrix is highly differentiated. Not only are we a payor agnostic provider of home and post-acute services, but our network based model provides national reach today with an ability to easily scale. We have the most experience with over 25 years in managing home based care as well as the broadest portfolio of home and post-acute services including home health, durable medical equipment, home infusion home based palliative and hospice care and post-acute and readmissions management. This home focused platform simplifies the coordination of home services for the members, health plans and hospitals. Over-time, the platform can also easily expand to include other types of home services. Not only does CareCentrix manage the broadest set of home services, but we also manage all lines of business; Medicare Advantage, Medicaid commercial and marketplace exchange.
Let me close today by emphasizing my excitement to be joining WBA at this key moment of transformation for our company and for the US healthcare system. WBA has the right assets, the right team and the right strategy. We are already providing care delivery across the healthcare continuum in driving consumer engagement through our platform.
Thank you and let me hand it back to Ros for closing remarks.
Rosalind Brewer — Chief Executive Officer
Thank you, John and thanks to everyone for joining us for today’s extended call. Before we kick-off Q&A, let me sum up what you have heard. Fiscal 2022 was a year of broad-based outperformance against our expectations. We are well positioned to drive continued execution through our resilient core business and by scaling our winning assets. We see a clear path for US Healthcare to achieve profitability starting in fiscal year 2024 and we’re already raising long-term sales targets. At the same time, we are investing in talent and capabilities and rapidly simplifying the portfolio as part of our transformation to a healthcare company. We have good visibility to tremendous growth with best-in-class assets that we have in-place today. This builds my confidence that our strategic priorities are working to drive our long-term growth algorithm.
In closing, we are pleased with this year’s performance. We are tackling the challenges that next year poses and we have conviction in the development of our new US Healthcare business and our future growth potential.
Now I’d like to open the line for questions.
Questions and Answers:
[Operator Instructions] Your first question comes from the line of Lisa Gill from JPMorgan. Your line is open.
Lisa Gill — JPMorgan — Analyst
Thanks very much. Thank you for all the details. And John, I have to personally say I’m very excited that you’re back on the public side of the market. So let me start there. When we think about all the comments that you made around Walgreens Health, I just really want to understand a couple of things. One, when we think about the more than 2 million lives that you’re talking about today, when I try to look back and I look at some of the other comments you made around at-risk lives at VillageMD, can you maybe just talk about how we think about those 2.3 million lives, how do you monetize those lives. Is this shifting towards value-based arrangements?
And then secondly, I know James talked about 2025 and the increase and getting the profitability in that segment. How do we think about the longer-term profitability of Walgreens Health.
Rosalind Brewer — Chief Executive Officer
Hi Lisa, this is Roz. I’ll start that off and James and I and John might fill in a few little pieces here. You asked the question about value based arrangement. So the assets that we have right now, I will talk about a little bit on the Village side. Village has a large amount of their current business that isn’t about value based arrangement. And you’ll see that even more of that will grow over-time. That is our objective. And then to think about how we tie our assets together, I want to just talk a little bit about the grounding of what we have in that relationship between the pharmacist and the primary care physician because that’s the real key for us in terms of what we do inside our stores and taking that relationship that we have between our current customer and the patient that comes into VillageMD and bring those two relationships together between the pharmacists, and the primary care physician.
When you think about value based care, John, do you want to say a few words about that.
John Driscoll — Executive Vice President and President, US Healthcare
Lisa, thank you for those kind words. It’s great to be on this side again. I really want to underscore the fact that I think this is an amazing platform. With regard to the contracted lives, well, we’re starting with contracting with health plans that are really enthusiastic about partnering with Walgreens around closing care gaps and working on screenings and really integrating more into the health care system. Over-time you will see us work more closely with those plans. On shifting to risk, it’s a natural baseline and we’ve obviously got some great assets with VillageMD and CareCentrix to accelerate that transformation over-time. But right now for those 2 million lives, it’s really initial contracting around leveraging the pharmacies to close care gaps and screenings.
James Kehoe — Executive Vice President and Global Chief Financial Officer
Yeah. And Lisa, you asked about the long-term margins. We’ve given a long-term target of mid-teens and it’s probably even a little bit on the conservative side. And as you’ve seen, we’ve sort of flipping the metric to EBITDA to emphasize that we’ve already passed the peak of the investments. And I think as you look out over the coming years, I think we have Shields which is immediately profitable and we’re not breaking out by unit, but it’s at least 100 million profit in the fiscal 2022 and that is growing like gangbusters. We’ve given you the revenue growth and you can probably assume that the profit growth on that business will outpace the revenue growth as it scales. CareCentrix is a new acquisition. I think you can make your own estimate. So I think we’ve said in the past it’s like mid to high single-digit margins and we’ve given you a revenue number, we’ve given you a broad number. So that’s pretty easy. I think the one we are probably struggling with a bit is VillageMD. We’ve been quite clear on this one that that’s in a investment phase and we actually accelerated the investments in 2022. So instead of 160 clinics in calendar 2022, we’ve gone to 200. So we’re actually doing the smart thing, we’re doubling down. This is a scale business. And the unique part of, as John said about the model is this is not an Oak Street. This is a model that breaks even in year three. So opening clinics for us, yes, it will be painful in the first two years.
We are still processing the Q&A portion of the conference call. We will be updating it as soon as we analyze and process the con call. Stay tuned here for more updates.
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