Ben Haynor

Ben Haynor of Lake Street Capital Markets asked about the impact of ALJ decisions on formalizing payer policies, whether payer criteria are becoming clearer, pipeline attrition metrics, how to replicate German success in the U.S., and growth expectations for AlterG and MyoCycle.

Answer

CEO Mark Grant explained that a high win rate in ALJ cases is key to bringing payers to the table to formalize processes. He noted that near-term claims are being processed more smoothly, indicating progress. Grant stated that pipeline attrition is currently low and the focus is on process formalization. To replicate German success, he emphasized focused execution, new channel partners, and operational rigor. He also confirmed the company expects growth from both AlterG and MyoCycle.

Inquired about the degree to which the new CorLife and MYOLYN partnerships are factored into the 2025 revenue guidance and asked for clarification on the reasons for patient attrition with the ReWalk system.

Answer

The impacts of the CorLife and MYOLYN partnerships are factored into the 2025 guidance, but conservatively, as they are new arrangements. The CorLife deal provides a significant conduit into the workers' compensation market, while the MYOLYN expansion opens up the much larger home-use market. The patient attrition mentioned was due to seasonal factors and patient-specific deferrals (e.g., illness), which are not unusual and are viewed as delays rather than lost sales.

Asked for specifics on ReWalk placements (Part B vs. other), Q4 AlterG guidance, the status of supplemental insurance payments, Medicare accounts receivable aging, and the development of a standardized claims process.

Answer

The company does not break down placements by payer. Q4 AlterG sales are expected to improve over the prior year. Supplemental insurance payments are contingent on the primary Medicare claim being processed, so they are also delayed. Medicare A/R doesn't go back far, and a reserve is already in place for potential non-payment. They have made significant progress in standardizing the claims submission process but noted that CMS is also on a learning curve.

Ben Haynor of Lake Street Capital Markets inquired about the relationship between the proposed CMS physician fee schedule and the separate Local Coverage Determination (LCD) affecting ultrasound reimbursement. He also asked if the LCD uncertainty had impacted customer interest, treatment volumes, or progress toward the company's goal of 1,000 installed units.

Answer

CEO Joseph Sardano and President Michael Sardano clarified that the LCD and the physician fee schedule are two separate matters. They explained that the LCD, which they are actively lobbying against and believe will not be implemented, only questions the frequency of ultrasound use. Conversely, they are very optimistic about the proposed physician fee schedule, which would increase the SRT delivery code reimbursement by over 300%. They acknowledged the LCD created a temporary market pause but believe a favorable resolution will accelerate system installations.

Asked for more detail on the progress of discussions with private equity groups, whether the company plans to report a 'patients-treated' metric for Fair Deal Agreements (FDAs), the expected ramp-up time for patient volumes at new sites, and whether the Q4 increase in G&A expenses was a one-time event.

Answer

The company has signed one large group to an FDA and is in advanced discussions with 3-4 others. They plan to report a patient-treated metric once numbers are significant. There is an approximate 3-month lag from signing an FDA to recognizing revenue due to site setup (8 weeks) and billing cycles (45-60 days). The spike in Q4 G&A was attributed to one-time professional fees and compensation adjustments, and is not expected to be the new run rate.

Ben Haynor from Lake Street Capital Markets requested an update on the telehealth pilot, including its rollout strategy and potential pricing. He also asked about interest from other hospitals following the CHKD partnership and whether any adoption trends are emerging for BabySat in states with Medicaid coverage.

Answer

President Jonathan Harris explained that the telehealth pilot integration is taking longer than expected but is targeted for a Q4 launch, with pricing yet to be determined. He confirmed that dialogue with other hospitals has increased since the CHKD announcement and that it's still too early to identify specific adoption trends for BabySat in Medicaid-covered states.

Asked for updates on the telehealth offering's rollout and pricing, interest from other hospitals following the CHKD partnership, and any observable adoption trends for BabySat via Medicaid.

Answer

The telehealth pilot is planned for a Q4 launch, with pricing yet to be determined. The CHKD announcement has spurred increased dialogue with other hospitals. It is still too early to identify significant adoption trends for BabySat through Medicaid channels, as it's a slower process.

Inquired about the long-term retention potential for the Owlet360 subscription, the details of its recent launch, international adoption dynamics, and progress with hospital and NICU partnerships.

Answer

The company stated it is in the 'super early days' of the Owlet360 subscription but believes continued feature rollouts, including telehealth, will drive engagement and retention. The late January date marked the public launch after a beta, with very positive initial feedback. Internationally, it's still early for adoption to accelerate, but Germany is a strong, growing market post-CE clearance. Regarding hospitals, their partner AdaptHealth is helping them get into NICUs, and physicians are now starting to recommend Owlet products.

Ben Haynor of Lake Street Capital Markets questioned the company's preference between acquisition versus de novo expansion for its OPSB business and asked if the anticipated 'halo effect' from the EOS portfolio development is already materializing.

Answer

CEO Dave Bailey clarified that the company prefers Greenfield (de novo) expansion in established territories and acqui-hires in new jurisdictions to build an initial footprint. He confirmed that the 'halo effect' from their investment in the EOS portfolio is already benefiting the broader scoliosis business by creating new opportunities with customers for their existing fusion products.

Ben Haynor from Lake Street Capital Markets asked for more specifics on the home care pilot, including the magnitude of the readmission reduction and the criteria for expanding to more states. He also questioned if the IQ Station could help access traditional hospital ultrasound budgets and requested an update on the next-generation P5 chip.

Answer

President, CEO & Chairman Joseph Devivo stated that while partner data is confidential, the pilot cut readmissions 'at least by half.' He explained the first state-wide rollout is to prove these results are transferable at scale. Devivo confirmed that the IQ Station is designed to compete with POCUS carts and access existing hospital capital budgets. He described the upcoming P5 chip as a 'generational step up' in image quality that he believes will make Butterfly's technology the clear choice over legacy systems.

Ben Haynor inquired about ATEC's penetration in geographies where it has been historically under-indexed and how adoption, particularly with EOS, accelerates on a regional basis.

Answer

Chairman & CEO Pat Miles responded that the EOS image is the "most coveted image in Spine" and foundational for alignment. He explained that academic institutions are enthusiastic about ATEC's ability to translate EOS data into predictive informatics to improve surgical durability. This enthusiasm for the ecosystem's potential is driving adoption and interest in previously underserved areas.

Ben Haynor of Lake Street Capital Markets inquired about the quantifiable value of deferred Enterprise Health sales, the projected timeline for the Personal Health business to surpass the Enterprise segment, progress on the patient claims process with partners like Pria, and the content scope of the new Ekso University platform.

Answer

CEO Scott Davis quantified the two deferred multi-unit sales at approximately $1.4 million, with a significant portion expected to close in Q3 2025. He projected the Personal Health business could overtake the Enterprise segment by 2027, driven by new distribution partners and a growing patient pipeline. Davis also noted positive progress in the claims appeal process, with an Administrative Law Judge (ALJ) approval in Q2, and explained that Ekso University will offer broad neuro-rehabilitation content beyond just exoskeletons to educate the entire industry.

Asked about the timing and financial implications of the additional cost savings, the drivers behind the updated guidance, and the potential for the upcoming Ayon launch to cause customers to delay current purchases (the Osborne effect).

Answer

The executive clarified that cost savings are part of a multi-year effort with no additional charges beyond what was stated, and the updated guidance reflects capital market weakness, not a change in disposable utilization. They do not anticipate an "Osborne effect" from the Ayon announcement; instead, they believe it will incentivize near-term upgrades to the required Apyx One generator.

The analyst asked about the nature of future milestone payments from AbbVie and inquired about the progress and expectations from the cross-promotion collaboration with Stratasys.

Answer

The company stated they cannot disclose the specific nature of the remaining $26 million in milestone payments from AbbVie. Regarding the Stratasys collaboration, the current focus is on developing the printing process for the breast implant using Stratasys's Origin One printer. Significant BioInk sales from this partnership are expected at a later stage.

Ben Haynor from Alliance Global Partners asked if the company's M&A strategy had changed due to COVID-19 and whether the current financial environment might make insurers more willing to consider reimbursement for their tests.

Answer

CFO Fred Knechtel mentioned that while there were some inbound M&A calls early in the pandemic, activity has slowed, and the company is internally focused on its rebound. President and CEO Jack Stover added that travel restrictions and the continued ability of small companies to raise capital have also cooled the M&A landscape. Regarding reimbursement, Stover stated the process remains highly data-driven, but he is pleased with the progress his team is making in converting agreements to contracts, attributing it to the company's growing stability and data.