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    Brooks O'Neil

    Senior Research Analyst at Lake Street Capital Markets

    Brooks O'Neil is a Senior Research Analyst at Lake Street Capital Markets, specializing in emerging growth healthcare service and medical device companies. He covers specific companies such as Tandem Diabetes Care, Sientra, Semler Scientific, Avita Medical, LifeMD, and P3 Health Partners, and has issued over 230 price targets with a 39% success rate and an average targeted upside of 32%, including a top-performing SMLR call with a 25.7% return in three days. O'Neil began his finance career at Dougherty & Co., spent 15 years at Piper Jaffray in institutional equity research and investment banking, and joined Lake Street after nearly 30 years in capital markets, earning Thomson Reuters Starmine’s No. 1 health services sector stock picker ranking twice. He holds a BA from the University of Connecticut, an MBA from Dartmouth’s Tuck School, and maintains securities industry credentials in accordance with FINRA requirements.

    Brooks O'Neil's questions to Electromed (ELMD) leadership

    Brooks O'Neil's questions to Electromed (ELMD) leadership • Q3 2025

    Question

    Brooks O'Neil of Lake Street Capital Markets inquired about Electromed's strategy for hiring new sales representatives, the continued suitability of the $900,000 to $1 million revenue-per-rep target, and the current outlook on the reimbursement environment.

    Answer

    President and CEO James Cunniff explained that the company is taking a thoughtful and deliberate approach to hiring, ensuring existing reps are prepared for territory changes and that new hires are high-quality. He also noted an investment in a new sales rep for the hospital business. CFO Brad Nagel added that since the company has exceeded the revenue-per-rep target for two of the last three quarters, they may revise it upward. Regarding reimbursement, Mr. Cunniff stated that the company feels insulated from volatility and has seen improved payer coverage opportunities due to a new leader in their payer relations department.

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    Brooks O'Neil's questions to Electromed (ELMD) leadership • Q2 2025

    Question

    Brooks O'Neil asked about the competitive landscape, specifically if any competitors have responded to the improved SmartVest. He also inquired about recent developments in drugs for treating bronchiectasis and whether the high revenue per sales representative is sustainable.

    Answer

    James Cunniff, an executive at Electromed, stated that while Hill-Rom recently upgraded its technology, it has not impacted Electromed's business. He emphasized that SmartVest remains best-in-class with its single-hose design, comfortable garments, and lifetime warranty. Regarding new drugs, Cunniff explained that an upcoming drug for bronchiectasis is viewed as complementary to, not a replacement for, airway clearance therapy. On sales force productivity, he attributed the high revenue per rep to better performance management, improved hiring, and enhanced onboarding processes, noting that revenue is now more broadly distributed across the entire sales team.

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    Brooks O'Neil's questions to AVITA Medical (RCEL) leadership

    Brooks O'Neil's questions to AVITA Medical (RCEL) leadership • Q1 2025

    Question

    Brooks O'Neil inquired about the anecdotal response and performance observed during the limited Q1 commercial launch of Cohealyx, and also asked for feedback on the launch of RECELL GO mini in trauma centers.

    Answer

    CEO James Corbett responded that the limited market release of Cohealyx validated preclinical data showing graft readiness in just seven days, citing a specific case at Ohio State. He confirmed that as of April 1, the company is fully stocked with all Cohealyx SKUs. Regarding RECELL GO mini, Corbett noted a positive response from existing trauma accounts, highlighting that the product is appropriately sized for the majority of traumatic wounds and that the expanded portfolio is enhancing the value proposition for trauma surgeons.

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    Brooks O'Neil's questions to AVITA Medical (RCEL) leadership • Q4 2024

    Question

    Brooks O'Neil of Lake Street Capital Markets asked for details on the renegotiated OrbiMed credit agreement, specifically the covenant cushion, and questioned if the company was amassing sufficient human clinical evidence for Cohealyx to drive significant revenue in the second half of 2025.

    Answer

    CFO David O'Toole provided specifics on the amended OrbiMed covenant, noting lowered TTM revenue requirements for Q1 ($73M) and Q2 ($78M) to provide more cushion. CEO Jim Corbett detailed the Cohealyx evidence strategy, explaining that early human cases are showing promising results and the post-market study design allows for interim data to be shared, which will support the commercial launch before the study is fully enrolled.

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    Brooks O'Neil's questions to AVITA Medical (RCEL) leadership • Q3 2024

    Question

    Brooks O'Neil of Lake Street Capital Markets asked about the hospital Value Analysis Committee (VAC) process, the reasons for a shortfall in new account conversions, and how management evaluates the performance of its expanded sales team.

    Answer

    CEO Jim Corbett clarified that the lower-than-expected new account conversions resulted from a deliberate strategic pivot to accelerate the transition of existing accounts to the RECELL GO platform, which drove record revenue. He also stated that the sales team's performance is evaluated on results, pointing to the 29.6% sequential quarterly growth as a key indicator of their success.

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    Brooks O'Neil's questions to AVITA Medical (RCEL) leadership • Q2 2024

    Question

    Brooks O'Neil asked if the revised, lower revenue guidance creates heightened pressure from debt covenants for the second half of the year. He also requested more color on the long-term strategy and focus for the company's international expansion.

    Answer

    CEO James Corbett responded that the company is not focused on the debt covenant but rather on strong execution, noting that July was a very strong month. For international expansion, he outlined a focus on approximately 10 EU countries via third-party distributors, with the key catalyst being the expected RECELL GO CE mark approval in Q3, which will simplify training and accelerate adoption.

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    Brooks O'Neil's questions to VIEMED HEALTHCARE (VMD) leadership

    Brooks O'Neil's questions to VIEMED HEALTHCARE (VMD) leadership • Q1 2025

    Question

    Brooks O'Neil inquired about the success of the recent sales reorganization and hiring, the current competitive environment, the strategic rationale for expanding into women's health via the Lehan's acquisition, and the potential for an increased pace of M&A.

    Answer

    CEO Casey Hoyt clarified that the previous hiring pause during the sales restructuring was intentional and that the company is now aggressively recruiting with positive results. He stated that Viemed competes more with the large underserved patient population than with specific companies. Regarding the Lehan's acquisition, Hoyt explained that the women's health business is a simple resupply model that can be scaled using Viemed's national payer contracts, while Viemed's complex respiratory expertise can be introduced to Lehan's existing operations. COO Todd Zehnder added that while the company is always looking for acquisitions, it remains patient and is not capital-constrained, citing its strong balance sheet.

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    Brooks O'Neil's questions to VIEMED HEALTHCARE (VMD) leadership • Q3 2024

    Question

    Brooks O'Neil of Lake Street Capital Markets asked for clarification on recent positive regulatory developments, questioning if they involve increased reimbursement or are solely focused on clarifying usage guidelines.

    Answer

    CEO Casey Hoyt explained that there are two separate regulatory items. The '75-25' relief is a rate reimbursement issue that could provide a net financial win for the company if reinstated. The other item, the NCD (National Coverage Determination), is not related to reimbursement but aims to establish clearer, data-backed clinical guidelines for NIV therapy, which would create a more stable business environment.

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    Brooks O'Neil's questions to VIEMED HEALTHCARE (VMD) leadership • Q2 2024

    Question

    Brooks O'Neil from Lake Street Capital Markets inquired about Viemed's strategy in a 'target-rich environment,' the potential to replicate its recent joint venture (JV) framework, and the financial implications of the Philips ventilator recall and buyback program.

    Answer

    CEO Casey Hoyt explained that the company is focused on sales efficiency and cross-selling across all product lines, driven by the recent sales force restructuring. He also noted they are proving out the current JV model before expanding it. COO Todd Zehnder added that the Philips buyback is a significant financial positive, allowing Viemed to replace its ventilator fleet at a cost advantage and record an accounting gain without negative impacts on cash flow.

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    Brooks O'Neil's questions to InfuSystem Holdings (INFU) leadership

    Brooks O'Neil's questions to InfuSystem Holdings (INFU) leadership • Q1 2025

    Question

    Brooks O'Neil inquired about the potential to expand the Biomed services business by adding new customers beyond the primary GE Healthcare partnership.

    Answer

    CEO Carrie Lachance confirmed that expanding the Biomed business is a key focus. She highlighted the company's strong regional technician network as a key asset that can be leveraged to secure additional work from both GE and new partners, thereby growing the operation and leveraging fixed costs.

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    Brooks O'Neil's questions to InfuSystem Holdings (INFU) leadership • Q3 2024

    Question

    Inquired about the level of equipment purchases, the robustness of the biomedical business pipeline, and the potential market size for the Chemo Mouthpiece opportunity.

    Answer

    Equipment purchases were $2.8 million for the quarter, not $10-12 million, and are necessary to support growth. The biomedical services pipeline is robust, and more deals like Dignitana are expected. The Chemo Mouthpiece opportunity has a very large total addressable market (around $0.5B), but it's too early to provide specific guidance, though the potential is in the millions of dollars, not hundreds of thousands.

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    Brooks O'Neil's questions to InfuSystem Holdings (INFU) leadership • Q2 2024

    Question

    Brooks O'Neil inquired about the Negative Pressure Wound Therapy business, specifically the interplay between prior-year leases and the new Smith+Nephew agreement. He also asked for updates on the biomedical services segment, including the strength of the GE partnership and new customer potential, and sought details on the expected timeline for the Sanara joint venture.

    Answer

    Executive Richard DiIorio explained that the older Cork Medical device leases are a separate business from the new Smith+Nephew referral agreement and will remain active. He affirmed the GE relationship is strong with new opportunities being reviewed, and other non-GE biomedical partnerships are imminent. Regarding the Sanara JV, DiIorio detailed a three-pronged approach including advanced wound care products, the new Radiaderm product for oncology, and a long-term value-based care model, with revenue contributions accelerating into 2025.

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    Brooks O'Neil's questions to Beta Bionics (BBNX) leadership

    Brooks O'Neil's questions to Beta Bionics (BBNX) leadership • Q1 2025

    Question

    Brooks O'Neil asked about the impact of the Abbott Libre 3 integration on new patient starts and questioned the economic rationale for payers to enthusiastically adopt the pharmacy model if it costs them more over the long term.

    Answer

    CEO Sean Saint and CFO Stephen Feider acknowledged the Libre 3 integration was a positive contributor but did not quantify its specific impact. Feider explained that payers favor the pharmacy model because it simplifies policing the 4-year replacement cycle and because they believe broader access to AID pumps improves patient outcomes, ultimately lowering total healthcare system costs.

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    Brooks O'Neil's questions to Beta Bionics (BBNX) leadership • Q4 2024

    Question

    Brooks O'Neil inquired about market reception to the Abbott Libre 3 Plus integration, the patient out-of-pocket cost experience in the pharmacy channel versus DME, and whether the Blue Cross Blue Shield plans associated with Prime Therapeutics were expected to be receptive to providing coverage.

    Answer

    CFO Stephen Feider and CEO Sean Saint declined to share CGM-specific adoption data, citing their CGM-agnostic stance. Feider detailed that the pharmacy channel is 'massively better' for patients, with minimal to no upfront cost compared to DME. He also confirmed they expect coverage from Prime's partner plans to begin in the near term and grow over time, without naming specific plans.

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    Brooks O'Neil's questions to Alphatec Holdings (ATEC) leadership

    Brooks O'Neil's questions to Alphatec Holdings (ATEC) leadership • Q1 2025

    Question

    Brooks O'Neil inquired about the market size and competitive landscape for ATEC's new Corpectomy system, and asked if EOS functionality would be integrated into the procedure.

    Answer

    Executive Patrick Miles explained that while the market is difficult to value, ATEC's key advantage is its unique prone position (PTP) approach, which offers access to both the front and back of the spine. He highlighted the system's advanced engineering and integration with SafeOp monitoring. Miles confirmed that EOS will be integral for pre-operative planning and post-operative assessment to ensure proper alignment, which is critical for improving long-term patient outcomes.

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    Brooks O'Neil's questions to Alphatec Holdings (ATEC) leadership • Q4 2024

    Question

    Brooks O'Neil asked for assurance that ATEC would not elevate spending in 2025 to capitalize on industry disruption and would remain focused on the profit delivery goals outlined in the prepared remarks.

    Answer

    Patrick Miles (Executive) assured that the company's strategic plan already incorporates the dynamics of a disrupted marketplace and that significant investments have already been made. He stated he does not foresee unique, outsized expenses that would undermine the company's financial thesis, expressing confidence in leveraging ATEC's expertise in spine.

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    Brooks O'Neil's questions to Alphatec Holdings (ATEC) leadership • Q3 2024

    Question

    Brooks O'Neil questioned how the company can convince investors it will not outspend its resources, given persistent concerns about cash burn.

    Answer

    Executive Patrick Miles emphasized the company's commitment to becoming self-funding, pointing to consecutive quarters of flat operating expenses and a streamlined organization. Executive J. Koning added that growth is generating profitability, highlighting a deliberate expansion of EBITDA margins and a significant 2024 investment in inventory that reduces the required spend for 2025, providing a clear path to cash flow breakeven.

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    Brooks O'Neil's questions to ACCURAY (ARAY) leadership

    Brooks O'Neil's questions to ACCURAY (ARAY) leadership • Q3 2025

    Question

    Brooks O'Neil inquired about the specific impact of deferred China revenue on the third quarter's adjusted EBITDA and asked whether other international markets, such as India and South America, could face tariff impacts similar to those anticipated in China.

    Answer

    Chief Financial Officer Ali Pervaiz explained that product margins were impacted by a higher margin deferral on China shipments in Q3, but noted that the year-to-date product margin of around 31% is in line with expectations. President and CEO Suzanne Winter added that while the China impact is currently the most significant, the company sees offsetting strength in its IMEA region, which includes India, and the non-China APAC region.

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    Brooks O'Neil's questions to ACCURAY (ARAY) leadership • Q2 2025

    Question

    Brooks O'Neil asked about the drivers behind the strong performance in Japan, a market previously described as mature. He also inquired about progress in other emerging markets like India and the competitive positioning of products such as the Helix system in terms of both price and clinical capability.

    Answer

    CEO Suzanne Winter explained that Japan's strong first-half performance was anticipated due to customer installation timing in what is primarily a competitive replacement market. Regarding other markets, she highlighted the EIMEA region's expected second-half growth, driven by the new Helix platform which has already secured orders in Pakistan and Northern Africa. She noted they are awaiting regulatory approval for Helix in India. Winter emphasized that the competitive advantage for products like Helix and Tomo C stems from differentiated clinical capabilities, such as helical delivery, rather than just pricing.

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    Brooks O'Neil's questions to ACCURAY (ARAY) leadership • Q1 2025

    Question

    Brooks O'Neil asked for an update on order tracking and the shipping timeline for the Helix product in India, and also inquired about the potential impact of U.S. election results on growth in foreign markets like China.

    Answer

    President and CEO Suzanne Winter confirmed that Accuray has received CE Mark for the Helix product, is taking orders in India, and expects to begin shipping in early Q3 after local regulatory testing is completed. Regarding the U.S. election, she noted that as the only U.S.-headquartered radiotherapy company, Accuray could benefit from policies favoring U.S. manufacturing, but the company is monitoring potential changes while remaining confident in the fundamental, growing demand for cost-effective cancer care.

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    Brooks O'Neil's questions to TANDEM DIABETES CARE (TNDM) leadership

    Brooks O'Neil's questions to TANDEM DIABETES CARE (TNDM) leadership • Q1 2025

    Question

    Brooks O'Neil inquired about the company's long-term expectations for the sales mix between the pharmacy channel and other channels like DME.

    Answer

    CFO Leigh Vosseller stated that while current guidance only assumes a modest contribution from the pharmacy channel in 2025, early learnings have been very positive. She indicated that the channel could represent a more significant opportunity than originally anticipated in the long term.

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    Brooks O'Neil's questions to TANDEM DIABETES CARE (TNDM) leadership • Q3 2024

    Question

    Brooks O'Neil followed up on the pharmacy contract, asking how Tandem's pricing would compare to a competitor's premium pricing in that channel.

    Answer

    EVP and CFO Leigh Vosseller stated that while she could not share contractual or competitive details, any agreement must meet two key criteria: lowering the patient's out-of-pocket cost and being at least as economically favorable as their existing DME contracts. She confirmed the new agreement met this standard.

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    Brooks O'Neil's questions to LifeMD (LFMD) leadership

    Brooks O'Neil's questions to LifeMD (LFMD) leadership • Q4 2024

    Question

    Brooks O'Neil requested an explanation for the fourth-quarter gross margin decline and an update on the outlook for the WorkSimpli business. He also asked about the status of Medicare reimbursement for both GLP-1 drugs and telehealth services, and for details on the planned Behavioral Health program.

    Answer

    CFO Marc Benathen attributed the gross margin dip to onetime costs from onboarding a new pharmacy, stating that margins are expected to normalize to 88-90%. He also confirmed WorkSimpli is back on track, generating over $1 million in monthly adjusted EBITDA. Executive Justin Schreiber expressed high optimism for eventual Medicare coverage of GLP-1s and noted that telehealth coverage has been extended with strong bipartisan support for a permanent solution. Marc Benathen then detailed the Behavioral Health launch, highlighting the hiring of industry veteran Julian Cohen and an initial async-first offering for anxiety and depression, with plans to partner for talk therapy solutions.

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    Brooks O'Neil's questions to Organogenesis Holdings (ORGO) leadership

    Brooks O'Neil's questions to Organogenesis Holdings (ORGO) leadership • Q4 2024

    Question

    Brooks O'Neil inquired about the current competitive environment, customer purchasing behaviors related to inventory, and the expected market launch timeline for ReNu following its BLA submission.

    Answer

    CFO David Francisco clarified that the market challenge stems from customer buying behavior pausing due to reimbursement uncertainty from the LCD delay, not from a change in competition. He noted that the short shelf life of living technologies limits inventory stocking. CEO Gary Gillheeney outlined the ReNu timeline, projecting a BLA submission by the end of 2025, potential FDA feedback in Q4 2026, and a market launch in late 2026 or early 2027.

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    Brooks O'Neil's questions to MIMEDX GROUP (MDXG) leadership

    Brooks O'Neil's questions to MIMEDX GROUP (MDXG) leadership • Q4 2024

    Question

    Brooks O'Neil of Lake Street Capital Markets, LLC requested an update on the status of several outstanding legal matters, including the AXIOFIL case with the FDA, the Surgenex lawsuit over employee turnover, and intellectual property enforcement against knockoff products.

    Answer

    CFO Doug Rice characterized the company's legal stance as playing 'offense' to protect its business. He noted the AXIOFIL case has been reassigned to a new judge with a hearing set for late March, a positive sign. The Surgenex case is proceeding through depositions. Regarding IP, he confirmed MiMedx has filed one lawsuit and is actively communicating with other companies believed to be infringing on its patents, viewing these actions as a way to protect its portfolio and potentially generate royalty streams.

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    Brooks O'Neil's questions to MIMEDX GROUP (MDXG) leadership • Q3 2024

    Question

    On behalf of Brooks O'Neil, an analyst asked for an update on the development and customer adoption of the MiMedx Connect portal since the previous quarter.

    Answer

    CEO Joseph Capper reported that customer adoption of MiMedx Connect continues to exceed expectations, with users providing positive feedback on its ability to enhance practice workflow. He added that the company is actively developing additional features based on this feedback to further integrate into customer operations and increase loyalty.

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    Brooks O'Neil's questions to HARROW (HROW) leadership

    Brooks O'Neil's questions to HARROW (HROW) leadership • Q3 2024

    Question

    Brooks O'Neil asked for additional details on Q3 summer seasonality, any unexpected challenges or concerns with the launches of VEVYE, IHEEZO, and TRIESENCE, and whether the company plans to re-engage the cataract surgery market for IHEEZO after its 'retina pivot'.

    Answer

    CEO Mark Baum explained that Q3 is historically weak due to summer vacations reducing surgical procedures. Regarding launches, he noted IHEEZO overcame early reimbursement hurdles and is now positioned for strong growth. He highlighted VEVYE's exceptional refill rates and stated that while TRIESENCE has faced minor issues, the company has contingency plans. Baum clarified that while they will service existing IHEEZO cataract customers, the strategic 'retina pivot' is to focus on the larger, more clearly reimbursed intravitreal injection market to achieve long-term revenue goals.

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    Brooks O'Neil's questions to P3 Health Partners (PIII) leadership

    Brooks O'Neil's questions to P3 Health Partners (PIII) leadership • Q3 2024

    Question

    Brooks O'Neil inquired about P3 Health's capital availability and liquidity runway, highlighting the Q3 ending cash balance of $63 million against a negative operating cash flow of $20 million for the quarter.

    Answer

    CFO Leif Pedersen confirmed the figures and stated that the current cash position supports core operations and strategic initiatives. He acknowledged the cash burn rate is being actively monitored, with a focus on optimizing working capital. Pedersen expressed confidence in maintaining liquidity, noting that the company has access to potential credit facilities or strategic financing options if required.

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    Brooks O'Neil's questions to SURMODICS (SRDX) leadership

    Brooks O'Neil's questions to SURMODICS (SRDX) leadership • Q2 2024

    Question

    Brooks O'Neil of Lake Street Capital Markets inquired about the total addressable market (TAM) for the SurVeil DCB, whether current revenue levels are sufficient to maintain Abbott's long-term interest, Abbott's potential interest in Surmodics' below-the-knee products, and the company's future R&D spending strategy.

    Answer

    Executive Gary Maharaj affirmed the partnership with Abbott is strong and that the SurVeil TAM is dynamic and potentially much larger than the current market. He noted no current discussions with Abbott on below-the-knee products but confirmed talks with other parties. On R&D, he explained the strategy of front-loading investment to build a pipeline, which will normalize over time. Executive Timothy Arens quantified the SurVeil TAM at over $1 billion and confirmed consistent monthly orders from Abbott since its late-January launch. He added that R&D spending is decreasing as a percentage of revenue and is not expected to return to previous highs.

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    Brooks O'Neil's questions to SURMODICS (SRDX) leadership • Q2 2024

    Question

    Brooks O'Neil inquired about the total addressable market (TAM) for the SurVeil drug-coated balloon, Abbott's long-term commitment, and the company's future R&D spending levels.

    Answer

    Executive Gary Maharaj affirmed the Abbott partnership is strong and positioned the TAM as every peripheral balloon angioplasty procedure. CFO Timothy Arens quantified the U.S. TAM at approximately $1 billion and noted consistent monthly orders from Abbott. Regarding R&D, both executives explained that spending as a percentage of revenue is expected to decrease from historical levels as the product pipeline matures and revenues grow, though strategic investments will continue.

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    Brooks O'Neil's questions to DYNATRONICS (DYNT) leadership

    Brooks O'Neil's questions to DYNATRONICS (DYNT) leadership • Q2 2024

    Question

    Brooks O'Neil of Lake Street Capital Markets inquired about the current demand environment for physical therapy services, sought more details on the company's new product pipeline, and asked for an assessment of the current inventory position.

    Answer

    Executive Brian Baker explained that a slowdown in new facility openings by large customers, attributed to a shortage of physical therapists and strategic clinic placement, has softened demand, though replacement equipment sales remain steady. Regarding new products, Baker noted that customers are guiding the development roadmap, with a limited launch planned for Q3 and a full launch in Q4. He also confirmed that inventory levels are well-managed, with low backorders and a healthy supply pipeline to support both existing and new products.

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