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Chairman, President & CEO Ivan Tornos stated that the market remains healthy and above pre-COVID levels, cautioning against reading too much into a single quarter. He highlighted strong May/April and a very strong July, favorable pricing, strong ASC volumes, and continued long surgical waiting lists, concluding the market is still growing at least 4%.

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President and CEO Ivan Tornos addressed the outlook, stating that Q1 growth, when adjusted for one less selling day, was near the mid-single-digit target. He projected an acceleration in the second half of 2025, driven by easier year-over-year comparisons following the 2024 ERP disruption and the full commercial launch of key new products. Tornos expressed strong confidence in achieving the full-year organic growth guidance of 3% to 5%.

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CFO and EVP Suketu Upadhyay explained that 2025 gross margins are expected to be in line with 2024. He detailed headwinds from inflation, capitalized costs, and FX, which are being offset by tailwinds from efficiency gains, better plant utilization, and lower E&O. He noted that H1 2025 gross margins would be similar to Q4 2024 levels, with a sequential step-up in H2. Any benefits from recent FX hedge gains would likely materialize in the 2026 P&L.

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CEO Ivan Tornos confirmed that the previous quarter's revision implant shortage has been resolved. He clarified that Q3 U.S. knee growth was slowed by ERP-related challenges that limited the rollout of new Persona sets, not by ongoing supply constraints. He also noted the strong, nearly 10% international growth in the quarter.

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Ashley McEvoy, Director, President & CEO, confirmed the plan, framing it as consistent with Insulet's history of investing in manufacturing capacity ahead of demand. She highlighted the successful ramp-up of facilities in Acton, MA, and Malaysia, and stated that continued investment in the supply chain is necessary to stay ahead of the curve and meet future global demand.

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President and CEO Ashley McEvoy confirmed the move reflects Insulet's historical strategy of investing in manufacturing capacity ahead of demand. She cited the successful scaling of facilities in Acton, MA, and Malaysia as evidence of this approach. The planned increase in CapEx is to continue building out the global supply chain to meet anticipated future global demand.

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President & CEO John Sheridan affirmed the company's belief in the portfolio approach, stating the market is segmented and different products are needed to cover the entire spectrum of user preferences. He highlighted continued interest in the t:slim X2 and the versatility of Mobi. He also noted that the organization is driving internal efficiencies to make implementing features like mobile apps and sensor integrations across platforms easier, allowing them to maintain a flat R&D spend.

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CFO Leigh Vosseller explained that while Mobi is a growing part of the mix, it is still early in its journey to becoming fully accretive. She noted pump costs improved for both t:slim and Mobi and highlighted a clear pathway to achieving a 60% gross margin as early as 2026, driven by Mobi, pharmacy pricing, and direct OUS sales.

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EVP and CFO Leigh Vosseller characterized the current period as a "transition year" due to the Mobi launch. She noted Mobi is the largest future contributor to gross margin but is a near-term headwind until it reaches scale, which she expects to begin showing benefits in 2025. She also cited pharmacy channel access as another key long-term margin driver.

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CEO Vladimir Makatsaria explained that strong, mid-single-digit procedure growth is outpacing market supply for oxygenators, and LivaNova is gaining share while expanding its own capacity, though third-party supply is a constraint. CFO Alex Shvartsburg addressed Neuromodulation, stating the company is pleased with the first-half performance despite headwinds and views the business as a durable mid-single-digit grower, having successfully managed the generator transition.

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President of Global Epilepsy Stephanie Bolton attributed the strong OUS performance to improved commercial execution, including talent upgrades and better customer segmentation, expressing confidence in its continuation. CFO Alex Shvartsburg clarified that the positive adjustment in the EPS outlook was driven primarily by top-line revenue growth and the associated gross margin upside, supplemented by ongoing operational spending optimization.

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CEO Vladimir Makatsaria corrected the term 'moonshots,' stating that key milestones have de-risked the DTD and OSA programs. He emphasized that the #1 priority is sustained growth in the core businesses, with reinvestment to support it. He noted R&D as a percent of sales is declining, with a proportional shift towards the core. CFO Alex Shvartsburg confirmed the strategy is to grow the core businesses at above-market rates with margin expansion, which funds investment in the high-growth, healthy-margin opportunities of OSA and DTD. He affirmed the goal is to drive earnings growth ahead of the top line.

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CEO Vladimir Makatsaria outlined a three-part strategy: maximizing the core epilepsy and cardiopulmonary businesses, setting direction for DTD and OSA pending key data, and defining a future growth portfolio. CFO Alex Shvartsburg explained the Q4 revenue slowdown is due to a difficult comparison to strong Essenz placements in Q4 2023, not a change in business fundamentals, and noted Q4 margins would be impacted by planned growth investments.

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CFO Daniel Wilson acknowledged awareness of the proposal, stating the team is exploring it in the context of the product roadmap and potential for additional reimbursement, pending the final rule. President and CEO Quentin Blackford added that such proposals ultimately create greater awareness of the disease state, which can serve as a lead generation opportunity for iRhythm's products.

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CEO Quentin Blackford described the Epic partnership as 'terrific,' citing very positive feedback on workflow efficiency from early adopters. He noted that a significant number of new accounts are scheduled for integration in Q1 2025, including a key competitive conversion. While there are anecdotal signs of a volume uplift, he stated the company wants to observe trends across a broader set of accounts before factoring it into forward-looking guidance.

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CEO Quentin Blackford expressed excitement for international markets, noting progress in the U.K. and early orders from new EU markets. He highlighted Japan as the most exciting opportunity, with a commercial launch expected in H1 2025. While he expects international to be an incremental contributor, growing from ~1-2% of revenue now to 8-9% over several years, he was cautious about providing specific guidance on the ramp.

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EVP & COO Heather Knight explained that IV Solutions trends played out as expected, but softness in U.S. Injectables was a surprise, leading to a more prudent second-half outlook. EVP & CFO Joel Grade noted that Q2 was expected to be the toughest comparison and that the company is on track with its stranded cost mitigation plans, which are designed to stay ahead of the roughly 24-month TSA rolloff period.

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EVP & COO Heather Knight noted that while IV Solutions performed as expected, U.S. Injectables saw unexpected softness, leading to more conservative guidance. EVP & CFO Joel Grade confirmed Q2 was the toughest comparison and stated that the company is on track to mitigate stranded costs by 2027, staying ahead of the 24-month TSA roll-off period.

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COO Heather Knight explained that while some hospitals are conserving IV solutions, the company has factored this into its forecast and expects utilization to improve as allocations are lifted. EVP & CFO Joel Grade noted that potential pharma tariff impacts are being proactively evaluated through scenario planning, but stated that imports from the Claris plant are not material.

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CEO José Almeida identified the primary driver for growth acceleration as the normalization of the Healthcare Systems & Technologies (HST) segment, particularly the Front Line Care business, as market and operational headwinds subside. CFO Joel Grade stated that while R&D investment will see modest growth to fuel innovation, the company expects to gain operating leverage on the SG&A line in 2025 as cost-containment measures take effect.

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EVP & CFO Jereme Sylvain noted that utilization among covered Type 2 users is high, at 75-80%. He explained that retention is driven by value-added software features like the Oura Ring integration and AI-powered meal logging, which provide actionable insights and help users manage their health more effectively.

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President & CEO Peter Arduini confirmed strong double-digit order growth across the nuclear medicine portfolio, driven by excitement for new therapeutics and diagnostics. VP & CFO James Saccaro explained that conversion times vary, with flow products like Ultrasound converting in 1-2 quarters, while larger project-based Imaging systems have a 9-12 month lead time from order to sale.

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CFO James Saccaro stated the company is controlling discretionary spending while protecting key R&D and commercial investments, with a clear line of sight on 2025 mitigation savings. CEO Peter Arduini gave examples of mitigation levers like shifting production between plants. On M&A, Arduini confirmed it's a prime environment and the company is actively looking for tuck-in acquisitions to drive growth.

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CEO Peter Arduini attributed the AVS strength to strong performance in both ultrasound, driven by new platforms, and interventional systems, where the Allia IGS Pulse cath lab and OEC surgical C-arms are exceeding expectations. CFO Jay Saccaro explained the free cash flow decline was due to a strategic inventory build late in the year and that the company sees an opportunity to optimize and reduce these levels in 2025, which will drive cash flow improvement.

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CEO Peter Arduini detailed the integrated nature of the PDx business, spanning proprietary molecules, specialized imaging equipment like PET/CT and StarGuide, and digital integration tools from its MIM acquisition. CFO Jay Saccaro addressed the 2025 P&L, stating that R&D growth will likely move closer in line with sales, and he does not expect a dramatic one-time step-up in variable compensation, as it tends to move with sales performance.

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CEO Charles Divita explained that the transition has been ongoing for several years and has now reached a point where over 50% of virtual care revenue comes from visit-based arrangements. He noted that in mental health, this figure is around 70%, indicating that underlying visit growth will increasingly translate into revenue growth, though some headwinds from the subscription model shift remain.

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CFO Mala Murthy attributed the Integrated Care decline to the onboarding of a large cohort of new members with core services, who have yet to be upsold. For BetterHelp, she cited the mix of international users and lower-priced weekly offers. CEO Chuck Divita defended the member growth strategy, stating it's crucial for the shift to visit-based fees and provides a base for upselling higher-value chronic care services, which are key to future growth.

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CFO Mala Murthy detailed the 2025 outlook, citing drivers for Integrated Care like international growth, the Catapult acquisition, and visit momentum, offset by a client loss and FX. For BetterHelp, she stated the focus is on stabilization through monitoring acquisition costs, driving international expansion, and improving the core platform, with a goal of modest sequential revenue improvement from Q2 onwards.

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Daveen Chopra, Corporate VP of TMTT, asserted that real-world EVOQUE outcomes are 'similar or better' than trial data, with more evidence forthcoming. CEO Bernard Zovighian added that EVOQUE will see continuous innovation. CFO Scott Ullem declined to set a specific 30% margin target, instead reiterating the goal of 50-100 basis points of annual margin expansion starting in 2026.

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Corporate VP Daveen Chopra asserted that real-world EVOQUE outcomes are similar to or better than the TRISCEND II trial results, with more data expected at upcoming conferences. CEO Bernard Zovighian added that next-generation devices will continue to improve outcomes. CFO Scott Ullem declined to set a specific 30% margin target, instead reiterating the goal of 50-100 basis points of annual margin expansion starting in 2026.

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Larry Wood, Group President of TAVR, noted that physicians are still absorbing the data, which highlights the unpredictability of asymptomatic aortic stenosis. A detailed education plan will launch post-approval. CEO Bernard Zovighian and Daveen Chopra, Global Leader of TMTT, reiterated their 'toolbox' strategy, stating TEER and replacement are complementary. They expect TEER to remain the larger mitral therapy for now, while the tricuspid repair/replacement mix is still being defined by clinicians.

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CEO Bernard Zovighian and Daveen Chopra, Global Leader of TMTT, attributed the 2024 TMTT strength to the expanding contribution of both PASCAL and EVOQUE in the U.S. and Europe. They expect this linear growth to continue in 2025. Regarding Q1 guidance, Larry Wood, Global Group President of TAVR, explained that a typical slowdown in patient screening in late December leads to a slower start in January for TAVR, which is factored into the forecast.

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CEO Bernard Zovighian deferred TCT-related questions to the upcoming conference. Daveen Chopra, Global Leader of TMTT, explained the NTAP provides incremental payment per case, while the NCD determines which patients are covered for reimbursement, expecting a draft NCD by year-end. CFO Scott Ullem confirmed the 27-28% operating margin for 2025 is a new base off which the company plans to grow.

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CMO Dr. Ken Stein detailed the strategy for EP category leadership, which includes a complete toolkit with mapping, access solutions, and a pipeline of new catheters like Farapoint and FarraFlex. CEO Mike Mahoney added that regional growth in Japan and China is a key focus. CFO John Monson explained that while OpEx was managed in Q2 to offset headwinds, the company will continue to reinvest for growth in H2, and he expressed confidence in delivering the full-year target of 75-100 basis points of operating margin expansion.

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Michael Mahoney, Chairman and CEO, clarified that the underlying growth was closer to 7% when adjusted for selling days. He anticipates improvement in Neuromodulation driven by new products and expects Endoscopy to remain consistent. While Urology is facing some temporary supply chain headwinds in 2025, he expects the overall MedSurg portfolio to deliver healthy, balanced growth, with Endoscopy and Neuromodulation growing above market.

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CMO Dr. Ken Stein clarified the strategy is to maintain an open mapping platform while offering differentiated features on their proprietary OPAL system. He noted the persistent AF population is as large as the paroxysmal segment and expects a label for this indication by year-end. Future growth drivers include FARAPOINT for atrial flutter, the AVANT GUARD trial for first-line therapy, and the REMATCH trial for repeat ablation procedures.

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CEO Michael Mahoney emphasized the company's decentralized structure, with dedicated global teams focused on businesses like Peripheral Interventions, Endoscopy, and Urology. He stated that significant investment in PFA has not detracted from investments in these foundational businesses, which continue to have rich organic pipelines and benefit from strategic M&A like Silk Road and Axonics.

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CFO Jamie Samath noted it's too early to see impacts from Medicaid changes but acknowledged potential hospital budget pressures, positioning da Vinci as a solution to improve efficiency. He highlighted strong U.S. placements (up 45%) but challenges in Japan and Europe. Head of Investor Relations Dan Connally stated that the supply of force feedback instruments will be constrained through Q1 2026. Jamie Samath added that da Vinci V-specific INA, including force feedback, was a minor positive contributor to the INA per procedure metric in Q2.

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CFO Jamie Samath noted it's too early to see impacts from Medicaid changes but highlighted Intuitive's ability to be part of the economic solution for hospitals. He confirmed U.S. placements were strong while OUS faced challenges. VP & Head of Investor Relations Dan Connally stated Force Feedback instrument supply will be constrained through Q1 2026. Jamie Samath added that da Vinci V-specific instruments, including Force Feedback, were a minor positive contributor to INA per procedure this quarter.

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Executive Gary Guthart explained that for well-run programs, da Vinci offers an outstanding 'total cost to treat' that is often better than open or laparoscopic surgery, along with superior outcomes. He acknowledged the challenge arises from the disconnect between operating budgets, which see the savings, and constrained capital budgets. The company's strategy is to first help customers improve utilization of existing assets. He concluded that because high-quality MIS is economically beneficial, hospitals are motivated to do more of it, positioning Intuitive as a key partner.

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CFO Jamie Samath clarified that lengthened selling cycles due to competition is something they have 'seen it clearly in China' and are acknowledging as a possibility elsewhere as more competitors enter the market. Regarding I&A per procedure, CEO Gary Guthart explained they add value-creating integrated technologies. However, Samath noted that while new instruments like force feedback will add revenue, the larger driver is procedure mix. He expects I&A per procedure to 'drift down slowly' as lower-cost benign procedures grow.

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CEO Gary Guthart described the Ion launch as being in two phases: in the U.S., it has 'crossed the chasm' with a focus now on utilization and new indications, while in Europe and China, it is at the very beginning of its journey. CFO Jamie Samath explained that usage-based arrangements are popular with customers for accessing capacity without capital budget consumption and expects the trend to continue, though the growth rate may moderate in the highly penetrated U.S. market.

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CFO Vaseem Mahboob identified the ability to convert a fitting into a claim (the bill rate) as the single biggest driver, which is improved by getting more patients in-network. He benchmarked a potential best-in-class conversion rate at 76%. CEO Brian Webster commented on the ambulatory model, stating it's too early to quantify but that Kestra is well-positioned due to its ability to monitor patients at home.

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CEO Jeff Tangney responded that multi-module products are performing very well, with point-of-care/formulary expected to be a nine-figure business this year, yet adoption is still in the low double-digit percentage of brands, indicating significant room for growth. Regarding engagement, he clarified they have a News Feed, not a newsletter, which just hit a new record of over 1 million unique prescribers with a 30% YoY increase in articles tapped.

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CFO Anna Bryson explained that growth is coming from both existing customers expanding their programs and stronger-than-historical growth from SMB clients. CEO Jeff Tangney added that Doximity's performance reflects a market realization that 'context matters,' suggesting clients are returning to Doximity's high-integrity clinical platform after trialing less effective channels.

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CEO Bryan Hanson explained that the growth is a combination of factors, with improved commercial execution being the primary driver. This enhanced focus is amplifying the success of both established, underpenetrated brands like V.A.C. and recent innovations like V.A.C. Peel and Place and the digitized eBowie-Dick sterilization test.

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CEO Bryan Hanson attributed the recent top-line traction primarily to commercial excellence initiatives, including changes in talent, compensation, and culture. CFO Wayde McMillan confirmed the shift from price-led to volume-led growth in the second half of 2024 provides confidence for the 2025 guide. Regarding end markets, Bryan Hanson noted that the strong Q4 dental growth was due to an easy comparison and a blended Q3/Q4 result is more indicative of the market.

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CFO Wayde McMillan explained that Q3 gross margin included a ~100 basis point onetime benefit that offset the 3M supply agreement markup and will partially reverse in Q4. He suggested averaging Q2 and Q3 margins to get a baseline just below 56%. CEO Bryan Hanson outlined portfolio assessment criteria, focusing on faster-growth markets with favorable margin profiles where Solventum has a right to win. Regarding capacity, Hanson clarified that constraints for new products like Peel and Place are demand planning issues, not capital-intensive, while P&F capacity does require significant capital investment. McMillan added that CapEx is guided to the low end of the $400M-$500M range.

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CFO Wayde McMillan explained that Q3 gross margin included a ~100 basis point onetime benefit that offset the 3M supply markup, and suggested averaging Q2 and Q3 margins would yield a baseline just under 56%. CEO Bryan Hanson outlined the portfolio assessment criteria: focusing investments on faster-growth markets with favorable margin profiles where Solventum has a right to win. Regarding capacity, Hanson clarified that constraints for new products like Peel and Place are related to demand planning, not heavy capital, while P&F capacity does require significant capital investment. McMillan added that CapEx is being directed toward the lower end of the prior range but will support both separation activities and focused growth driver investments.

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CFO Preston Wells described pricing as a well-exercised muscle, noting positive trends in MedSurg and Neurotechnology and less price erosion in Ortho, which is a key lever to offset tariffs. VP Jason Beach and CEO Kevin Lobo confirmed Pangea is seeing excellent momentum and contributing materially, with an ongoing rollout in the U.S. and international launches planned for Australia, Canada, and Japan.

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CEO Kevin Lobo reported that all 2024 acquisitions are performing at or above their deal models and integrations are proceeding smoothly. He added that Mako Shoulder has received exciting early feedback, with 2025 being a limited launch year to refine training before a wider rollout in 2026.

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CEO Kevin Lobo highlighted the MedSurg portfolio as the largest opportunity for international growth, calling it a multi-year tailwind. Regarding Mako, he expressed extreme excitement for its potential in shoulder, comparing it to the knee application. For spine, he believes Mako will make Stryker highly competitive but noted it may not be as transformational, as the robotic offering is less differentiated in that specific market.

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Chairman, CEO and President Thomas Polen explained that intelligence gathering is led by business-level teams close to the markets, supported by a central strategy group and external consultants. While acknowledging recent forecasting challenges in research funding, he highlighted BD's strong track record of being ahead of the curve on other macro issues, such as China's VBP, inflation, and supply chain disruptions. He affirmed that while they always strive to improve, their processes have proven effective in many areas.

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Chairman, CEO and President Tom Polen clarified that the Biosciences slowdown was expected due to challenging comps from a year ago before the research spending downturn fully hit BD. He stated the outlook remains cautious. For Pharmaceutical Systems, he noted ongoing destocking in vaccine categories but expects a recovery in the second half of the year. He affirmed BD's strong position, with an 80% win rate on new biologic drugs and over 50 GLP-1 biosimilar contracts.

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EVP and CFO Chris DelOrefice explained that the company is excited about the P&L shape for FY25. He highlighted that the expected 100 basis points of operating margin expansion will be driven primarily by gross margin improvement from the BD Excellence program. This allows for reinvestment in growth drivers like selling and R&D, creating what he described as a very healthy P&L for the long term.

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President and CEO Scott Cutler acknowledged stronger growth from the SMB segment but emphasized the overall strategy remains focused on leveraging technology to support the sales team across all segments. Regarding capital allocation, he stated there is a 'very high bar' for M&A, with a preference for portfolio acquisitions, and that the primary focus is on organic growth and execution.

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An executive, likely CFO James Lucania, clarified that the fiscal 2026 guidance does not assume any M&A. He reiterated the company's disciplined approach, operating within established spending envelopes for technology and sales. The primary capital allocation priorities are returning capital to shareholders via buybacks, paying down revolver debt from the BenefitWallet acquisition, and maintaining balance sheet capacity for future deals, all while driving EBITDA margin expansion.

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