Yuan Zhi • B.Riley Securities

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EVP & CFO Mark Stolper explained that rising utilization has led them to convert some capitated contracts to more profitable fee-for-service arrangements. Chairman, President & CEO Dr. Howard Berger stated that remote scanning (TechLive) is already being deployed across states and the goal is to have the full MRI fleet enabled by early 2026. He confirmed they have capacity for Alzheimer's-related imaging, which drives both PET and subsequent MRI scans.

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President and CEO Dan Paterson clarified that there are no 'free samples' and that the patient assistance program for bridging supply has been used very little. He stated the most used program is co-pay assistance, which results in zero out-of-pocket costs for the majority of commercial patients. For Medicare patients, the yearly out-of-pocket maximum under the IRA kicks in quickly, limiting their costs.

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CEO Brian Markison stated that the new formulation will be a "complete add on" as existing contract language already contemplates such additions. He highlighted that this could also provide a beneficial opportunity for a 340B best price reset for the franchise.

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President Paul Blanchfield explained that there is a distinct difference in growth patterns. Early adopters, such as large academic centers under contract, have high utilization but slower current growth. In contrast, smaller, non-contracted community sites were later adopters and are now exhibiting higher growth rates from a lower base. The company is now evolving its strategy to increasingly focus on these higher-growth accounts.

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CEO Brian Markison reiterated that the company's strategic contracts were established over a year ago, anticipating no change, making the new separate payment policy an upside. Chief Commercial Officer Amanda Morgan added that while the market is complex, PYLARIFY's differentiation, broad availability, and strong strategic partnerships have secured the vast majority of its hospital and imaging center business.

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President Paul Blanchfield explained that CMS's final calendar year rate reflects a move to support innovative radiopharmaceuticals, particularly those that recently lost pass-through status. He noted that since Lantheus has consistently reported ASP for PYLARIFY, the company is well-positioned for a potential future shift by CMS to an ASP-based payment methodology, which the agency has indicated it is open to.

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CEO Tom Logan described the nuclear medicine market as strong, driven by the 'Theranostic revolution,' with improving margins from both pricing power and a favorable mix shift to software. CFO Brian Schopfer addressed the order question by stating that while not providing a precise number due to lumpiness, year-to-date order growth in nuclear power remains positive even excluding SMRs. He emphasized that the segment's double-digit revenue growth is the most encouraging sign, as it contains very little SMR contribution.

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CFO Brian Schopfer stated that while he doesn't comment on quarter-to-quarter backlog movements, he expects backlog to grow as the large projects in the pipeline are secured. He confirmed these large orders are 'back half loaded' for 2025. Schopfer acknowledged that project delays are an inherent risk, particularly in the new build nuclear space, but affirmed that the company accounts for this in its forecasting and remains confident in its full-year guidance.

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CEO Tom Logan speculated that business in Ukraine would likely resume before trade normalizes with Russia, and Mirion is prepared to support both existing infrastructure and new builds. On the U.S. regulatory front, Logan described customer excitement driven by favorable state-level actions in Texas and Iowa, the potential revival of the VC Summer plant, and a pro-nuclear stance from federal leadership. He noted the key issue remains streamlining NRC processes for new builds.

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Executive Brian Schopfer explained that the backlog is approximately 75% Technologies and 25% Medical, with the established 45-50% conversion to revenue over the next 12 months remaining consistent. Executive Thomas Logan elaborated on the EDF relationship, noting that the Sizewell-C win was a direct follow-on to their work at Hinkley Point C. He also highlighted a separate, broader strategic frame agreement with EDF that positions Mirion as a sole-source supplier for key systems on up to 20 future reactors, streamlining procurement for EDF's new build program.

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CEO Dan Virnich stated that TOI has not observed a similar jump in oncology care utilization or a change in patient acuity within its populations. He explained that contract pricing uses recent historical utilization data and cost trends, making it relatively current. Virnich also confirmed that capacity fill in Florida is tracking to plan with potential upside. CFO Rob Carter reaffirmed guidance, clarifying that the company still expects to achieve positive adjusted EBITDA and free cash flow in Q4 2025, not for the full second half.

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CFO Rob Carter confirmed that 2025 growth relies on new capitated contracts and organic growth, with the capitated segment being the most significant driver of profitability. CEO Dan Virnich added that new markets like Florida offer higher value creation opportunities due to higher benchmark utilization and a focus on Medicare Advantage. Virnich noted Florida clinics are at about 40% capacity, offering significant growth potential, and stated that macro trends like the IRA and potential 340B changes are favorable for TOI's value-based model.

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