Executive Summary

Augmedix delivered strong Q3 execution: revenue grew 50% year over year to $11.77M with GAAP gross margin expanding 390 bps to 49.5%, driven by adoption of Augmedix Live/Notes and scale efficiencies; dollar-based net revenue retention (NRR) rose to 157% from 130% a year ago .
Profitability improved: GAAP net loss narrowed to $4.41M vs. $5.49M in Q3’22, EBITDA loss improved to $3.72M and Adjusted EBITDA loss to $3.08M; operating expenses were roughly flat sequentially ($10.23M vs. $10.00M in Q2) .
Guidance raised: FY2023 revenue outlook increased to approximately $44.5M from at least $43.5M (Aug 7) and at least $42M (May 12), reflecting momentum in product adoption and improved gross margins .
Strategic catalysts: launched early access for Augmedix Go (fully automated AI note), deepened HCA collaboration to ER, announced HITRUST certification, and new digital health partnerships—supporting platform and data strategy .

What Went Well and What Went Wrong

What Went Well

Broad-based growth and retention: Revenue +50% YoY to $11.77M; Health Enterprise NRR reached 157% (vs. 148% in Q2 and 130% in Q3’22), indicating strong expansion in existing customers .
Margin trajectory: GAAP gross margin improved to 49.5% (from 47.0% in Q2 and 45.7% in Q3’22). CFO cited offshore mix shift, AI automation in Notes, and scale as drivers: “US to OUS ... gives us a nice lift ... Notes is becoming more efficient with all the AI and automation ... we continue to gain scale and efficiencies” .
Product and platform progress: Early access launch of Augmedix Go; enhanced HCA and Google Cloud collaboration; HITRUST certification; and three new digital health partnerships (Myndshft, Ellipsis Health, The Sullivan Group). CEO: “tremendous opportunity ... healthcare systems ... increasingly looking to leverage our structured data ... and bi-directional communication channel” .

What Went Wrong

Still loss-making with cash burn: GAAP net loss of $4.41M; EBITDA loss of $3.72M; operating cash flow YTD negative $14.47M, though cash/eq. was $22.29M at 9/30 and term loan interest-only extended to July 2024 after meeting financial tests .
Operating expenses edged up YoY: GAAP OpEx $10.23M vs. $9.05M in Q3’22 (though roughly flat seq.) as the company invests in growth and AI roadmap .
Competitive questions intensifying: Analysts probed risk from Microsoft/Nuance and potential new entrants; management highlighted differentiation via structured data and a bi-directional communication channel beyond “flat file” notes .

Financial Results

Metric	Q3 2022	Q2 2023	Q3 2023
Revenue ($USD Millions)	$7.86	$10.78	$11.77
GAAP Gross Margin %	45.7%	47.0%	49.5%
GAAP Operating Expenses ($M)	$9.05	$10.00	$10.23
Net Loss ($M)	$(5.49)	$(5.03)	$(4.41)
GAAP EPS ($)	$(0.15)	$(0.12)	$(0.10)
EBITDA ($M)	$(5.00)	$(4.16)	$(3.72)
Adjusted EBITDA ($M)	$(4.52)	$(3.60)	$(3.08)

KPIs

KPI	Q3 2022	Q2 2023	Q3 2023
Dollar-based Net Revenue Retention (Health Enterprise)	130%	148%	157%
Average Clinicians in Service (CIS)	1,121	1,534	1,650

Segment breakdown: Not disclosed in the company’s press releases/8-K for this period .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue ($M)	FY 2023	At least $43.5 (Aug 7, 2023)	Approximately $44.5 (Nov 6, 2023)	Raised
Revenue ($M)	FY 2023	At least $42.0 (May 12, 2023)	At least $43.5 (Aug 7, 2023)	Raised

Note: On the Q2 call, management guided Q3 revenue to approximately $11.4–$11.5M; actual Q3 revenue was $11.77M, above that intra-quarter guide .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q1 & Q2 2023)	Current Period (Q3 2023)	Trend
AI/technology initiatives (Augmedix Go)	Q1: “progressing according to plan” with Go targeted for later 2023 . Q2: high interest; testing in ambulatory and with HCA in acute; on track for commercial launch later 2023 .	Early access launch of Augmedix Go; continued collaboration with HCA to deploy Go in ER; reinforced platform/data strategy .	Accelerating productization and deployment .
Gross margin drivers	Q2 GM 47.0%; mix shift offshore, AI automation, scale efficiencies discussed across ops .	GM reached 49.5%; CFO reiterated drivers: offshore mix, AI efficiency in Notes, and scale .	Improving margins with multiple levers .
Enterprise adoption/NRR	Q1 NRR 136% . Q2 NRR 148% .	Q3 NRR 157% with growing adoption of Live and Notes .	Strengthening retention/expansion .
Regulatory/security & governance	Q2: Established AI Advisory Council .	Q3: HITRUST certification; first AI Advisory Council meeting held .	Enhanced compliance/governance posture .
HCA collaboration	Q1: “landmark strategic partnership and financing” with HCA . Q2: testing Go with HCA in acute care .	Continued collaboration to launch Go in ER; drove inbound interest/validation per Q&A .	Expanding scope and commercial pull .
Competitive landscape	Limited explicit commentary Q1–Q2; focus on platform differentiation .	Addressed MSFT/Nuance competition; differentiation via structured data and bi-directional communication channel beyond “flat file” notes .	Competition rising; narrative stresses defensible data/platform .

Management Commentary

CEO on Q3 momentum and opportunity: “Growing adoption of Augmedix Live and Augmedix Notes drove 50% revenue growth and net revenue retention of 157%, while expanding gross margins by 390 basis points to 49.5%... We are delivering strong financial results while expanding our product portfolio and building out the foundations of our data and platform strategies.” .
CEO on platform/data strategy: “...vendor partners will be able to use our delivery platform through APIs so that they and our health system partners can efficiently benefit and generate incremental ROI from our structured data and bi-directional communication channel to the point of care.” .
CFO on margin levers: “...helped by the shift... onshore to offshore... Notes is becoming more efficient with all the AI and automation... and we continue to gain scale and efficiencies” .
CEO on competitive positioning: “...every company we’ve encountered... are focused on the medical note itself... We deliver... structured data that is mineable... and [a] bidirectional communication channel...” .

Q&A Highlights

Competition: Management acknowledged aggressive competition (e.g., Microsoft/Nuance) but underscored differentiation via structured data outputs and a bi-directional communication channel, plus breadth across Live/Notes/Go .
Gross margin drivers: CFO attributed sequential and YoY margin gains to offshore mix, AI/automation gains in Notes, and scale efficiencies; indicated “more to come” though incremental .
HCA signal value: Management cited inbound interest from major enterprises post-HCA partnership announcement, viewing it as validation for solving complex problems in acute settings .
2024 framing: Management referenced long-term plan of 30%–45% revenue growth and continued margin improvement and expected 2024 to fall within those parameters (tone: constructive but appropriately cautious) .

Estimates Context

S&P Global (Capital IQ) consensus data was unavailable via our estimates tool for AUGX at the time of analysis; therefore, we cannot present definitive consensus comparisons for Q3 2023. We will update if/when S&P Global mapping becomes available.
As a reference point, management’s intra-quarter Q3 revenue outlook given on the Q2 call was approximately $11.4–$11.5M; actual Q3 revenue was $11.77M, above that range .

Key Takeaways for Investors

Momentum intact: Revenue acceleration (+50% YoY) with expanding gross margins (49.5%) and improving EBITDA losses suggests operating leverage is emerging as scale and AI-driven efficiencies build .
Retention/expansion strength: Health Enterprise NRR of 157% underscores effective land-and-expand motion and multi-product traction (Live, Notes, Go pipeline) within large systems .
Guidance credibility: FY23 revenue guidance was raised twice during 2023 and Q3 outperformed the intra-quarter revenue guide—supporting execution confidence into year-end .
Product catalyst: Early access for Augmedix Go and the HCA ER collaboration are near-term catalysts; success here broadens TAM and should support structurally higher margins than Live over time, per management .
Competitive posture: While competition is intensifying, management emphasizes differentiation via structured data and a bi-directional point-of-care channel—an important narrative to monitor for moat durability .
Risk checks: Company remains loss-making with ongoing cash burn, though liquidity improved (cash/eq. $22.29M at 9/30) and term loan interest-only extended to July 2024 after exceeding covenants; watch execution vs. investment pace .
What moves the stock near term: Evidence of successful Go deployments and additional enterprise wins/expansions, continued gross margin gains, and sustained NRR elevation are likely the key trading catalysts .

Supporting documents and sources:

Q3’23 8-K and press release (financials, guidance, product and partnership updates) .
Q2’23 8-K and press release (trend and prior guidance) .
Q1’23 press release (trend) .
Q3’23 earnings call transcript (prepared remarks and Q&A) .

S&P Global consensus disclaimer: S&P Global consensus data for AUGX was unavailable via our tool at the time of this analysis; comparisons to Wall Street estimates will be added once access is restored.

Augmedix, Inc. (AUGX)·Q3 2023 Earnings Summary