2024 Guidance and Sales Dissynergies
Q: Has your guidance philosophy changed, and how will $150M sales dissynergies impact 2024?
A: Management remains confident in their $2.45B to $2.475B revenue guidance for 2024 and acknowledges potential sales dissynergies of $150 million due to the merger integration. This dissynergy represents about 7% of combined 2022 sales and is a gross number before considering cross-selling opportunities, which are expected to offset the impact over time. They believe the guidance is realistic, with upside potential, and expect mid to high single-digit growth after the dissynergies stabilize.

Confidence in Achieving Mid-30s EBITDA Margins
Q: How confident are you in reaching mid-30s EBITDA margins post-merger?
A: Management is confident in achieving mid-30s EBITDA margins by the third year post-merger. They plan to realize $170 million in synergies, with 40% ($68 million) in 2024, primarily from SG&A and R&D savings. Longer lead-time improvements in manufacturing and operations are expected to contribute more significantly in 2025 and 2026, driving profitability improvements.

Timeline for Dis-synergies to Stabilize
Q: When will dissynergies stabilize, and growth pick up post-integration?
A: Management expects to see dissynergies stabilize by the end of the second quarter of 2024, reaching a steady state by June. They believe the sales force will have settled in, system implementations will be smoothed out, and they can return to focusing on innovation, taking share, and growing.

Impact of New Spine Robotics Competitors
Q: How will new spine robot competitors affect your market position?
A: Management acknowledges potential new competitors in spine robotics but believes they are well-positioned to compete head-to-head. They emphasize their superior robot and the large unmet clinical need, noting that even with competition, the market has ample room for growth. The merger enhances their size and reach, allowing for faster penetration and robust competition.

Stock Buybacks and Capital Allocation
Q: Why did you repurchase stock in Q4, and how does it affect priorities?
A: Management considers the stock undervalued and took the opportunity to repurchase shares in Q4 using strong cash reserves. They believe the market overreacted, and the buyback reduces dilution while showing confidence in long-term prospects. They continue to prioritize tuck-in M&A but will use buybacks opportunistically.

Ortho Robot Launch and Future Contributions
Q: What's the strategy and expected impact of the ortho robot launch?
A: The ortho robot is built but not yet FDA-approved, with anticipated approval in the second half of the year. Management does not expect material contributions in 2024 but sees it as a 2025 story. They are scaling up implant sets and planning the launch strategy, targeting both ASCs and hospitals, and will invest to build momentum over time.

Growth Expectations vs. Market
Q: Are you growing at market rates, and where will growth come from?
A: Management expects mid to high single-digit growth after initial dissynergies. They acknowledge growth is slowing in early 2024 due to dissynergies but believe cross-selling opportunities and international expansion will drive growth. Key areas include spinal implants, trauma, Enabling Technologies, and leveraging both legacy portfolios.

Sales Rep Attrition and Integration Feedback
Q: What's the impact of rep attrition post-integration, and how are you addressing it?
A: Rep attrition is in line with expectations and mostly sporadic. There was low overlap (about 3% in the U.S.), so integration focused on reorganizing efficiently. Management is working to fill vacancies and focusing on competitive recruiting as a growth mechanism.

Product Rationalization and Free Cash Flow
Q: Are you planning product rationalization, and how will it affect cash flow?
A: There are no plans for product rationalization; instead, they will let customer preferences guide the portfolio over time. Management expects improved free cash flow through $170 million in synergies, better asset utilization, and controlled CapEx, leading to better return on invested capital.

Future of Robotics in Spine and Beyond
Q: Is spinal robotics hitting a ceiling, and what's next?
A: Management believes spinal robotics is in its infancy, with significant room for growth in capabilities and procedural applications. They are expanding into areas like cranial procedures and developing power solutions to enhance surgeon experience. They see robotics as a long-term growth area with much potential.

Augmented Reality Headset Timing and Competition
Q: When will your AR headset launch, and how does it compete?
A: The augmented reality headset XR is expected to launch by midyear. Management is excited about integrating it with their Enabling Technologies to create a stronger offering for surgeons.

Enabling Technologies Financing Arrangements
Q: Are you seeing shifts in financing arrangements for Enabling Technologies?
A: In Q4, there was an increase in volume-based sales, partly due to higher interest rates affecting revenue recognition. Management expects the mix of placements versus outright sales to vary quarter-to-quarter based on customer preferences.

ASC Strategy and Opportunity
Q: How are you approaching the ASC market opportunity?
A: Management recognizes the migration of procedures to ASCs and is developing strategies to address this trend. They are considering the best ways to place Enabling Technologies and expect to strengthen their push into ASCs later in 2024 and into 2025.

Integration Upside and Downside Surprises
Q: What were the upside and downside surprises in integration efforts?
A: Upside surprises included opportunities for operational improvements in manufacturing and the willingness of teams to embrace common goals. Downside involved the heavy lifting required for common processes, reports, and systems, which are necessary but less exciting amid innovation and growth potential.

Competitive Rep Hiring and Recruiting Trends
Q: How are competitive rep hiring and overall recruiting trends?
A: There is significant interest from competitive reps, with meaningful conversations and potential hires. Recruiting was strong in 2023 but lighter than previous years due to merger focus. Management aims to return to heavier recruiting efforts and is pleased with current interest.