Outset Medical Inc (OM) 2023 Q4 法說會逐字稿

Thank you for standing by, and welcome to the Outset Medical fourth-quarter 2023 earnings conference call.

感謝您的耐心等待，歡迎參加 Outset Medical 2023 年第四季財報電話會議。

(Operator Instructions)

（操作員說明）

As a reminder, today's program is being recorded.

提醒一下，今天的節目正在錄製中。

And now I'd like to introduce your host for today's program, Jim Mazzola, Head of Investor Relations.

現在我想介紹一下今天節目的主持人，投資者關係主管 Jim Mazzola。

Please go ahead, sir.

請繼續，先生。

Good afternoon, everyone, and welcome to our fourth quarter 2023 earnings call.

大家下午好，歡迎參加我們的 2023 年第四季財報電話會議。

Here with me today are Leslie Trigg, Chair and Chief Executive Officer; and Nabeel Ahmed, Chief Financial Officer.

今天和我在一起的還有董事長兼執行長萊斯利‧特里格 (Leslie Trigg)；財務長納比爾‧艾哈邁德 (Nabeel Ahmed)。

We issued a news release after the close of market today, which can be found on the Investor Relations pages of outsetmedical.com. This call is being recorded and will be archived in the Investors section of our website.

我們在今天收盤後發布了新聞稿，您可以在 outsetmedical.com 的投資者關係頁面上找到該新聞稿。本次電話會議正在錄音，並將存檔在我們網站的投資者部分。

It is our intent that all forward-looking statements made during today's call will be protected under the Private Securities Litigation Reform Act of 1995.

我們的目的是，今天電話會議期間所做的所有前瞻性陳述都將受到 1995 年私人證券訴訟改革法案的保護。

These statements relate to expectations or predictions of future events and are based on our current estimates and various assumptions and involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied.

這些陳述涉及對未來事件的預期或預測，基於我們目前的估計和各種假設，涉及重大風險和不確定性，可能導致實際結果或事件與預期或暗示的結果或事件有重大差異。

Outset assumes no obligation to update these statements.

Outset 不承擔更新這些聲明的義務。

For a list and description of the risks and uncertainties associated with our business, please refer to the Risk Factors section of Outset's public filings with the Securities and Exchange Commission, including our latest annual and quarterly reports.

有關與我們業務相關的風險和不確定性的清單和描述，請參閱 Outset 向美國證券交易委員會提交的公開文件中的風險因素部分，包括我們最新的年度和季度報告。

With that, I will now turn the call over to Leslie.

現在，我將把電話轉給萊斯利。

Thanks, Jim.

謝謝，吉姆。

Good afternoon, everyone, and thank you for joining us.

大家下午好，感謝您加入我們。

We exited 2023 having made progress in building a strong foundation from which to serve providers, patients, and investors in 2024 and for the long term.

我們在 2023 年結束時在建立堅實的基礎方面取得了進展，為 2024 年和長期服務提供者、患者和投資者提供了服務。

We came away from the year with clarity on areas we need to continue to strengthen and scale, pride and the difference we are making for providers and patients, confidence in the lead we have with Tablo from years of innovation, and our investments in service and support infrastructure, and conviction around the opportunity based on the vast unmet need for better dialysis outcomes in both the acute and home setting.

在結束這一年時，我們清楚地認識到我們需要繼續加強和擴大規模的領域，我們對我們為提供者和患者帶來的變化感到自豪，對我們與Tablo 多年創新的領先地位以及我們在服務和服務的投資充滿信心。支持基礎設施，並基於急診和家庭環境中對更好透析結果的巨大未滿足需求而對機會充滿信心。

In the fourth quarter, we delivered revenue of $30.5 million, right in line with the revised expectation we set in November to close the year at $130 million, an increase of 13% over 2022.

第四季度，我們實現了 3,050 萬美元的收入，與我們 11 月設定的年終收入 1.3 億美元的修訂預期一致，比 2022 年增長 13%。

As we have grown and built scale, particularly in the acute setting, our recurring revenue business model continues to distinguish itself, anchor our guidance for the future, and support our drive to profitability.

隨著我們不斷成長和擴大規模，特別是在嚴峻的環境下，我們的經常性收入業務模式繼續脫穎而出，為我們未來的指導奠定基礎，並支持我們實現盈利。

As we look at progress in our end markets beginning in the acute setting, our focus on enterprise selling and dialysis insourcing has continued to elevate the financial benefits and strategic importance of Tablo to provider customers.

當我們著眼於嚴峻環境下終端市場的進展時，我們對企業銷售和透析內包的關注繼續提升了 Tablo 對提供者客戶的財務效益和策略重要性。

During 2023, 25% of our provider customers were newly landed, and 75% were existing customers who chose to expand their Tablo use within their networks.

2023 年，我們的供應商客戶中有 25% 是新登陸的，75% 是選擇在其網路中擴展 Tablo 使用的現有客戶。

This distribution highlights the progress we are making within this large market segment and the opportunity for continued long-term growth.

這種分佈凸顯了我們在這個龐大的細分市場中取得的進展以及持續長期成長的機會。

The percent of new-to-Outset customers increased in 2022 and 2023, demonstrating the network effect we have previously discussed.

2022 年和 2023 年新加入 Outset 客戶的比例增加，證明了我們之前討論過的網路效應。

For example, as hospital administrators and clinicians move between facilities and health systems, they are ambassadors for Tablo and the benefits and insourcing program can provide.

例如，當醫院管理人員和臨床醫生在設施和衛生系統之間流動時，他們是 Tablo 以及可以提供的福利和內包計劃的大使。

Additionally, we educated over 400 doctors last year alone.

此外，光是去年我們就培訓了 400 多名醫生。

And we've amassed an extensive evidence base, demonstrating the power of Tableau clinically, operationally, and economically.

我們已經累積了廣泛的證據基礎，展示了 Tableau 在臨床、操作和經濟方面的強大功能。

And on top of that, more than 10,000 nurses are now trained on Tablo.

除此之外，目前已有超過 10,000 名護理師接受了 Tablo 培訓。

In terms of our footprint, we have shipped Tablo consoles to more than 700 sites in all 50 states, including to top national health systems where we have about 20% console penetration and within the top 50 regional IDNs where we are less than 10% penetrated today.

就我們的足跡而言，我們已將Tablo 控制台運送到所有50 個州的700 多個站點，其中包括頂級國家衛生系統（我們的控制台滲透率約為20%）以及前50 個區域IDN（我們的滲透率不到10%）今天。

We estimate the acute total addressable market is roughly 40,000 consoles.

我們估計潛在市場總量約為 40,000 台遊戲機。

And as we reported in January, we have an installed base of just over 4,000 acute and sub-acute consoles.

正如我們 1 月報導的那樣，我們的安裝基數剛剛超過 4,000 台急性和亞急性控制台。

So we still have a lot of runway ahead of us.

所以我們前面還有很長的跑道。

As dialysis insourcing with Tablo has grown, it is no surprise to us that we saw in the fourth quarter, our Tablo [Pro plus] software purchased with more than 80% of the console shifts in the acute setting, demonstrating its value in the ICU.

隨著Tablo 透析內包的增長，我們在第四季度看到我們的Tablo [Pro plus] 軟體在急性環境下超過80% 的控制台切換被購買，這對我們來說並不奇怪，這證明了它在ICU 的價值。

The results Tablo can deliver in the ICU are clear when we look at customers like Covenant Health, a regional system with about 20 inpatient facilities.

當我們觀察像 Covenant Health 這樣的客戶時，Tablo 在 ICU 中可以提供的結果是顯而易見的，Covenant Health 是一個擁有約 20 個住院設施的區域系統。

Prior to Tablo, covenant patients on dialysis had an average length of stay in the ICU, the most expensive part of the hospital, of over 13 days.

在 Tablo 之前，接受透析的契約患者在 ICU（醫院最昂貴的部分）的平均住院時間超過 13 天。

When Covenant measured the ICU length of stay of patients on Tablo, it was cut to eight days.

當 Covenant 測量 Tablo 上病患的 ICU 住院時間時，它被縮短為八天。

These results demonstrate what's possible when providers control their own destiny.

這些結果表明，當提供者掌控自己的命運時，一切皆有可能。

In addition, to the decrease in length of stay, Covenant also saw total ICU dialysis treatment costs declined substantially from $1.3 million to $240,000, and cost per treatment cut roughly in half.

此外，由於住院時間縮短，Covenant 也發現 ICU 透析治療總費用從 130 萬美元大幅下降至 24 萬美元，每次治療費用約減少一半。

These results have become very reproducible because our team has developed over the years proprietary expertise in guiding and supporting providers through the outsource to insource transition.

這些結果變得非常可重複，因為我們的團隊多年來在指導和支援供應商從外包到內包的轉型方面積累了專有的專業知識。

With the essential investments behind us in creating and world-class field service, customer success, and clinical support organization, we are well positioned to deliver not just an exceptional product, but an exceptional, highly differentiated change management experience.

憑藉我們在創造世界一流的現場服務、客戶成功和臨床支援組織方面的重要投資，我們不僅能夠提供卓越的產品，還能提供卓越的、高度差異化的變革管理體驗。

It took us years to build this infrastructure and know-how.

我們花了數年時間來建立這種基礎設施和專業知識。

We consider it one of the strongest competitive advantages we have as a company.

我們認為這是我們公司最強大的競爭優勢之一。

The data backs that up as well.

數據也證明了這一點。

For example, we continually track customer satisfaction metrics.

例如，我們不斷追蹤客戶滿意度指標。

And I am pleased but not surprised that in 2023, our customers reported a 95.4% satisfaction rate with the performance of our field service organization.

我很高興但並不感到驚訝的是，2023 年，我們的客戶對我們現場服務組織的表現的滿意度為 95.4%。

This is pretty phenomenal when you consider how rapidly our installed base and treatment volume has grown.

考慮到我們的安裝基礎和處理量增長得有多快，這是相當驚人的。

And we did it while maintaining a 97% uptime across the Tablo installed base and reducing our cost to serve by nearly 25%.

我們做到了這一點，同時保持了 Tablo 安裝基地 97% 的正常運作時間，並將服務成本降低了近 25%。

Turning now to the home end market.

現在轉向家庭終端市場。

We continue to make progress building the strong foundation we are establishing for long-term growth.

我們不斷取得進展，為長期成長奠定堅實的基礎。

In 2023, we deployed more than 500 Tablo consoles to home providers, growing our home base more than 60% to more than 1,300 consoles.

2023 年，我們向家庭提供者部署了 500 多台 Tablo 遊戲機，使我們的家庭數量增加了 60% 以上，達到 1,300 多台遊戲機。

We've talked on previous calls about our two-tiered home penetration strategy, which entails partnering with progressive mid-sized dialysis organizations and working upstream to create greater channel access for patients by expanding the universe of healthcare providers offering home dialysis.

我們在先前的電話會議中談到了我們的兩層家庭滲透策略，該策略需要與先進的中型透析組織合作，並向上游開展工作，透過擴大提供家庭透析的醫療保健提供者的範圍，為患者創造更大的渠道。

We saw our strategies on both fronts pay off in 2023.

2023 年，我們在這兩方面的策略都取得了成效。

With the MDOs, which manage dialysis care for about 180,000 patients, which translates to a roughly $9 billion addressable market, we continued to see nice growth in the number and depth of programs offering Tablo.

MDO 為約 18 萬名患者管理透析護理，這意味著約 90 億美元的潛在市場，我們繼續看到提供 Tablo 的項目數量和深度的良好增長。

Exiting 2023, our largest home program managed by an MDO, averaged 25 patients at home on Tablo.

截至 2023 年，我們最大的由 MDO 管理的家庭計劃在 Tablo 上平均有 25 名患者在家。

Most home hemodialysis programs historically have had one to five patients home with the incumbent device.

歷史上，大多數家庭血液透析計畫都有一到五名患者在家中使用現有設備。

Furthermore, we continue to see unparalleled retention rates.

此外，我們繼續看到無與倫比的保留率。

Our longest tenured patient has dialyze at home now for 3.5 years, demonstrating Tablo's differentiated patient experience.

我們任期最長的患者現已在家中進行透析 3.5 年，展示了 Tablo 差異化的患者體驗。

High retention rates not only benefit patients, but also help minimize expensive churn for providers.

高保留率不僅有利於患者，還有助於最大限度地減少醫療服務提供者昂貴的流失率。

In terms of our efforts to increase channel access by expanding the provider universe with new entrants, we hit some new milestones in 2023.

在透過新進業者擴大供應商範圍來增加通路進入方面，我們在 2023 年實現了一些新的里程碑。

For the first time, two of our fastest growing home dialysis providers were not previously in the home dialysis business.

我們成長最快的兩家家庭透析提供者之前從未涉足家庭透析業務，這還是第一次。

As we've talked about in the past, the majority of patients actually start their dialysis journey in the hospital.

正如我們過去談到的，大多數患者實際上是在醫院開始透析之旅。

That means hospitals, sub-acute providers, others at the top of the funnel have an opportunity to direct patients' home first.

這意味著醫院、亞急性醫療服務提供者和其他處於管道頂部的人有機會首先引導患者回家。

And many of them are starting to adopt a home-first mindset where the patient could exit the hospital, a long-term care facility or skilled nursing facility and go directly home without ever entering a dialysis clinic.

他們中的許多人開始採取「以家為先」的心態，患者可以離開醫院、長期護理機構或熟練的護理機構，直接回家，而無需進入透析診所。

Like Outset, these new market entrants see the opportunity to disrupt and improve care delivery for dialysis patients.

與 Outset 一樣，這些新的市場進入者看到了顛覆和改善透析患者護理服務的機會。

We are pleased to announce that during the fourth quarter, we successfully secured several new sales agreements with skilled nursing facilities, including with one of the nation's largest SNF providers.

我們很高興地宣布，在第四季度，我們成功與熟練的護理機構（包括全國最大的 SNF 提供者之一）簽訂了幾項新的銷售協議。

The partnership underscore the growing recognition of Tablo's value proposition within the post-acute sector.

此次合作凸顯了 Tablo 的價值主張在急性後期領域日益得到認可。

Furthermore, our successes throughout the year continue to position us as a trusted partner in delivering dialysis services across the care continuum.

此外，我們全年取得的成功繼續使我們成為在整個護理過程中提供透析服務的值得信賴的合作夥伴。

Importantly, these agreements reflect an industry trend of SNF providers seeking to enhance patient care by offering in health and home dialysis services, which matches our commitment to innovation and meeting the evolving needs of the dialysis community.

重要的是，這些協議反映了 SNF 提供者尋求透過提供健康和家庭透析服務來加強患者護理的行業趨勢，這符合我們對創新和滿足透析社區不斷變化的需求的承諾。

Operationally, we made progress during Q4 and 2023, strengthening our regulatory and quality organization, processes and best practices, with lessons learned from our experiences and our ongoing focus on continuous improvements.

在營運方面，我們在第四季度和 2023 年取得了進展，加強了我們的監管和品質組織、流程和最佳實踐，並從我們的經驗中吸取了教訓，並持續關注持續改進。

This past quarter, we added our eighth 510(k) clearance to implement new PCB-free silicone tubing in Tablo.

上個季度，我們增加了第八個 510(k) 許可，以在 Tablo 中實施新的無 PCB 矽膠管。

As we disclosed in our filings, the FDA initiated an industry-wide review of silicone tubing in 2022.

正如我們在文件中所揭露的那樣，FDA 將於 2022 年啟動對矽膠管的全行業審查。

With the 510(k) clearance in hand, we are proactively integrating the changes into our manufacturing process, and in the coming weeks, intend to begin implementing the new PCB-free tubing in the field.

有了 510(k) 許可，我們正在積極地將這些變更整合到我們的製造流程中，並在未來幾週內，打算開始在現場實施新的無 PCB 管材。

Additionally, on the regulatory submission front, we remain in interactive review with FDA on the TabloCart 510(k) submission and continue to forecast sales of TabloCart with free filtration resuming during the second half of 2024.

此外，在監管提交方面，我們仍在與 FDA 就 TabloCart 510(k) 提交進行互動審查，並繼續預測 2024 年下半年恢復免費過濾的 TabloCart 的銷售。

Our results continue to highlight the strength and potential of our recurring revenue model, which provides us with visibility into a large portion of our 2024 and longer-term financial guidance.

我們的業績繼續凸顯了我們經常性收入模式的優勢和潛力，這使我們能夠了解 2024 年和長期財務指導的大部分內容。

Every Tablo in the home generates roughly $15,000 per year through its useful life.

家裡的每台 Tablo 在其使用壽命內每年產生約 15,000 美元的收入。

Every Tablo in the acute setting generates roughly $20,000 per year as there are more treatments performed on each device in the hospital than with a single patient at home.

急診環境中的每台 Tablo 每年大約能產生 20,000 美元的收入，因為醫院中每台設備上進行的治療比家裡單一患者進行的治療還要多。

Recurring revenue is driven today by the sales of disposables for every treatment and our service contracts.

如今，經常性收入是由每次治療的一次性用品銷售和我們的服務合約所驅動的。

These components will continue to grow as we place new Tablo consoles.

隨著我們放置新的 Tablo 控制台，這些組件將繼續增長。

As we announced last month, we exited 2023 with over 50% of our total revenue coming from recurring revenue and see even greater potential over the longer term through our software pipeline.

正如我們上個月宣布的那樣，2023 年結束時，我們總收入的 50% 以上來自經常性收入，並且從長遠來看，我們的軟體管道具有更大的潛力。

Finally, we congratulate our team members, Steve Williamson, on his appointment to lead another public medical device company.

最後，我們祝賀我們的團隊成員 Steve Williamson 被任命領導另一家上市醫療器材公司。

He joined us at a key time when we were building our national sales and service organization.

他在我們建立全國銷售和服務組織的關鍵時刻加入了我們。

Thanks to him building a team of incredibly capable and talented commercial leaders who run our sales, service, and marketing organizations today.

感謝他建立了一支由非常有能力和才華橫溢的商業領袖組成的團隊，他們今天負責管理我們的銷售、服務和行銷組織。

We do not currently intend to backfill his position.

我們目前不打算填補他的職位。

Before I turn the call over to Nabeel for more detail on the quarter, I want to reiterate what I believe are the most important advances we made during the year.

在我將電話轉給 Nabeel 以了解有關本季度的更多詳細資訊之前，我想重申我認為我們在這一年中取得的最重要進展。

First, we achieved scale in the acute end market by demonstrating that Tablo and insourcing with Tablo are strategic implements to reducing costs and retaking control of care for some of the most compromised patients.

首先，我們透過證明 Tablo 和 Tablo 內包是降低成本並重新控制一些最受影響患者的護理控制的策略實施，在急診終端市場實現了規模化。

Second, we expanded our home footprint via partnerships, both with new market entrants and existing providers, who share our vision for the better patient experience that Tablo can enable.

其次，我們透過與新市場進入者和現有提供者的合作夥伴關係擴大了我們的家庭足跡，他們與我們有著共同的願景，即透過 Tablo 實現更好的患者體驗。

It is early, but we are laying a strong foundation for growth in one of the largest and most unchanged corners of healthcare.

雖然現在還為時過早，但我們正在為醫療保健領域最大且最具變化的領域之一的成長奠定堅實的基礎。

Third, with recurring revenue exceeding 50% of total revenue in 2023, we have proven the strength of our business model and demonstrated how we can deliver value well into the future.

第三，到 2023 年，經常性收入將超過總收入的 50%，我們已經證明了我們業務模式的優勢，並展示了我們如何在未來創造價值。

Four, we continue to expand gross margin, exceeding our guidance, and demonstrating that we remain on a clear trajectory to reach our 50% milestone.

第四，我們繼續擴大毛利率，超越我們的指導，並表明我們仍然走在實現 50% 里程碑的明確軌道上。

At the same time, we demonstrated strong operating leverage that we expect will persist and expand in each year toward reaching our profitability goals.

同時，我們展示了強大的營運槓桿，我們預計這種槓桿將持續存在並每年擴大，以實現我們的獲利目標。

And finally, we widened Tablo's competitive moat across technology, regulatory, and clinical evidence in ways that deepen connections with providers and patients.

最後，我們透過加深與提供者和患者的聯繫的方式，擴大了 Tablo 在技術、監管和臨床證據方面的競爭護城河。

Standing by customers and helping them achieve their goals requires much more than a great product, which we certainly have with Tablo.

支援客戶並幫助他們實現目標需要的不僅僅是出色的產品，而我們的 Tablo 確實具備了這一點。

But it also requires an experienced sales and clinical support team, backed by the strength of a mature service organization, which is underpinned by software, analytics, change management know-how, and technical support.

但它還需要一支經驗豐富的銷售和臨床支援團隊，並以成熟服務組織的實力為後盾，而該組織以軟體、分析、變革管理專業知識和技術支援為基礎。

This is a very difficult-to-replicate ecosystem, and we enter 2024 in a strong competitive position from which to continue our growth.

這是一個非常難以複製的生態系統，進入 2024 年，我們處於強大的競爭地位，可以繼續成長。

With that, I'll turn it over to Nabeel.

這樣，我就把事情交給納比爾了。

Thanks, Leslie.

謝謝，萊斯利。

Hello, everyone.

大家好。

Revenue for the fourth quarter was $30.5 million, in line with our pre-announcement slightly above the third quarter of 2023, and a decrease of 4.7% compared to 32 million in the fourth quarter of 2022.

第四季的營收為 3,050 萬美元，與我們預先公佈的略高於 2023 年第三季的水準一致，比 2022 年第四季的 3,200 萬美元下降了 4.7%。

The change from last year was driven by a decrease in console revenue for the reasons we outlined in the third quarter and was partially offset by an increase in consumables revenue.

與去年相比的變化是由於控制台收入下降造成的，原因我們在第三季度概述了，但消耗品收入的增加部分抵消了這一變化。

Product revenue was $22.9 million, a decrease of 13% compared to the $26.4 million in the fourth quarter of 2022.

產品營收為2,290萬美元，較2022年第四季的2,640萬美元下降13%。

Service and other revenue was 7.6 million, increasing 11% sequentially from the third quarter and 35% compared to $5.6 million in the fourth quarter of 2022.

服務和其他收入為 760 萬美元，較第三季季增 11%，較 2022 年第四季的 560 萬美元成長 35%。

Consumable revenue was $12.6 million, up 15% from the prior quarter and 58% versus the prior year.

消費品收入為 1,260 萬美元，季增 15%，年增 58%。

Cartridge utilization continued to perform well, highlighting the strength of our recurring revenue model.

墨盒利用率持續表現良好，凸顯了我們經常性收入模式的優勢。

Based on our cloud data, we see console utilization in the hospital setting of around five treatments per week and home consoles of just about three per week.

根據我們的雲端數據，我們發現醫院環境中的控制台利用率約為每週 5 次治療，而家用控制台每週約為 3 次。

Moving to gross margin and operating expenses, I will highlight our non-GAAP results.

談到毛利率和營運費用，我將重點放在我們的非公認會計準則績效。

I encourage you to review the reconciliation of GAAP to non-GAAP measures, which can be found in today's earnings release.

我鼓勵您查看 GAAP 與非 GAAP 衡量標準的對賬，這可以在今天的收益報告中找到。

Our fourth-quarter gross margin was 26.7%, a more than 100-basis-point sequential improvement from the third quarter and a 9.6-percentage-point increase from 17.1% in the fourth quarter of 2022.

我們第四季的毛利率為 26.7%，比第三季季增了 100 個基點以上，比 2022 年第四季的 17.1% 成長了 9.6 個百分點。

Gross margin expanded for the 11th consecutive quarter, with our mix of higher-margin recurring consumable revenue and service and other revenue representing 66% of total revenue as compared to roughly 59% in Q3 of this year.

毛利率連續 11 個季度成長，利潤率較高的經常性消費品收入和服務及其他收入佔總收入的 66%，而今年第三季約為 59%。

The year-over-year increase was driven by a nearly 20-percentage-point expansion in product margin that was partially offset by a decline in service and other gross margin as a result of planned investments we made during the fourth quarter that we do not expect to repeat in the first quarter of 2024, including roughly $0.5 million to implement the silicon tubing updates that Leslie mentioned.

同比增長是由於產品利潤率增長了近 20 個百分點，但由於我們在第四季度進行的計劃投資導致服務和其他毛利率下降，部分抵消了這一增長。預計將在2024 年第一季重複，其中包括大約50 萬美元用於實施Leslie 提到的矽管更新。

Operating expenses of $36.4 million declined 14% sequentially from the third quarter and 4% from the prior-year period, driven in part by the expense reductions we outlined last quarter.

營運費用為 3,640 萬美元，較第三季環比下降 14%，較去年同期下降 4%，部分原因是我們上季度概述的費用削減。

From Q4 of last year, the largest decrease in spending came from G&A, which declined 15%.

從去年第四季開始，支出降幅最大的是 G&A，下降了 15%。

We reported a fourth-quarter non-GAAP net loss of $29.5 million, or $0.59 per share, compared to a non-GAAP net loss of $34.1 million, or $0.71 per share, for the same period in 2020.

我們報告第四季非 GAAP 淨虧損為 2,950 萬美元，即每股 0.59 美元，而 2020 年同期非 GAAP 淨虧損為 3,410 萬美元，即每股 0.71 美元。

We ended the quarter with approximately $207 million in cash, cash equivalents, short-term investments, and restricted cash.

截至本季末，我們擁有約 2.07 億美元的現金、現金等價物、短期投資和限制性現金。

In January, we added $66.5 million drawn from our term loan agreements, bringing our cash balance early in 2024 to roughly $270 million.

1 月份，我們從定期貸款協議中增加了 6,650 萬美元，使我們的現金餘額在 2024 年初達到約 2.7 億美元。

As previously reported, revenue for the full-year 2023 increased 13% to $130.4 million from $115.4 million in 2022.

正如先前報導的那樣，2023 年全年收入從 2022 年的 1.154 億美元增長 13% 至 1.304 億美元。

As a reminder, we lapped the expiry of our pandemic-related contract with HHS this year.

提醒一下，我們與 HHS 的流行病相關合約今年已到期。

Excluding the impact of the HHS contract in the prior period, revenue grew close to 20%.

剔除前期 HHS 合約的影響，營收成長接近 20%。

Product revenue was $103.5 million, an increase of 11% from 2022.

產品營收為 1.035 億美元，較 2022 年成長 11%。

And service and other revenue was $26.8 million, an increase of 22% from 2022.

服務和其他收入為 2,680 萬美元，較 2022 年增長 22%。

Recurring revenue for the full year was [53%], up from 44% in 2022.

全年經常性收入為 [53%]，高於 2022 年的 44%。

Gross margin for the year reached 23.6% from 16.1% in 2020.

全年毛利率從2020年的16.1%增加至23.6%。

The 750-basis-point increase was ahead of our initial expectations and driven by the same factors that we believe will continue to expand gross margin to 50% and beyond.

750 個基點的成長超出了我們最初的預期，並且受到我們認為毛利率將繼續擴大至 50% 及以上的相同因素的推動。

These factors are: number one, console cost-down programs; two, the portion of higher-margin products and consumables as consoles are placed; and three, service leverage.

這些因素是：第一，控制台成本降低計畫；二是主機等利潤較高的產品及消耗品部分投放；三是服務槓桿。

Operating expenses were $161.9 million, including R&D expenses of $46.8 million, sales and marketing expenses of $83.8 million, and G&A expenses of $31.4 million.

營運費用為 1.619 億美元，其中研發費用為 4,680 萬美元，銷售和行銷費用為 8,380 萬美元，一般管理費用為 3,140 萬美元。

Net loss was $134.2 million, or $2.70 per share, compared to a non-GAAP net loss of $135.8 million, or $2.82 per share, for 2022.

淨虧損為 1.342 億美元，即每股 2.70 美元，而 2022 年非 GAAP 淨虧損為 1.358 億美元，即每股 2.82 美元。

Turning to our guidance for 2024.

轉向我們的 2024 年指導。

We continue to expect revenue of $145 million to $153 million, growing 12% to 18% over 2023.

我們仍預期營收為 1.45 億至 1.53 億美元，比 2023 年成長 12% 至 18%。

As we have previously mentioned, we anticipate the first quarter to be roughly even with the fourth-quarter revenue.

正如我們之前提到的，我們預計第一季的營收將與第四季的營收大致持平。

And then building through the year, particularly in the second half as we lap the elongation of our selling cycle, and as Leslie mentioned, we plan for TabloCart with prefiltration to return to the market.

然後在這一年中，特別是在下半年，隨著我們銷售週期的延長，正如 Leslie 所提到的，我們計劃讓預先過濾功能的 TabloCart 返回市場。

Our guidance for non-GAAP gross margin continues to be in the low 30% range for the full year, exiting the year in the mid-30% range for the fourth quarter.

我們對全年非 GAAP 毛利率的指引繼續保持在 30% 的低水平範圍內，第四季度則處於 30% 的中水平水平。

Again, gross margin expansion is driven by console cost-down programs, recurring revenue from a larger installed base, and service leverage.

同樣，毛利率的成長是由控制台成本降低計劃、更大的安裝基礎帶來的經常性收入以及服務槓桿推動的。

With the cost reductions we undertook in 2023, we continue to anticipate OpEx in 2024 of $140 million to $145 million.

隨著我們在 2023 年削減成本，我們繼續預計 2024 年的營運支出將達到 1.4 億至 1.45 億美元。

As a reminder, we recorded a charge in the fourth quarter of $2.5 million associated with the cost reductions we discussed on the November call.

提醒一下，我們在第四季度記錄了 250 萬美元的費用，與我們在 11 月電話會議上討論的成本削減相關。

Finally, we expect to deliver operating leverage and to consume substantially less cash in 2024 than we did in 2023 as a result of revenue growth, gross margin expansion, and reduced OpEx.

最後，由於收入成長、毛利率擴張和營運支出減少，我們預計 2024 年將實現營運槓桿並消耗比 2023 年大幅減少的現金。

With the guidance we provided, cash used is expected to move lower each year through our expected breakeven in 2027, giving us a long cash runway.

根據我們提供的指導，預計所用現金將逐年減少，直至 2027 年實現盈虧平衡，這為我們提供了較長的現金跑道。

We remain bullish on the tailwinds in our business and affirm the longer-term guidance we provided in November.

我們仍然看好我們業務的順風車，並確認我們在 11 月提供的長期指導。

We continue to expect revenue growth in the high-teens annually beginning in 2025 and gross margin continuing to expand, reaching our 50% milestone exiting 2027.

我們繼續預計，從 2025 年開始，每年的收入成長將達到兩位數，毛利率將繼續擴大，到 2027 年將達到 50% 的里程碑。

With that, I think we're ready for Q&A.

至此，我想我們已經準備好要進行問答了。

Operator, please open the lines.

接線員，請開通線路。

Rick Wise, Stifel.

瑞克懷斯，史蒂菲爾。

Hi, everybody.

大家好。

Maybe, I mean, Leslie, you laid out very clearly all the progress, and it feels like in the end, steady as she goes, making progress kind of period.

也許，我的意思是，萊斯利，你非常清楚地列出了所有的進展，感覺就像最後，她穩步前進，取得了進展。

And it feels like the setup for this year is a positive one.

感覺今年的設定是正面的。

Could you talk about some of the most important incremental drivers?

您能談談一些最重要的增量驅動因素嗎？

And I hate to ask where might there be some upside.

我不想問有什麼好處。

I imagine TabloCart coming earlier, but things like the skilled -- for example, the skilled new contracts that -- skilled nursing accounts, help us think about the implications of that and any new product launches.

我認為 TabloCart 會更早出現，但是諸如熟練的新合約之類的東西 - 熟練的護理帳戶，可以幫助我們思考這一點以及任何新產品發布的影響。

What's not in the guidance -- the measured tempered guidance you're giving us now?

您現在向我們提供的經過審慎的指導，其中沒有包含哪些內容？

Sure.

當然。

Hi, Rick.

嗨，瑞克。

Good to hear from you.

很高興聽到你的消息。

Yeah, we do feel that we're really well set up for 2024.

是的，我們確實覺得我們已經為 2024 年做好了充分的準備。

We know this is a year of execution for us.

我們知道，今年對我們來說是執行的一年。

And accordingly, we are focused on delivering against the goals we've set out for the year and and feel that we're very, very well positioned to do exactly that.

因此，我們專注於實現我們今年設定的目標，並認為我們非常非常有能力做到這一點。

I think to answer your question, certainly the return of TabloCart post-FDA clearance is expected to be a positive catalyst point one to point two.

我想回答你的問題，FDA 批准後 TabloCart 的回歸預計將成為第一點到第二點的積極催化劑。

We are experiencing early wins in this new segment of the post-acute space.

我們正在經歷急性後空間這一新領域的早期勝利。

As a reminder, when we entered the post-acute space, we decided to focus first on long-term acute care facilities, and we have facilities and had a lot of success there.

提醒一下，當我們進入急性後領域時，我們決定首先關注長期急性護理設施，我們在那裡擁有設施並取得了巨大的成功。

We've mentioned in the past that were contracted now with -- and Tablo is being used by all 10 of the largest 10 post-acute providers in the LTAC and the rehab space.

我們過去曾提到過，現在 LTAC 和復健領域最大的 10 家急性後治療提供者中的所有 10 家都在使用 Tablo。

And so we have the opportunity to start to turn our attention the third leg of that growth stool, which is the skilled nursing facilities.

因此，我們有機會開始將注意力轉向成長凳的第三條腿，即熟練的護理設施。

The nice part about that is that we can penetrate that market with our exact same sales force and our exact same field service team.

最好的一點是，我們可以透過完全相同的銷售團隊和完全相同的現場服務團隊來滲透該市場。

So we can do so with a lot of operating leverage behind it.

因此，我們可以透過大量的營運槓桿來做到這一點。

So I would say that the early wins in the skilled nursing facilities are expected to be an additional catalyst for growth in 2024.

因此，我想說，熟練護理設施的早期勝利預計將成為 2024 年增長的額外催化劑。

Third, I would say, continued gross margin expansion.

第三，我想說的是，毛利率持續擴張。

We've obviously had strong gross margin gains in 2023.

2023 年，我們的毛利率顯然出現了強勁成長。

We expect another year of very consistent expansion.

我們預計又一年會出現非常持續的擴張。

Our team has made 800 or 900-basis-point improvements look easy; it's not.

我們的團隊已經讓 800 或 900 個基點的改進看起來很容易；它不是。

And so I want to call attention to that and compliment our teams across the organization for making that happen, but we do have very high confidence in our ability to meet and exceed expectations on the gross margin front.

因此，我想提請大家注意這一點，並讚揚我們整個組織的團隊實現了這一目標，但我們確實對我們達到並超越毛利率預期的能力充滿信心。

And maybe lastly, think the four key takeaways with recurring revenue now over 50% of our total revenue, it gives us a very strong basis off of which to grow with a lot of visibility.

也許最後，想想經常性收入現在超過我們總收入 50% 的四個關鍵要點，它為我們提供了一個非常堅實的基礎，使我們能夠以很高的知名度實現增長。

So those are probably the four growth vectors and catalysts that we look forward to through calendar year '24.

因此，這些可能是我們期待 24 日曆年的四個成長向量和催化劑。

Okay, great.

好的，太好了。

And just on the TabloCart progress.

就 TabloCart 的進展而言。

And I apologize, you're probably sick of answering the question, but any incremental updates on your engagement with the agency?

我很抱歉，您可能厭倦了回答這個問題，但是您與該機構的合作有任何增量更新嗎？

Are they asking questions?

他們在問問題嗎？

Again, the second half sounds like a reasonable projection to me, but could it happen earlier?

同樣，下半場對我來說聽起來像是一個合理的預測，但它會發生得更早嗎？

Any additional perspective there?

還有其他的觀點嗎？

Thank you.

謝謝。

Of course.

當然。

Sure.

當然。

No, I'm not sick of answering the questions at all.

不，我一點也不厭倦回答這些問題。

It's a very reasonable and expected question.

這是一個非常合理且符合預期的問題。

The engagements -- the answer is the engagement continues to be very collaborative and very constructive.

參與－答案是參與仍然非常具有協作性和建設性。

We are in interactive review.

我們正在進行互動審核。

So to answer that part of your question, we are in the process of questions and answers, and more questions and more answers is following the path that all of our other eight submissions and clearances have followed over the last number of years.

因此，為了回答您問題的這一部分，我們正在問答過程中，更多的問題和更多的答案正在沿著我們過去幾年中所有其他八個提交和許可所遵循的路徑進行。

And so, net-net, it's progressing exactly as we had expected it to.

所以，網路網絡，它的進展完全符合我們的預期。

There is always a chance that the review finishes earlier than expected, but I think we still feel confident in the guidance that we've given around the second half return to TabloCart.

審核總有可能比預期提前完成，但我認為我們仍然對下半年返回 TabloCart 時給予的指導充滿信心。

Thank you so much.

太感謝了。

Of course.

當然。

Shagun Singh, RBC Capital Markets.

Shagun Singh，加拿大皇家銀行資本市場。

Hi, this is [Avi] on for Shagun.

大家好，這是 Shagun 的 [Avi]。

Thanks for taking my question.

感謝您提出我的問題。

So, Leslie, what trends are you seeing for Tablo console uptake pending TabloCart with prefiltration approval?

那麼，Leslie，您認為在 TabloCart 獲得預過濾批准之前，Tablo 控制台的採用趨勢是什麼？

Is there something that the company can do to drive more sales more meaningfully in the interim including on the marketing front?

在此期間，公司可以做些什麼來更有意義地推動更多銷售，包括在行銷方面？

And then I have a follow-up.

然後我有一個後續行動。

Yeah, sure.

好，當然。

Well, I really like the distribution of our growth in 2023, and I would expect it to follow a similar pattern in 2024.

嗯，我真的很喜歡 2023 年的成長分佈，我預期 2024 年也會遵循類似的模式。

And what I mean by that is a catalyst always for us remains new customer wins, and we had a nice number of those in 2024, new customers that decided to in-source with Tablo for the first time.

我的意思是，贏得新客戶始終是我們的催化劑，2024 年我們有許多新客戶決定首次與 Tablo 進行內源合作。

At the same time, we always have our eye on expansion.

同時，我們始終著眼於擴張。

Why?

為什麼？

Because a hospital or health system would not perpetuate its use of Tablo within other new hospitals inside of its network if the technology and the experience around it were not delivering on its promises to lower cost and deliver operational and clinical benefits.

因為如果技術和相關經驗不能兌現其降低成本並提供營運和臨床效益的承諾，醫院或衛生系統就不會在其網路內的其他新醫院中永久使用 Tablo。

And I think the expansion numbers that we saw in '23 than we expect in '24 proved that it is.

我認為我們在 23 年看到的擴張數字比我們在 24 年預期的要多，這證明了這一點。

And so, I guess I would say how does it get accelerated?

所以，我想我會說它是如何加速的？

I'll talk maybe a little bit more about the network effect, or maybe a better word for it is kind of its flywheel.

我可能會更多地談論網路效應，或者更好的說法是它的飛輪。

We have demonstrated that these cost reduction and clinical benefits are reproducible as more and more hospitals have publish their experience, share their experiences publicly in their data.

我們已經證明，隨著越來越多的醫院發布他們的經驗，在數據中公開分享他們的經驗，這些成本降低和臨床效益是可以複製的。

We talked about Covenant Health in the script here just a minute ago as an example of that.

就在一分鐘前，我們在劇本中討論了 Covenant Health 作為一個例子。

And what we do see now as our reference base continues to grow and as health system executives move around and clinicians around the world, and the investor ship around Tablo is continuing to grow quite substantially, plus now that we've trained -- I mentioned, over 10,000 nurses, we're seeing sort of a flywheel effect developing within the nursing community, as well as a lot of support for the benefit that Tablo provides them.

我們現在所看到的是，隨著我們的參考基礎不斷增長，隨著衛生系統高管和臨床醫生在世界各地流動，以及Tablo 周圍的投資者隊伍繼續大幅增長，再加上現在我們已經接受了培訓——我提到過，超過 10,000 名護士，我們看到護理界正在形成一種飛輪效應，以及對 Tablo 為他們提供的好處的大量支持。

Thanks for that color.

謝謝那個顏色。

And Nabeel, what are the factors that could potentially get you to deliver at or above the top end of your guidance in '24?

Nabeel，有哪些因素可能會讓您在 24 年達到或超過指導上限？

Yeah.

是的。

Hey, Avi.

嘿，阿維。

So guidance, as you may remember from the last time from our November call, we have assumed at the midpoint of guidance that we are placing roughly the same 1,400 consoles, round numbers, as we placed in 2023 and 2022.

因此，您可能還記得上次 11 月電話會議的指導意見，我們假設在指導意見的中點，我們將投放與 2023 年和 2022 年大致相同的 1,400 台遊戲機（整數）。

We're also assuming, again, within guidance here at the midpoint that capital spending doesn't change, meaning its impact on our sales cycle doesn't change.

我們也再次假設，在中間的指導範圍內，資本支出不會改變，這意味著它對我們銷售週期的影響不會改變。

And so as we think about moving anywhere through our guidance range, it really depends on, number one, on the number of consoles we place.

因此，當我們考慮在我們的指導範圍內移動到任何地方時，它實際上取決於，第一，我們放置的控制台的數量。

And that could be either as a result of getting TabloCarts earlier, or it could just be underlying demand in both our large end markets.

這可能是由於更早獲得 TabloCarts 的結果，也可能只是我們兩個大型終端市場的潛在需求。

We've also seen in the past overperformance come from ASP and also from more treatment sales than we have modeled.

過去，我們也看到超額表現來自於平均售價以及比我們模擬的更多的治療銷售。

So we can see upside in a variety of ways.

因此，我們可以透過多種方式看到好處。

Thanks.

謝謝。

Kristen Stewart, CL King.

克里斯汀·斯圖爾特，CL King。

Hi.

你好。

Thanks for taking my question.

感謝您提出我的問題。

Do you hear me okay?

你聽到我說話好嗎？

Yes, perfect.

是的，完美。

Okay, perfect.

好的，完美。

I'm just wondering (technical difficulty) just just provide (technical difficulty) color on the cost reductions that you guys are taking, the initiatives across the company, and what gives you confidence that you can get the cash burn down in 2024?

我只是想知道（技術難度）只是提供（技術難度）關於你們正在採取的成本削減措施、整個公司的舉措以及是什麼讓您有信心在 2024 年實現現金消耗？

Yeah.

是的。

Hey, Kristen.

嘿，克里斯汀。

So the expense reduction initiatives are the ones we announced in our last call as well.

因此，我們在上次電話會議中也宣布了削減費用的舉措。

And what we did is we really took a look at all of our spending and anchored around two pillars.

我們所做的是，我們真正審視了我們所有的支出，並圍繞著兩個支柱。

So one thing we wanted to protect was our commercial ability to execute into our guidance range and beyond as we think about our long-range horizon here, so meaning out through 2027 and beyond.

因此，我們想要保護的一件事是，當我們考慮我們的長期視野時，即在 2027 年及以後，我們執行指導範圍及以上的商業能力。

So we wanted to preserve our ability to perform on the top line.

因此，我們希望保持我們在營收的表現能力。

And then we wanted to make sure that we preserved R&D capability, both to continue to drive cost down on our console and to find software, which we've long talked about as where we think the future is going to be.

然後，我們希望確保保留研發能力，既要繼續降低控制台成本，又要尋找軟體，我們長期以來一直在談論我們認為未來的發展方向。

So once we have these two pillars, we sort of went through everything else in our P&L and just made sure that we were spending at an appropriate level given our expected rate of growth.

因此，一旦我們有了這兩個支柱，我們就會檢查損益表中的其他所有內容，並根據我們的預期成長率確保我們的支出處於適當的水平。

That resulted in taking out roughly $25 million worth of OpEx in round numbers and allows us to -- last in 2023, we just printed about $162 million of OpEx non-GAAP.

這導致我們拿出了價值約 2500 萬美元的營運支出，並讓我們能夠——去年 2023 年，我們剛剛印製了約 1.62 億美元的非 GAAP 營運支出。

And our guidance for 2024 is about $140 million to $145 million.

我們對 2024 年的指引約為 1.4 億至 1.45 億美元。

So that's kind of the exercise we went through.

這就是我們所經歷的練習。

Now, from a cash perspective, we burned just under $120 million in 2023, and our expectation is to burn significantly less than that, about $100 million in 2024 and then to burn incrementally less each year moving forward as we have revenue growth, gross margin expansion, and OpEx leverage off this new lower base.

現在，從現金角度來看，我們在2023 年消耗的資金略低於1.2 億美元，我們的預期是，到2024 年，我們的消耗量將大大減少，約為1 億美元，然後隨著收入、毛利率的成長，每年的消耗量都會逐漸減少擴張和營運支出利用了這個新的較低基數。

(technical difficulty) for taking my

（技術難度）

(technical difficulty)

（技術難度）

Great.

偉大的。

Thanks, Kristen.

謝謝，克里斯汀。

Drew Ranieri, Morgan Stanley.

德魯‧拉涅利，摩根士丹利。

Hi, Leslie.

嗨，萊斯利。

Hi, Nabeel.

嗨，納比爾。

Thanks for taking the question.

感謝您提出問題。

Maybe for Leslie, just your comments about the whole market.

也許對於萊斯利來說，只是您對整個市場的評論。

You mentioned one of the MDOs was averaging about 25 patients on with Tablo.

您提到其中一個 MDO 平均約有 25 名患者使用 Tablo。

And you mentioned the historical reference of like one to five patients on incumbent devices.

您提到了使用現有設備的大約一到五個患者的歷史參考。

Just maybe help us bridge what the characteristics are of that MDO that's now out to like 25 patients.

也許可以幫助我們了解現在已向 25 名患者提供的 MDO 的特徵。

And there's such a significant population of home patients still out there.

而且仍然有大量的家庭患者。

What's really going to get the market to make more progress in getting patients from in center to the home over the next 12, 24 months?

在接下來的 12、24 個月內，什麼真正能讓市場在將患者從中心轉移到家中取得更大進展？

How are you thinking about that?

你覺得怎麼樣？

And thanks for taking the question.

感謝您提出問題。

Sure.

當然。

Yeah, good to hear from you, Drew.

是的，很高興收到你的來信，德魯。

So I guess one comment, first and foremost, we really were excited by the examples that we have amongst the home programs of getting into, I'll call it elevations of a home patient census that have never been seen before.

所以我想有一個評論，首先也是最重要的是，我們真的對我們進入家庭計劃中的例子感到興奮，我將其稱為以前從未見過的家庭患者人口普查的高度。

We do have -- as I said, our highest home program has been averaging 25 patients.

我們確實有——正如我所說，我們最高的家庭計劃是平均 25 名患者。

That's not a ceiling.

那不是天花板。

And one of the things that I'm most excited about and very curious about is how much higher above 25 can we go.

我最興奮和好奇的事情之一是我們能比 25 更高多少。

And I think it's quite a bit higher.

我認為這個數字要高一些。

That is because our training time on Tablo, really irrespective of patients' demographic, is materially faster than the incumbent devices.

這是因為，無論患者的人口統計數據如何，我們在 Tablo 上的訓練時間都比現有設備快得多。

So we're just enabling patients to get home more quickly.

所以我們只是讓病人能夠更快回家。

And again, our retention rate, the retention rate is absolutely critical here.

再說一遍，我們的保留率，保留率在這裡絕對至關重要。

We have had a markedly higher retention rate, both short term within 90 days and longer term at 12 months.

我們的保留率明顯更高，無論是 90 天內的短期保留率還是 12 個月的長期保留率。

And that helps tremendously.

這有很大幫助。

Well, our goal is to get patients home and enable them to stay home.

嗯，我們的目標是讓患者回家並讓他們留在家裡。

And I think our team and our technology has done a really good job of doing that.

我認為我們的團隊和技術在這方面做得非常好。

So your second part of your question was how do we reach for -- even against higher shelves, if you will, of the number of patients home.

所以你的問題的第二部分是我們如何達到——即使是在更高的架子上，如果你願意的話，也能達到回家的病人數量。

I think it's twofold.

我認為這是雙重的。

With the existing dialysis providers, it is growing the number of patients per home program.

憑藉現有的透析服務提供者，每個家庭計畫的患者數量正在增加。

We're really focused on going deep with the programs that we have, which we're starting to see [for Q], keeping that retention rate high.

我們真正專注於深入研究我們現有的計劃，我們開始看到[Q]，保持較高的保留率。

And then adding more patients at the top of the funnel, as we talked about in the prepared remarks, by creating more new market entrants that are sending patients home.

然後，正如我們在準備好的演講中談到的那樣，透過創建更多新的市場進入者將患者送回家，在漏斗頂部添加更多患者。

We are seeing movement there.

我們看到那裡有動靜。

We're seeing new market entrants get into the business of home dialysis who are motivated by and attracted to the economics of home.

我們看到新的市場進入者進入家庭透析業務，他們受到家庭經濟的激勵和吸引。

And also, they're starting to think about the journey to home.

而且，他們開始考慮回家的旅程。

How do we get patients into the home, where do they -- how and where are they trained, how are they supported?

我們如何讓患者進入家中，他們在哪裡——他們如何以及在哪裡接受培訓，他們如何獲得支持？

They're thinking about all those questions in really different and creative ways.

他們正在以非常不同且富有創意的方式思考所有這些問題。

All of which I think will contribute to have greater patient flow direct to the home with a home-first mindset.

我認為所有這些都將有助於以家庭優先的心態讓更多的患者直接進入家庭。

So as with all things that are transformative, transformation of market this big is not -- certainly not going to happen overnight.

因此，就像所有具有變革性的事物一樣，如此大的市場變革當然不會在一夜之間發生。

We've always expected it to grow at a steadily linear fashion.

我們一直期望它以穩定的線性方式成長。

But I do think all the right work is being done now, which we expect to feed a high double-digit growth rate far, far into the future for us on the home and the acute side for that matter.

但我確實認為現在正在做所有正確的工作，我們預計這將為我們在家庭和緊急方面的未來帶來兩位數的高成長率。

Does that answer your questions?

這能回答你的問題嗎？

Operator, I think we can go to the next question.

接線員，我想我們可以進入下一個問題了。

Thank you.

謝謝。

(Operator Instructions) Shagun Singh, RBC Capital Markets.

（操作員指令）Shagun Singh，RBC 資本市場。

Hey, Leslie.

嘿，萊斯利。

Thank you for squeezing me in.

謝謝你把我擠進去。

I was just wondering if you can talk a little bit about what the Street is missing about the Outset Medical story.

我只是想知道你是否可以談談華爾街對 Outset Medical 的故事缺少什麼。

And given where the stock is at, is there any change in strategy or anything you're looking to do differently?

考慮到股票的現狀，策略是否有任何變化或您希望採取哪些不同的做法？

Thank you for taking the follow-up.

感謝您的關注。

Sure, happy to.

當然，很高興。

Well, I think that as I take a step back and look at the Outset's story, I see a couple of things.

嗯，我認為當我退後一步看看開頭的故事時，我看到了一些事情。

Number one, I see a market with very high barriers to success.

第一，我認為市場的成功壁壘非常高。

We have now scaled to a point where we have scaled the high barrier and raised it for others, those who are already in the market and those who might be attempting to enter it.

我們現在已經達到了這樣一個程度：我們已經跨越了高門檻，並為其他人、那些已經進入市場的人和那些可能試圖進入市場的人提高了門檻。

Two, I see a business that is predicated on a very high percentage of recurring revenue, which provides visibility, durability.

第二，我認為一項業務的經常性收入比例非常高，可以提供可見度和持久性。

And that percentage of recurring revenue will only continue to get greater in the future.

而這個經常性收入的比例在未來只會繼續變得更大。

I also see a market with incumbent competitors that are providing services and products that health systems and patients are increasingly frustrated by and which are driving them to actively seek new solutions.

我還看到一個市場，現有的競爭對手正在提供令衛生系統和患者越來越沮喪的服務和產品，並促使他們積極尋求新的解決方案。

I think that the last point I'll make is that this is about much more than a technology.

我認為我要說的最後一點是，這不僅僅是一項技術。

It is about the ecosystem that we've built around Tablo that I spoke to in the prepared remarks.

這是關於我在準備好的演講中談到的我們圍繞 Tablo 構建的生態系統。

We have become, in a proprietary way, exceptional at guiding optimal health system customers through the change management process.

我們以專有的方式在引導最佳醫療系統客戶完成變革管理流程方面表現出色。

We've become exceptional in moving and supporting patients in the home.

我們在運送和支持家中患者方面表現出色。

We've become exceptional in our field service organization, our clinical support organization, and our ability to educate and train physicians and nurses.

我們的現場服務組織、臨床支援組織以及教育和培訓醫生和護士的能力都非常出色。

And so, perhaps if anything's being underappreciated, maybe it is the recurring revenue element of the story, the unprecedented retention rate in the home, and the strong gross margin gains that we've already made with a very, very clear road map now, both to this next milestone to 50% gross margins and a very clear roadmap to a profitable business in addition to a high-growth one.

因此，也許如果有什麼被低估的話，也許就是故事中的經常性收入元素、前所未有的家庭保留率，以及我們現在通過非常非常清晰的路線圖已經取得的強勁毛利率收益，既要實現毛利率達到50% 的下一個里程碑，又要製定非常清晰的路線圖，以實現獲利業務和高成長業務。

Just any change in strategy or the business as usual?

只是策略或業務有任何改變嗎？

Our strategy remains exactly the same.

我們的策略保持完全相同。

I think we are in the early innings of both acute and home.

我認為我們正處於急性比賽和主場比賽的早期階段。

We're very proud of the roughly 10% or 11% penetration we have on the acute side, but that leaves 90% to go.

我們對急性側約 10% 或 11% 的滲透率感到非常自豪，但還剩下 90% 的滲透率。

And so I think our strategy of focusing on what we call kind of land-and-expand, both landing new customers, adopting insourcing with Tablo, and delivering a product and team experience that motivates existing customers to expand within their network, continues to pay dividends.

因此，我認為我們的策略是專注於所謂的“土地和擴張”，既吸引新客戶，採用Tablo 內包，又提供產品和團隊體驗，激勵現有客戶在其網絡內擴張，這將繼續帶來回報。股息。

And then on the home front, I think the strategy remains resonant at the mid-sized dialysis organizations, continuing to deepen the patient census and volume in our existing programs and similarly landing new market entrants at the top of the funnel who are very motivated to enter this business and provide patients with additional channels of access through which to go home.

然後在國內，我認為該策略仍然在中型透析組織中引起共鳴，繼續深化我們現有計劃中的患者普查和數量，並同樣在漏斗頂部吸引新的市場進入者，他們非常有動力進入這一行業並提供患者回家的額外管道。

So I think when we look at our growth, as I look, for example, at 60% growth just on the home console front in 2023, we feel very confident in the components and the commercial strategy at large moving through 2024.

因此，我認為，當我們看到我們的成長時，例如，2023 年家用遊戲機方面的成長為 60%，我們對 2024 年的組件和整體商業策略非常有信心。

Thank you so much.

太感謝了。

Of course.

當然。

(Operator Instructions) Joshua Jennings, TD Cowen.

（操作員說明）Joshua Jennings，TD Cowen。

Hi, good afternoon.

嗨，下午好。

Thanks for taking the questions.

感謝您提出問題。

I was hoping to just ask about the competitive countermarking that was ongoing in 2023 and where that stands today.

我只是想問一下 2023 年正在進行的競爭性反標記以及目前的情況。

I believe it's most impactful in some ICU settings.

我相信它在某些 ICU 環境中影響最大。

And comparison freeing up the Tablo XT is not appropriate for all care settings.

比較釋放 Tablo XT 並不適合所有護理環境。

So just the dynamic between CRRT versus some of the on-label treatment types for Tablo.

這就是 CRRT 與 Tablo 的一些標籤治療類型之間的動態。

Has that died down?

那已經平息了嗎？

Or has your team been able to counteract that effectively?

或者您的團隊是否能夠有效地應對這一問題？

Where does that stand, Leslie?

萊斯利，這是什麼意思？

Yeah, sure.

好，當然。

Nice to hear from you, Josh.

很高興收到你的來信，喬許。

Well, in short, our team has done a really, really good job.

嗯，簡而言之，我們的團隊做得非常非常好。

And in responding to that, we were caught a little flat-footed, as we've noted in end Q3, Q4, but not so anymore.

對此，我們有點措手不及，正如我們在第三季末、第四季末指出的那樣，但現在不再這樣了。

And I would also add that we have not necessarily seen any new competitive activity since then.

我還要補充一點，從那時起我們不一定會看到任何新的競爭活動。

We exist now in a competitive market.

我們現在處於競爭激烈的市場。

It's not a surprise when we have taken as much market share and grown as fast as we have.

當我們佔據如此多的市場份額並以如此快的速度成長時，這並不奇怪。

So I would expect to see competitive activity, and we're more ready for today than we ever have been in the past.

因此，我希望看到競爭活動，而且我們比過去任何時候都為今天做好了更多準備。

I would say that the other thing that we're fortified by is the technology itself.

我想說的是，我們的另一件事是科技本身。

Tablo is the only device in the market that can deliver dialysis therapy anywhere between zero and 24 hours.

Tablo 是市面上唯一可在 0 到 24 小時之間提供透析治療的設備。

I think its utility and its value in the ICU is further supported by a statistic that Nabeel gave, which is that 80% of our console sales last quarter had the Tablo [Pro Plus] software attached to it, which is a feature, the 24-hour feature that you would only use in the ICU.

我認為 Nabeel 提供的一項統計數據進一步支持了它在 ICU 中的實用性和價值，即我們上季度銷售的遊戲機 80% 都附帶了 Tablo [Pro Plus] 軟體，這是一個功能，24 -小時功能，您只會在ICU 中使用。

And so I think that speaks to the clinical value that Tablo delivers in the ICU.

因此，我認為這說明了 Tablo 在 ICU 中提供的臨床價值。

And none of that is changed as a result of the warning letter or the competitive activity around it, which is the good news.

這一切都不會因為警告信或圍繞它的競爭活動而改變，這是個好消息。

Thanks.

謝謝。

And then just one follow-up on the home opportunity.

然後是主場機會的一次後續行動。

I think you've called out just the stat, about 40% of the US dialysis population have any Medicare Advantage and that payers ultimately may drive more patients to the home to secure an economic benefit.

我認為您剛剛提到了統計數據，大約 40% 的美國透析人群擁有醫療保險優勢，付款人最終可能會促使更多患者回家以獲得經濟利益。

Can you just -- has there been any actions by payers to date, or do you expect any in 2024?

到目前為止，付款人是否採取了任何行動，或者您預計 2024 年會採取任何行動嗎？

Or how could that evolve?

或者說它是如何演變的？

Maybe just remind us of how economically beneficial home is for these payers.

也許只是提醒我們，住房對這些付款人來說是多麼有利的經濟利益。

Thanks a lot.

多謝。

Yes.

是的。

Of course, I'm happy to.

當然，我很樂意。

Well -- and maybe I'll take a half step back and say thank you to all of the structural tailwinds and the more foundational growth drivers for home are all still firmly intact.

好吧——也許我會退半步，對所有結構性順風表示感謝，而國內更基礎的成長動力仍然完好無損。

As a reminder, the ETC model from CMS is in place and providing increasing benefits or increasing incentives, I should say, between now and 2027.

提醒一下，從現在到 2027 年，CMS 的 ETC 模式已經到位，並提供了越來越多的福利或越來越多的激勵措施。

So that model, we believe, will continue to incent providers of all types to send more patients home quickly.

因此，我們相信，這種模式將持續激勵各類醫療服務提供者快速送更多病患回家。

We do still see patient preferences being influenced in a positive way toward home as a result of COVID.

我們仍然看到，由於新冠疫情，患者對家庭的偏好受到了正面的影響。

I think patients are more confident sort of forward leaning toward home than ever.

我認為患者比以往任何時候都更自信地傾向於家庭。

And that's also aided by, I think, kind of the normalization of the hospital, the home environment and movement.

我認為，這也得益於醫院、家庭環境和活動的正常化。

And then the third big structural tailwind is one that you cited.

第三大結構性順風就是你提到的。

Yes, we do continue to see data that roughly 40% of the dialysis population is already signed up for Medicare Advantage.

是的，我們確實繼續看到數據顯示大約 40% 的透析族群已經註冊了 Medicare Advantage。

These payers, prior to Medicare Advantage eligibility for dialysis patients, used to be able to transition their commercial patients over to Medicare at month 30.

這些付款人在透析患者獲得 Medicare Advantage 資格之前，過去能夠在第 30 個月將其商業患者轉為 Medicare。

And now that's no longer the case.

現在情況已不再如此。

So they will be supporting their dialysis members effectively in perpetuity.

因此，他們將永久有效地支持透析成員。

And so we do expect to see increasing involvement amongst the Medicare Advantage providers to urge their partners to move more patients into the home.

因此，我們確實希望看到醫療保險優惠提供者越來越多地參與，敦促他們的合作夥伴將更多患者轉移到家中。

I'll say, as I said a couple of minutes ago, I think transformation at this level in any market rarely happens overnight.

我想說，正如我幾分鐘前所說的那樣，我認為任何市場的這種水平的轉型很少會在一夜之間發生。

And so I would not necessarily expect to have results to report back to you on that next quarter per se.

因此，我不一定希望能夠向您報告下個季度的結果。

But in almost every conversation we are having with payers, it involves a discussion around how do we move more patients home.

但在我們與付款人進行的幾乎每一次對話中，都涉及如何讓更多患者回家的討論。

We believe that the cost of care is lower and that the quality of care is higher in the home.

我們相信家庭照護成本更低，照護品質更高。

So the conviction and the belief and the motivation is certainly already present.

因此，信念、信念和動機肯定已經存在。

Great.

偉大的。

Thanks so much.

非常感謝。

Thank you.

謝謝。

This does conclude the question-and-answer session of today's program.

今天節目的問答環節到此結束。

I'd like to hand the program back to Leslie Trigg for any further remarks.

我想將程式交還給萊斯利·特里格 (Leslie Trigg) 以供進一步評論。

Thank you, and thanks to all of you for joining today.

謝謝你們，也謝謝大家今天的加入。

We look forward to our next update on our first-quarter call, and hope you all have a great evening.

我們期待第一季電話會議的下一次更新，並希望大家度過一個愉快的夜晚。

Thank you, ladies and gentlemen, for your participation in today's conference.

女士們、先生們，感謝你們參加今天的會議。

This does conclude the program.

這確實結束了該程式。

You may now disconnect.

您現在可以斷開連線。

Good day.

再會。