Semler Scientific Inc (SMLR) 2023 Q4 法說會逐字稿

Good afternoon, and welcome to the Semler Scientific 2023 fourth quarter financial results conference call. (Operator Instructions) Please note this event is being recorded. Before we begin, Semler Scientific needs to remind you that certain comments made during this call may constitute forward looking statements and are made pursuant to and within the meaning of the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995 as amended.

These include statements regarding the expectations for expansion of the business and the development of marketing in additional products, including receipt and timing of an additional 510(K) clearance for QuantaFlo, an investment in emerging growth opportunities. Such forward-looking statements are subject to both known and unknown risks and uncertainties that could cause actual results to differ materially from such statements.

Those risks and uncertainties are described in the press release and our SEC filings. The forward-looking statements made today are as of the date of this call, and the company does not undertake any obligation to update the forward-looking statements. If you do have a copy of today's release, you may obtain one by visiting the Investor Relations page of the website, semlerscientific.com.

I would now like to turn the conference over to Doug Murphy-Chutorian, CEO of Semler Scientific. Please go ahead.

Good afternoon, everyone. Thank you for joining us for our fourth quarter and full year 2023 results call. Year over year, we continue to achieve annual revenue and earnings growth. Now I'm pleased to introduce our CFO, Renae Cormier, who will provide you with further details when. Renae.

Thank you, Doug, and good afternoon, everyone, and thank you for being part of today's conference call. Today, I'll be presenting an overview of our fourth quarter 2023 financial results and discussing recent corporate developments. Jennifer Oliva Herrington, who leads our marketing sales and related operations will be providing information about our market developments and opportunities. Following our remarks, Doug, Jennifer, and I will be available to address any questions you may have.

I'm excited to announce continued growth in revenues and earnings in the fourth quarter 2023. This achievement is a testament to the hard work of our team as well as the ongoing support of our customers who continue to recognize the clinical benefits and value of our technology.

Now to the details of our fourth quarter results. Total revenues in Q4 2023 were $15.1 million, an increase of 9% compared to the fourth quarter of 2022. Our revenues continued to be driven by continued sales of QuantaFlo to existing and new customers to test for peripheral arterial disease or PAD. We believe the promising results that were published in two large independently conducted peer-reviewed study by QuantaFlo customers in 2022 are having an impact. These studies underscore the importance of identifying a symptomatic PAD patient enabling the implementation of preventative measures.

Fixed fee revenues were $8.8 million, a decrease of 2% year over year. We saw end of 2023 cleanup of underutilized units by some customers resulting in the decline. We see continued interest in our products from existing customers as well as new customers such as hospitals, value-based care providers, and major pharmaceutical and retailer market.

Variable fee revenues were $5.8 million, an increase of 28% year over year. We continue to see strong demand from our home risk assessment customers using QuantaFlo for PAD during home -- in home examination. Equipment and other revenues were $0.5 million, an increase of 71% year over year. Equipment revenues remain strong versus historical levels because the majority of equipment sales are to variable fee customers. We believe it is a sign of future potential growth in the fee per test market.

Fourth quarter 2023, our three largest customers, including their related affiliates, comprised 37%, 32% and 11% of quarterly revenues. Operating expenses in Q4 2023, which includes cost of revenue, were $12.5 million, an increase of 23% year over year. Our Q4 2023 results included $2.5 million write-up in cost of revenues in the Insulin Insights's prepaid licenses and also $0.6 million impairment of [Knology's] investments in other income.

While we continue to market Insulin Insight because we believe in its clinical benefits for diabetic patients, our marketing efforts over the past three years have not yielding significant results to date. As a percentage of revenue, operating expenses increased to 83% compared to 74% in 2022, due primarily to the write-off. Pretax income was million compared to $4 million in the prior year.

Net income was $4.2 million or $0.62 per basic share and $0.55 per fully diluted share compared to $3.2 million or $0.48 per basic share and $0.41 per fully diluted share in 2022. We had cash, cash equivalents and short-term investments at December 31, 2023 of $57.3 million.

Now I'd like to turn the call over to Jennifer to provide a more in-depth discussion of our market developments an opportunity. Jenna, are you still there?

(multiple speakers) Sorry. Thank you, Renae. As I look into the future, I'm excited about similar potential to support the identification of chronic diseases by our customers, which is a large burden on our healthcare system. Cardiovascular disease is the number one cost to the healthcare system as well as the number one cause of death worldwide, which makes early detection of chronic cardiac conditions so critical. In January, we announced we are seeking a new 510(K) clearance from the FDA to broaden the labeling for QuantaFlo, extending its application to include aiding in the diagnosis of other cardiovascular diseases.

We aim to receive clearance with this expanded label in the second half of 2024. Upon achieving this milestone, our focus will shift towards effectively upselling our existing customer base with this enhanced offering. In the interim, we remain dedicated to the promotion and sales of QuantaFlo as a valuable aid in the diagnosis of PAD. This proactive approach ensures that we continue providing our customers with a trusted solution while positioning ourselves for future success in the broader cardiovascular diagnostic market.

By supporting early diagnosis of peripheral arterial disease we are hopeful that healthcare providers will initiate preventative management of chronic cardiovascular disease. We believe that this proactive approach may save lives and also lower healthcare expenditures. As we set our sights on the future, we envision a healthcare landscape where our technology plays a pivotal role in shaping healthier outcomes for patients while delivering substantial economic benefits to our customers.

Our sales and marketing goals are to further establish QuantaFlo for PAD as a standard of care, given the proven clinical benefits of early diagnosis and preventative treatments; and to diversify our customer base by adding medical centers, additional value-based care providers, penetrating deeper into the VA system, and growing the self-insured employer pharmaceutical and retail market.

And now Renae will give our concluding remarks. Renae?

To achieve this plan, we are reinvesting in emerging growth opportunities with a focus on expanding our customer base for PAD. We believe that these opportunities hold promise and represent an exciting aspect of our company's future. Additionally, our commitment to research and development remains unwavering as we prioritize the enhancement of existing products and data services, sustain the forefront of innovation, and consistently deliver cutting-edge solutions to our customers.

Our long-term vision includes extending our reach to encompass additional cardiovascular applications, reflecting our dedication to continuous expansion. A key strength of our technology lies in its portability and accessibility, allowing us to actively contribute to addressing health and equities prevalent in cardiovascular disease by providing tools that can be utilized in diverse settings we play a role in breaking down barriers, ensuring that more individuals have access to early detection and intervention.

As part of our growth strategy, we are exploring inorganic growth initiatives to further diversify our product portfolio. Through strategic partnerships and exploring new opportunities, we aim to broaden our impact on the market and expand our offering. We extend our gratitude for your interest in our company and appreciate your continued support as we embark on this journey of innovation.

Now, operator, if you could please open the line, Doug, Jenn, and I will be happy to address your questions.

(Operator Instructions) Brooks O'Neil, Lake Street Capital Markets.

Thank you very much. Good afternoon, everyone. Appreciate all the prepared remarks. I guess I'll start off by just asking, it looks to me like the $2.5 million write off to the Insulin Insight Investment may have obscured to some extent the benefit of the 30% expense reductions you're targeting for the company. Can you just give us a quick update on whether you're successful in taking the 30% expenses out of your expense base this year?

Sure. So you're right, it does obscure the numbers there and the $2.5 million write-off is in cost of revenues. And there are some noise between Q3 and Q4 between when we had some expenses or reversals and the Q4 expenses. So we were able to take out these expenses and you should see that more clearly going forward, as we won't have these one-time items.

Okay, good. And then just thinking about the business in the report, the fixed license fee is pretty flat this quarter. Would you say, as I think you mentioned in your prepared remarks, some cleanup from customers -- but how would you evaluate the demand environment for the fixed fee side of the business? Obviously, in light of the changes to the CMS risk methodology.

Sure. So we are in constant contact with our customers, and we've had reaction from customers that have been mixed. So as you saw, we aren't giving guidance for 2024. But we do believe that the motivation to do testing is still there. Although it's less for some customer that's phasing in with that CMS decision that you referred to. So we do continue to expand our market with customers that are not dependent on Medicare advantage. And ongoing going into 2024, we will remain nimble and adjust according to market conditions.

So I mean, just trying to follow up on this a little bit, Renae. You would say, right this minute you're not seeing much in the way of [due] interest from MA plan sponsors, and there could be some softening of demand from existing customers in that arena. Is that a fair way to characterize it?

I don't know that I was going to expend that specific a detail. But when we're looking at expanding our market, we are looking to expand outside the Medicare advantage space. So in other spaces that we've talked about before, like the hospital systems, retail pharmaceutical markets and then also delegated medical groups.

Okay. And would you say -- I'm just trying to think this through quickly on the flight. I've always had a sense one of the appeals of the MA market is that you didn't need to get any kind of a specific reimbursement decision from the payers to reimburse doctors who provided the test. Do you see in the future a need or opportunity to pursue what I might call a more traditional route to revenue generation reimbursement for your service, your test?

Right. So now at this time. Some of these markets that we're going after are more in the value-based care side, and so looking at the perspective of identifying these patients early to put preventative measures in place ahead of time of major events that can be very costly.

Sure. That makes all the sense in the world. Okay. Let me switch gears for a second and just -- obviously you commented about the 510(K) submission for heart dysfunction. One of the things that I think I recall from your press releases talking about the decision to submit a new 510(K) is there -- is the opportunity to be more clear about the conditions that QuantaFlo can test for. Have you been able to achieve any clarity either in your own minds or in conversation with the FDA about the kinds of tests, cardiovascular tests that QuantaFlo might work for?

We have. And so what we've talked about at this time is we're just broadly classifying it as cardiovascular diseases. And as we progress into the second half, we hope to have this 510 clearance at that time, and then we will be able to talk in more detail about what it's specifically cleared for.

Okay, that makes sense to me. Maybe I'll just ask you one broad one. I'm just curious, I know you're in a unique position as you interact with the MA plan sponsors out there, and frankly, as you mentioned, the value-based care providers, how would you say people are evaluating the changes the government has put in place for the risk model for MA reimbursement? Is it changing people's behavior in a substantial way? Are the changes more tweaks to the basic methodology? How do you read it right now?

Sure. So it's hard to classify it as one particular thing because we are getting different reactions from different customers. And as you saw in 2023, we did have record revenues for the year. And so as the year progressed, we still continue to see testing from our customers, both the existing customers and new customers. So as we work through 2024, again, we're going to adjust according to market conditions. But there aren't it's really clear reaction from customers as they have been met.

Okay. Okay. I'll leave it at that. Thanks for taking my question.

Great. Thanks so much, Brooks.

This concludes our question and answer session. I would like to turn the conference back over to Renae Cormier for any closing remarks.

Thank you, Dave. As we wrap up this conference call, we wanted to emphasize our ongoing commitment to delivering clinical benefits through earlier diagnosis of chronic cardiovascular conditions. The continued recognition of the value of this approach by our customers underscores the crucial role our technology plays for patients, physicians, facilities, and payers in an evolving healthcare landscape.

Moving forward, our primary objective remains steadfast. To preserve and strengthen our current revenue opportunities and profitability within the chronic disease space with a focus on cardiovascular diseases. We appreciate your participation in today's discussion, and thank you for your ongoing support. Goodbye.

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.