Neuronetics Inc (STIM) 2026 Q1 法說會逐字稿

Good day and thank you for standing by. Welcome to the Neuronetics first quarter 2026 financial and operating results call. (Operator Instructions) Please be advised that today's conference is being recorded.

各位好，感謝您稍候。歡迎參加 Neuronetics 2026 年第一季財務與營運成果電話會議。(接線員指示) 請注意，今日會議將被錄音。

I would now like to hand the conference over to your first speaker today.

現在我想把會議交給今天的第一位講者。

Good morning, and thank you for joining us for the Neuronetics first quarter 2026 conference call. Joining me on today's call is Neuronetics' President and Chief Executive Officer, Dan Reuvers. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements covered under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements related to our business, strategy, financial and revenue guidance and other operational issues and metrics.

各位早安，感謝您參加 Neuronetics 2026 年第一季電話會議。今天與我一同出席的有 Neuronetics 總裁兼執行長 Dan Reuvers。在開始之前，我要提醒各位，管理層在本次電話會議中討論的某些資訊將包含前瞻性陳述，並受 1995 年《私人證券訴訟改革法》安全港條款所涵蓋，其中包括與我們的業務、策略、財務與營收指引，以及其他營運議題與指標相關的陳述。

Actual results can differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business. For a discussion of risks and uncertainties associated with Neuronetics' business, I encourage you to review the company's filings with the Securities and Exchange Commission, including the company's annual report on Form 10-K, which was filed in March and the company's quarterly report on Form 10-Q for the quarter ended March 31, 2026. The company disclaims any obligation to update any forward-looking statements made during the course of this call, except as required by law.

由於與公司業務相關的風險與不確定性，實際結果可能與這些前瞻性陳述所述或所暗示者存在重大差異。關於與 Neuronetics 業務相關的風險與不確定性之討論，我鼓勵各位查閱公司向美國證券交易委員會（SEC）提交的文件，包括公司於 3 月提交的 Form 10-K 年度報告，以及截至 2026 年 3 月 31 日季度的 Form 10-Q 季度報告。除法律要求外，公司不承擔更新本次電話會議期間所作任何前瞻性陳述的義務。

During the call, we'll also discuss certain information on a non-GAAP basis, including EBITDA and adjusted EBITDA. Management believes that non-GAAP financial information taken in conjunction with US GAAP financial measures provides useful information for both management and investors by excluding certain noncash and other expenses that are not indicative of trends in our operating results. Reconciliations between US GAAP and non-GAAP results are presented in the tables accompanying our press release, which can be viewed on our website.

在本次電話會議中，我們也將討論若干非 GAAP 口徑資訊，包括 EBITDA 與調整後 EBITDA。管理層認為，非 GAAP 財務資訊若與美國 GAAP 財務衡量指標一併使用，透過排除某些非現金及其他不代表我們營運結果趨勢的費用，能為管理層與投資人提供有用資訊。美國 GAAP 與非 GAAP 結果之間的調節表已列示於隨新聞稿附上的表格中，可於我們的網站查閱。

With that, it's my pleasure to turn the call over to Neuronetics' President and Chief Executive Officer, Dan Reuvers.

接下來，我很榮幸把電話會議交給 Neuronetics 總裁兼執行長 Dan Reuvers。

Thanks, Mark, and welcome, everyone, to our first quarter 2026 earnings call. I'll begin by sharing some perspectives on my background and why I joined the company, discuss some early observations, and then I'll walk through the key drivers of our performance in the quarter. Then I'll walk through our quarterly financial results in greater detail, and I'll conclude with my perspective on the rest of 2026 before opening the line for questions. This is my first earnings call as CEO of Neuronetics, and I'm pleased to be here. I've spent about 35 years in the med tech industry, and most of my career has been in businesses where patient impact, execution and operational rigor drive the outcome.

謝謝你，Mark，也歡迎各位參加我們 2026 年第一季財報電話會議。我將先分享一些關於我的背景以及我加入公司的原因，談談一些初步觀察，接著說明本季表現的關鍵驅動因素。然後我會更詳細地說明本季財務結果，最後在開放提問前，分享我對 2026 年剩餘期間的看法。這是我以 Neuronetics 執行長身分主持的第一場財報電話會議，我很高興能在此與各位交流。我在醫療科技產業約 35 年，職涯大多在以病患影響、執行力與嚴謹營運管理決定成果的企業中任職。

Most recently, I served as CEO of Tactile Medical, where we grew revenue from $187 million to approximately $300 million. During that time, we expanded patient reach, grew gross margins, delivered record earnings and cash flow generation. Before that, I spent 12 years with Integra LifeScience, where I led the $1 billion Codman Neurosurgery division. And earlier in my career, I held leadership roles at several other med tech companies.

最近，我擔任 Tactile Medical 的執行長，期間我們將營收從 1.87 億美元成長至約 3 億美元。在那段時間，我們擴大了病患觸及範圍、提升毛利率，並創下獲利與現金流生成的紀錄。在此之前，我在 Integra LifeScience 任職 12 年，領導其 10 億美元規模的 Codman Neurosurgery 事業部。更早之前，我也在其他數家醫療科技公司擔任領導職務。

There were a couple of things that drew me to this role. First, our mission to renew lives by restoring hope for patients and their families is one that I'm passionate about. It's amazing how many people have reached out to me since taking the role, sharing their stories of how they or someone they knew have either suffered from depression or better yet benefited from one of our therapies. Second, I think my background gives me a great perspective on how to move this business forward. My experience in the device space will allow me to come up to speed on the NeuroStar business quickly.

有幾個因素吸引我擔任這個職位。第一，我們的使命是透過重燃希望來重塑病患及其家人的生活，這是我非常投入且熱忱所在。自我上任以來，令人驚訝的是有這麼多人主動聯繫我，分享他們或他們認識的人如何受憂鬱症所苦，或更好的是，如何從我們的療法中受益。第二，我認為我的背景能讓我對如何推動這項業務向前發展有很好的視角。我在醫療器材領域的經驗，將使我能快速熟悉 NeuroStar 業務。

And it's notable that Tactile was vertically integrated, meaning we designed, manufactured and sold our therapy solutions, but also directly build third-party payers, an experience I expect to draw on as we continue to improve efficiency within our Greenbrook clinics.

值得一提的是，Tactile 採垂直整合模式，也就是我們設計、製造並銷售我們的治療解決方案，同時也直接向第三方付款方進行帳單請款；我預期會運用這些經驗，持續提升 Greenbrook 診所的營運效率。

Since stepping into the role, I've spent the bulk of the last month on a listening tour. I've been on the road with our field team, inside our clinics and meeting with customers. I've also engaged with shareholders, analysts and others, helping me shape my understanding of the business. My approach has been deliberate and comprehensive, intended to allow me to fully understand this business before making decisions about where to lean in, where to adjust and how we maximize the value of what we have. With that said, what I've seen in my first few weeks has reinforced my conviction in the underlying opportunity that exists for us.

自接任以來，我在過去一個月大部分時間進行了「傾聽之旅」。我與我們的前線團隊一同出差，走訪診所並與客戶會面。我也與股東、分析師及其他人士交流，協助我建立對業務的理解。我的方法是審慎且全面的，目的是在決定該加大投入之處、需要調整之處，以及如何最大化我們既有資產價值之前，先充分理解這門業務。話雖如此，我在最初幾週所看到的一切，更加強了我對我們所擁有之基本機會的信心。

First, on the NeuroStar side, I see a clear opportunity to broaden how we go to market and reach customer segments where we've not historically been positioned to compete. I'll talk more about that in a moment. Second, with the Greenbrook clinics, workflows are key to optimizing profitability in our clinics, not only ensuring that patients have an efficient path to initiate their treatment and gain relief, but also to minimize operational handoffs. Revenue cycle management is also an area where I've spent time in my previous role. And what I've seen inside our clinic operations tells me there is more opportunity ahead.

第一，就 NeuroStar 而言，我看到一個明確的機會：拓寬我們的市場進入策略，並觸及過去我們在定位上未能有效競爭的客戶族群。我稍後會再多談一些。第二，就 Greenbrook 診所而言，工作流程是提升診所獲利能力的關鍵，不僅要確保病患能以高效率的路徑啟動治療並獲得緩解，也要將營運交接環節降到最低。營收循環管理也是我在前一個職務中投入過時間的領域。而我在診所營運中所看到的情況告訴我，未來仍有更多機會可挖掘。

Lastly, we have a talented team that's focused and executing. And I've been genuinely impressed with the quality of the people and the conviction toward our mission across the organization. Now before I walk through the quarter, I'd like to briefly address two items. First, on our recently announced CFO transition. Steve Pfanstiel departed earlier this month to pursue an opportunity outside Neuronetics. We've initiated a comprehensive search to identify his successor. We appreciate Steve's contributions during his time at Neuronetics, and we'll provide updates as the search progresses. Ultimately, this allows me to select a partner that I'm confident, can help me lead our next chapter.

最後，我們擁有一支專注且執行力強的優秀團隊。我也確實對組織內人員的素質，以及全體對我們使命的堅定信念印象深刻。在我回顧本季之前，我想先簡要說明兩件事。第一，關於我們近期宣布的財務長（CFO）交接。Steve Pfanstiel 於本月稍早離任，以追求 Neuronetics 以外的機會。我們已啟動全面性的搜尋，以尋找他的接任人選。我們感謝 Steve 在 Neuronetics 任內的貢獻，並將在搜尋進展過程中提供最新資訊。最終，這也讓我能選擇一位我有信心、能協助我帶領公司邁向下一篇章的夥伴。

Second, I want to share some perspective on the comments made by certain shareholders about our business. While we believe that the integrated NeuroStar and Greenbrook businesses provide us with a strong foundation to grow from, we respect some shareholders' views that the separation of the business could potentially unlock shareholder value. The Board and I are aligned on operating this business with discipline and on making decisions that create long-term value for our shareholders. I assure you that I'm evaluating this business with an open mind, and I appreciate everyone's patience as I work through my process.

第二，我想就部分股東對我們業務所提出的評論分享一些看法。雖然我們相信整合的 NeuroStar 與 Greenbrook 業務為我們提供了強健的成長基礎，但我們也尊重部分股東的觀點：將業務分拆可能有機會釋放股東價值。董事會與我在以紀律經營本業、並做出能為股東創造長期價值的決策方面立場一致。我向各位保證，我正以開放的心態評估這項業務，也感謝大家在我推進自身評估流程期間的耐心等待。

With that context, let me share a bit more about our performance in the quarter. Our Q1 results were largely in line with expectations, and we're making progress on the commercial and operational priorities already in motion. Starting with the NeuroStar business. During the quarter, we shipped 34 systems, up 10% year over year. We continue to support our installed base with the most comprehensive training and clinical resources in the category. We're also modernizing how we deliver that support with more virtual, on-demand and real-time engagement tools that provide customers with choices on how they want to be supported.

在這樣的背景下，讓我再多分享一些我們本季的表現。我們第一季的結果大致符合預期，且在既有推進中的商業與營運優先事項上持續取得進展。先從 NeuroStar 業務談起。本季我們出貨 34 套系統，年增 10%。我們持續以同類別中最全面的訓練與臨床資源，支援我們的既有裝機客戶。我們也正以更多虛擬、隨選與即時互動工具來現代化支援交付方式，讓客戶可依其偏好選擇支援形式。

We're piloting an expanded set of commercial models for NeuroStar. Customers exist with a range of needs. And while we have a history of providing unparalleled ongoing support to our customers, we also know that not all customer's needs are the same. So expanding our go-to-market menu is a priority. I'm convinced that we can compete on a broader horizon by listening to customers and responding in kind. Early feedback has been positive, and I'll have more to share in August.

我們正在為 NeuroStar 試行一套擴充的商業模式組合。客戶的需求範圍很廣。雖然我們一向以提供無與倫比的持續性支援著稱，但我們也知道並非所有客戶的需求都相同。因此，擴充我們的上市策略選單是優先事項。我深信，只要傾聽客戶並做出相應回應，我們就能在更廣的戰場上競爭。初步回饋相當正面，我會在八月分享更多資訊。

Now a few comments on Greenbrook. Clinic revenue grew 15% in the quarter. Growth in the quarter was driven by continued strength in SPRAVATO with treatment growth year over year and expansion of buy-and-bill. On the TMS side, within our clinics, volumes were modestly below prior year levels in the quarter, which we attribute in part to weather disruption across portions of our footprint during the first two months of the quarter. We saw patient flow normalize as the quarter progressed, and we expect to return to more typical volume trends as we move into the second quarter.

接著談談 Greenbrook。本季診所營收成長 15%。本季成長主要來自 SPRAVATO 持續強勁，治療量年增，且 buy-and-bill 模式持續擴大。在 TMS 方面，就我們診所內部而言，本季量能較去年同期略低；我們認為部分原因是本季前兩個月我們部分據點受到天候干擾。隨著季度推進，我們看到病患流量回復正常，並預期進入第二季後將回到較典型的量能趨勢。

Within our clinic operations more broadly, the focus remains on workflow and revenue cycle management. The team has made real progress on collections and operational efficiency, and we see continued runway. We've also leveled our marketing investment across the year rather than front-loading it, which we believe is the right cadence for the business. We acted during the quarter to better align our cost structure.

更廣泛地看我們的診所營運，重點仍放在工作流程與營收循環管理。團隊在收款與營運效率方面已取得實質進展，我們也看到仍有持續改善空間。我們也將行銷投資在全年更平均地配置，而非前置投入，我們認為這是對業務而言合適的節奏。本季我們也採取行動，使成本結構更為匹配。

These steps are expected to deliver annualized savings of approximately $2.5 million to $3 million with net savings beginning in the third quarter. Profitability and cash are top priorities and will be a focus of mine going forward. Taken together, the quarter reflects a business that's executing on the priorities already in motion while we lay the groundwork for our next phase of growth.

預期這些措施可帶來約 250 萬至 300 萬美元的年化節省，且淨節省將自第三季開始顯現。獲利能力與現金是最優先事項，未來也將是我關注的重點。綜合而言，本季反映出公司在既有推進中的優先事項上持續執行，同時也為下一階段成長奠定基礎。

With that, I'll walk through the financial results in greater detail. Unless otherwise noted, all performance comparisons are being made to the first quarter of 2026 versus the first quarter of 2025. Total revenue in the first quarter was $34.5 million, an increase of 8% compared to revenue of $32 million in the first quarter of 2025. The increase in revenue was primarily driven by higher US clinic revenue. Total revenue from our NeuroStar business, inclusive of our system revenue as well as treatment session revenue was $12.9 million in the first quarter of 2026. This represents a decrease of 3% versus the prior year.

接下來，我將更詳細說明財務結果。除非另有說明，所有績效比較皆為 2026 年第一季相較於 2025 年第一季。第一季總營收為 3,450 萬美元，較 2025 年第一季的 3,200 萬美元成長 8%。營收增加主要由美國診所營收提升所帶動。我們 NeuroStar 業務的總營收（包含系統營收以及治療場次營收）在 2026 年第一季為 1,290 萬美元。這較去年同期下降 3%。

US NeuroStar system revenue was $3.2 million, an increase of 13% on a year over year basis, and we shipped 34 systems in the quarter, an increase of approximately 10% versus the prior year. US treatment session revenue was $9.1 million, a decrease of 5%, while system treatment utilization increased 3.5%. This was offset primarily by a reduction in customer inventory levels. US clinic revenue was $21.5 million, a 15% increase year over year. The results were driven by continued strong SPRAVATO growth and overall pricing improvement.

美國 NeuroStar 系統營收為 320 萬美元，年增 13%；本季出貨 34 套系統，較去年同期增加約 10%。美國治療場次營收為 910 萬美元，下降 5%，而系統治療使用率提升 3.5%。上述影響主要被客戶庫存水位下降所抵銷。美國診所營收為 2,150 萬美元，年增 15%。結果主要由 SPRAVATO 持續強勁成長及整體定價改善所帶動。

Gross margin was 46.9% in the first quarter of 2026 compared to 49.2% in the prior year quarter. The decrease in gross margin is a result of revenue mix with clinic revenues representing a higher portion of our overall revenues. We also saw some negative impact from the increase in SPRAVATO buy-and-bill from Q1 of last year when we were still launching that offering.

2026 年第一季毛利率為 46.9%，相較去年同期為 49.2%。毛利率下降係因營收組合所致，診所營收占我們整體營收的比重提高。此外，SPRAVATO buy-and-bill 的增加也帶來一些負面影響；去年第一季我們仍在推出該項服務。

Operating expenses during the quarter were $25.1 million, a decrease of $1.6 million or approximately 6% compared to $26.8 million in the first quarter of 2025. The decrease is primarily attributable to savings in SG&A expenses, where we have driven and will continue to drive efficiencies. Net loss for the quarter was $10.8 million or $0.16 per share as compared to a net loss of $12.7 million or $0.21 per share in the prior year. First quarter 2026 adjusted EBITDA was negative $6.6 million as compared to negative $8.6 million in the prior year, an improvement of $2 million.

本季營業費用為 2,510 萬美元，較 2025 年第一季的 2,680 萬美元減少 160 萬美元，約下降 6%。下降主要歸因於 SG&A 費用節省；我們已推動並將持續推動效率提升。本季淨損為 1,080 萬美元或每股 0.16 美元，相較去年同期淨損 1,270 萬美元或每股 0.21 美元。2026 年第一季調整後 EBITDA 為負 660 萬美元，相較去年同期為負 860 萬美元，改善 200 萬美元。

Moving to the balance sheet and cash flow. As of March 31, total cash was $19 million, consisting of cash and cash equivalents and restricted cash as compared to $34.1 million as of December 31. Cash used by operations in the first quarter was $9.4 million. This compares to an operating cash use of $17 million in Q1 of 2025, an improvement of $7.6 million versus the prior Q1.

接著看資產負債表與現金流。截至 3 月 31 日，現金總額為 1,900 萬美元（包含現金及約當現金與受限制現金），相較於 12 月 31 日為 3,410 萬美元。第一季營運活動使用現金為 940 萬美元。相較於 2025 年第一季營運活動使用現金 1,700 萬美元，較前一年第一季改善 760 萬美元。

As previously disclosed, in March 2026, we amended our debt agreement with Perceptive Advisors, which reduces our outstanding debt obligation and interest expense. Under the amendment, we made a one-time principal payment of $5 million to Perceptive Advisors, along with adjustments to the existing debt covenants.

如先前揭露，2026 年 3 月我們與 Perceptive Advisors 修訂了債務協議，降低了我們未償債務義務與利息費用。依據修訂內容，我們向 Perceptive Advisors 一次性支付 500 萬美元本金，並對既有債務契約條款（covenants）進行調整。

Now turning to guidance, which remains unchanged. We continue to expect total revenue between $160 million and $166 million, gross margins to be between 47% and 49%, operating expenses in the range of $100 million to $105 million, inclusive of approximately $8.5 million of noncash stock-based compensation. Cash flow from operations between negative $13 million and negative $17 million.

接著談到財測，維持不變。我們仍預期總營收介於 1.60 億至 1.66 億美元，毛利率介於 47% 至 49%，營業費用介於 1.00 億至 1.05 億美元（包含約 850 萬美元的非現金股權基礎薪酬）。營運活動現金流介於負 1,300 萬至負 1,700 萬美元。

As a reminder, our operating cash flow is projected to improve beginning in the second quarter and then sequentially through the remainder of the year, with operating cash flow being flat to positive during the second half of the year. And in the second quarter, we expect to see mid-single-digit growth.

提醒一下，我們預期營運現金流將自第二季開始改善，並在今年剩餘期間逐季改善；下半年營運現金流將持平至轉為正值。此外，在第二季，我們預期將看到中個位數的成長。

As we look ahead to the remainder of 2026, our priorities are clear. We're focused on disciplined execution, sharpening how we go to market and continuing to drive the business towards being cash flow positive. The pilots we have underway in the NeuroStar side of the business are designed to expand our reach and within our clinic operations, we'll continue to focus on workflow, collections and operational efficiency. We expect these benefits to continue building throughout the year.

展望 2026 年剩餘期間，我們的優先事項很明確。我們將專注於有紀律的執行，精進我們的市場進入策略，並持續推動業務朝向現金流轉正。我們在 NeuroStar 業務端正在進行的試點計畫，旨在擴大我們的觸及範圍；在診所營運方面，我們將持續聚焦於工作流程、收款與營運效率。我們預期這些效益將在全年持續累積。

Looking further out, I want to briefly touch on COMPASS Pathways pending psilocybin therapy. The regulatory process is Compasses to navigate, but the Trump administration's recent executive order prioritizing such submissions is certainly encouraging. If approved, we believe Greenbrook is among a very small number of providers genuinely equipped to deliver it.

再往後看，我想簡要談一下 COMPASS Pathways 尚在審核中的裸蓋菇素（psilocybin）療法。監管流程如同指南針般需要導航，但川普政府近期發布的行政命令將此類申請列為優先事項，確實令人鼓舞。若獲核准，我們相信 Greenbrook 將是少數真正具備交付該療法能力的服務提供者之一。

The protocol requires certified settings, trained clinical staff and a proven back-office infrastructure for benefits investigation and prior authorization, all of which we already have in place through our SPRAVATO operations. While we will be prepared to execute if the product is approved, similar to SPRAVATO, we'd expect the revenue ramp to be measured in the first year of launch, but the narrow pool of providers capable of delivering this therapy represents a durable advantage for our business.

該治療方案需要經認證的場域、受訓的臨床人員，以及用於給付資格查核與事前授權的成熟後台基礎設施；這些我們都已透過 SPRAVATO 的營運建立到位。若產品獲核准，我們將做好執行準備；與 SPRAVATO 類似，我們預期上市第一年的營收爬坡將較為循序漸進，但能夠提供此療法的供應者範圍有限，將為我們的業務帶來持久的優勢。

As I mentioned earlier, my approach in these first few weeks has been deliberate. I'm committed to making decisions that balance the interest of our patients, physicians, colleagues and shareholders. And I expect to be able to share an even more grounded view of where we're headed when we report next quarter. I want to thank the Neuronetics team for the work they've put in this quarter and for the welcome they've given me. I look forward to updating you all on our progress in August.

如我先前提到的，我在這最初幾週的做法是審慎而有計畫的。我致力於做出能平衡病患、醫師、同仁與股東利益的決策。我也預期在下季財報發布時，能分享對我們前進方向更為踏實、扎根的觀點。我要感謝 Neuronetics 團隊在本季投入的努力，以及他們對我的歡迎。我期待在 8 月向各位更新我們的進展。

And with that, I'll open the call for questions. Operator?

接下來，我將開放提問。接線員？

(Operator Instructions)

（接線員指示）

Bill Plovanic, Canaccord Genuity.

Bill Plovanic，Canaccord Genuity。

So three questions for you, Dan, if I could. One is just clarity on the performance in the Greenbrook sites. I just want to make sure I heard that the -- was it the treatment revenue and number of treatments was down year over year, backing out the SPRAVATO. I just want to make sure I heard that correctly.

Dan，我有三個問題，如果可以的話。第一個是想更清楚了解 Greenbrook 各據點的表現。我想確認我是否聽對了——扣除 SPRAVATO 之後，治療營收與治療次數是年對年下降，對嗎？我只是想確認我聽到的是正確的。

Yeah. Overall, we were pleased with the Greenbrook performance. We were up double digits, as we said, about 15%. The TMS volumes were off a little bit, Bill. And we think that, that was related to a couple of things.

是的。整體而言，我們對 Greenbrook 的表現感到滿意。如我們所說，年增達雙位數，大約 15%。Bill，TMS 的量有稍微下滑一些。我們認為這與幾個因素有關。

One, weather, which we -- pretty concentration up here in the Northeast. And then we were a little lumpy in our ad spend as we exited last year. So smoothing that this year, I think, is going to bring that more in line with consistency. But we also saw better performance in March than we did in January and February. So it was -- we don't think that, that was a trend as much as an event.

第一是天氣因素——我們在東北部的據點相當集中。另外，我們在去年年底退出時的廣告支出有些不均勻、呈現波動。因此今年把投放節奏拉平，我認為會讓表現更趨於一致。但我們也看到 3 月的表現優於 1 月與 2 月。所以我們認為那與其說是一個趨勢，不如說是一個事件造成的。

On the SPRAVATO side, we saw growth in both the buy-and-bill and the A&O segments, double digit in both segments. And yes, buy-and-bill was up as a mix compared to Q1 of last year. But I think it's worth noting that we've also seen that kind of equilibrate over the last couple of quarters as far as mix between that and A&O.

在 SPRAVATO 方面，我們在 buy-and-bill 與 A&O 兩個區塊都看到成長，兩者皆為雙位數成長。而且是的，與去年第一季相比，buy-and-bill 的占比提高。但我認為值得注意的是，過去幾個季度我們也看到 buy-and-bill 與 A&O 之間的組合占比逐步趨於平衡。

Okay. Great. And then just secondly, one of the biggest challenges new executives face when they come into a company is just making sure to keep the team intact and turnover. And I just wanted to see if you could provide any color on what you've seen thus far. I know it's only been 45 days, but just kind of what you're seeing across the organization thus far.

好的。很好。第二個問題，新任高階主管進入公司時最大的挑戰之一，就是確保團隊穩定、避免人員流失。我想請你分享一下你目前看到的情況。我知道你才 45 天，但想了解你目前在整個組織中觀察到的狀況。

Yeah. It's -- first of all, I've been really impressed with how much the mission permeates through the company. People are really connected with the impact that we're making on patient's lives. I mentioned in my opening comments that I was on -- I've been on a listening tour for the first month for the most part. And that gave me an opportunity to go out and spend time with folks in the field as well as having spent a good amount of time in the office.

是的。首先，我對公司的使命感能如此深入人心印象非常深刻。大家真的與我們對病患生活所帶來的影響緊密連結。我在開場致詞中提到，基本上我在第一個月進行了一次「傾聽之旅」。這讓我有機會走出去與前線同仁相處，也在辦公室投入了相當多時間。

So I've met with a lot of people, have been trying to connect as best I can with things like podcasts and town halls. And so far, I've been pleased with, as I said, kind of where people's attitudes are. I think there's an anxious enthusiasm to think about how we might do things different, how we might continue to find ways to get better. So overall, I would say, quite good. And I don't -- I haven't seen anything as far as turnover spikes or anything that would have, I would say, raised an eyebrow for me.

因此我見了很多人，也透過像是 podcast、全員大會等方式，盡可能建立連結。到目前為止，我對大家的態度——如我所說——感到滿意。我認為大家帶著一種焦急但正向的熱情，去思考我們如何能做得不同、如何持續找到變得更好的方法。所以整體而言，我會說相當不錯。而且就人員流動而言，我沒有看到任何異常的離職高峰或任何會讓我覺得需要特別關注的情況。

Okay. I think just the last question is really elephant in the room. I mean you addressed it, but I just wanted to hit home on it. Just you ended the quarter with $19 million of cash, $13 million unrestricted. It sounds like given the guidance that would tell us you'll use $4 million to $8 million of that during the full year. I would expect most of that would be in the second quarter given the guidance that the back half would be positive. I just -- any thoughts, comments? Is that enough to get you through with working capital? And just how are you thinking about that today?

好的。最後一個問題算是房間裡的大象。你有提到，但我想再把重點問清楚。你們季末現金為 1,900 萬美元，其中 1,300 萬美元是不受限制的。聽起來依照你們的指引，代表全年將使用其中約 400 萬到 800 萬美元。我預期其中大部分會發生在第二季，因為你們指引顯示下半年會轉為正值。我只是想問——有任何想法或評論嗎？就營運資金而言，這樣的現金水位足以支撐你們度過嗎？以及你們目前是如何看待這件事的？

Yeah. I mean we're always evaluating the balance sheet. But I think as we shared at the midpoint of $15 million of burn for the full year, the math would lead you to $14 million at year end. So -- and you're also right in that our assumptions are that we would be flat to positive in the second half of the year. So based on the current plan, we feel like we've got sufficient headroom in the balance sheet to get us -- to take us through the year.

是的。我的意思是，我們一直都在評估資產負債表。但我認為，正如我們先前分享的，以全年燒錢（現金消耗）1,500 萬美元的中位數來看，按數學推算，年底會是 1,400 萬美元。所以——而且你也說得對，我們的假設是下半年會持平到轉為正向。因此，基於目前的計畫，我們覺得資產負債表上有足夠的緩衝空間，能讓我們——帶我們走完今年。

Adam Maeder, Piper Sandler.

Adam Maeder，Piper Sandler。

Congrats on the new role and look forward to working with you again. Two for me, one kind of housekeeping question and one bigger picture question. Just on the housekeeping item, weather. It sounded like there was an impact to TMS volumes at Greenbrook clinics. I was hoping you could kind of quantify that for us.

恭喜你擔任新職務，也期待再次與你合作。我有兩個問題，一個算是例行性的問題，另一個是比較宏觀的問題。先就例行項目來說，天氣。聽起來天氣對 Greenbrook 診所的 TMS 量有影響。我希望你能幫我們大概量化一下影響程度。

Is it also reasonable to assume that your stand-alone NeuroStar business also saw some headwind from weather? And how do we think about how quickly these patients can potentially kind of be -- their sessions can be recaptured? And then I had a follow-up.

另外，是否也可以合理假設，你們獨立的 NeuroStar 業務同樣也受到天氣帶來的逆風？以及我們該如何看待這些病患可能多快能把——他們的療程次數補回來？然後我還有一個追問。

Yeah. I'm not going to quantify on the Greenbrook side, Adam, but we did see -- we do think that there was some of the impact there, particularly because we saw more of the weakness in January and February than we did in March. It's also worth noting on the NeuroStar side that TMS patients are coming in every single day. So trying to manage a schedule around weather is more difficult than SPRAVATO patients that are coming in more episodically and have a lot more latitude in scheduling.

是的。Adam，我不會去量化 Greenbrook 那邊的影響，但我們確實看到——我們確實認為那裡有一些影響，特別是因為我們在 1 月和 2 月看到的疲弱程度比 3 月更明顯。另外也值得一提的是，在 NeuroStar 這邊，TMS 病患是每天都會來。所以要在天氣因素下管理排程，比起 SPRAVATO 病患（較為間歇性來院、排程彈性更大）要困難得多。

So I think that was one of the reasons that we saw the impact within Greenbrook. On the NeuroStar side, we think that we saw some of the same kind of impact from weather. But that said, from a total utilization standpoint, we were actually up low single digits on absolute utilization within our NeuroStar business as far as treatment sessions were concerned. We saw a little softness in the revenue rec just because we had a little bit of customer inventory on hand that folks are working through. But overall, I would say the business held up quite well in spite of the weather.

所以我認為，這也是我們在 Greenbrook 看到影響的原因之一。在 NeuroStar 這邊，我們認為也看到了類似的天氣影響。不過話說回來，從整體使用率的角度來看，就治療場次而言，我們的 NeuroStar 業務在絕對使用率上其實是小幅個位數成長。營收認列方面我們看到一點點疲軟，主要是因為客戶手上還有一些庫存，大家正在消化。但整體而言，我會說即使在天氣影響下，業務表現仍相當穩健。

Okay. Fantastic. And then for my follow-up, Dan, in the press release, you talked about significant value in the business that's yet to be fully realized. You also have a large shareholder who issued a letter last month for -- asking for a strategic review and potentially a sale of the TMS business. And you touched on it in the prepared remarks.

好的。太棒了。那接著我的追問，Dan，你在新聞稿裡提到公司業務中仍有尚未完全實現的重大價值。你們也有一位大股東上個月發了一封信——要求進行策略性檢視，並可能出售 TMS 業務。你在事先準備的發言中也有提到。

I think I heard you're evaluating the business with an open mind. I guess I was hoping you could share a little bit more color here on your early learnings and thoughts as you think about kind of the broader makeup of Neuronetics. And one question that I sometimes get from investors is the NeuroStar business, the stand-alone business, why can't that business grow faster given the size of the total addressable market? And what are the plans to kind of catalyze that business? And sorry for the multipart question.

我想我聽到的是，你們正以開放的態度評估這項業務。我希望你能多分享一些你目前初步的觀察與想法，當你在思考 Neuronetics 更廣泛的業務組成時。另外，投資人有時會問我：以整體可服務市場（TAM）的規模來看，NeuroStar 這個獨立業務為什麼不能成長得更快？你們有哪些計畫可以催化這項業務？抱歉問題有點多。

Yeah. Yeah, no problem. So first, as it relates to the shareholder letter that we saw. As I said in my opening remarks, I mean, I really have been on a listening tour, and I've had outreach to that shareholder along with others just to make sure that I'm hearing some of their thoughts and concerns. I think there's some frustration there.

是的。是的，沒問題。首先，關於我們看到的那封股東信。如我在開場致詞所說，我確實一直在進行「傾聽之旅」，也已聯繫那位股東以及其他股東，確保我能聽到他們的一些想法與疑慮。我認為那裡面有一些挫折感。

And quite frankly, I appreciate it. I think that what I'm still trying to do is really look at the business through a variety of different lenses, and I'm pretty pragmatic about it. I mean I'm not wed to a predetermined conclusion, but I'm also not inclined to be impetuous and make sure that I look at the business overall.

坦白說，我很感謝。我認為我目前仍在做的，是從多種不同角度來看這門生意，而且我相當務實。我的意思是，我不會先預設結論，但我也不會衝動行事；我會確保從整體面把業務看清楚。

I think as it relates to what can we do to continue to demonstrate strength and growth, which under any outcome scenario adds long-term value for shareholders, it's looking at the NeuroStar business, I do think that we probably under punched our weight here lately. The opportunity to expand our go-to-market menu is one of the things that I believe is going to be a helpful catalyst for us. And we're still in pilot phases on that, Adam. But ultimately, we have taken an approach that has conveyed what I would call unparalleled support to our TMS customers. I don't think any other competitor out there comes even close to the kind of support we provide to our customers.

我認為，至於我們能做什麼來持續展現實力與成長——在任何可能的結果情境下，這都能為股東創造長期價值——其中一點是檢視 NeuroStar 業務；我確實覺得我們最近可能沒有充分發揮應有的實力。擴大我們的市場進入（go-to-market）方案選單，是我相信能成為有助益催化劑的事情之一。而且 Adam，我們目前仍在試點階段。但最終，我們採取的做法，向 TMS 客戶提供了我所稱的無與倫比的支援。我不認為市場上有任何其他競爭對手，能接近我們提供給客戶的支援水準。

But that said, not all customer's needs are the same. So I think it's important for us to expand our menu and allow customers to kind of establish which parts of value they want and make sure that we've got kind of a broader girth of go-to-market menus that they can select from. So we're in the midst of doing some pilots right now. I think we'll have a lot more clarity over the next couple of months, but it includes making sure that we're looking at incentive comp that it's aligned with our direction, that we have an opportunity to revisit our funnel and make sure that we've slotted those in the right spaces. So more work to do, but I think that as we continue to really reevaluate our go-to-market and with an open mind look at how we can make sure that we're matching the right level of support to that, which the customer wants to pay for.

不過話說回來，不是所有客戶的需求都一樣。所以我認為，我們擴大方案選單很重要，讓客戶能夠界定他們想要哪些價值要素，並確保我們有更廣的 go-to-market 方案組合可供他們選擇。因此我們目前正在進行一些試點。我想接下來幾個月我們會更清楚；其中包括確保我們檢視並調整獎酬激勵（incentive comp），使其與我們的方向一致；也包括有機會重新檢視我們的銷售漏斗，確保把各項機會放在正確的位置。所以還有很多工作要做，但我認為，隨著我們持續重新評估 go-to-market，並以開放的心態思考如何確保我們提供的支援水準，能與客戶願意付費的內容相匹配。

I think that's a ratio that I expect will bear some fruit.

我認為這樣的比例關係，我預期會帶來一些成果。

Danny Stauder, Citizens JMP.

Danny Stauder，Citizens JMP。

Just my first one, following up on kind of the TMS question. But Dan, I wanted to ask about the commercial strategy for TMS. We know there was a realignment of the capital sales team and system sales have been strong the last two quarters. But as you sit here in the early days of your tenure, just broadly, how do you think about the balance between focusing on driving utilization per site versus expanding the installed base? Are there any potential strategic changes here? Or how do you think about that balance?

我的第一個問題是延續剛才關於 TMS 的問題。Dan，我想請教你們的 TMS 商業策略。我們知道資本設備銷售團隊做了重新調整，而且過去兩季系統銷售表現強勁。但在你上任初期，從更宏觀的角度，你如何看待在「提升單點使用率」與「擴大裝機基礎」之間的平衡？這裡是否可能有任何策略調整？或者你如何看待這個平衡？

I think continuing to drive utilization is an important one because whether we're on a sessions model or otherwise, it's what's the underlying creation of demand and the more utilization our customers continue to find more patients they can help. One way or another, that's going to lead to an expansion of our business. So I think we're going to continue to look to how we can expand our socket placement or placement of new capital units. I think that's one of the places where we've probably slipped a bit and focusing on new placements and expansion of capital and making sure that it's our unit that resides in those clinics.

我認為持續推動使用率是一個重要重點，因為無論我們採用的是按療程（sessions）模式或其他模式，背後的本質都是需求的形成；而使用率越高，我們的客戶就能持續找到更多他們可以幫助的病患。不管怎麼說，這都將帶動我們業務的擴張。因此，我認為我們會持續思考如何擴大我們的插槽（socket）布點，或新增資本設備單位的布署。我認為這是我們可能稍微有些鬆懈的地方之一——聚焦於新布點與資本擴張，並確保在那些診所裡配置的是我們的設備。

Whether regardless, I guess, of what economic model is in place, we just want to make sure that we're demonstrating the most value across the competitive landscape. And I think that between the support we provide with our account managers in the field with benefits investigation, our co-marketing, training, service, the cloud-based TrakStar utility that we've got, I just don't think anybody can compare there. And we're going to, as I said, continue to work through a couple of pilots. But the things that got us there, I think, will continue to be durable areas of value and how we structure that, I think, is some of the things that we're still titrating a bit.

無論現行採用的是哪一種經濟模式，我們都希望確保自己能在競爭格局中展現最大的價值。我認為，結合我們外勤客戶經理在給付資格/福利查核（benefits investigation）方面提供的支援、共同市場推廣（co-marketing）、訓練、服務，以及我們的雲端 TrakStar 工具，我真的不認為有人能在這方面與我們相比。而且如我所說，我們也會持續推進幾個試點計畫。但我認為，讓我們走到今天的那些要素，仍會是具韌性的價值來源；至於要如何加以架構，我想仍有一些部分我們還在做些微調與校準。

Great. Appreciate that. And then just one on the Compass collaboration. Obviously, the recent update from the administration is good news. But I just want to get a sense of how meaningful this could be? Obviously, Compass is already pretty far along in terms of the approval process, but do you feel this recent update could be more important on the reimbursement pathways? I know that's been a focal point for eventual contribution. So just any thoughts you have there would be appreciated.

很好。謝謝你的說明。接著再問一個關於與 Compass 的合作。顯然，政府近期的更新是個好消息。但我想了解這可能有多大的意義？Compass 在核准流程上顯然已經推進得相當深入，但你是否覺得這次更新在給付/報銷（reimbursement）途徑上可能更為重要？我知道那一直是未來貢獻的重點。所以也請分享你對此的任何看法，謝謝。

Yeah. Well, first of all, I think that the whole Compass opportunity and psychedelics at large represent a big opportunity for us given our footprint and our infrastructure. I was really excited in my first month to see the Trump executive order leaning into the FDA process on some of these. So I think that it probably adds or it shortens the fuse. How much? I don't know, but it probably shortens the fuse on the path to approval, which I think is encouraging for all of us that are in this space.

是的。首先，我認為整體 Compass 的機會，以及更廣泛的迷幻藥（psychedelics）領域，考量到我們的據點規模與基礎設施，對我們而言都是很大的機會。我在上任第一個月看到川普的行政命令，推動 FDA 在其中一些項目的審查流程，我感到非常振奮。所以我認為這可能會增加動能，或縮短引信時間。縮短多少？我不確定，但它可能會縮短通往核准的時間，我認為這對所有在這個領域的人來說都是令人鼓舞的。

I'm not sure how much it impacts reimbursement. I think that's probably a separate track, but certainly, the pursuit of that in tandem on Compass' behalf, all of those things sort of point to faster than slower. And as we get into 2027, we'll certainly look forward to being able to try and better quantify what we think that means to us. I think if you look at the SPRAVATO rollout from the early days, as much enthusiasm as there was, it's a bit measured in its early adoption. But I think that the momentum is certainly moving in the right direction on this one.

我不確定它對給付/報銷會有多大影響。我認為那可能是另一條軌道，但當然，Compass 方面同步推進相關工作，這些因素整體上都指向「更快而非更慢」。隨著我們進入 2027 年，我們也會期待能更好地量化這對我們意味著什麼。如果你回頭看 SPRAVATO 在早期的推廣，即便當時熱度很高，初期採用仍相對審慎、循序漸進。但我認為在這個項目上，動能確實正朝著正確方向前進。

Great. I appreciate that. And just one last one for me. I just wanted to ask on some of the TMS coverage expansion to include nurse practitioners. I was just curious, high level, if there have been any incremental conversations with accounts on this topic? Have you seen that customers are waiting for this, maybe somewhat higher demand? Just anything more on how this could impact utilization and how you think it will play out in '26 and beyond, would be great.

很好。謝謝你的分享。我這邊最後一個問題。我想問關於 TMS 給付範圍擴大、納入護理師執業者（nurse practitioners）的部分。我想了解一下，從高層次來看，你們是否就這個議題與客戶帳戶有任何新增的對話？你們是否看到客戶在等待這項變更、或需求可能因此略為提高？以及這可能如何影響使用率、你們認為在 2026 年及之後會如何發展——若能多分享一些會很有幫助。

Yeah. So that's the reference to the UHC and the Optum coverage policy change where nurse practice can now be eligible to deliver TMS versus licensed psychiatrists. I think it's a good move. We've got a lot of really quality nurse caregivers out there. I don't know that they were waiting for it as much because maybe they didn't -- sometimes you never know if it's ever coming, but there are 35 million covered lives in the 26 states that will be affected.

是的。這指的是 UHC 與 Optum 的給付政策變更：護理師執業者現在也可符合資格提供 TMS，而不再僅限於具執照的精神科醫師。我認為這是個好的改變。外面有很多非常優秀的護理照護人員。我不確定他們是否真的在等待這件事，因為也許他們並不——有時你也不知道它是否真的會來；但在將受影響的 26 個州中，涵蓋了 3,500 萬名受保人。

And I think what it will allow us to do or has allowed us to do is go revisit some of those clinics that are managed by nurse practs where TMS just wasn't a viable option because of the reimbursement limitations. So I think it probably added a number of accounts to our target list, but still early days since we're, I think, a month in.

我認為這將讓我們能做的、或已經讓我們能做的，是回頭重新拜訪一些由護理師執業者管理的診所；過去因為給付限制，TMS 並不是可行選項。因此，我認為這可能讓我們的目標名單新增了不少帳戶，但目前仍是早期階段，因為我們大概才進行了一個月。

This concludes the question-and-answer session. I would now like to turn it back to Dan Reuvers for closing remarks.

問答環節到此結束。接下來我想把時間交回給 Dan Reuvers 作結語。

Yeah. I just wanted to thank all of our employees for a hard-fought quarter as they all are as we continue to try and restore hope to patients and their families. And I wanted to thank our shareholders for their support, and I look forward to sharing an update on our progress when we have an opportunity to share the results of our second quarter. Thank you.

好的。我想感謝我們所有員工在本季的辛勤投入——每一季都是如此——我們持續努力為病患及其家屬重燃希望。也要感謝股東們的支持；我期待在我們有機會分享第二季業績結果時，向各位更新我們的進展。謝謝。

Thank you for your participation in today's conference. This does conclude the program. You may now disconnects

感謝各位參與今天的電話會議。本次會議到此結束。您現在可以斷線