Tactile Systems Technology, Inc. (NASDAQ:TCMD) Q4 2023 Earnings Call Transcript

Elaine Birkemeyer: Yes, thanks Margaret. Yes, I think our current guidance suggests a decline in Q1 of about 25% to 27%, so if you take a look back, it’s fairly similar – I went back to 2020 and it’s in line with what we’ve seen over the past several years. I think as we think about Q1 and what Dan mentioned, again it will be our hardest comp. We had 22% growth last quarter and we’re making a lot of investments in the first half of the year, which really will accelerate growth in the back half – you know, the sales rep adds, the technology. I think the other thing just to note that we saw in Q4 and will continue to see in this year as well is that Entre growth continues to outpace Flexitouch. We’re still growing Flexitouch, but the Entre growth, as Dan mentioned, is a bigger segment that we’ve chosen to focus on, and that does mute growth a little bit in the sense that our patient served is actually growing faster than our revenue growth, and so that’s another piece that we saw in Q4 and will continue to see in Q1 as well.

Margaret Andrew: Okay, and then the second thing that I wanted to push on a little bit as well is that 2025 LRP, and so again just to put some finer numbers on it, if I look at what that implies for ’25, you do need a 15% top line growth number in 2025, which is maybe up from 10% this year, so 50% acceleration, I guess, in sales growth and a pretty sizeable margin expansion of 300 basis points plus. As you kind of look at that, are you assuming a meaningful uptick in head and neck, or acceleration relative to that next-generation system to reach those numbers, and then kind of a similar comment on the margin side, what gets you to get that pretty meaningful step-up as you go into 2025? Thank you.

Daniel Reuvers: Sure Margaret. As I said, it’s tough to do a three-year plan linearly, but if you looked at 2023, 14% lymphedema growth was ahead of the 13% CAGR we’d kind of put out there for a three-year window. I think that while we expect this might be a little bit less than that in 2024, there are some things that we think are going to be really well positioned as we enter 2025. Remember last year, we added zero heads and we just got productivity out of the ones from the past in expanding demo performance with other allied support folks on the training side. We think that there’s still opportunity to continue to expand that in the second half of this year, and we would enter next year then with a higher productivity profile, presumably, in our entire sales force, along with some folks that we would add in the first half of this year that should be entering 2025 with just a naturally higher trained productivity quotient on top of it.

The tech deployed work that we’re working on to try and simplify the process for HCPs to submit their referrals, it’s not an insignificant one. We saw at the beginning of last year that when we can make things a little bit easier, whether through forms or process, it does actually have an impact on prescriber behavior, so the investments that we’re making this year are intended to introduce by the back half of this year an electronic EMR experience that should be easier for the prescriber, and we think that influences their vendor choice and it also influences just the volume of patients they’ll take the time to prescribe for. Head and neck, as you alluded to, that one’s certainly going to be a more contributor once the results are complete this year, into next year; and I think the other one is we’ve clearly stated that AffloVest is going to have a headwind in the first half of this year, and we’ll have a more normalized expectation for next year.

I think there’s reason to believe that our top line growth can have some ebbs and flows, but we think that–you know, as I said, we should enter the on-ramp of 2025 with some things nicely set at the table. I think from a profitability standpoint, I’ll just let Elaine add a little bit of color to the other half of the question.

Elaine Birkemeyer: Yes, I think as I mentioned, 2024 we don’t expect large EBITDA margin gains, and really this is–we’ve got sales reps that we will be carrying on our books that are not going to achieve productivity until later in the year. Similarly, we’ll be making investments in technology that we will not have fully ramped and in adoption until later 9in the year, so those things change in 2025, those are now fully productive assets, and then we will continue to have the opportunity to optimize once they’re in place to see further opex improvements. That’s really why that profile for 2025, we think is going to look different from an EBITDA margin expansion compared to 2024.

Margaret Andrew: Thank you, guys.

Operator: Thank you. As a reminder, if you’d like to join the question queue, please press star, one on your telephone keypad. Our next question comes from the line of Suraj Kalia with Oppenheimer & Company. Please proceed with your questions.

Suraj Kalia: Good morning Dan, Elaine. Can you hear me all right?

Elaine Birkemeyer: We can, thank you.