All right, everybody. If you're here for the NeuPath presentation, I would kindly ask that you take your seats. Proceeding with the presentation on behalf of NeuPath will be Stephen Lemieux, CEO of NeuPath. Stephen.
Perfect way. Yep. We good here?
Yep. You're good.
Awesome. Perfect. Thank you. Welcome to the presentation for NeuPath Health, and thank you to Bloom for hosting us in this conference. Another great conference this year. Just before I get started, just a couple of typical disclosures, I will be making forward-looking statements, and we do use non-IFRS measures in our presentation. NeuPath Health. We operate one of Canada's largest network of medical facilities focused on the treatment of chronic pain. We have approximately 150 doctors that work for us who see over 200,000 patient visits a year, and all of our patients are referrals. We have a strong referral network of about 5,000 referring physicians that feed into the 12 clinics that we have in both Ontario and Alberta. We have an improving strong Google patient satisfaction score. On average now, we're just over 4.6 out of five.
In Ontario, we operate around the GTA. We have two brands. One's NeuPath Centre for Pain & Spine, which is really focused on the GTA and Ottawa, and then we have InMedic, which is really our Southwestern Ontario brand. In Alberta, we have HealthPointe, which is our main clinic in Edmonton. We partner with Central Alberta Orthopedics in Red Deer, so we have a 50/50 partnership with them there, and we own a minority interest in two physiotherapy clinics in the Edmonton market. When you think of chronic pain, this is actually a vast spectrum of all the different things that we treat. We have everything from sports injury right through to complex cases such as fibromyalgia. We treat arthritis, back pain, joint pain, spine pain, and really everything that comes in between.
That's why when we talk about the network of doctors we have, we have a broad range of doctors with broad specialties who can all treat different areas of chronic pain and all bring their own good experience and skill set to the table. We have regulated medical facilities. What this means, in both markets that we operate, the government authorities come in, they regulate our facilities on a regular basis. To give you an idea, like in Ontario, this is one step below a private surgical center. We have to go through all this regulation when we open, and then it's usually on an every three-year basis. We have specialized medical doctors, so everyone that's in our professions. We have everything from GPs who have gone through specialized training in pain, anesthesiologists, neurologists, physiatrists.
They bring a broad range of services to deal with the broad range of treatments that we can offer. We utilize specialized equipment, too, so everything from portable ultrasound machines that we can move in and out of different treatment rooms to full fluoroscopy suites to deal with more complicated procedures, such as a spinal RFA, depending on what the patient needs. We have a strong organic growth profile, which I'll talk about. We grew last year at 20%, and we have lots of opportunity to continue to grow organically as well as inorganically. I'll really talk about the growth strategy coming up. We have growing positive cash flows. We've been utilizing our cash flows for share buybacks, to invest in technology to really improve the efficiencies of our clinics, and to invest in our growth strategy.
On the financial side, we had 20% revenue growth last year. Came in just under, just over CAD 87 million. We did disclose that we had a one-time item in the second quarter, and if you adjust for this, our revenue growth would be around 17%. On the adjusted EBITA side, grew adjusted EBIT approximately 60%. It came in just under 7% of revenue. If you adjust again for that one-time item, it's about a half percent difference in adjusted EBITA, but well above the 5.2% we had in the year before. The interesting part we want to draw attention to here is the adjusted EBITA is growing at a much quicker rate than revenue, showing that we're really getting leverage from our G&A. We have a strong balance sheet. This has come a long way.
We've got cash of CAD 4.5 million, net debt of CAD 1.7 million. This is giving us operating leverage, like, or not operating. It's giving us leverage of 0.3%. On the balance sheet too, we partner with national banks. The debt facility, this is a 10-year facility. They've given us an acquisition line as well as a working capital line, which we still haven't utilized. They've been a great partner for us as we start to continue discussions as we look at executing on our growth strategy. The one thing I want to highlight, and we've got members of our team here, Joe Walewicz's our former CEO who's returned to the board, and Jeff's here.
Where we're sitting today, talking about the growth strategy and the vision for the future would not be possible without the great job that team did turning the business around, improving the financials, improving the EBITA, and really driving the cash flow. That's right, yeah. Yeah. I want to just talk briefly about capacity utilization. Historically, we reported capacity utilization, and it was really a measure about how well a job we're doing utilizing the schedules that physicians give us. We reported, so last year, that number was just north of 82%. We started getting the question from investors and from people looking at the company. It's like, "Well, 82%, where can you really grow? Are you guys capping out? Is this the end of what the NeuPath story can be?" That is as far from the truth as you can imagine.
We looked at different metrics. When you look at what we do now, it's the utilization of physical capacity. We're looking at if we operated the business 40 hours a week. How many patients can we see during that 40 hours a week, and how well are we doing filling those patient spots? Last year, we reported that at 51%, up from 48%. There's a tremendous amount of opportunity for us to grow this business just from what we can control. How we do that, it's really all about growing physician hours. There's multiple levers that we can do here. We look at the recruiting side. We have a recruiter that was working with us on bringing doctors in from Canada.
We've expanded and brought more recruiters in to start working on attracting doctors from the United States, international doctors from Europe, and that pipeline, as well as looking at the physicians we have in the medical staff and getting word-of-mouth referrals, having them refer colleagues and introduce us to them so we can start building those relationships. If you look at the doctors we brought in, we brought in five doctors in 2025, mostly from the recruiting piece. We onboarded two doctors in Q1. One came through the word-of-mouth channel, one came through the referral network, and we expect through those networks to onboard probably another eight doctors throughout the rest of this year. The other piece for increasing physician hours is getting our own roster doctors to add time. To give you an example of this, we've had a doctor that joined us.
Some doctors come in from the hospitals. They gave us one day as they get comfortable with what it's like to work in a community-based healthcare clinic. When we started this year, they approached us and they're like, "Look, I'm going to Instead of working one day with you, if you have room, we'd love to add to the practice." Now some of those doctors are working two days or three days. It's another great tool to really continue to add doctor hours so we can grow the business. A third lever we have, it's really investing in technology in our clinics.
Sandee, who is unfortunately not here, but he's our Chief Information Officer, he's done a great job going around, working with doctors, understanding the patient flow, and trying to find ways to invest in technology to really make their day more efficient. As you can all imagine, the most burdensome piece of a doctor's life is charting, trying to remember the full conversations they have with patients, and then going back and then documenting all that. By utilizing AI, they wear little microphones that can record the entire patient encounter, go back to their workstation. There's a full transcript of what they've been through.
Not only that, the doctors who start to train it a little bit, it'll even give them, it's like, "You were talking to this patient about a knee issue, but I didn't catch any of this information in the notes." As the nurse is wrapping up, the doctor can go back in, clarify a few things, finish that note and move on. That's allowed some of our doctors in a typical day to see anywhere from two to four more patients, which is great when you think of that over the whole course of the treatment the doctors are offering. Improving medical facility efficiency. One of the initiatives Joe and the team did was they put clinical managers into a lot of our clinics. This really helped, and we saw a lot of this in the improvement in 2025.
Just having someone there who understands how each doctor works, what the right patient flow is, and really maximizing the use of the facility and making sure we optimize the patient flow helps make those facilities more efficient and also helps us maximize the amount of patient throughput we can get. On the other realm of bringing in doctors, then we look at the M&A side. The M&A we're looking at are there clinics where there's multiple doctors that we'd like to have join the team, that we can provide good service. Our value add prop is really, you come in and join the team. We will take care of all the back office administration. I'll talk about this in a little bit. You can focus on the medicines. You come in, you're not worrying about your staffing, your medical supplies.
You just focus on treating the patients. We'll continue to look at new service offerings. Last year, we launched Arthrosamid. This was in partnership with a relationship we had with a pharmaceutical company. This is a permanent knee injection. This is a cash pay procedure. It's roughly CAD 4,300 a joint, and we launched that in March of last year with a couple doctors in our business. Since we've launched that, we've done about 260 joints. We've rolled that out across most of our clinic network, and we continue to have new doctors starting to add this as a tool into their practices. Also on the M&A side, we're also looking at acquiring business in the pain space, but we also look at what's available that's similar to what we do. When we look at our offering, a lot of our patients need imaging.
It's always looking, can we partner with diagnostic companies? As we look at building greenfields, is that something we include? That's a service that all of our patients need. Partnering with some mental health companies, as you can imagine, the journey some of these patients go through who have severe chronic pain where they can't get back to work, mental health has a significant impact on their lives, trying to make sure we can address that as well. Why would a doctor choose NeuPath? It's a question I've gotten a lot over the last couple of days, and it really comes down to a variety of different things we can do. One is by having this network of doctors.
As we recruit doctors that are coming out of med school, they've got a network of doctors that they can learn and grow from, they can talk to, and then they can also learn different procedures and get more comfortable with the procedures they're doing. For the doctors in the network, it gives them people they can talk to as they start to handle complex cases, and having that network is valuable to them. I mentioned briefly the investment in AI, knowing that you have a team with you that's always looking to make sure you have the right tools to do your job, listening to what the doctors say as they bring us different ideas or different tools that they think will help their practice. As we pilot that with certain doctors, the ones that work well, we can roll that out across the practice.
We offer an annual physician forum. This is a valuable tool for two pieces. It's one, when we bring all of our doctors and medical staff together, we can offer training sessions, we also offer workshops. When we ran this last year, we'd offer workshops on migraines. We had a pharmaceutical company come in so they can learn a little bit of a different service offering if they choose to add that to their practice. We also did, just when we started doing our workshops on AI, really teaching and training the doctors on, wearing the mic, how that whole process works and how that can improve their charting.
It also helps us on the M&A side, because the biggest question we get is when we're going out and introducing new clinics, they understand the value prop from, "This is how you guys can take care of the back office. These are all the different things you can do that you take off my plate so I can focus on medicine." The doctors really want to be assured that the leadership team, we're not going to dictate medicine. We're not going to tell them the minimums or the procedures they need to do. By attending the physician forum, they can talk to any of our doctors or medical staff. We also introduce them to our medical directors.
It helps build that comfort from doctors who are in the system, that they learn that they have the freedom to practice their medicine, and that we won't interfere with that. That's all in addition to making sure when they come to work every day, we have a great team at all of our medical facilities. They work hard. It's a very professional team, and they understand what the patient needs and really work to optimize the patient flow. Then we take care of all the back office administration. Everything from billing, finance, filling their schedules, and making sure everything they do so they have a good day there. Briefly on the Canadian market, the chronic pain, there's a large growing demand here. This impacts one in five Canadians, and it's one in three for people that are over 65.
There's a large growing demographic. We really don't have an issue on bringing patients into the business or getting referrals in. It's really all about growing doctor hours and having more doctors in the system to treat the patients. It's a highly fragmented market. There's approximately 160 clinics across the country. Most of these clinics are single center clinics owned by one or two doctors. As I mentioned, it's about getting out to these clinics, making the relationship, selling them on the value proposition that NeuPath can bring in, then giving them the time to work with our doctors to build the trust that they know they can come in and practice their medicine, and we won't interfere with that, then we can move into the valuation piece. On our capitalization table, we're approximately 35% institutional owned. Board and management owns 12%.
Bloom Burton's covered in both of those buckets. They own roughly 8%, and the management team continues to buy in the open market. As we get opportunities to buy, you'll see us, you'll see the insider filings from myself, Joe, and members of our board and Jeff. On the share capital, it's a really clean cap structure, we cleaned this up last year, 56 million shares outstanding, 62 million on a fully diluted basis, and we continue to use our normal course issuer bid. We have an experienced leadership team, there's myself, Jeff, who's here with us today. He's been the CFO of the company since 2019. Sandy, who couldn't join us, but he's been a tremendous asset on the IT side, really focusing on how do we drive value and how do we bring technology into the clinics?
Beneath this, we've got a great team of leads that work at each of our brands, and one of them is with us, joined us as well today. They do a great job of just managing the business, keeping the great relationships with the doctors, and making sure that this is a great place for both the doctors and all the medical staff to work. Since we were here to kind of wrap up from last year, we've had a great year financially. 20% revenue growth, strong EBITDA margins, and a strong balance sheet. The key with this balance sheet is as we look to bring businesses in or acquire, we've got eventually at like 0.3 times lever. We get the ability to go up to 2.5 times.
That means we can utilize our balance sheet with the cash and debt we have to bring in a lot of the acquisition targets we have. When we look at these acquisition targets, we're really looking at partnering with doctors. We're looking at going to buy 50 or more % so we can take over the back office. The doctor is still partnered with us, and now we're aligned in the growth. It's very similar to the model we have in our Red Deer clinic. Executive leadership. As I mentioned, we've had some changes, I stepped into this role in April. Joe returned to the board. We've got a great team. We've all worked together. We've known each other through our lives and our pharmaceutical journey from when we started our careers here to where we are now.
It's been a great team to work with. It's been great working with Joe when he was in the CEO role, now having him on the board and continuing that ongoing mentorship and just having that counsel as we go through and try to make decisions. We're all really aligned. We're all really excited about where this business is going, and it's just great to have a team like that that's all driven with a central focus. In conclusion, we've got multiple drivers to really grow value here. The key takeaway here is this is all about driving and growing doctors' hours, and there's multiple ways that we can do that, as I mentioned.
Through recruiting, expanding our own network, bringing M&A. We are active in all the channels. That's the C-suite team, all of the leads of the different companies, and really working to establish those relationships with doctors. We've got, like I mentioned, we got the chronic pain market. That's a growing market. All the clinics are highly fragmented. We continue to go out. We still think this company is tremendously undervalued, which is why we're all active buying the stock. We continue to utilize the NCIB. At that, I will open up to questions.
If you have a question, please just raise your hand. I'll come over with the microphone.
Stephen, good work.
Thanks.
Can you talk about physician churn in your system?
Yeah. Our physician churn is low. Last year we brought in, it was a net five new doctors into the business. This year, we've added two new doctors in the first quarter, three, but we've had no turnover in our doctors in this piece. We had some churn historically, but nothing recently. We're really trying to focus on making sure the experience the doctors have and everything that we offer, because by offering those doctors a better service, they like where they're working, and it also helps with that referral network, and it really drives the vision, because having our own doctors refer new doctors in the business is what grows. We pay a lot of attention to not only bringing doctors in, but making sure we provide a great work environment for the doctors we have.
Sure. Mm-hmm. Yep.
Are you setting yourselves up or what's your thinking in terms of we're the only OECD country that doesn't have a private extensive service, right? At all kinds of extremes. In Sweden, for example, the public service is run by private practices. In virtually every other country, I don't live in Canada, but I understand that in Canada it takes a long time to get non-lethal medical services. Are you going to be ready to expand that? I understand there are a number of other medical services here in the city. People tell me of Medcan, Telus-
Yes
which I thought was a telephone company, but anyway, and so on. Do you-
It's a good question. In the Canadian marketplace, we play in the chronic pain piece, we work within the government paid system. If you think of the patient journey, around the GTA, patients that get referred to the business, we can usually have them into a clinic within two to four weeks, it's pretty quick. We do have some markets where the wait lists are longer and could be upwards of 12 months, but it really gets into the type of procedure that the patient needs, the more specialized it is, and then the more specialized equipment. We make sure patients as they're referred in, it's really important to talk to those doctors, have them understand so the patient understands what the journey is. Yeah, we're fortunate with our space.
We can bring patients in quickly, especially for patients suffering from chronic pain. That's important just to get their mobility back and improve their quality of life.
Sure. Mm-hmm. Any other questions? There.
In terms of payers, how much is private versus other government or insurance?
Yeah, we're mostly government insurance, so Ontario and Alberta are our two major payers. The government side accounts for over 90% of our revenue.
Yeah.
The good side of that is they're great payers, they pay us. We'll bill Ontario, you bill a month in arrears, you get paid right away. Alberta, we can bill on a weekly system, we can always collect the money that we get from the services. We share the revenue with the doctors, we can pay the doctors before. We're never using our own working capital to.
Yeah
the doctor services.
Right. Yeah. Okay. Yeah, I was going to ask just sort of average fee, maybe doctor hours and how those doctor hours.
Yeah
progressing, say. What were they last year and what are they now.
Yeah
What are you expecting them to be? Recruiting and churn is always-
Yeah
Small movements.
I don't know the exact number, but I know doctor hours last year with the doctors we brought in, we probably grew that just north of 10%. On the fees, it really depends on the service. You'll get everything from a sports medicine service where you can be like CAD 100 for a patient visit, upwards of CAD 800 or CAD 900 for the complicated procedures that would be done in a fluoroscopy suite. What's the range? Is it about CAD 100? Yeah, about that. Yeah. The fee? Probably in the CAD 400 range. Right. Yeah. Mm-hmm.
Yeah. I've been involved with several roll-ups, that was going to be my question is around what is the % of overhead fees that your physicians usually pay?
Yep.
You see it in the 20%-30% range, right? That's the question there. The second part is the non-OHIP, non-Alberta kind of billables, braces, medical tests, and all the other stuff.
Yeah.
Is flowing patients into that as easy as you think it is or is it more growth in the future? Two-part.
Sure. Yeah. On the first one, so on the overhead, so it's a little different from the GP model, but for our non-image guided procedures, it typically averages the physician keeps 70%, we keep 30%. For the fluoroscopy suites and the image guided, that's typically in the 50/50 range that we share with those billings. For the question around the braces, so selling braces, that's not something we do. If patients need that, we'll refer them to physiotherapy clinics either in our network, but that's not an area that we do. Most of our business is all through government pay. On the cash pay sides, we have our Arthrosamid, which we talked about, and then a lot of our clinics will do prolotherapy or PRP or some of the other examples of cash pay services.
Sure. Yeah. We had one more question here. Nope, you're good. Any other questions? We have time for a few more. If there are any. Okay.
I was going to-
Oh, sorry.
Here you go.
Yeah. Do you mind passing? Yeah.
Oh, sorry.
Are you co-locating with pharmacies or has there been any relationships with pharmacies?
No, we don't co-locate with pharmacies. When patients come in, a lot of the treatments are medications that we buy that we distribute, we don't write a lot of prescriptions.
Okay. Thank you, Stephen.
Perfect. Thank you.