Good morning, everyone. Welcome to the B of A HealthCare Conference. I'm Craig Bijou, one of the medtech analysts here. It's a pleasure to have GE HealthCare. From the company with us is Jay Saccaro, CFO, and Carolyn Borders, who's Chief Investor Relations Officer. Jay, Carolyn, thank you both.
Great. Thank you for the invitation to the conference. As always, it's nice to be here again. It's nice to see everybody in attendance. Thanks for your interest in our company and support.
All right, Jay. Let's start with tariffs. Obviously, over the weekend, we heard about the reduction of tariffs, both for China to the U.S., U.S. to China. You have been one of the companies that has been most affected by China Tariffs specifically, at least within medtech. I also think you guys did a very good job of laying out your exposure and some of the mitigating actions that you're taking and what the impact that would have. I guess maybe just start with your reaction to the lowering of the tariffs, and then we'll kind of get into a little bit more detail there.
Sure. I think from our perspective, this is a great first step in terms of establishing a nice trading relationship with China based on the terms and the discussions that have started. I think from our perspective, as you mentioned, we're very impacted by global trade. In particular, we're impacted by this U.S. and China trade back and forth. We highlighted in our earnings material roughly $0.85 of impact from tariffs. Of that, $0.65 relates to U.S. and China. We were heartened to see the news. Hopefully, there's a temporary pause on a portion of the tariffs, so hopefully the trade negotiations continue.
Got it. You did highlight on the call, you maybe, or I guess you had a good guess that you said if tariffs came down by 100 basis points or 100 points, 100% on both sides, it would be a $0.40 impact, I believe is the number that you used. Maybe just help us think about with the temporary tariffs, is that still the right way to think about the impact from the reduction of tariffs? Are there some other factors, and this is, I guess, specifically for 2025 that we should be thinking about?
Sure. I think that gives you a good rule of thumb. What we said on the earnings call is to the extent that there is an improvement in the tariff rate by 100 basis points reciprocally each way, the benefit of that, and that occurred on May 1, that would be about a $0.40 tailwind to the guidance that we shared. Good news is the final amount is similar to that, perhaps is a little bit more in total. There is a little bit of exposure in terms of an element that might revert in August. I think on balance, it is a good planning assumption for now.
Got it. And then just in terms of what you guys are going to do, I mean, you're still keeping your guidance irrespective of the lowering of the tariffs. And I mean, no change that you're making today.
Yeah, we're not adjusting our guidance today. Why? Because we gave you the sensitivity necessary to kind of think about the implications of the changing trade dynamic with China. Secondly, who knows what's going to happen in the coming weeks in terms of new deals, in terms of different facets and how things go. We will take the opportunity in our earnings call in July to refresh guidance. I'm hopeful that we'll have a trade deal with China that makes a lot of sense and continuation of what we've discussed here. We will move forward along the lines of what we've laid out already.
I do think a lot of investors want to understand what that means for 2026. You also gave a lot of color on the call. Tariffs in 2026, you expected the impact to be less than what it was in 2025. That was through additional mitigating steps that you were going to take. How are you thinking now with the potential for lower tariffs about those mitigating steps? How should we be thinking about what the impact will be in 2026?
Sure. For those who are not aware, we previously said we expect the 2026 impact to be $0.85 or below. We had basically done a lot of work based on the tariff structure that existed at the time to walk through a series of planning supply chain initiatives that would allow us to lower the overall impact in 2026. As you look at it, in 2025, the fourth quarter is the most prominent impact that we have, or it was. I think it still may be. The fourth quarter was the most prominent impact that we had. Were you to simply extrapolate, you would come up with a number much larger than $0.85.
Our team's got hard to work in terms of identifying opportunities to mitigate dual sourcing of supply chain, thinking about more local for local manufacturing, thinking about simplification of bonded logistics routes, et cetera, et cetera. A lot of work went into it. What we were able to say is, look, if the tariffs stay where they're at, we feel good about the 2026 number. It's clear based on what we've heard and were these changes to remain in effect, we would feel even better. In terms of specific amounts, part of this will depend on the final nature of the deals because some of the things that you might be willing and interested in doing in a 150% tariff scenario may be different in a 50% scenario. You may have a different threshold.
I'm excited about the deal that we have in place thus far and the opportunity that we have. We'll work very carefully and we'll have some updated perspective on this when we share guidance in July.
Got it. Maybe one more on tariffs. I believe on the Q1 call, you said PDx, any impact to PDx was not included in the tariff estimates that you made. I wanted to make sure that that was true and understand your position on PDx. Even with the new executive order on pharma that's out, what potential impact could that have on the ultimate tariff impact for you guys?
Yeah, I think there's a key question, which is at the center of this, and we don't have clarity on the answer to it yet. Is PDx, the Pharmaceutical Diagnostics, included as part of the Section 232 investigation? What is it in relation to the most recent executive order? We don't exactly have clarity on whether PDx is involved or treated as a pharmaceutical with respect to those definitions. Our contention and belief is these are diagnostic products used in conjunction with imaging equipment to kind of identify, better characterize elements in the human body. It doesn't feel like it's a pharmaceutical product. That's kind of what we're working through right now and really looking to ensure that we have the right support to make that contention and that the administration sees it that way as well. It's a very different thing.
We will have to see how this plays out. I do not have a clear answer at this point yet, but we are working through that.
Got it. Maybe shifting away from tariffs. And just a couple of weeks ago, you presented pretty strong Q1 results, 4% revenue, organic revenue growth, record organic order growth. So maybe just, and it was well ahead of your guidance. So maybe just talk about kind of what you saw in the quarter, what went better than what you were expecting, and some of the drivers of the particularly strong order growth.
Yeah, we were really pleased with the order growth in the first quarter. 10% was a record for us. It was on the back of a fourth quarter, which was pretty good. I think we had 6% order growth in the fourth quarter. Stacking two quarters in a row of very robust growth. Over the last perhaps year, we've seen a robust environment in the U.S. Imaging, first of all, radiology and imaging is an area in many hospitals which is constrained. There is real interest in expanding or getting the latest equipment because it's revenue generating. It meets an acute need in the hospital. There is real interest in equipment. That played out in the first quarter. We saw very robust sales, orders for imaging for our AVS business, lots of broad-based interest.
The second thing is from a European standpoint, we did see a really nice performance. In the financial statements, you would see that the European business grew 0%. There was actually a bit of growth on a constant currency basis. What was interesting to me is we saw really good performance from an order standpoint, not to the level of the U.S. by any stretch, but solid order growth coming from our European business, which we had not seen in a while. There had been some overhangs in Europe as it related to stimulus in the 2021, 2022, even a little bit of 2023 timeframe that was impacting performance. We also did a reorganization about a year ago, centralizing Europe under an international leader. That commercial execution orientation has started to play real dividends.
We're really pleased with the Nuffield deal, which we announced, but also lots of collaborations with governments and ministries of health and healthcare institutions across Europe. We're seeing good momentum there. China, we've discussed, kind of it was a low single-digit decline. Largely speaking, what we anticipated, we're not anticipating that market. We're going to see some recovery, a little bit of better performance in the second half off of down mid-single in the first half, but no real changes to our perspective on that market. It really came down to robust performance in the U.S. and Europe and robust performance in imaging and AVS within that.
Got it. I do want to ask about China. I want to ask about the guidance. Just given some of your comments on the strength of order growth in the U.S. and Europe, maybe just talk about the broader hospital CapEx environment and kind of what you're seeing there. I know you do a lot of surveys. It seems to be pretty still robust. There does not seem to be a ton of consternation about recession or other pressures that may limit buying. Just wanted to get your perspective. What are you hearing from your customers?
I should ask you because you all do a great quarterly survey that we read, by the way. We do a quarterly survey of our top customers. I think it corroborated a lot of what you saw as well, which is the environment is not bad. I know that there is a lot of uncertainty around what is going to happen with new budgets and what implications does that have for 2025 and 2026? How does hospital profitability look in that new world? A lot of questions about that. At the same time, we have seen thus far this year, it has been solid. Good order, certainly good order momentum in the first quarter, and that has continued through April. It has been a nice start to the year. I think we will watch it very carefully.
We survey this every quarter and we look at not only the aggregate, but the rate of change. I know you do the same thing. It will be interesting to see how this shakes out. Thus far, we have not seen a dramatic negative impact as a result of concerns. On the contrary, the environment's been robust.
Just commenting on, I do not think this is on global procedure growth too. We are continuing to see that remain very healthy. That bodes well for our pharmaceutical diagnostic business. It is both CapEx and procedures.
Maybe a quick follow-up on that. The survey or your customers, how focused are they on 2026? Because I think that's always something that comes up within even our CapEx survey. And when we think about it, we think about the near term, you can say the budgets are in place, they're going to be buying. But what's the perspective thought on 2026? And is there any, so are they actually thinking out to 2026 when you talk to them?
A little bit. I do think the crystal ball gets a little cloudier as you forecast out a year or two years. I think it's more reliable when we ask the question, "Hey, what are your plans for the remaining nine months of the year?" There's a pretty good line of sight for what expectations a hospital has in terms of deployment of capital. As you look forward a year or two, it's a little bit of a softer call. I would say that we put more reliability in the short-term questions. We do ask some questions longer term, but I think the reliability is much more in the short term.
Got it. I want to talk about guidance. We talked about the strong Q1 guidance for the full year. On the revenue side, you reiterated and you gave some Q2 guidance of 1%-2%, which is obviously a step down from Q1. Maybe just talk about how we should be thinking about the rest of the year and what are some of the factors that despite the 4% growth that was actually above in Q1, above your guidance that you reiterated. Are there any other concerns that we should be thinking about? Maybe just kind of walk us through how we should be thinking about the cadence of growth throughout the year.
Sure. I think for us, the way we put together the revenue forecast, you have roughly half of your business, which is recurring revenue. And not exactly recurring, but behaves like recurring revenue. What I mean by that is our PDx business, very volume-based, kind of moves along in a fairly linear manner. Our service business too, another business that moves along very linearly. That's about half your business. The remaining piece of your business is equipment-related. In the case of the equipment-related business, we look at a number of things as we put together the revenue forecast. We look at the order funnel that we have, and then we look at historic conversion rates of that order funnel to orders. That gives us orders that we need for the particular forecast period. We also look at the backlog. You'll recall we have a record backlog in place.
We're so proud of the tremendous work that we were able to do to secure this great backlog. What happens with the backlog is every piece of equipment in that backlog gets a date. Many of the dates are this year, some are next year, but you have hard dates on all of that. That allows us, with a high degree of fidelity, to give a revenue forecast. By this point in the year, you're likely over 80% "secured." From our standpoint, as we put together this forecast and as we looked at the Q1 result, the words we used on the call were increasing confidence in our ability to deliver the year. We felt really good about all the elements, the ingredients that I just laid out for you.
The order funnel, anticipated conversion to orders, plus your secured backlog, that whole mix gave us a high level of confidence in what we're going to be able to do. We didn't change guidance, but we feel good about the 2%-3%. I think we'll hopefully continue to deliver on that amidst a very volatile macro backdrop, but so far, so good. Now, as it relates to the second quarter, again, this comes down to very specifically when are you delivering things. Part of the reason why Q2 might be below Q1 or Q3 really simply comes down to when are things slotted for delivery. A lot of those orders that we had in the first quarter come in the second half of the year, which is fine with me, right?
As long as it's penciled in and secured and we have a commitment from our customer, whether it comes in Q2 or the second half, it's not really an issue for us. We have a lot of that coming in the second half of the year. I think it sets us up very well. We also have some coming in 2026, which also, I don't mind, from my perspective, starting to secure 2026 revenues allows our business to behave perhaps less like a pure capital business and more like a planned capital or even recurring business. What I mean by that is if there are sales that are committed in 2026 attached to new facility builds, that's great. We know it now, and it goes into that secured calculation that I described earlier.
Maybe if I just push you a little bit on, you talked about the 6% organic growth in Q4, 10% organic growth in Q1. Obviously, there's some correlation to order growth and then subsequent quarters, whether it's two, three, however many down the road, you're going to realize the revenue on those orders. So I guess why shouldn't we expect something closer to the 6%-10%? I'm not suggesting that it's going to be that high, but even kind of getting back to your mid-single digit target that you have.
Remember, we talked about this year being this 2%-3%, and a lot of that came down to performance in China. As China restores to a more normal level of growth, it's a lot easier to get to our mid-single digit target. We're expecting that in the very near future to start to make that turn. We'll talk 2026, 2027. We talked about mid-single digits from now till 2028, and this year is not mid-single digits. That implies the rest of the year is really start to become that. First of all, your comment is right on it. For me, it was really important to see that acceleration in order momentum. It's outstanding and it's supportive of the long-term thesis. We said mid-single, to get there, you need good order performance.
The only thing I would say is before the 6%, I think we were one or two in Q3. You have to look at this over a multiple period of quarters. In Q2, we are not going to grow orders 10% again. That was a great performance, do not get me wrong, but it was a little bit outsized relative to our expectation. Q2 will be hopefully a good order growth, but not along the lines of what you have seen. This is just about building consistent momentum. Craig, here is the interesting thing. What is starting to happen is a lot of the new products that we have launched. We talk about this vitality index of 50%, which is really quite high, products launched in the last three years. What you see is the benefits of that.
That is triggering to some extent people to decide to replace and to decide to purchase our equipment. I think all of these things are starting to come together in a very good way. I am optimistic about where we can take this in the coming years based on that commitment to innovation that we had, based on the commercial excellence work that we have talked extensively about, the enterprise partnerships, and then based also on the continued work we are doing in digital. All of those things wrapped together create a very compelling story and I think support the long-term story from a financial standpoint.
I think it's worth noting too for investors that orders isn't the only metric to look at because sometimes that can be lumpy. We like to also give you backlog and book to bill. Take the three of those together and hopefully paint a picture of how we expect to get to our revenue targets.
Got it. Thank you. That's helpful. Let's move on to China. We've been talking about China stimulus for over a year now and some of the uncertainty there. Maybe just kind of level set where we are within the stimulus, the progress that's being made today.
We're starting to see progress. I think we were surprised by the pace at which the recovery was occurring last year. We ultimately had to reduce guidance in the second or third quarter as a result of what was going on in China. As we got through it, we really decomposed the stimulus process into a multi-step, maybe five-step process of initiation all the way through successful order to sale. I think we got our arms around it reasonably well. What I would say at this point is things are progressing, broadly speaking, in line with what we expected to see. In the first quarter, we declined 1% as reported. There were some negative FX mix in there. Overall, it was a decent quarter, kind of where we expected it to be.
As we go to the second quarter, it won't quite be as good as the first quarter based on, and this from a revenue standpoint, and this comes back to this question about when your backlog is getting delivered. As we look at the second quarter, I think we'll see a decline more than the first. On balance, in the first half of the year, we're going to be mid-single decline. As we look out into the second half of the year, there are a few things that we take comfort in. One is the backlog and one is scheduled. Second is some of this stimulus starting to pay off even in the second quarter into the third quarter that starts to benefit the second half and beyond. We put these things together and we feel okay about how the second half looks.
I would also say we feel good about what we've been able to do from a competitive standpoint in the market. As we've looked across the landscape, our performance was not bad compared to others in the market. I think that was a testament to all of the hard work and execution focus from our team in China.
I guess in China specifically, when you talk about starting to see some of that, the stimulus pay off, is that orders or revenue growth in the second half?
No, for us, we'll start to see a better revenue profile in the second half in terms of growth rates versus the first. We don't really give order guidance by country. We don't really report order by country. We did it a couple of times last year when it was just so important to the story and such a beneficial piece of information for our investors. The problem with giving order growth by country is it's inherently lumpy. When you're talking about even China is a big country, sure, but in the grand scheme of the entire company, it's relatively small. When you start talking about order growth and things of that nature, it can move around a lot in a given month or quarter.
Yeah. I guess the question is just the potential for stimulus benefit in the second half, which it sounds like there's some versus what it could look like in 2026 when it really starts flowing.
Yeah, we're hopeful that once we're through 2025, you start to see a more normal China. Here's the interesting thing about that market. It's been challenging now for six, eight quarters. I mean, it's been challenging for quite some time in that market, actually since the middle of 2023 or, yeah, middle of 2023 when anti-corruption was initially announced. So we've had challenges for some time. The interesting thing is people aren't purchasing. Therefore, every day that passes, the installed base gets one day older. The desire to purchase gets one day more. We're starting to see that pent-up demand. Ignoring stimulus and ignoring all of these other factors, the fact of the matter is equipment's aging.
That starts to represent an opportunity for us in and of itself in support of what we hope for this business over the midterm is mid-single digit growth. We're not expecting high single digit, but mid-single digit growth over in the coming years.
Got it. I think we have a few minutes left. Let's just touch on Fugato. Obviously, recently launched, I think the general view of, I'd say my view, and then maybe the general view of investors is that the expectation for the $30 million might be a little bit conservative in the first year. Maybe just talk about how that launch is going and some of the factors that get you to that $30 million for 2025.
First of all, we certainly hope you're right. We are working so hard to make you right as well, to prove you right. From our standpoint, it's all about successfully setting up all of the parameters to successfully launch and accelerate growth. It starts with previously getting the CMS reimbursement in the right corridor. We have that in place. Once you have that, you have to get your local manufacturing networks in place. We have 13 local providers who can deliver real time. By the end of the year, we'll be at 26, and we'll have roughly 90% coverage of the market by the end of the year from a supply standpoint. You have to have commercial carrier insurance in place. Another important step, another area where we're making really good progress. Those are all key ingredients.
You have to sell it. There are a few hundred relevant centers that do most of the scanning and imaging in the U.S . It starts with having the right segmentation and then putting the right sales plan in place with respect to each of them so that we can convert. Hypercare, once you have them on, we have to make sure it is a great experience. Once you have the momentum in place, you can build from there. For me, it is all of these building blocks. We have a very rigorous tracking mechanism that I actually get to see every week with the progress that we are making. Have we hired the reps? Have we onboarded the manufacturers? Where are we with commercial carrier insurance? How many doses? How many centers? How many centers ramping? The ramp rate.
All of that is in a weekly tracker that Pete and I look at along with the rest of the team. It is that kind of execution. This is not a simple launch, right? Because you heard me describe all the different elements that have to be in place. So far, it is going well. I am pleased with each of the different ingredients that we have and that we have been able to put forth. What I am hopeful of, for me, the most important number is what is the December sales? Because this is a number that you do not, it is not like a lot of things, there is year-end buying. This is not that because it expires.
To the extent that we can get this ramped correctly, and certainly I hope we beat the $30 million, and if we have a robust December number, all the work we are doing is to line up that number correctly so that as we move into 2026, there is a very strong jumping-off point. At that point, we have said hopefully in excess of $500 million. That is our expectation. Hopefully it is well in excess of that. Let's see.
Great. I think with that, we're out of time. So Jay, Carolyn, thank you very much.
Great. Thank you so much.