All right, let's get started. I'm Robbie Marcus, the MedTech analyst at JPMorgan. Very happy to introduce Tim Herbert, the CEO of Inspire, for our next presentation. Tim will do some presentation followed by Q&A. Tim.
Very good.
Thanks, Robbie. And thanks for having us again, J.P. Morgan, for hosting us and giving us a nice time here on Monday morning, get a chance to meet with everybody over the next couple of days. This is fantastic. This morning we pre-announced our Q4 and full-year revenue, which reflects really a continued growth and adoption of the Inspire V system. We also provided initial revenue guidance for 2026, and this guide of 10%-11% revenue growth is in line with our indication that we provided at our last earnings call. Our initial revenue guidance does not include any contributions from the increased reimbursement at this time. We do view the recent reimbursement developments as a positive step. We are working with all the relevant agencies to gain full alignment around that subject.
We continue to believe 64568 best describes the Inspire V procedure, and 64568 has been associated with Inspire since our FDA approval back in 2014. 64568 was billed and paid for Inspire V procedures throughout 2025. And you'll recall the software update that happened mid-year on July 1 was a key element to be able to launch the Inspire V device. So as we learn more, we will certainly provide updates, including at our upcoming earnings call. Now, what drives the team at Inspire is our mission and our positive persistence to deliver strong patient outcomes and overcoming challenges. And that is what the company is all about, and that's kind of where we kind of build from.
I'm going to spend a few minutes running through some slides that talk about the core elements that bring us to where we are and what's going to be the keys to our success going forward. First, let me show the chart. This is our full-year guide. We're going to be approximately $912 million in 2025. The Inspire V neurostimulator system launch has gone very, very well. 100% of the physicians have been trained, over 95% of the contracts have been executed, and about 90% of the centers are on SleepSync program, very, very important. We presented significant data of the safety and efficacy of Inspire. I'm going to show you some of that data here as well, and here you can see our initial revenue guidance. It's so proud to say of $1.3 million-$1.13 million.
First time I had a chance to say that, and that's pretty exciting. As an overall summary, we still have a very large under-penetrated market. Many publications are already out there talking about the safety and efficacy of Inspire, and we continue to develop more as we go. 1,300 employees now delivering therapy to patients with over 300 million covered lives in the United States. So we'll keep proceeding with growing the adoption of Inspire. And you can see that we've now exceeded over 125,000 patients with Inspire. So the Inspire V solution is significant, and we're so proud of this product and the experience that we've had in 2025 really is what's going to be the key driver taking us forward.
Obviously, you see the picture of the Inspire V neurostimulator only has one port, and that one port is for a stimulation lead because the sensing lead is now incorporated inside the device and using an accelerometer to detect respiration. And the key to Inspire and the key to hypoglossal nerve stimulation is closed-loop stimulation. We know the airway is most susceptible to collapse during the inspiratory period. And so that sensing is a key element to be able to know when the patient inhales, exhales to be able to time that stimulation out. The Inspire V is now at a 30-45-minute procedure, a significant reduction from Inspire IV. That really helped us late in the fourth quarter because we're able to add additional cases. And we were scheduling cases even the last week of the year, had a significant number of implants done on New Year's Eve.
These are the patients with the high-deductible insurance plans that really need their procedure done before their high-deductible resets the next day, so really a busy time the last couple of weeks, but the Inspire V and the lower procedure times really allow us to be able to capitalize on that. A couple of things about Inspire V, it's not only a nice initial program, but it's also our platform moving forward, so Inspire VI is going to be our key development project that we're working on this year, and it's really a software upgrade, and what we are looking to introduce is sleep detection, and so when a patient falls asleep, the device turns itself on. They no longer need the remote that you see there to turn the device on at night.
They get up in the morning or they get up there in the middle of the night, it'll pause itself and turn itself back on when the patient goes back to sleep. I want to talk a little bit about some of the data that we generated. We did a clinical study in Singapore, and this has been published earlier. It was on 44 patients, but this is now upgraded or updated to show the latest clinical data. Here we again show the respiratory waveform with, I don't think you can see the mouse right there, that you can see as a patient inspires. We want to time that and provide stimulation throughout the inspiratory phase of respiration, and we can do that. We measure that with a parameter called inspiratory phase overlap percentage. The Inspire IV device was good.
It had 79% of the breath, so the inspiratory cycle was covered. But going to an accelerometer, we get an improved respiratory sensor, and we've taken that up to 87% of the breath we can capture. That's significant and driving overall outcomes. As you can see from the apnea-hypopnea index, we were going from, I can't read that, 38 down to 8.4 events per hour. If you took that in terms of response rate or the famous Sher criteria, that's a 79%, almost an 80% responder rate. That's significantly better than where we were back in 2012, and it kind of sets the bar for comparison of where people need to be going forward. 100% successful implants, right? 20% reduction in surgical time. Therapy adherence, very important. Averaging six hours per night at six months. That's really profound. What we need to do is take that a little bit higher.
And the way we're going to do that is Inspire VI. Inspire VI is going to take adherence to as high as we can get it because the device will turn itself on when the patients fall asleep. We also measured our own results with our Inspire V limited market release in the US. And you can see the same benefit. Six hours a night, 80% of the night used. We have three other functions that we added in small step-sized start impulse, meaning it just doesn't turn on. It kind of turns on with a ramp. And you see people are starting to take advantage of those key features as well. So very important, strong safety. And we're currently tracking 49 patients. What you're seeing here is the data from the first 49 patients who have crossed over their six-month timeframe and very, very strong outcomes.
SleepSync was a part of the Inspire V launch. We made that a key part of centers, and so they can use SleepSync to not only initiate and track their patients, but to track their performance long-term. What's key is we also can monitor that data and make sure we know that patients are getting the best care to make sure that we can track what centers are doing really well, what centers might need a little bit of additional training, so really kind of a key feature. Now that we have centers on SleepSync, we can start building utility to this. One example is today prior authorizations are done by eFax, right, but we are now testing a feature. It's in a limited release test right now that SleepSync is used to provide the information to our reimbursement team to prepare the prior authorization submissions.
We can start tracking patients now from when they go to our Advisor Care Program through their whole pathway, through implant, and of course for long-term follow-up, so SleepSync is going to continue to grow to become a very important part of the important tool as we go forward. At Inspire, everything we talk about is for the patient and to make sure we have continuous improvement in our safety and making sure we have a positive experience for all the patients. Two measures that we use to measure this is what is the percent of patients who can survive from a device explant, if you will, and go back all the way to 2018, 6% of the patients had a chance of having an explant, and you can see that is out at 90 months, right, but every year we can show continuous improvement going forward.
2020, the COVID year, there's always an anomaly. But look where we are right now, less than a 1% chance of having an explant. That's consistent improvement. And that's being very strict in the operating room, driving, sterilization with the team right there, making sure that we have strong outcomes. And so patients don't choose or elect to have their device removed. On the right-hand side is the survivability for revisions, right? And the revision rates have gone from 10% back in 2018 to look where we are right now, 1-1.5%. And a key to this is the majority of the revisions were attributed to the pressure sensing lead, which no longer exists. So we have a significant improvement again to be able to take this. We would love this to be zero.
Now we know that's very difficult to do, but that doesn't mean we're not going to continue to keep pursuing this. Here's the big breakthrough for the year. Three independent universities went and looked at the TriNetX database, large government database tracking sleep apnea. Virginia Commonwealth University, Thomas Jefferson University, University of Texas Medical Branch. What we have found is use of Inspire has shown long-term cardiovascular benefits as compared to CPAP and of course as compared to no treatment, and these are statistically significant numbers. This is going to only be enhanced as we start going forward. Not only is Inspire going to show that we're treating just the symptoms and severity of sleep apnea and AHI, the apnea-hypopnea index, but now we're going to start showing key changes in cardiovascular health. That's what this is all about.
That's going to really make a strong impact on patients' lives both now and into the future. You're going to see a lot more as we kind of really lean in on additional data collection from the cardiovascular side. So as we continue to grow over the years, back in founded in 2007, right? And shout out to my original board person, Dana, right here in front and still on the board today, right? And we have been really focused on patient outcomes. And if you put the patient first, we'll never lose our way. We'll always keep driving forward in the right directions. We're always going to have challenges, right? Whether it's going to be external environments, whether it's going to be reimbursement, whether it's going to be whatever.
But the team is positioned to be able to address those with positive persistence, be able to just overcome those as we will today with the challenges that we have. But now we're up over 125,000 patients with Inspire, and we're just getting started. We have quite a ways to go. We still have a significant untapped market. And even though we're talking about 125,000 patients with Inspire, there's 500,000 people per year that are capable of receiving Inspire and benefiting from it. So as we always do at J.P. Morgan, we ramped up our direct-to-consumer efforts when we came after the launch, so in the beginning of the third quarter. And so we created new content because we want to get the message out there that now we're really showing improvements in the sleep quality.
And so what we've done says, "You know, you can sleep so good, you can now dream again." So we always love coming here. We always show some of our new commercials. It's kind of fun that we like to do because sleep apnea is still a disease that really sets up for direct communication with patients. They want to be a part of the process. And so our outreach programs continue to grow, and we continue to show a strong yield in helping patients come in, see their physician, see if they're available or a good candidate for Inspire, and then benefiting from it. So this is the living room rescue, all right? Oh, wait, back up. Do you guys have to help me? Where do I do it here?
Dana's kettlebell workout has taken a strange turn. Rex can't help, but he can talk.
You don't see that, do you?
Weirdo. This is wonderful news.
All right, let's start that over. Now I know what I'm doing. I always put this commercial first because it's my, yeah.
Dana's kettlebell workout has taken a strange turn. Rex can't help, but he can talk. Weirdo.
Okay, how do we get back to this? Okay, there you go. Now there's no sound. Do you guys do something or do I get to do something? This is how I run out the clock, Robbie, so you can't answer any questions. Okay, so it was me. Let's see.
Let's go here. This is what's going on here. Okay. Dana's kettlebell workout has taken a strange turn. Rex can't help, but he can talk.
There it is.
Weirdo. This is wonderful news. It means she's sleeping deeply enough to dream thanks to her Inspire implant and Bill's sleeping better too.
If CPAP doesn't work for you, check out Inspire Therapy, a proven sleep apnea treatment. No mask, no hose, just sle ep. Learn more and view safety info at inspiresleep.com.
Okay, what's important there, we got a lot of feedback before that when people saw our commercials, they didn't really understand what it was. So you see the little image of the neurostimulator, they can start to understand now that it is a procedure. It's not just something. So when they come in, it kind of helps bring that forward. That was one of the feedbacks that we heard. So we also brought a little holiday to it. And Scrooge has sleeping challenges, obviously, right? And he dreams. So we made a little fun with this. We ran these ads during the holidays. That's kind of fun.
Ebenezer, Ebenezer. I am the... Let me stop you there, chaps.
Turns out all this bah humbug business was just my sleep apnea. But with this Inspire implant, I'm a new man. Last night at supper, I even left a tip. Now what? If CPAP doesn't work for you, check out Inspire Therapy, a proven sleep apnea treatment. No mask, no hose, just sleep. Learn more and view safety info at inspiresleep.com.
That's scored really well. So then every now and then, as we continue to grow, we're going to attract people. So I'm sure everybody's a fan. I was talking to Kurt last night. He's a big fan of the Golden Bachelor and the Golden Bachelorette. So the Golden Bachelorette had two people to choose from, and they do the overnight thing, whatever that's called. And one person snored and one did not. The one that did not won. It just so happened, Chuck happened to have Inspire.
So what do we do? We go contract with Chuck and we started, we filmed some commercials. There's also, I can't remember his now-wife's name, but we also filmed commercials with her too. And so these have been running, especially when we do the Golden Bachelor.
After winning her heart, everyone's asking, what's my secret? My skills in the kitchen? My impeccable style? Not bad. My charm? No. The real secret is my Inspire implant that treats my sleep apnea. When CPAP couldn't, Inspire Therapy helped me sleep better and be the best version of me. No mask, no hose, just sleep. Learn more and view safety info at inspiresleep.com.
That's pretty cool. That's an adventure with real people. So, all right, so Robbie, one more slide, and then I said we're going to go half and half.
So really proud to announce Matt Osberg has joined Inspire as new CFO. He's going to be starting later in January. Comes to us from a host of experience from Apogee to Helen of Troy at Best Buy. He's an early EY guy and has many years' experience. He is from Minneapolis, although he's traveled the world with his career. And really not a med tech person, but we searched the world to find the right individual. We know med tech. We weren't necessarily focused on a med tech person. We want somebody who could really bring in and help us go to the next level. So very exciting from that standpoint. Inspire V fully launched.
Very good adoption, significant improvement in surgical time, patient outcomes, and really the key driver to the momentum that we saw in the fourth quarter to close the year and exciting to start the new year. SleepSync is now broadly adopted, that was a key part of the Inspire V launch, and now we can continue to build the utility and build tools that can really help the sleep physicians manage more patients, and now we're working with overall health outcomes. That's going to be really a key driver going forward so did provide the revenue guidance of $1.003 billion-$1.013 billion, and this all that, of course, does not include any contribution from increased reimbursement, and we are working on the reimbursement. We view this as positive.
We have to get all the parties together to get a good clarification, get good alignment from all the agencies to really provide clear clarifications. And we'll continue to report back as we make progress there. So at that, we're right there. I'll invite up Robbie Marcus to join us on stage.
Great. Tim, maybe a lot to talk about. Maybe we could start with fourth quarter. You beat by, I think it was $7 million. Maybe just talk through some of the trends you saw in the quarter. Inspire V is now in full launch, what you saw there, and we'll get to reimbursement. But was there any stocking or bolus of procedures in the fourth quarter with some of the confusion around reimbursement?
Right. Back in the third quarter earnings call, we always looked at there's going to be a big step up in Q4.
We always have a big step up from Q3 to Q4. Q4 is our high seasonality quarter. Again, back with the high deductible insurance plans and patients demanding that they get their patient in December before the end of the year. So yeah, really a good momentum going forward. And that's helped out quite a bit with Inspire V because of the reduced time to surgical time allowed centers to be able to do additional cases. And as I mentioned earlier, that we were scheduling cases the last week of the year. And that's kind of unheard of in the past because they knew with their reduced time, they could slide in one or two more cases to help those patients out. So good momentum with Five to drive it. Kind of just above where we set our guide to be and good momentum with Inspire V.
So really exciting to be able to keep moving into the new fiscal year.
Okay. As we think about 10%-11% revenue guide for 2026, that's reiterating what you said on the third quarter call. That doesn't include any uplift in price in 2026. As you think about sort of the trends coming out of 2025, stabilization, Inspire V launch now in full swing, what does the 10%-11% assume? And what has to change from current trends to get you to that?
Got it. I think what we want to do is continue to focus on the adoption of 5 and really leverage the new data that we have, the new outcomes that we have. Can't underestimate the impact of not having the sensing lead in the chest wall for an ENT to do that part of the procedure.
That's one of the key feedbacks that we've been getting from the ENTs is really simplifying the procedure, yet improving the outcomes by having an accelerometer with the sensing. So those are the key elements that we'll be able to keep driving utilization. You leverage our direct-to-consumer to build awareness, including with Inspire V, and really keep doing what we do to keep growing the adoption. And we're so untapped. Our market is, the penetration is so low. It just creates an opportunity for us to continue to open more centers, but really focus on growing utilization at same-store sales or at existing centers.
Talking about data, you had some up on the slides with pretty good cardio data. Is there any way to differentiate Inspire on the label versus CPAP using some of that?
I think this is the first year that data has come out.
And so we're going to keep leaning in on that. We're also going to be trying to collect some more prospective data to be able to help leverage that and go back to FDA and see if we want to have a discussion and what we can do to be able to look at labeling and marketing claims associated with that. But it's really a profound change to be able to have the cardiovascular benefit. That's something that people have been asking for since 2007 when we launched, not just AHI, but does it really help with outcomes? And that's going to be a key factor for reimbursement down the road.
So in November, reimbursement, the final outpatient ruling affirmed that Inspire should be billed under 64568 and came along with nearly a 50% premium versus the older code of 64582.
There were some acts that came out in December and said, no, Inspire may not be applicable for that newer higher reimbursed code. What's the current status in your view today of reimbursement, what doctors should be billing for, and what's Inspire doing to clarify that amongst the implanting community?
Sure. We'll go all the way back to 2014 when we got approval. We always had challenges back then with the first code. What should Inspire be billed under? In the end, we stuck to our guns. 64568 was the code we used back in 2014. We stayed with that. We had to develop an add-on code for the pressure sensing lead. That's how we operated until just several years ago when we came out with 64582, which is a full system description that included stimulation lead, sensing lead, and a neurostimulator.
So it was a two-wire system, and that's still in existence today. And Inspire IV is still used to bill that. As we developed Inspire V, when we go to the certified coders and we look at what code best describes that procedure, it's 64568. And we implemented that at this meeting last year. We talked about that. And that was put in place. And we had been building 64568 for the whole year, including one of the limitations I mentioned earlier about the software not being updated to allow online billing for centers for Medicare. And that was updated on July 1 to allow 64568 for Inspire V. And that was part of the key momentum going all the way through the whole year. So really from a descriptor and from a coding, nothing's really changed.
And I think that the surprise to everybody is when CMS was really smart and they came up with a new tech APC because they just weren't ready to go to a level six ambulatory payment classification yet. So when they came out with the 1580 or the new tech APC, I think that is just a big change and it caught everybody by a little surprise. And I think what you're saying is a little bit of a reaction from that. So what our job is is to get all the parties together. So we're communicating with everybody, all the agencies, make sure they're communicating. Obviously, the societies are heavily involved in this as well. And get all the parties together.
Everybody just kind of take a breather, slow down a little bit, and let's get the clarification laid out so everybody can understand what's the proper way to do this. We continue to bill 64568 into the new year. Obviously, it's very early in the year, so we don't have results on payment yet. But we're staying very active with it, and we're being very open and providing all the information that all the appropriate parties need to have to be able to get clarification across the board.
Do you have a time set up for a meeting with all of the relevant parties?
We have been meeting with all the relevant parties for some time now, as you can imagine. The key is going to be what's the timing to be able to get full alignment with all the parties. That's what we don't have.
So we're going to keep working. People know time is of the essence. People know the impact that this has had for Medicare patients across the United States. And so I think the agencies are working diligently, and we'll keep providing updates. And we do have an update on our earnings call coming up in just a few short weeks.
So you said you're still billing the newer higher code into the new year here where 12 days in, probably half of that in business days. So you don't have an answer yet, I imagine, on if it's getting reimbursed. But maybe we could think about into 2026. You have the full year guidance. Sometimes at this conference, you'll come in on first quarter.
How do you want the street to think about first quarter, given there might be a little confusion in the market and maybe some push out of procedures if it's not resolved soon?
Sure. I think that we look at it as kind of, when we did our initial indication, we had our plan set up to run our game in 2026. And I think that we want people to kind of just think about that. That would be a good way to look. So when we started talking about cadence of the quarters, I think that the way consensus is right now, we're probably comfortable with that today. And we'll keep running our programs. And if we can get alignment and resolution, then we can come back and revisit that.
Okay. Maybe another reimbursement one.
I believe it was one of the MACs was referring people to maybe implant with the old code with the 52 modifier, which has lower reimbursement for physicians. Any comment on that? And is that what you're hearing doctors doing in that MAC region?
We just need to kind of get all the parties to come back and work on that. We don't agree that that's the right way to go. That goes back to where we were here a year ago, right? And the MACs, including that MAC, had been covering 64568 all through 2025. So that's part of the overall discussion with all the parties. And so that's one that we have to report back on.
Maybe moving on, one of the bright spots for Inspire the past several years has been the earnings and the leverage you've gotten down the P&L.
You have a very low share count. So every $1 million is a nice addition to earnings per share. Bit of a reset last year, but still great leverage. And third quarter, we'll wait for fourth quarter to see what EPS does. I imagine with the beat, we'll see a good quarter. How are you thinking about spending and margins in 2026, especially perhaps with some upside from Inspire V and the ability to continue to drive margins and EPS up?
So let's kind of work backwards and through that. So yes, Inspire V does provide some improvements in margin. We demonstrated that in the third quarter and look forward to providing data that's currently in audit. And we'll do that, give the EPS update at the earnings call in a couple of weeks. But we do see that benefit moving forward into 2026.
But we're going to continue to spend as well. As I mentioned, our top priority right now is working on Inspire VI as a development project. We're going to keep continuing to build our team in the field. We're going to keep working internationally. And we're going to continue on with our direct-to-consumer. So we're not slowing down our approach to growth and continue to keep pushing and investing in the company going forward. But with our gross margin, we do have the benefit to be able to be profitable. And that's a nice change. And especially as we're getting to a point now that we can provide revenue guidance over $1 billion to be able to come back and talk about that at their earnings call of being profitable with it as well. So really look forward to providing that input coming forward.
But yeah, we're going to keep investing in the company, no question about it.
Just see anybody with questions in the room?
Can we call on people?
Sure.
Pardon me.
I'll just let me repeat the question. What's the impact of GLP-1s, if any, and how are you thinking about that moving forward?
Right. With the other discussion, I'm not sure we're going to have GLP-1 discussions today, but no, thank you for asking that. Very important part of our business. And we do think long-term it's going to be a tailwind for us. And I think there's a significant population with a high BMI that we simply just cannot treat because of the lateral wall collapse that I've talked about many times and associated with a very large neck circumference.
The GLP-1s are really helping people lose weight and reduce that neck circumference and to relieve the lateral wall collapse so we can treat the tongue base collapse. And I think that when we did our survey one and a half quarters ago and looked at our sleep physicians, half of them now have established weight management programs where they are prescribing GLP-1s and they are managing patients on GLP-1s. What's key for them to maintain insurance is they have to track utilization of the GLP-1 or adherence to GLP-1s. They have to track improvements in weight loss and improvements in sleep apnea. But I think what we'll see is people will be losing weight and there will still be people with residual AHI that requires treatment. And that's where the tailwind starts. So I think we're just at the beginning of starting to see the patients lose weight.
We do have some evidence of showing people losing weight and then receiving Inspire. Now, the trick is they got to stay on the GLP-1 or they got to maintain that weight loss because they put the weight loss back on us and the lateral wall comes back. So that being said, we do believe that GLP-1s may not solve the world's problems, and so we do have our own development program to be able to treat high BMI patients. So we're actively pursuing that. We call that a dual-channel device. So another key research program that we have going on this year to really address the lateral wall collapse and have a different mechanism to be able to stim to treat that. So we're addressing that in twofold, multiple ways, but we'll keep tracking the GLP-1s closely.
We know that it really is a benefit for the overall sleep market. GLP-1s has just created this awareness, and people come into their family doctor saying, "I want a GLP-1 because I want to lose weight. I want to feel better. I want to look better," and they say, "Well, okay, let's do some tests. We want to check for diabetes, for heart failure. Let's do a sleep study because if you have sleep apnea, you might get coverage with your insurance company," and sleep physicians, when they find a patient with moderate to severe sleep apnea, they are not just sending them back. They're going to treat those patients, and that's how they get captured in there, and it's going to only grow the overall sleep apnea market, so it's going to be a long-term benefit.
Tim, you talked a good amount on innovation.
You spent a good amount on R&D. You're just launching Inspire V now. What is next? When should we expect Inspire VI? I believe that'll have auto sleep detection. That's more of a software than a hardware upgrade. How do we think about sort of the cadence of new innovation rolling out to patients?
Yeah, I think just keep continually innovating and keep continually releasing new products that can take our outcomes to a higher level and just improve the patient experience even better. So we're actively, and we divide it in two. So we have the therapy side and then we have the digital side. So on the therapy side, we're already actively working on Inspire VI to get to auto sleep detection and activation. We know we have programs beyond that with 7 and 8 that's going to start to get to auto titration.
In other words, having a device that will auto program itself. Now, that's years down the road. But with the sensing, we can be able to detect when patients are having events and not. We are looking at avenues right here on new indications such as high BMI and going to a dual-channel device and really leveraging our technology to a whole new indication. On the digital side, we know that what we talk about is a limitation on the number of surgeons doing procedures. We just don't have the capacity to support the demand that we have. But eventually, we're going to solve that, and then we're going to push the burden to the sleep physicians who have to manage all these patients. So we need SleepSync as a tool to be able to help manage the significant number of patients that are available.
So you'll see the utility of SleepSync just continue to grow as we move through the years. And now we're at the point now with the core program out there across the U.S. Now we can do just incremental changes as we go. Prior authorization is one that I already mentioned. So we're going to continue to keep pushing innovation hard because that's kind of what we're all about.
Maybe as I think about drivers of growth, it's probably at this point, you've talked about this on some of the past calls. It's not new centers as the biggest driver of growth or potential. It's the ability to drive better utilization within existing centers. Where do you stand in terms of the programs or what you're doing in the field? And how do you feel about the ability for Inspire to execute on that in 2026?
Great question.
I got one minute to speed answer. We get an extra time, so we're going to start up front and we have our direct-to-consumer program where we get people coming to our Advisor Care Program, but we have to help them make that first appointment so we're going to work diligently to be able to improve that conversion rate and once they're at the center, we need to be really efficient with the ENT surgeons to optimize their time when they're in our office so in other words, use a navigator, use advanced practice provider to educate the patients so when the patient sees the ENT, they're qualified and they can go straight to the OR. We already talked about five, reducing the time to do a procedure that allows them to do more cases in a day.
And of course, make sure you have good partnership with sleep physicians on the backside to be able to manage the patients and make sure we optimize therapy outcomes from that standpoint. Three, two, one.
That was a good fast answer with little time. Tim, thank you very much.
Thank you very much. Thanks, everybody, for coming.