We have Brian Webster, President and CEO, and Vaseem Mahboob, Chief Financial Officer.
Thank you. Thank you for having us
Thank you. I guess maybe to start out, you know, 2026, even since your IPO, you've seen very consistent execution, which has been really nice. You got a good beats and guidance raises on the top line and gross margin, and talking about the momentum in the business and kind of the progress you've made in 2026.
Yeah. I think, I think our fiscal year of 2026, which we just ended in April, I think the start of the year was really about getting some of the momentum from the benefit of all of our payer contracts being in place. We had worked for a couple of years to get all those contracts in place. Once we got to that sort of 70%+ payer mix under contract, it really unlocked the rest of the business model. That was sort of the way we started the fiscal year. Then, we saw great momentum coming from that. We built out our commercial team substantially. We've added about 60 reps in the last, I guess, 13- months, so that's quite an expansion of the sales team.
We now have about 130 reps. Getting all those reps in place, getting them trained up, out in the field, starting to see productivity, is a big driver. That plus the insurance coverage has really gotten the engine going, and we're starting to see, you know, terrific momentum.
That's helpful. You're gonna be giving guidance in the next earnings call. It's kinda Q4, fiscal Q4, given your fiscal year. How should we think about some of the, kind of the key drivers in 2027 and, you know, any kind of puts and takes you'd call out?
I think we're mid-July is our earnings call, so we'll be giving official guidance then. I think the drivers for FY 2027 will look a lot like 2026 in that we've got continuing sales force expansion. What you'll see is, as we build out the revenue pathway in FY 2027, you'll start to see the benefit of all these hires that we did in FY 2026 as they get on the productivity curve. I think that will be a big part of the story. We'll continue to see revenue cycle management improvements as we get closer to, you know, accrual-based accounting on some of the with some of the payers and we'll see a combination of those things are going to deliver, we think, you know, top-tier med tech growth here in the coming year.
We saw your competitor just reported this week actually, their 12-month growth was like 8% for their LifeVest business over the last 12- months. The market's clearly growing if you're taking share and they're growing high single digits. How should I think about, you know, just the underlying market growth rate and kind of the acceleration there?
Yeah. It, it's, they just reported on Monday, they reported 8% growth in their business. We, you know, we're at about 60% growth in our last quarter, the math there is the market's growing at 14%. I think we would all agree that a big existing market growing at 14% is something to behold, and we're pretty happy about that. The real impetus behind that growth is the fact that our competitor figured out that we were gonna take a bunch of their market share, the only way that they were going to be able to grow their business was to grow the market, and that's exactly where we want them. We want them to be out pounding the pavement, you know, using clinical data to push the narrative around WCD use.
We're seeing the benefit of that. You have ZOLL doing that, and Kestra doing that, these physicians are hearing it in stereo now, we're seeing the market grow. I would not be surprised at all is, as we get into the next year, if we see that market growth continue to accelerate because we're adding a lot of sales territories.
How sustainable is this market acceleration?
Well, the math on the TAM, if you will, is 850,000 patients are eligible for a WCD and only this past year, only about one in seven that were eligible actually were prescribed one. I think that it's very reasonable with continued good clinical data and execution that we can turn that one in seven to two in seven, three in seven, maybe even four in seven. I think we've got a good runway for extended market growth for the next five- years certainly.
On market share, 12%, 13% right now, only on half the accounts. Can you kind of help us understand, like, the market share and some of the key accounts that you're in and what, how that's indicative of where share is going for you?
Yeah. That rep count, about 130 reps as we ended our fiscal year, that gets us to maybe 60% market coverage in the U.S. market. You know, I think in the markets that we're actually in, we're certainly more than double that kind of share. We're definitely seeing where we put a rep and we resource it with clinical resource and things like that, we're definitely seeing, we're getting, you know, 25%, 30%, and beyond percent market share. I would remind you; it's a one doc at a time model, you know. There's no hospital contract, there's no buying committees, clinical committees. You have to go get one doc at a time.
What happens is the rep gets in there, they convert that first physician, and then they go right next door, and they work on the next one and the next one. You see gradual penetration in those accounts kind of quarter over quarter. We'll see that some of our more tenured reps we're seeing, you know, 70%+ kind of market share in those accounts. I think we'll see continued penetration which will convert into, you know, a really good sales productivity metrics.
Obviously the low-hanging fruit's just taking share, right?
Yeah.
Share conversion. Can you talk about the process and sort of strategy of getting into account and opening an account and taking share, and then how then you take the share kind of post being in an account?
I think the first thing we do is when we're putting a new territory in, we're looking at the intersection between previous prescribing history, because we have all the data and we know who the high prescribers are. We're looking at the intersection between that and where we have payer contracts, when we see those two things, that's where we want to put a rep. The rep comes in, first thing they do when they open up their sales force, you know, instance is they see all their prescribers paraded and they know who exactly to go after.
Once the rep starts to get some productivity, start to see that they can really develop that territory, we'll drop in a clinical specialist who will help them to manage the accounts as they're bringing them up. That's how we're seeing really good acceleration even with our top tier reps who are, you know, who are really nailing the numbers. We're adding clinical people to help them and now they're growing even faster.
On your sales force expanded to 130 from 80 at the end of last year. If, how are these territories, you know, ramping in productivity at this stage?
I think we have a model that.
Yeah
maybe you want to answer the model on that.
Yeah, sure. I think the financial model that we had put out there, Travis, was based on a rep starting doing about 40 fittings in the first six- months as they ramp up. When we define ramp up, we are talking about like they're coming in, getting trained, getting the product, activating their 1099 fitters, and then kind of building out, you know, those initial accounts that Brian talked about. They get to 10 fittings at month six, means they're scaled up, then they stay there for 10 for that first year, they go to 12 the following year, and 15 in year three. What we are seeing is the returns are, like, absolutely fantastic. We all of our reps are averaging better than kind of the model.
You know, our top reps are starting to put points that are north of 50 fittings per month, so, you know, plenty of room to go. In our business it's not that reps are not performing, they're just scaling from the left-hand side of the curve over to the right.
When you think about kind of the doubling of reps and how much of this is like getting reps in the right place, ahead of reimbursement wins and, you know, potential guideline updates ahead of the expansion there?
I think we're being very thoughtful about where we add reps. We tend to want to go deeper where we have really good account concentration. We have a, I can think of several different territories where we had a high producing rep. We went in, we split the territory, added another rep in there, and now we have two really high producing reps. We've seen that in at least a handful that I know of recently. I've looked at that data and that's really exciting because that means we can do that effectively without running off the rep, you know. 'Cause the reps are, they go out there and they earn that business, and you don't wanna take that business away from them. There's so much business out there that they can go rebuild it and, that's been a great strategy so far.
You've had your, I guess, ACE data in hand for a couple of quarters now. What's been the receptivity to docs and kind of feedback, you know, are you seeing it help with share gains or market expansion in any way?
I think the ACE-PAS, which is our post-approval study data, 21,000 patients, the largest ever WCD study by the way, I think it's been really well received. Number one, it gives the rep something to go talk to the doc about. Number two, the data is rock solid supporting the product, so it allows the rep to defeat any myth that the competitor has been telling the physicians. Then it's also really focused on something very important, which is identifying that the percentage of risk in these patients is higher than the physicians generally thought it was.
That's why you're going to see market growth, is because the docs are gonna start saying, "Hey, maybe this patient that yesterday I didn't prescribe a WCD for, maybe tomorrow I'm going to because I understand that they have more risk than I thought they did." I think that's probably one of the most powerful things in that data set that we're seeing a benefit of.
On the guidelines, can you remind us kind of what the guidelines are today and the timeline to change those, and how you think they're gonna change and the impact on the market as those do change eventually?
Yeah. The guidelines today, a WCD, and these are AHA and HRS rhythm guidelines, basically. The WCD today has a combination of 2A and 2B guidelines recommendations. 2A for awaiting implant patients or somebody who's an ICD patient that's getting their lead extracted or their generator changed, those are super high risk, so those are 2A indication. The standard post-MI patient is a 2B indication. We think that with some work and all this data that we're putting on the table, we think we can get the wheels turning to get the guidelines updated. We've got to start with, you know, new scientific statements around it from KOLs.
That hopefully will open the doors to the guidelines committee starting to talk about it. We think there's a lot of data there. We probably will add some outcome data that will help solidify the data set. If we can get even from a 2B for that big population moved up to a 2A, then I think the market goes from one in seven, it goes to two, three or four in seven. It would be dramatic impact because it takes the risk assessment out of this sort of solely in the hands of the doc into now, they've got more of a protocol run program. That's where we want it to get to, and we think it should get to.
We think the patient should have a vote in, whether they are protected by a device like this, and we think that would lead to more of that.
How quickly could we see it in prescribing patterns?
I think it's reasonable to think within a couple of years. It's not gonna happen next month. You don't get these committees to act very quickly. As you shouldn't, right? It's clinical evidence. They need to be thoughtful about it. I think it's reasonable that within a couple of years.
Then on the competitive side, just curious what the kind of the latest you're seeing from your competitor there. They've upgraded their WCD as well. Just are you seeing any impact on that? Obviously, the market's expanding, so it's one of the impacts.
Yeah.
Uh, anything-
Yeah. Our competitor, ZOLL, they brought out, they launched their Gen 5, fifth generation WCD in December. I think they were a little embarrassed about it because it wasn't a really big launch. We certainly wouldn't have launched a product that way. I think it's an iterative product change for them as they continue to manage their fleet of assets. What they didn't do is bring any innovation in this new platform that was going to change our competitiveness. There's still no feature that they have in their product that is better than any one feature in our product. The product came out, it's bigger, it's heavier. We love it, we're excited to compete against it.
The other competitor that's got the larger, patch-like product, anything from them?
Yeah. There's another company called Element Science that's trying to do a stick-on AED, basically. We haven't seen them in the market much. We've seen them in a couple of accounts that were their clinical trial accounts. We haven't seen much activity out of them yet.
Okay. I didn't think so. Just making sure. On the algorithm side, you launched a new algorithm, HRS. What's been the receptivity to that, and how does it kind of strengthen your pitch to doctors and position?
We're really excited about that. We, at HRS, we launched a new upgrade to the algorithm. What I love about it is it's med tech. This is exactly the way med tech is supposed to work, right? You go out, you launch a product, you do a post-approval study, you look at your own data, and you improve your product based on what you learn, and you improve the opportunity to take care of these patients. We did that. We looked at our data. We saw we could further reduce the already low false alarm rate. We also saw we could further reduce the inappropriate shock rate. We're gonna cut our false alarm rate by 50%. The inappropriate shock rate will be reduced by over 60%.
Both of those were already leading the category, we're just making, we're extending the lead, if you will. We're doing that because we saw an opportunity to do a better job of taking care of these patients.
Okay. Helpful. Vaseem, bring out a little bit your, I guess kind of target gross margin, if you look at kind of your peer, kind of mid-80% gross margins, 85% gross margins. What's the path for you to get to that and, you know, the progress so far on the gross margin side?
Yeah, I mean, you know, big shout out to the team. I mean, we are now expanding gross margins nine quarters in a row. Really, it's been quite a journey to get there. I think what's true is what we've been saying about the model and how we get there, right? As you run more volume through the P&L, you're gonna get the leverage that you get from the volume. There's two big parts to it. One, we have already completed all of the kinda unit cost reduction projects, you know, that we had to do. We're not touching the hardware because we want to preserve that CapEx investment, you won't see that. Most of our cost out programs have been focused on the disposable itself, and I think, you know, that's pretty well understood.
I think really for us, the big driver of gross margins going forward is gonna be continuing that journey from being out of network to being in network. As we move those patients in, we're gonna get paid for those fittings, and as a result, get higher revenue per fit, which will just translate into price and coming down into the P&L. We feel really, really good about, you know, the progress that we have made and where we are on that journey. I think the unit economics, Travis, is really the silver lining here, which is, you know, a $10,000 asset acquisition cost over 10- years is gonna generate $300,000 of revenue and $250,000 of cash margin. The investment in CapEx, as you believe the market exists, is, you know, we should be doing all day long.
I think that's really where the focus is to make sure that we have the product available for the team, so that we can meet that service level and give our sales team the comfort that they have product and they can never say no. At the same time, you know, go out and drive more volume through the P&L, and we got good line of sight to those 70%+ gross margins.
On the macro side, just you are seeing some inflation, oil, resin, shipping costs, and computer chips, and anything that you'd kind of call out where we should think about you have some exposure to?
No, I think the numbers that we see, and I think now we've been in this kind of environment for a little bit, is de minimis. You know, freight cost as it is is not a big deal for us. The chips and everything else, we have, you know, done advanced purchases and things like that. We feel pretty good about. I think we tell, I mean, the fact that we have made a $75 million investment in our CapEx, we have a supply hedge, and we have an inflation hedge because we are our biggest supplier.
Yeah. It's an interesting model when you're when the hardware, you're depreciating it over so long, and you're using the product over and over again. Things like the memory chips that are in the headlines today, you know, we did advanced buys of that, seeing some of that price uplift coming. We have a bunch of stock, but even at a little bit higher price, the per unit price increase is less than $0.20. You know, it's just, it doesn't matter in this model.
It's being used so many times.
Right.
That's right.
Right.
Over a longer period of time.
Right. On the OpEx side, just maybe help us understand how much OpEx is needed to support kind of the top line at this stage and, you know, why not go faster?
Yeah. Fiscal 2026 has been, like, a really foundational year for. We talked about that. You know, we've been investing in the right places. When you look at the way the dollars have been going, really focused on building out that direct-to-cardiology sales force that Brian talked about, making sure that that team has the resources. I think one of the great advantages that we have is we know where the fittings are at a ZIP code level. We look for two things: where are the fittings and, you know, whether they have insurance coverage, and that's where we are deploying the reps.
What we are doing now is, as Brian talked about some of those platinum reps going out and winning business, now we are supporting those resources with clinical specialists, a very proven model where they're now farming the account, whereas the hunters are going out and doing more bringing on accounts online. I think the dollars are going to be focused mostly on the distribution side. We have a very exciting pipeline, which is really a call option for the business. There's nothing baked into the numbers for some really exciting stuff that we have coming in the pipeline, so we'll continue to invest in R&D. I think 2027 will be all about confirming what we have said ahead of that investment, which is that there's a lot of exciting revenue growth to come.
What are some of the things in the pipeline that are coming?
New exciting innovations. We developed the system to be platforms, right? We have a WCD platform, which is the electronics. We have the wearable platform; we have the digital platform. We have new pretty exciting innovation happening on all three of those platforms. You'll see, you know, over the next several years, you'll see sort of an annual cadence of new innovation coming onto the market.
Likely see some sort of innovation next year.
Yep.
On the Biobeat collaboration, you know, maybe just help us understand, like, why and kind of what you were thinking about that, you know, collaboration and investment?
Well, the why comes back to what I was saying earlier about, you know, looking at your own data. What we looked at our post-approval data, and 72% of the patients had hypertension, and the physicians who were putting them on the guideline's drugs, one of the most important things that they needed to know was what's going on with their blood pressure while they're going through their drug treatment. They wanna know blood pressure, they wanna know weight fluctuation. Those are the two biggest things. We said, you know, we met through our board member, Ray Cohen. We met this Biobeat team and, you know, they had a really innovative, first FDA-approved, wireless patch-based, blood pressure monitoring.
We looked at that and spent a bunch of time with them and figured out that, gee, if we integrated that into our system, then we could provide that kind of blood pressure monitoring to the physician. We'll couple that data with our ECG data to present, you know, one set of data to the physician who can get a better look at what's going on with those patients and allow them to manage the titration of those drugs as effectively as they can. We also, as part of that structure, will have the ability to do Bluetooth weight scale data we'll be able to collect as well and complete that whole picture. We're excited about it.
We've got an ongoing R&D partnership with Biobeat today, and doing some different commercial collaborations with them, but we're super excited about where that's going to go. I think for the platform, it's a signal that we are going to drive that platform towards a vital signs monitoring capability in the home environment. We've already got the defibrillation capability, and that's for the most severe patients. All these heart failure patients that are wearing our system for the long haul, we can put various vital signs monitoring signals in there and give the physicians a really full view on what's going on with them, those patients while they're getting better. We're excited about being able to add additional clinical utility to the product, but also being able to monetize that.
It basically adds revenue per patient as well.
Yep. Yep.
When you're thinking about the collaboration with Biobeat, what all is involved in kind of getting the products to work together? Where are we in that process? I don't think they're on the market yet, can you kind of timing?
Well, they're Biobeat's on the market as a, as a standalone with their patch-based device, and they're making good commercial progress, ramping up a sales team, and really doing a lot of kind of, I would say, market development activities right now. They, they've got that work going on. They're continuing to do some clinical work. We're focused right now on the R&D project with them, where we're working on the integration of the actual hardware into our wearable, and also the integration of the data platform so that we can, as I mentioned, we can present that data uniformly to the physicians. A lot of, lot of work going on between the companies. That's going great. I don't think this is a long-term project.
You know, it's something that I would expect within the next 18- months or something like that, we'd be able to see that, come to market.
Are there other opportunities to partner with other people, other companies in a similar way?
Yeah. I think there's opportunities to extend the partnership with Biobeat even beyond that first measurement, which is the blood pressure. There's also, because we built it as a platform, there's also the opportunity to bring in other technologies into that. We're spending, you know, a good amount of time kind of vetting some of those opportunities. As you know, there's a lot of companies out there that have, you know, a particular area of focus, we're evaluating that. The vision is when these patients go home, we want them to have this ability to have diagnosis of all the vital signs measurements that we can that can help, you know, help to manage them as they're getting better. With that in mind, we're gonna, you know, we're gonna continue to add more capability.
Do you think that helps? Is the kind of the, I guess, the incentive for you more giving more value for your product so you get more share, or is there other things that we're not thinking about?
Well, we wanna monetize these for obvious reasons, we will approach every one of them with that goal in mind. If the worst thing that happens though is we just gain more share in a really big market, that won't be a bad outcome. That's the nice thing about the strategy, is you've got the two prong. You know, you can go get more revenue per fit because you're already spending all the money to get that patient. Right? You can go get more revenue per fit. If that can help you to get 5% more share in the WCD market, that has dramatic impacts on the business.
When you think about revenue per fit, is it, like, single-digit uplift or double-digit uplift, 50% uplift? Any way to kind of quantify revenue per fit uplift?
It'll depend on the modality, but I think it's reasonable to think that it's double-digit uplift...
Okay.
- percent-wise, for sure.
If you think about potential for utilization, is this something like Would it just be the heart failure patients or would everybody maybe use it?
I think we will, we will likely segment the way we bring the, the technology to market. You know, if you have a short term patient who's, maybe that explant patient or something like that, I'm not sure there's a big benefit to putting that kind of a technology in there. If you do have that longer term, heart failure patient, then that's where you really get to see the benefit.
Okay. Internationally, is that even part of the strategy at this point?
Yeah, we're, you know, we're working on get our CE mark. We wanna make sure we have that optionality. You know, the reality is we have so much to do here in the U.S. and so much opportunity. We're not gonna take our eye off of that ball, but we do wanna advance the international far enough where we can pull that trigger when we want to. There are some nice developments. We've heard just last week that some of the market development that's going on over there has led to new and expanded reimbursement in France. That's great, 'cause that's one of the. It's probably the second-largest country for the category in Europe.
There's been some expansion in Florida Medicaid and, you know, the VA as well. Can you just help us understand how important that is and as that rolls out?
Well, the VA's important because you know, once you get on the Federal Supply Schedule, now you have a license to hunt within the VA hospitals. Many of the high producing territories in the U.S. have VA hospitals in them, so our team is putting concentrated effort on going into those hospitals. We've seen some really nice wins, including a few that I've heard of already where the VA has said, in that particular hospital, has said, "We're exclusively gonna use the Kestra device in this hospital." The Florida Medicaid, it helps us in a couple of ways. It helps us to get more business, so it was still a barrier that we had to overcome.
ZOLL would be able to say, "Well, we cover Florida Medicaid, you should give your patients to us," and that. It helps us to knock down that barrier, but it also just helps us with some of the patients where we did take a Medicaid patient, we weren't getting paid nickel for it. Now we'll get paid at least the Medicaid rate. That's a revenue per fit, you know, increase that'll be a benefit to us.
Great. Thanks a lot, man. We're out of time.
Okay.
Awesome.
Thank you.
Thank you for having us.
Thanks everybody.