Earnings Labs

Viemed Healthcare, Inc. (VMD)

Q1 2022 Earnings Call· Sun, May 8, 2022

$9.98

+1.01%

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Transcript

Operator

Operator

Greetings and welcome to the VieMed first quarter 2022 earnings call. [Operator Instructions] As a reminder, this conference is being recorded. I would now like to turn the call over to Todd Zehnder, Chief Operating Officer. Thank you, you may begin.

Todd Zehnder

Analyst

Thank you, Darryl. Good morning, everyone. Please note that our remarks in this conference call may include forward-looking statements under the U.S. federal securities laws or forward looking information under applicable Canadian Securities legislation, which we collectively refer to as forward-looking statements. Such statements reflect the company's current views and intentions with respect to future results or events and are subject to certain risks and uncertainties which could cause actual results or events to vary from those indicated in forward-looking statements. Examples of such risks and uncertainties are discussed in our disclosure documents filed with the SEC or the Securities Regulatory Authorities in certain provinces of Canada. Because of these risks and uncertainties, investors should not place undue reliance on forward looking statements. The forward looking statements made in this conference call are made of as of today, and the company undertakes no obligation to update or revise any forward looking statements except as required by law. The first for the first quarter financial news release, including the related financial statements are available on the SEC’s website. I'll turn it over to Casey to get things started.

Casey Hoyt

Analyst

Thank you, Todd. Good morning, everyone. Thank you for joining our call today. We'd like to begin by acknowledging the dedicated team of respiratory therapists, behavioral health specialists, staffing professionals, and administrative support staff who work tirelessly to deliver the best in class care to our patients living within the communities we serve. As of March 31, our VieMed family of employees grew to 662. Compared to the same time last year, our total headcount grew by over 25%. We continue to believe our investments and dedication to our people drive a unique company culture that ultimately helps differentiate our home delivery model from the competition. This has certainly contributed to our success in being able to acquire and develop good people amongst the battle for talent throughout the country. As a result of this robust hiring growth, we were able to organically enter four new territories in the first quarter of 2022. Through our hands on training programs, evolving middle management, and a new recruiting platform inside of VieMed healthcare staffing, we are on our way to achieving the territory growth goals set at the beginning of the year. In addition to the internal recruiting engine that VieMed healthcare staffing has provided, high contract demand and successful sourcing activities has resulted in an incredibly strong start to revenue generating external services. In its first full quarter as an operating division, the experienced team that we built at VHS generated over 1 million in revenues. We are very optimistic about the growth and synergies that VieMed healthcare staffing contributes to our organization. The geographic and service offering growth during the quarter was combined with exceptionally strong growth in our historic business activities. As the impact of the Omicron variant began to weaken early in the quarter, we finally witnessed a…

Todd Zehnder

Analyst

All right, thank you, Casey. In reviewing the financial results all five years are in US dollars and the full results have been made available on the SEC website, as well as SEDAR. Our core business generated net revenue of $30.2 million during the first quarter of 2022 as compared to net revenues of $25.5 million in the first quarter of 2021, which equates to an 18% increase. Our sequential growth for the core business was 4%. We have once again seen solid growth in our major product lines being vents, PAPs, and oxygen. During the first quarter, we generated approximately $2.1 million of revenue from our other sources, primarily the vaccine tracing revenue generated during the quarter with our call center. We still have an established unit in place at this time, it can scale up or down in a very short period, therefore we will continue to pursue these opportunities in the future. Our margin percentages, both gross and EBITDA, are once again very healthy, and are primarily influenced by our core business. As our product lines continue to diversify, there might be some influence on these margin percentages, but the notional growth is the main priority for the business. Our gross and EBITDA margins during the quarter came in at 61.2% and 22.5%, accordingly. Our first quarter gross and EBITDA amounts came in at $19.7 and $7.3 million respectively. We are once again encouraged by the rapid growth of our oxygen and sleep businesses as they continue to benefit from our ongoing national rollout of these products. Our first quarter revenue from vents was approximately 71% of our core revenue, as compared to 80% in the first quarter of 2021. Importantly, our vent revenue has grown during the same time, but the product diversification is beginning to…

Casey Hoyt

Analyst

Thanks, Todd. To sum up the overall theme of the first quarter, I would say execution fueled by demand driven by return to normal course of business. I'm very proud of our management team as it specifically relates to the performance metrics on recruiting, acquiring, and developing talent. I've watched our sequential improvement since the beginning of the pandemic on talent development and driving processes that helped rapidly increase our organic growth. At VieMed, that we never take our eye off the ball as it relates to the growth strategies that got us to this point. We do however, pay close attention to what the future holds. As I think about the strategies ahead for growing our business in a different way, I can categorize them into four buckets. First, getting acquisitive with expanding our payer and geographical footprints. We know that our growth can be achieved in a faster way through finding companies that have different payer contracts with possibly different patient populations in areas that we're not physically in just yet. We don't have an acquisition report on yet we continue to analyze these businesses and hope to execute on this strategy soon. Second, hospital partnerships. Being in position to help drive the continuum of care from the facility to the home and the way that we are viewed as a valued partner. Initiatives are well underway to provide further solutions to our referral sources, allowing them to be in position to treat a growing Medicare population of patients. Third, as that solutions provider, we must be willing and nimble enough to offer solutions that have the highest demand for our referral partners. The staffing and behavioral health divisions are great examples of us providing this type of deliverable while still complementing our core business. And lastly, business development through the expansion of national payer contracts. As payers evolve into a more value based world, as a clinically focused organization who can prove positive outcomes through the lens of data technology, VieMed becomes an essential piece of the puzzle in treating large populations of patients in a way that saves money. These are the four areas of focus that will drive tremendous growth for VieMed and ultimately drive shareholder value in the future. This concludes our prepared remarks. I want to thank everyone for taking time to join our call today and look forward to answering further questions. Thank you.

Operator

Operator

Our first question is coming from the line of Brooks O'Neill with Lake Street Capital Markets. Brooks O’Neil: Thank you very much. Good morning, guys. I have a couple questions. I might have gotten distracted briefly in the middle of your prepared comments, which I thought were excellent by the way, very comprehensive, but I'm curious if you commented at all about sort of the month to month progression that you saw during Q1 in the core business. And any comments you have relative to April would be extremely helpful.

Todd Zehnder

Analyst

No, we did not make any comments about that, Brooks. But I can give you a little bit of additional info. I mean, obviously the first quarter began with Omicron affecting our country. And while it didn't swell up the hospital system, we had a bunch of employees and referring physicians that just went down with it. So I would say that January and February were very much lighter than March, which is a good trend. And March and April, if you stack those on top of each other are the two best collective months that we've seen back to back since the pandemic began. Brooks O’Neil: Great. I was hoping you'd say something like that. And it sounds like business is pretty much returned to normal, would you say at the end of April?

Todd Zehnder

Analyst

I'd say yes. I mean, it's as close to normal as we've seen. And I think, we can't sit here and say that we're having a bunch of restrictions out there around the country. Have things changed some? Yes. I mean, the whole world changed some, but are we back to where we think we can grow this company like we did pre-pandemic? Absolutely.

Casey Hoyt

Analyst

I would just add to that, and say that I've talked a lot about talent development and acquisition and training, the training programs that we evolved throughout the pandemic, when we were kind of sitting on the bench, if you will, are really paying off right now. We’re seeing a lot of our sales reps, whereas we would normally have five or six superstars per month, we're now seeing that we're having 11 and 12 show up, and it's a direct correlation in my mind to all of the development and training that we added along the way through project next level, which we were talking a lot about last year. So we're seeing a lot of those efforts come to fruition. Brooks O’Neil: Great, Casey. And I mean, I took from your comments that you're not feeling constrained in your ability to hire the kind of respiratory therapists or other professionals or other team members that you need to aggressively grow the business going forward.

Casey Hoyt

Analyst

Not as it relates to the labor shortage or anything like that. It's -- we still have the same constraints that we always had, it’s just finding the right people, the clinicians that we're often trying to convert into salespeople. But the good news is that VieMed healthcare staffing is proven out to be a great internal recruiting platform that's helping our sales managers be more efficient with just monitoring day to day things with the sales force and kind of taking recruiting out of their world. And that's proven to be very efficient and effective. And so these guys are still, I would consider, getting things going and haven't hit their complete stride just yet, but every day gets better and better. So I'm really excited about that infrastructure change that we made. Brooks O’Neil: Great, great. So you guys know, I'm getting a little older. So I can sometimes not remember all the numbers that were in place pre-pandemic. But I kind of have a recollection that organic growth in the 30 to 35% range. What's kind of the target? Am I thinking about that right? And I might think -- is it reasonable to think that your goals would be the kind of try to get back there? Recognizing that there have been changes in the business and as you scale, that that kind of a number gets tougher?

Todd Zehnder

Analyst

I think those are all fair comments, Brooks. We are targeting in that 30 to 35% range. I'm not sure if we got it every quarter or every year. That we -- pre the pandemic, but that is sort of what we wake up striving for. And I think the comment that the -- I'm not sure about the change in the business, as much as just the law of bigger numbers becomes a little bit more difficult. But that doesn't mean that's not what we're striving for. And look, what we always go back to, I think the number as of right now is 94% of what we define as the potential market is untapped. So there are plenty of patients who need our services, we've just got to continue to execute on going to find them. Brooks O’Neil: Yes, that's great. Let me just ask you one more. I think I recall that you sort of quantified your exposure with this current OIG review in the range of sort of a maximum of 5 million bucks. Again, am I remembering that correctly? And is that still kind of the sort of worst case scenario you see for what's going on out there with those guys?

Todd Zehnder

Analyst

That I got to correct you on that one. I can't call it your old age, you just probably had one slip up, but it was actually a $9 million total exposure. And that continues to remain. And like I said, we're hoping to get their review here hopefully in the next 30 days. That's kind of what we're anticipating. And we can update everybody at that point. Brooks O’Neil: Okay, great. Thanks again for taking my questions. Congratulations on the great job you're doing out there.

Operator

Operator

Our next question is coming from the line of Nick Corcoran with Acumen Capital.

Nick Corcoran

Analyst

Good morning. I think Brooks asked most of the question I have. The one thing that I don't think you addressed earlier was the bad debt expense from the quarter was higher than the typical run rate. Can you maybe give a little bit of color on what happened in the quarter? And what your expectation for the year will be?

Todd Zehnder

Analyst

Yes. Thanks, Nick. We did take a higher bad debt percentage in this quarter. We have traditionally always said the first quarter is the most difficult with deductibles resetting and just new insurance plans and people change insurance and so forth. So it's kind of the toughest time for us from a billing and collection standpoint. And that we've been on a new workflow system for a period of time, we're getting better at looking at what our realizations and how much reserve we need. So we took a higher percentage in the quarter. I would anticipate that our total annual percentage should remain the same if not get better than last year. We have consistently over the last few years, gotten probably 100 or 200 basis points better in our collection efforts. So I'm hopeful that that happens. I'm pretty confident that the year over year bad debt will remain consistent. It's just that we’re going to be a little bit, I guess, more accurate on a quarterly basis.

Nick Corcoran

Analyst

Great. And then your Q2 guidance shows strong year over year growth and sequential growth. How should we think about the remainder of the year? Like, can you keep that growth up? Or do you think it will come down a bit?

Todd Zehnder

Analyst

That's obviously a kind of ties into what Brooks' question was as well. We are hopeful that this sequential growth continues. And if you do, you're starting to stack up. I think our midpoint was something around 6% to 8% or, our range was 6% to 8% sequential. If you do that, then you're on your way back up to that 25% to 35% growth range. That's not formal guidance. We don't have formal guidance out there, but we show up every day hoping to get back to those lofty ranges that we used to hit.

Operator

Operator

Our next question is coming from the line of Doug Cooper with Beacon Securities.

Doug Cooper

Analyst

Good morning, guys. Good quarter. Just getting back to the growth looks to my model, if you hit this upper end of the range in Q2, it'd be the best year over year growth quarter in the core businesses Q1 2020. So yes, pre-pandemic. The year via growth and vent patients this quarter was about 10%, core revenue growth up 18%. So diversification, is working. What is the outlook for the increase in the vent patients in particular, I mean, obviously, you're doing a great job in the CPAP, and oxygen, so forth.

Casey Hoyt

Analyst

It's no different than what we saw pre-pandemic. I mean, we, like Todd mentioned, we're still after that underserved population, the 94% of folks that need us. We got to continue to get our studies out there that prove the mortality rates decreasing and the reduction in hospitalizations and ER visits, which are ultimately leading to savings. All that science and data that we've developed is going to be key in really moving the market penetration needle. But our game to get to the VIP business is no different as it relates to finding people, getting them in good areas, getting them up and running, and trained to walk and talk the VieMed way. I'd like to think that hospital partnerships and really getting inside of the hospital becoming more of an extension of their continuum of care is the next way to really hit the core business in a different way. And so we're in the midst of those kinds of discussions. And certainly, the ability to use staffing as a lead in to help our hospital partners is key right now because they're just yearning for more clinical staffs. We’re able to help, and then the next conversation is okay, well, we're helping here and staffing, but how can we further help you into the home with treating these respiratory patients in a unique way. And so that's going to be something that we really try to hone in on and focus on in 2022. And we hope that just ends up being another organic growth strategy.

Doug Cooper

Analyst

Casey, mentioned that you're going into four new territories and Q1 and you're on track to hit your goals. Can you just remind us what the goals for new territories is this year?

Casey Hoyt

Analyst

I believe we said 25 last quarter is the new goal, or 28 -- it’s either 20 or 25. But we're looking good on that as we're sitting here in April two, we're increasing our rate from the first quarter. And so we hope to stay on track for that. But last year, and the incremental number was five, Doug, so the fact that we added four in the first quarter is a good sign that we're on track to hit that goal are pretty close, at least.

Doug Cooper

Analyst

Okay. And, can you give us an idea of your, say you hit the goal of 20-25 new territories, what would be your geographical penetration of the US at that point? Just to give us an idea.

Casey Hoyt

Analyst

It's we're in 45 states with where are respiratory therapists have patients, and we're treating patients. So that's kind of how we highlight a state. But again, we're not in New York, and I'll just use that as an example of it, but it's not on the top of mind to get into New York. We can classify a new area in a state that we have really good coverage, but it's 60 miles down the road, but it is an incremental new area with a new rep, a new set of respiratory therapists, new hospital system, it's basically like starting up a new business. And we made that change at the beginning of the year to not talk about just where we're hiring reps, because reps can come and go, but that area, that incremental new business area is the way that we want to start reporting it because just because a rep comes and goes doesn't mean that we can't sustain and maintain in a new area. And so, I think it's the right way for you guys to think about how we're growing versus just tracking our new hires. Those sales reps do so many different things. We have hunters, we have farmers, and we have assistant sales reps, and so on and so forth. So it's just -- it wasn't right, just tracking it that way. It's better to just watch it for new areas.

Todd Zehnder

Analyst

And I'll add one other context is that like in the case of states, we used to talk about states and a lot of detail and so forth. And when we just to put it in context, I think we have eight sales reps in the state of Louisiana. I think we only have one in California. So calling those that were in both of those states, we know that there's a ton of runway in California, right, just because of the pure size and population. So Casey is right. We're serving patients, I think in 45, but the density that we have available to be in those states is just tremendous.

Doug Cooper

Analyst

And does that correspond to data like you get a national payer contract? Is that going to be ease your entry in this or expansion or entry into some of those areas you’re not in?

Todd Zehnder

Analyst

Yes, it's always easier to go into a state when you've got good contracts already, it just gives the sales force so much more ability to impact patients’ laws and to take all patients from referral sources. And that's always a challenge. So as we move into state, it does take us some time to get our model out there and to get new insurance contracts. But we've done pretty good at doing that overtime.

Doug Cooper

Analyst

Okay. My last one is for me, Todd, you said he started buying stock back March 10. Is that right?

Todd Zehnder

Analyst

Yes, that was the date that we were able to go live.

Doug Cooper

Analyst

Okay. And what was the average price of the stock you would you buy back? Do you have that?

Todd Zehnder

Analyst

I don't have it. I know it's in the filing. I think through March -- I mean, through March 31. It was like 475 485, something like that.

Doug Cooper

Analyst

And if you continue to buy stock back in this quarter?

Todd Zehnder

Analyst

We do. It was actually 484. I just saw the number 484 for the average. And we have -- we continue to buy -- I can't give numbers yet. I have to give them at the end of the quarter, but we’ve pretty much been buying every day.

Doug Cooper

Analyst

Okay, great. That's it for me. Thanks for your beautiful outlook for you guys. Nice. Thank you very much.

Operator

Operator

Our next question is come from the line of Prasath Pandurangan.

Prasath Pandurangan

Analyst

Hi, good morning. Thanks for taking my question. I just have the one unanswered. Could you talk about the margin structure and growth prospects for the staffing solutions business related to the core business?

Todd Zehnder

Analyst

The staffing margins currently, we're running, I don't have an exact EBITDA margin, but I think it is accretive to the business currently. And it really depends on the type of contracts we have. I think over time, as we become more of a traditional -- or a piece of the business becomes more traditional staffing, it could be running at a lower EBITDA margin than the core business. But thus far, because we've been more of what I guess would be defined as placement revenue generation and more of just a fee based business instead of just gross salaries and expenses. It has been a creative thus far. So we don't have a complete breakout just yet. But I do know that it did a little bit over a million dollars in top line revenue for the quarter.

Operator

Operator

Our next question is come from a line of Brooks O'Neill with Lake Street Capital Markets. Brooks O’Neil: Sorry, guys, I was listening to Doug's question, and it occurred to me I'm not sure I know the number of total business series you're in and I can imagine, and I'm not this kind of a modeling guide myself, but I can imagine that 60 miles down the road from New York City, there's a lot of people 60 miles down the road. From some place in rural Louisiana, there might not be that many people, but how do you think about the number of territories you have? And any way you think about what's left to go after out there?

Todd Zehnder

Analyst

We're going to have to get back to you on that, Doug. I think the numbers in the 60s right now. And it's not like we're not disclosing, we just -- we don't have it in front of us. But we've got probably about 80 total sales reps if I had to guess and some of those are in -- like in one area. So it's probably mid-60s. And we'll just have to ping you later offline. Thank you. There are no further questions at this time. I would now like to turn the call back over to Casey Hoyt for any closing comments.

Casey Hoyt

Analyst

Well, thanks, everyone for joining the call. We appreciate all of your thoughtful questions and look forward to continuing to drive shareholder value. Have a nice day.

Operator

Operator

This does conclude today's teleconference. We appreciate your participation. You may disconnect your lines at this time. Enjoy the rest of your day.