Vivos Therapeutics, Inc. (VVOS) Q4 2025 Earnings Report, Transcript and Summary

Good day, everyone, and welcome to the Vivos Full Year 2025 Earnings Conference Call. [Operator Instructions] This conference call is being recorded and a replay of today's call will be available on the Investor Relations section of Vivos' website and will remain posted there for the next 30 days. I will now hand the call over to Brad Amman, Chief Financial Officer for introductions and the reading of the safe harbor statement. Please go ahead.

Thank you, operator. Hello, everyone, and welcome to our 2025 conference call. A copy of our earnings press release is available on the Investor Relations section of our website at www.vivos.com. With me on the call today is Kirk Huntsman, Vivos Chairman and Chief Executive Officer. Today, we will review the financial results for the full year 2025 as well as more recent developments and Vivos' plans for 2026 and beyond. Following these formal remarks, we will be happy to take questions. I would also like to remind everyone that today's call will contain forward-looking statements from our management made within the meaning of Section 27A of the Securities Act of 1933 as amended and Section 21E of the Securities and Exchange Act of 1934 as amended, concerning future events. Words such as aim, may, could, should, projects, expects, intends, plans, believes, anticipates, hopes, estimates, goal and variations of such words and similar expressions are intended to identify forward-looking statements. These statements involve significant known and unknown risks and are based upon a number of assumptions and estimates, which are inherently subject to significant risks, uncertainties, contingencies many of which are beyond the company's control. Actual results, including, without limitation, the results of Vivos' growth strategies, operational plans, including sales, marketing, distribution, medical sleep provider, acquisition and integration, research and development, regulatory initiatives, cost savings plans and plans to generate revenue as well as future potential results of operations or operating metrics such as the potential for Vivos to achieve future positive cash flows or profitability and other matters to be addressed by Vivos management in this conference call may differ materially and adversely from those expressed or implied by such forward-looking statements. Factors that could cause actual results to differ materially include, but are not limited to, the risk factors described in other disclosures contained in Vivos' filings with the Securities and Exchange Commission, including the risk factors and other disclosures in our Form 10-K for the year ended December 31, 2025, which was filed with the SEC today our interim quarterly reports and other filings with the SEC, all of which are -- or will be accessible on the Investor Relations section of the Vivos website as well as the SEC's website. Except to the extent required by law, Vivos assumes no obligation to update statements as circumstances change. Finally, please be aware that the U.S. Food and Drug Administration has given certain specific Vivos appliances, 510(k) clearance to treat mild to severe OSA with the FDA clearance of certain Vivos products for severe OSA in November 2023 and moderate to severe OSA in children ages 6 to 17 years of age in September of 2024. Treatment of patients with severe OSA with these specific appliances is no longer needed to be performed off-label at the clinical discretion of the treating doctor and is now an integral part of the Vivos treatment protocol. Treatment of OSA of any severity or any other condition with any other of Vivos FDA-cleared devices remains at the clinical discretion of the treating doctor. For further information on our results for the years ended December 31, 2025 and 2024, please see our earnings release which was distributed earlier today and our annual report filed on Form 10-K, which is available on the SEC filings portion of the Investor Relations section of our website. With that, I'll turn to a discussion of our 2025 year-end results. In the fourth quarter of 2025, Vivos completed its second full quarter of activity following our June 10, 2025 acquisition of the Sleep Center of Nevada, demonstrating that our pivot of our sales, marketing and distribution model has taken hold. Overall, revenue was positively impacted by the sales strategy shift and focus towards sleep center affiliations. The full year 2025 revenue increase of $2.4 million or 16% was due primarily to an increase of approximately $4.8 million in sleep testing services and an increase of approximately $2.2 million of revenue generated from the treatment to patients launched at 2 of SCN's 7 sleep center locations. The increase in revenue during the year was partially offset by the decline in product revenue to our legacy VIP dentists of approximately $1.4 million in appliance and tooth positioner sales. Additionally, we had a decrease in service revenue of approximately $2 million in our VIP enrollment revenue and a decrease of $700,000 in sponsorship, conference and training related revenue. As we pivoted our business model to a medical provider focused business strategy and reduced our dependence on enrolling and training VIP dentists to sell our products, we fully expected revenue from these legacy programs to decline. For the year ended December 31, 2025, we sold 25,441 oral appliances and tooth positioners for a total of approximately $6.5 million, an 18% decrease in revenue from the year ended 2024, when we sold 16,182 oral appliance and tooth positioners for a total of $7.9 million. The revenue decrease is directly attributable to an increase in discounts offered during the same period with $1.6 million in discounts offered during the year ended December 31, 2025, when compared to approximately $200,000 of discounts offered during the year ended 2024. Coupled with an increase in tooth positioner sales, a lower price point product when compared to Vivos more advanced appliances. We will discuss this more in a bit, but now that we've gotten through the initial integration phase of SCN, including the achievement of critical insurance coverage for our more advanced OSA appliances, we are expecting more revenue from higher price point products in 2026 and beyond. Cost of sales increased by approximately $900,000 or 15% to $6.9 million for the full year ended 2025 compared to $6 million for the year ended 2024. This was primarily due to approximately $1.1 million in higher costs in diagnostic services related to new sleep center affiliations and an increase of $0.5 million related to additional staff associated with the sleep center affiliations in both Nevada and our Detroit affiliated center. Gross profit was $10.5 million for the full year ended December 31, 2025, compared with $9 million for the full year ended December 31, 2024, an increase of 17%. The 17% increase in gross profit during the full year 2025 compared to 2024 was attributable to an increase in revenue of approximately $2.4 million, offset by an increase in cost of sales of $900,000. Gross margin remained constant at 60% for the years ended December 31, 2025 and 2024. Operating expenses for the first -- for the full year ended December 31, 2025, were $30.4 million compared to $20.2 million for the full year ended 2024. This increase resulted primarily from an increase in general and administrative expenses related to our new model. General and administrative expenses increased $9.8 million to $27.7 million for the year ended 12/31, 2025 compared to approximately $17.9 million for 2024. This increase was primarily due to $6.7 million in costs associated with running SCN operations and related Vivos treatment centers. In addition, we incurred approximately $1.6 million related to professional fees, most of which were onetime expenses and $800,000 associated with salaries and wages in Vivos personnel as well as infrastructure costs of approximately $600,000 when compared to the year ended December 31, 2024. Sales and marketing expenses decreased by $300,000 to $1.4 million for 2025 compared to $1.7 million for 2024. This decrease was primarily driven by a $200,000 decrease in commissions as well as a $100,000 decrease in convention and trade show expenses. This is again attributable to our focus on bringing SCN online rather than our legacy business model. Depreciation and amortization expense was approximately $1.3 million for the year ended 2025 compared to $600,000 for the year ended 2024. Depreciation and amortization increased due to an increase in depreciable assets related to the SCN asset acquisition and additional depreciation on affiliations model assets. For the full year ended December 31, 2025, our net loss increased to $21.2 million, reflecting higher costs of our strategic transition during the year. Approximately $1.4 million of expenses were onetime out-of-pocket costs. In addition, resources were used in recruiting and training staff, rightsizing the team in anticipation of demand and procuring space and equipment requirements. Regarding cash flow, net cash used in operating activities amounted to approximately $15.3 million and $12.7 million for the years ended December 31, 2025 and 2024, respectively. As of December 31, 2025, we had total liabilities of approximately $26.7 million compared with $7.3 million as of December 31, 2024, reflecting the debt we incurred to acquire and fund SCN. As of December 31, 2025, we had approximately $2 million in cash and cash equivalents. Subsequent to the end of fiscal year 2025, on January 16, 2026, we announced that we raised $4.6 million in gross proceeds from a warrant inducement transaction. On April 7, 2026, we announced the completion of a private placement with our existing private equity investor, New Seneca Partners raising gross proceeds of $2.25 million. These financings bolstered our post year-end stockholders' equity, which we need to continue to augment with additional equity financing in order to stay in compliance with NASDAQ's minimum stockholders' equity requirement. In summary, we're seeing significant increases in revenue reflecting the acquisition of SCN and related treatment revenue from providing patients with OSA treatment options, which is extremely encouraging. We are also seeing increased costs from hiring SCN personnel on the diagnostic side as well as additional hiring on the treatment side. We believe the strategic move to acquire SCN and other potential affiliate alliances and acquisitions set the stage for stronger performance in the coming quarters. For more detailed information, I refer to you to our earnings release and our full Form 10-K filed today. With that, I'll now hand over the call to our Chairman and CEO, Kirk Huntsman, to discuss the progress we have made to date on SCN, our Detroit affiliation and our business generally. Kirk?

Thank you, Brad. Good afternoon, everyone, and thank you for joining us on today's conference call. After many years of actively searching for a business and distribution model, capable of more fully realizing the monetary and profit potential of our advanced proprietary technology, we are pleased to announce today that we are beginning to see the emergence of the very kind of improved financial results we always believe were possible. As we moved to acquire Sleep Centers of Nevada in June of 2025, we said we believed that our new business and distribution model could deliver impressive financial returns for the company as many more patients would be exposed to and select Vivos treatment. And whereas the company would, at the same time, have far superior economics as compared to our legacy VIP model. Today, we are pleased to report that our MSO DSO provider support model as implemented at SCN there in Las Vegas has proven to be everything we expected it to be. As a result of our emerging momentum and success in Las Vegas at SCN, many other revenue and profit opportunities are also emerging, which we believe will further grow and expand our top line revenue with strong margins and enhanced patient outcomes. Thus, 2025 was a pivotal year for Vivos, a year in which we proved our core thesis around patient demand and preference for our Vivos method over other more traditional treatment modalities such as CPAP or surgery, a year in which we experienced strong clinical support and endorsement from actual medical sleep specialists a year in which we took great strides forward with insurers towards providing more comprehensive coverage for our treatments and a year in which our pathway forward came boldly and clearly into focus. As Brad mentioned, in 2025, we grew full year revenue by 16%, something we regard as quite an achievement, considering that much of our financial gains from the SCN transaction were directly offset by revenue losses attributable to our strategic pivot away from our prior market selling through dentists. We also maintained gross margin despite significant ramp-up investments in our sleep testing and treatment services and the integration of the Sleep Center in Nevada. So while our 2025 operating loss includes material onetime upfront investments in this new model, we believe these actions, together with recently announced significant cost savings initiatives and strengthened capital structure have now positioned Vivos to drive higher top line growth, better contribution margins and a clear path forward towards our goal of cash flow positive operations by the end of this year. Of course, in June 2025, we completed the acquisition of SCN and have been ramping up our operations there in Las Vegas. Generally speaking, what we found there since closing the transaction in early June has been extremely encouraging. We note that the enthusiastic endorsement of Vivos treatments by medical specialists at SCN who have been patiently waiting many years for a viable alternative option to CPAP for their patients has been critical to our ultimate success in that market. Thus far, we have seen many more OSA patients from SCN who are interested and willing to accept Vivos treatment as alternatives to CPAP than we had forecast. So much so that we have expanded the physical facilities and also our staffing and number of clinical providers to handle the patient demand. No doubt, it has taken time, investment and hard work to integrate SCN into our operations, and more work remains to be done. But put simply, these important efforts are starting to pay off. Notably, we recently announced that SCN has received notices of in-network status with a number of commercial health insurance payers, along with participating status with Medicare. We believe this major development, along with the addition of several newly trained providers will positively impact patient access to our patented and proprietary OSA treatments and modalities and the resulting top line revenue and gross profitability from operations in that market. The insurance payers now covering our SCN operations collectively cover a substantial portion of the insured population in the greater Las Vegas metropolitan area, representing what we believe to be a significant addressable patient population for both OSA testing and treatment. Central to our efforts to build revenue and momentum across all markets has been our creation of what we call Sleep Optimization or SO teams. Each SO team consists of approximately 16 medical, dental and support staff who are all specially trained and equipped by Vivos. The primary focus of each SO team is to ensure that each and every patient is fully informed and educated about all treatment options and what might be best for their condition and situation, and then to assist them in getting into their treatment of choice, which most of the time involves treatment from Vivos products and services. Our operational growth plan is driven by our deployment of our SO teams, each consisting of one nurse practitioner or physician's assistant and 2 specialty trained dentists, employed by an independent medical or dental professional corporation, 6 dental assistants, 6 administrative support personnel and 1 treatment navigator. These SO teams can be dedicated to high-demand locations or spread across multiple locations as circumstances dictate. We currently have approximately 1.5 SO teams deployed across 2 SCN locations and expect to have additional partial or whole SO teams deployed during 2026. We anticipate an initial ramp of up to 60 days for SO teams to become fully functional and up to 6 months or longer before net revenue collections match revenue-generating activities such as OSA Diagnostic Services or OSA treatment case starts. Based on the current volume of OSA patient demand, we believe the current addressable market served by SCN could support several additional SO teams, especially if certain planned growth initiatives and patient referrals meet expectations. Such initiatives include, but are not limited to, the expansion of diagnostic and treatment services, the establishment and rollout of a pediatric OSA program and the collaboration with certain specialty medical groups who treat patients with comorbid OSA who lack the ability to test, evaluate and treat such patients within their existing practice environments. Keep in mind that there are well over 240,000 OSA patients that have been tested and seen by SCN providers since 2019. Based on our experience to date, we believe our limiting constraints for near-term revenue growth at SCN have been: one, insufficient physical space to see an optimal number of patients; two, an adequate number of providers and staff recruiting, training and onboarding; and three, customary issues with third-party payer credentialing. At the end of 2025, our operations at the 2 SCN locations we have onboarded were fully booked for appointments through April of 2026, and we were processing what we believe were less than 40% of patients attempting to get appointments for treatment. Our 2 greatest barriers to servicing more OSA patients at that time we're a lack of Vivos train providers and delays in obtaining full access to most major insurance carriers. As I mentioned, we have made good progress in both areas since then, although further work remains. We are working to fully meet current demand by adding SO 2 teams, further insurance participation access being granted and additional facility space is made ready. We view this as significant upside potential for Vivos. Our initial average case revenue and acceptance rate for Vivos treatment at SCN to date based on a limited number -- or limited period of operations at 2 of SCN's 7 locations suggests that each SO team could potentially generate collections well in excess of $500,000 per month, net of adjustments with contribution margins well above 50%. In addition to current Vivos diagnostic and treatment options, we expect to be able to offer SCN patients additional diagnostic and treatment services that could generate and will generate, we expect, additional revenue. Our operational experience in Las Vegas at SCN is proven to be invaluable in terms of providing numerous additional revenue and profit growth opportunities and also positioning us as the clear market leader with several competitive advantages. No other sleep testing or treatment center in Nevada or elsewhere in the United States offers patients the full range of treatment options, including the ability to rehabilitate and restore their airway health like we do nor does any other testing or treatment center offer patients the kinds of adjunctive treatments and services that we offer, such as CO2 laser treatments, myopia functional therapy and home EEG testing or alternative treatments for insomnia, excessive daytime drowsiness, chronic sinusitis or other sleep disorder related conditions. We believe our particular combination of such services represents a much needed evolution over the traditional CPAP-only type treatments that are currently the norm across the United States today. Each of those services enhance patient care and clinical outcomes while adding significantly to our overall revenue and profit potential. Perhaps most importantly, as news of our relationship with SCN has spread throughout the medical community, we have begun fielding inquiries from across the United States from rather large medical specialty groups such as cardiologists, neurologists, functional medicine doctors, primary care groups, hospitals and others. And while each group may have their own individual reasons for reaching out, they all tend to share 1 thing in common, a large majority of their patients have obstructive sleep apnea and their OSA is rendering whatever other health conditions they may have, such as diabetes, cardiovascular disease, hypertension, Alzheimer's, depression, et cetera, much, much worse. One prominent cardiologist recently said to me, "Kirk, obstructive sleep apnea is cardiovascular disease. We now know that and it is rocking our cardio interventions and killing our patients prematurely if they don't get the help they need to identify and treat it." These groups all say basically the same thing, that they are not sleep specialists and thus are ill prepared to treat their patients sleep and breathing disorders. They need someone else to handle it for them and Vivos is very well positioned to do just that. We are currently exploring partnering and affiliation opportunities with several medical specialty groups in various parts of the United States. Each of these groups report treating between 20,000 and 40,000 patients per month within their specialty and tell us that they believe 85% to 90% of those patients also have obstructive sleep apnea, with most of them undiagnosed and untreated. Creating these affiliations and optimizing them will come with financing and other challenges such as we've dealt with at SCN, but the prospect of replicating our new model around the country has us excited. One significant benefit of our affiliation model as opposed to our acquisition model, is that it is much more capital efficient than a pure acquisition model. Typical capital outlays for an affiliation are under $1 million a piece, while similar sized acquisitions may require 10 to 15x as much capital. Moreover, affiliations typically preserve about 75% to 80% of the economics for the company. Typically, in each affiliation, we will seek to collaborate with local medical groups to enhance the diagnosis and treatment of their patients with OSA through a regulatorily compliant services and support model suited to each circumstance, but largely patterned after our Sleep and Airway Medicine Center, what we call SAMC model in Nevada with SCN. We believe the SAMC model not only meets the clinical and medical requirements of both patients and providers, but also present significant revenue-generating opportunities for Vivos. For reference, our current revenue per case in Nevada averages just under $5,000 with contribution margins above 50%. We expect those figures to improve further as we continue to roll out additional diagnostic and treatment modalities, some of which are already underway. I would also like to take the opportunity to point out some significant progress being made by our research and development team led by Dr. Bahar Esmaili at our Highlands Ranch Clinic in Colorado. Her team's efforts there are showing what we believe are unprecedented and consistently positive clinical outcomes for patients with sleep and breathing disorders, many of whom are seriously ill and desperate for help and who have typically flown in from all around the world to receive treatment there in Colorado. We firmly believe that through the efforts of Dr. Esmaili's team in Colorado significant diagnostic and clinical breakthroughs are being made, such that later this year and throughout 2027, we expect to begin publishing key case studies and clinical results. In December, we announced the grand opening of our latest SAMC Center near Detroit in Auburn Hills, Michigan. Our opening in Auburn Hills signals the continuation of Vivos' national expansion strategy to leverage commercial affiliations with high-volume sleep clinics and physician on sleep and other medical practices to bring Vivos' proprietary line of FDA-cleared diagnostic and therapeutic products and services to tens of millions suffering from OSA and related health conditions, as I just referenced. We believe our new affiliation model will be very attractive to both medical specialty groups and more than accredited sleep center operators and owners around the country who may not want to be acquired but may instead be looking to grow their business and referral networks by offering a highly differentiated treatment package to OSA patients. We have several growth initiatives planned for 2026 and beyond, which have the potential to further increase our growth in current -- in our current and new markets. Such initiatives include the expansion of diagnostic and treatment services, the establishment and rollout of a pediatric OSA program, and the collaboration with certain specialty medical groups who treat patients with comorbid OSA, but who lack the ability to test, evaluate and treat such patients within their existing practice environments. Importantly, we have designed our model to be readily expanded and adapted to other locations throughout the United States. Our M&A team continues to field calls and inquiries from both acquisition and affiliation prospects around the country. As previously mentioned, we are currently in negotiation with several potential affiliation candidates in various key markets. Given our experience with SCN, we believe these opportunities should be similarly accretive. In summary, we believe our initial results with SCN are a strong indication of the potential upside for Vivos. As we roll forward, we expect to continue to modify and refine our model to make it even more efficient with the potential for even higher revenue and better gross margins. Furthermore, we fully expect that this model, including the potential for both acquisitions and affiliations is highly replicable and scalable across multiple markets. As it expands, we expect that we'll continue to be highly accretive to top line revenue growth as well as create the potential for cash flow positive operations and bottom line profitability. We believe that this methodical effort patiently executed over time has put Vivos in a much better position to realize the full potential of our technological advantage in industry-leading products and services. Most importantly, perhaps, we believe this new model will now begin to help improve the lives and health of many more patients, who have up until now not had access to the kind of life-changing treatment that we provide. For all of us here at Vivos, that mission of improving lives and providing fresh hope to the tens of millions of Americans who suffer from breathing to sleep disorders is what drives us each and every day. Now that we found a business model to match the superiority of our technology, those aspirations are becoming a reality, and it feels great. That concludes our prepared remarks. Now we'll be happy to take questions. Operator?

[Operator Instructions] Your first question is from Scott Henry from AGP.

A lot of moving parts with the new business model. Just an observation followed by questions. Obviously, you did about $6.8 million in Q3 which dropped to $3.8 million in Q4, if I back out the 3 quarters, assuming that's accurate. Two questions. One, what happened in Q4 to make it lower than Q3? And two, we're already in April, what are your thoughts on Q1? Do you expect it to look more like the third quarter or the fourth quarter?

Okay. Great question, Scott. So listen, our new model is highly dependent upon total doctor days. We have to have providers who show up and are available to treat patients. And when providers are absent or provider -- or we have insufficient numbers of providers then our production necessarily declines. And that's exactly what we experienced in Q4. We had some challenges with some of our existing -- at the time, our existing provider group, most specifically are dentists. So we had -- some dentists have -- they had family problems, some of them had health issues, some of them had travel constraints, and we just had an unexpected and unforeseeable set of circumstances that whereby we lost a lot of -- we lost a few providers that we didn't expect to lose. And we set about immediately trying to recruit and train, but that doesn't happen overnight. And so throughout the fourth quarter, we struggled with that issue. We remedied it. We recruited an excessive number of -- what we believe an excessive number of providers. So we have some redundancy now. And as we move into Q1 and especially as we go further into Q2 here, we feel very, very good. Some of those providers to replace the ones that we lost were -- they came on throughout the quarter in Q1. So the full impact of having replaced these doctors and replaced the doctor base will start to be seen towards the end of Q1 and then into Q2. But that's a great question. And I think it highlights some new dynamics of our model, which are, we have to have sufficient dentists in network with payers and having them producing every single day. When a dentist doesn't show up for a day, it can be it can be $15,000, $20,000, $30,000 or more of lost production -- lost productivity. So if you have just a few days a week of doctors who you've lost doctor days with, it can make a significant impact on your monthly revenues pretty quick, and that's what happened in Q4.

Okay. So it sounds like we should see some improvement in Q1, but the bulk of it probably in Q2.

Yes. And there's a couple of reasons for that. It's doctor days, as I mentioned. And it's also, as we got towards the end of Q1, Scott, you'll see that in February -- or I'm sorry, in March, we announced that we had in-network access. We've been granted in-network access with a number of of payers. Well that in-network access just started to fold into the revenue productivity stream in the latter part of Q1. So yes, for all of those reasons, you'll see it start to fold into Q1, but most of the impact is going to be in Q2 forward. But it's a significant change. Both of those things combined are significant.

Okay. And then you mentioned possibly being cash flow positive exiting 2026. What kind of quarterly revenue run rate would you need to achieve that goal? Approximately.

Brad, do you want to take that?

Yes. I mean this analysis involves a revenue increase as well as reducing -- as you heard in our last press release, we trimmed some legacy VIP costs. So it's not just revenue, but there's costs associated as well. We were -- yes, $17 million for 2025, roughly on a run rate basis, we need to be close to double that by 2027 to hit that number going forward on a net income positive basis.

Okay. All right. Great. Just final question on the balance sheet. I see that $8.3 million in current portion of long-term debt. Do you have to deal with that in the next 12 months? Or what's the status of that situation now that it's classified as short term or current?

Yes. I mean when -- throughout the year when we're reporting that in our quarterly filings, that was long term, the maturity date on that is in 2026. So we've reclassified all of that in -- as short-term debt on our balance sheet.

Okay. And I guess you would anticipate rolling that over at some point?

Rolling it over or paying it off. I mean, so far, we have been compliant with the debt covenants on those pieces of debt. So we'd either raise capital to pay it off or you'll roll it over into additional debt and extend those terms.

[Operator Instructions] Your next question is from Robert Sassoon from Water Tower Research.

I've got a few questions actually. One, if we look at the leverage performance, can you speak to the year-on-year growth you saw in diagnostic and treatment revenue generated under the new model?

So I'm not sure exactly what the question is. Can you just clarify that?

On the growth in sleep testing services and treatment centers, is that is -- Robert, is that kind of what...

Yes, that's correct. Yes. That's correct.

I mean we had about $4.8 million in sleep testing service revenue over 2024. So we had about $6 million sleep testing service revenue in 2025. That increase of $4.8 million is entirely due to SCN, on the diagnostic side. On the treatment center side, in 2025, those diagnostics, people testing positive for OSA are what allowed us to recognize $2.2 million in treatment revenue. So in total, between those 2 buckets, the diagnostic of $6 million and the $2.2 million of treatment revenue is an increase of over $8 million of revenue, and that revenue is really where we think the growth is going to be. If you look at the full year, the total revenue was $2.4 million increase. That $2.4 million increase was offset had some VIP revenue decreased by $2 million and some of the other legacy items decreased accordingly. So the fact that we had an increase of $7 million to $8 million in new model revenue, that was offset by VIP revenue, which we totally expected. But going forward, that VIP revenue starts to roll off. So we won't see those big decreases in legacy revenue as we move into 2020 -- throughout 2026 and beyond.

Okay. Got it. So you mentioned your strategies to expand your alliance model. So what key lessons have you learned from the integration of SCN and how that -- will that shape your -- that particular expansion in alliance?

That's a great question. I would say we've learned how to work with medical doctors in a collaborative manner. We've learned how to coordinate treatment and care of patients across the various specialties. We've learned how to navigate the insurance payer community and how to also set up the entities that we need to be regulatorily compliant. So we have to navigate a number of different fronts to make these things come about. But once we get the structure in place for each situation and once we -- stuff them with sufficient providers and then put those providers under contract in-network with these payers, we have a significant -- I think, a significant advantage over anybody else coming into the market because this is a, as I think somebody else said, there are a lot of moving parts and there's a lot of structure that has to go into place, and it's not for somebody that doesn't understand it. So yes. So we have it down. We haven't figured out. We have it -- also we're in the process of contracting with a national firm that has insurance contracts across the country in each state, and all of those things accelerate by contracting with them, we will accelerate our in-network participation and the time to revenue generation is cut dramatically down. So those are lessons that I would say we've learned and we're applying them as we go.

Yes. You -- I have a couple of other questions. What is -- you recently announced a partnership with SoundHealth, are you seeing any traction from that yet? Or is it still early days?

Yes. We're -- it's still fairly early. But in Las Vegas, we're having trouble keeping those -- their units in stock. I think patient demand for that is good. I don't think that even if that continues on that, that will be a material aspect of our earnings or profits or whatnot. But the patient demand there has been -- has exceeded expectations and patients are loving the treatment, and we're seeking to expand that relationship.

Okay. So final question for me. Can you discuss your long-term growth prospects and explain why you're particularly excited about the opportunities ahead?

Well, look, we spent -- it seems like a long time wandering in the desert of trying to figure out what kind of business model we could deploy that would do justice to our breakthrough technology. And we really came to the conclusion back a couple of years ago that furthering our efforts down the path of the dental community was just not going to ever get it done. And so as we pivoted, we basically told the world that well, we've got a different way to do this, and we think this is going to work. And so we put forward that prospect. We went out on a limb. We sort of bet the farm here on what our experience was going to be out there at SCN. And -- I mean, to our great pleasure what's happened out there at SCN so far has been really, really good. And again, I know that it doesn't show up fully in the numbers. But the core underlying thesis that we had going into that acquisition in June of last year, our core underlying thesis that we could, in fact, generate great patient demand by intercepting the patients at the time that they are being diagnosed and deciding upon their treatment modality that at that juncture in the patient journey, that was the ideal juncture in which to introduce Vivos as an alternative to CPAP. And we bet that patients would rather fix their OSA in 9 to 12 months and prefer that option over going into a CPAP where they have to wear that thing for the rest of their life, every night. So we made that bet, that bet is paying off. We see further, as I mentioned in my remarks, the amount and number of clinical contacts that we've had with specialty groups around the country, hospitals, cardiology groups, neurologists, all these groups coming to us saying, we need what you guys are doing. We hear that you have something different than CPAP. Our patients don't like CPAP. They don't want CPAP. When can you come see us. And that kind of demand is something we're excited about. The cost to affiliate and set up SO teams in various markets is a fraction of what it costs for us to acquire these companies like we did with SCN. And so because of all those things, we are really, really excited about what the future holds. I mean, we used to talk about whether our -- whether patients were getting better, whether we were having clinical success, we're so far beyond that right now. We know beyond any shadow doubt that we have the best technology there is on the market today to treat and resolve obstructive sleep apnea. There's no question about it. Now the issue is how can we get that in front of as many people as possible.

Right. And do you think you're going to get over those sort of barriers that you mentioned earlier in terms of recruiting the right people, the right -- expanding the SOTs to be able to implement that?

Yes, I do. In fact, we've demonstrated that here in the first quarter. We've constituted the full measure of a team and a half out there in Las Vegas. We have additional doctors and providers, nurse practitioners and others ready to go for other opportunities that we're exploring right now. So we are -- I don't think that's going to be a limiting constraint in the future. I readily admit that it took us a little bit by surprise in Q4. We just didn't expect some of the attrition that we had in our provider pool. But now we know to have redundancy, to have the kind of team that is perhaps a little more robust than what we had planned for. But at the same time, the redundancy will pay dividends when we have providers who leave unexpectedly or have personal issues or whatever. So we're learning as we go, but I think we're in great shape to do that. There's no difficult -- we have no challenges recruiting doctors or recruiting nurse practitioners or recruiting staff members. Yes, we -- that's always what we're going to be doing, and it's going to be an ongoing effort as we roll forward. But there is no shortage of dentists or nurse practitioners or staff members available to work in our model. We just had to be out in front of that, and we got caught a little by surprise in Q4.

Anyway, it sounds like it's a pretty encouraging picture looking ahead.

Our next question is from Yi Chen from H.C. Wainwright.

Yi, are you there?

Yi Chen, your line is open.

All right. Operator, let's go ahead and close off. I don't think he's there.

Thank you. There are no further questions at this time. Please proceed with the closing remarks.

On behalf of Vivos, I would just like to express our gratitude and thanks for all of the investors and analysts and investment bankers and whatnot that have supported us over the course of time. I think it's been a little bit of a longer journey than any of us had hoped for. But we -- I think it's pretty clear from this report, we are more optimistic about the prospects for this company today than we probably have ever been. And the cooperation of providers, of the medical sleep community, of specialists, of payers, of all the different constituencies, which make this all possible is just so gratifying, and we are very pleased about all that. And I just want to express on behalf of all of us here at Vivos, a profound gratitude for everyone who's hanging there with us all these years. And I just know that the brighter days are ahead, and we're excited about this. And we think the future here at Vivos is very bright. So thank you very much, everyone, and have a great night and appreciate your participation today. Thank you.

Thank you. Ladies and gentlemen, the conference has now ended. Thank you all for joining. You may now disconnect your lines.