EX-99.1 2 radnet_ex9901.htm PRESS RELEASE

Exhibit 99.1

 

 

 

FOR IMMEDIATE RELEASE

 

RadNet Reports Second Quarter Financial Results with Record Quarterly Revenue and Adjusted EBITDA(1) and Revises Upwards 2024 Financial Guidance Ranges

 

·Total Company Revenue increased 13.9% to $459.7 million in the second quarter of 2024 from $403.7 million in the second quarter of 2023; Revenue from the Digital Health reportable segment (inclusive of intersegment revenue) increased 36.4% to $15.8 million in the second quarter of 2024 from $11.6 million in the second quarter of 2023
·Digital Health Revenue growth resulted in part from a $3.2 million (or 136.6%) increase in AI Revenue, which climbed to $5.6 million during the second quarter of 2024 from $2.4 million in the second quarter of 2023
·Total Company Adjusted EBITDA(1) was $72.3 million in the second quarter of 2024 as compared with $60.4 million in the second quarter of 2023, an increase of 19.7%; Digital Health reportable segment Adjusted EBITDA(1) increased 135.2% to $3.3 million in the second quarter of 2024 from $1.4 million in the second quarter of 2023
·Total Company Adjusted EBITDA(1) margins increased by 76 bps to 15.7% in the second quarter of 2024 as compared with 15.0% in the second quarter of 2023
·Adjusting for unusual or one-time items in the quarter, Adjusted Diluted Earnings Per Share(3) was $0.16 for the second quarter of 2024; This compares with Adjusted Earnings Per Share(3) of $0.10 for the second quarter of 2023
·Aggregate procedural volumes increased 9.2% and same-center procedural volumes increased 6.1% compared with the second quarter of 2023
·Completed a successful refinancing of our senior secured Term Loan and Revolver, reducing borrowing costs, extending maturities and funding approximately $168 million of additional cash to the balance sheet
·As of June 30, 2024, we had a cash balance of $741.7 million and Net Debt to Adjusted EBITDA(1) ratio of 1.1
·Previously announced acquisition of six American Health Imaging centers in Houston was completed on June 1, 2024; RadNet has begun the integration of these centers into the previously purchased Houston Medical Imaging operations
·RadNet revises full-year 2024 guidance levels to increase Revenue, Adjusted EBITDA(1) and Free Cash Flow(2) ranges

 

LOS ANGELES, California, August 7, 2024 – RadNet, Inc. (NASDAQ: RDNT), a national leader in providing high-quality, cost-effective, fixed-site outpatient diagnostic imaging services through a network of 398 owned and operated outpatient imaging centers, today reported financial results for its second quarter of 2024.

 

Dr. Howard Berger, President and Chief Executive Officer of RadNet, commented, “Both the Imaging Center and Digital Health reportable operating segments demonstrated strong growth and achieved record quarterly results. Total Company Revenue grew 13.9% as compared with last year’s second quarter to a record $459.7 million. The Digital Health segment Revenue of $15.8 million increased 36.4% from last year’s same quarter. The strong growth in Digital Health was, in part, driven by the AI businesses, whose Revenue increased 136.6% as compared with last year’s second quarter, mainly from the continuing success of the rollout of the Enhanced Breast Cancer Detection (EBCD) DeepHealth AI-powered screening mammography program.”

 

 

 

 1 

 

“Improved reimbursement from commercial and capitated payors, continued strong demand for advanced imaging modalities, the growth of the Digital Health businesses and effective cost controls resulted in an increase to Adjusted EBITDA(1) margins. Total Company EBITDA(1) margin of 15.7% during this second quarter increased by 76 basis points over last year’s second quarter.” added Dr. Berger.

 

Dr. Berger continued, “Including the recently announced joint venture with Providence Health System, a recent expansion of the Ventura County, California partnership with Dignity Health and certain new de novo centers we have opened within existing joint ventures, as of the end of this second quarter, we had 149 of our 398 centers (or 37.4%) held in partnership with leading health systems. These partnerships allow us to play a more integral role within the local healthcare communities we serve by increasing access, disseminating new technologies and improving the quality of patient care.”

 

“Given the positive trends we continue to experience in virtually all aspects of our business and the strong financial performance of the second quarter, we are revising upwards certain guidance levels in anticipation of financial results that we believe will exceed both our original expectations and the amendments we made to the guidance ranges upon releasing our first quarter 2024 results in May. We have increased 2024 guidance ranges for Revenue, Adjusted EBITDA(1) and Free Cash Flow(2),” added Dr. Berger.

 

Dr. Berger continued, “In response to high demand and patient backlogs in many of RadNet’s local markets, we continue to pursue expanding capacity through the development and construction of new imaging centers. We anticipate opening approximately six new centers by year end 2024 and an additional 15 centers in 2025. Approximately half of these new centers will be within existing health system partnerships. Within Digital Health, but for Houston, we are substantially complete with implementing the EBCD program. Continued development of the DeepHealth OS technology platform places us on-track towards beginning implementation within RadNet in the coming months and within external customers as early as the first quarter of 2025. The DeepHealth OS integrates generative AI capabilities to help us and external customers automate and drive efficiencies for many of the back-office and support functions involved with running imaging centers.”

 

“RadNet’s balance sheet continues to strengthen. In April, we completed a successful refinancing of our term loan and revolving line of credit, resulting in a reduction of interest rates, an extension of maturities and the funding of additional cash to the balance sheet of approximately $168 million. At quarter end, we had a cash balance of $741.7 million, and our leverage ratio of Net Debt to Adjusted EBITDA(1) was at a record low, slightly above 1.0,” concluded Dr. Berger.

 

Second Quarter Financial Results

 

For the second quarter of 2024, RadNet reported Total Company Revenue of $459.7 million and Adjusted EBITDA(1) of $72.3 million. Revenue increased $56.0 million (or 13.9%) and Adjusted EBITDA(1) increased $11.9 million (or 19.7%) as compared with the second quarter of 2023.

 

For the second quarter of 2024, RadNet reported Digital Health Revenue (inclusive of intersegment revenue) of $15.8 million and Adjusted EBITDA(1) of $3.3 million. Revenue increased $4.2 million (or 36.4%) and Adjusted EBITDA(1) increased $1.9 million (or 135.2%) as compared with the second quarter of 2023. Digital Health Revenue and Adjusted EBITDA(1) growth was due in part from a $3.2 million (or 136.6%) increase in AI Revenue, which climbed to $5.6 million during the second quarter of 2024.

 

Unadjusted for unusual or one-time items impacting the second quarter, Total Company Net Loss for the second quarter of 2024 was $3.0 million as compared with a Total Company Net Income of $8.4 million for the second quarter of 2023. Net Loss Per Share for the second quarter of 2024 was $(0.04), compared with a Net Income per share of $0.12 in the second quarter of 2023, based upon a weighted average number of diluted shares outstanding of 73.4 million shares in 2024 and 60.9 million shares in 2023.

 

 

 

 2 

 

There were a number of unusual or one-time items impacting the second quarter including: $1.9 million of non-cash loss from interest rate swaps; $5.6 million of non-cash interest expense related to extraordinary interest rate swap Other Comprehensive Income amortization, $0.8 million expense related to leases for de novo facilities under construction that have yet to open their operations; $8.8 million of debt restructuring and extinguishment expenses related to the April 2024 successful debt refinancing transaction; and $3.3 million of non-capitalized research and development expenses related to the DeepHealth Cloud OS and generative AI. Adjusting for the above items, Total Company Adjusted Earnings(3) was $12.0 million and diluted Adjusted Earnings Per Share(3) was $0.16 during the second quarter of 2024. This compares with Total Company Adjusted Earnings(3) of $5.9 million and diluted Adjusted Earnings Per Share(3) of $0.10 during the second quarter of 2023.

 

For the second quarter of 2024, as compared with the prior year’s second quarter, MRI volume increased 16.0%, CT volume increased 14.8% and PET/CT volume increased 20.4%. Overall volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 9.2% over the prior year’s second quarter. On a same-center basis, including only those centers which were part of RadNet for both the second quarters of 2024 and 2023, MRI volume increased 11.7%, CT volume increased 9.9% and PET/CT volume increased 13.7%. Overall same-center volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 6.1% over the prior year’s same quarter

 

Six Month Financial Results

 

For the first six months of 2024, RadNet reported Total Company Revenue of $891.4 million and Adjusted EBITDA(1) of $130.8 million. Revenue increased $97.1 million (or 12.2%) and Adjusted EBITDA(1) increased $22.2 million (or 20.4%) as compared with the first six months of 2023.

 

For the first six months of 2024, RadNet reported Digital Health Revenue (inclusive of intersegment revenue) of $30.5 million and Adjusted EBITDA(1) of $6.8 million. Revenue increased $7.8 million (or 34.4%) and Adjusted EBITDA(1) increased $5.4 million (or 381.5%) as compared with the first six months of 2023. Digital Health Revenue and Adjusted EBITDA(1) growth was due in part to a $5.8 million (or 128.2%) increase in AI Revenue, which climbed to $10.3 million during the six month period of 2024.

 

Unadjusted for one-time or unusual items, Total Company Net Loss for the first six months of 2024 was $5.8 million as compared with a Total Company Net Loss of $12.6 million for the first six months of 2023. Net Loss Per Share for the six month period of 2024 was $(0.08), compared with a Net Loss per share of $(0.21) in the six month period of 2023, based upon a weighted average number of diluted shares outstanding of 71.8 million shares in 2024 and 59.2 million shares in 2023.

 

2024 Guidance Update

 

RadNet amends its previously announced guidance levels as follows:

 

Imaging Center Segment

 

  Original Guidance Range Revised Guidance Range After Q1 Results Revised Guidance Range After Q2 Results
Total Net Revenue $1,650 - $1,700 million $1,675 - $1,725 million $1,685 - $1,735 million
Adjusted EBITDA(1) $250 - $260 million $255 - $265 million $257 - $267 million
Capital Expenditures(a) $125 - $135 million $130 - $140 million $135 - $145 million
Cash Interest Expense(b) $40 - $45 million $37 - $42 million $32 - $37 million
Free Cash Flow (2) $65 - $75 million $68 - $78 million $72 - $80 million
       

 

(a)Net of proceeds from the sale of equipment, imaging centers and joint venture interests and New Jersey Imaging Network capital expenditures.
(b)Includes payments to and from counterparties on interest rate swaps and nets interest income from our cash balance recorded in Other Income.

 

 

 

 3 

 

Digital Health Segment

 

 

Original

Guidance Range

Revised

Guidance Range After

Q1 Results

Revised

Guidance Range After

Q2 Results

       
Total Net Revenue (inclusive of intersegment revenue) $60 - $70 million $60 - $70 million $60 - $70 million
       
Adjusted EBITDA(1) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI $12 - $14 million $13 - $15 million $13 - $15 million
       
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI $11 - $13 million $12 - $14 million $12 - $14 million
       
Capital Expenditures $3 - $5 million $3 - $5 million $3 - $5 million
       
Free Cash Flow(2) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI $8 - $10 million $8 - $10 million $8 - $10 million
       
Free Cash Flow(2) After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI $(2) - $(5) million $(2) - $(5) million $(2) - $(5) million

 

“We have increased guidance ranges of our core Imaging Center reporting segment for Revenue and Adjusted EBITDA(1). Furthermore, despite increasing the Capital Expenditures guidance range by $5 million, we are expecting Free Cash Flow(2) to be higher for the year. This is the result of the projected increase in Adjusted EBITDA(1) and lower Cash Interest Expense. With respect to the Digital Health reportable segment, we remain on track to meet our original guidance levels.”

 

Conference Call for Tomorrow

 

Dr. Howard Berger, President and Chief Executive Officer, and Mark Stolper, Executive Vice President and Chief Financial Officer, will host a conference call to discuss its second quarter 2024 results on Thursday, August 8th, 2024 at 7:30 a.m. Pacific Time (10:30 a.m. Eastern Time).

 

Conference Call Details:

 

Date: Thursday, August 8, 2024

Time: 10:30 a.m. Eastern Time

Dial In-Number: 844-826-3035

International Dial-In Number: 412-317-5195

 

It is recommended that participants dial in approximately 5 minutes prior to the start of the 10:30 a.m. call. There will also be simultaneous and archived webcasts available at https://viavid.webcasts.com/starthere.jsp?ei=1680804&tp_key=197206db18 or http://www.radnet.com under the “Investors” menu section and “News Releases” sub-menu of the website. An archived replay of the call will also be available and can be accessed by dialing 844-512-2921 from the U.S., or 412-317-6671 for international callers, and using the passcode 10191154.

 

 

 

 4 

 

About RadNet, Inc.

 

RadNet, Inc., is the leading national provider of freestanding, fixed-site diagnostic imaging services and related information technology solutions (including artificial intelligence) in the United States based on the number of locations and annual imaging revenue. RadNet has a network of 398 owned and/or operated outpatient imaging centers. RadNet's markets include Arizona, California, Delaware, Florida, Maryland, New Jersey, New York and Texas. Together with affiliated radiologists, inclusive of full-time and per diem employees and technologists, RadNet has a total of over 10,000 employees. For more information, visit http://www.radnet.com.

 

Forward Looking Statements

 

This press release contains “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements are expressions of our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, and anticipated future conditions, events and trends. Forward-looking statements can generally be identified by words such as: “anticipate,” “intend,” “plan,” “goal,” “seek,” “believe,” “project,” “estimate,” “expect,” “strategy,” “future,” “likely,” “may,” “should,” “will” and similar references to future periods. Forward-looking statements in this press release include, among others, statements about our anticipated business results, balance sheet and liquidity and our future liquidity, burn rate and our continuing ability to service or refinance our current indebtedness.

 

Forward-looking statements are neither historical facts nor assurances of future performance. Because forward-looking statements relate to the future, they are inherently subject to uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Therefore, you should not place undue reliance on any of these forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following:

 

·the availability and terms of capital to fund our business;
·our ability to service our indebtedness, make principal and interest payments as those payments become due and remain in compliance with applicable debt covenants, in addition to our ability to refinance such indebtedness on acceptable terms;
·changes in general economic conditions nationally and regionally in the markets in which we operate;
·the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities;
·our ability to maintain our current credit rating and the impact on our funding costs and competitive position if we do not do so;
·our ability to acquire, develop, implement and monetize technology, digital health initiatives, artificial intelligence algorithms and applications;
·volatility in interest and exchange rates, or credit markets;
·the adequacy of our cash flow and earnings to fund our current and future operations;
·changes in service mix, revenue mix and procedure volumes;
·delays in receiving payments for services provided;
·increased bankruptcies among our partner physicians or joint venture partners;
·the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act;
·the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof by federal and state regulators or related litigation result in a reduction in coverage or reimbursement rates for our services, or other material impacts to our business;

 

 

 

 5 

 

·closures or slowdowns and changes in labor costs and labor difficulties, including stoppages affecting either our operations or our suppliers' abilities to deliver supplies needed in our facilities;
·the occurrence of hostilities, political instability or catastrophic events;
·the emergence or reemergence of and effects related to future pandemics, epidemics and infectious diseases; and
·noncompliance by us with any privacy or security laws or any cybersecurity incident or other security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information.

 

Any forward-looking statement contained in this current report is based on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that we may make from time to time, whether as a result of changed circumstances, new information, future developments or otherwise, except as required by applicable law.

 

Regulation G: GAAP and Non-GAAP Financial Information

 

This release contains certain financial information not reported in accordance with GAAP. The Company uses both GAAP and non-GAAP metrics to measure its financial results. The Company believes that, in addition to GAAP metrics, these non-GAAP metrics assist the Company in measuring its cash-based performance. The Company believes this information is useful to investors and other interested parties because it removes unusual and nonrecurring charges that occur in the affected period and provides a basis for measuring the Company's financial condition against other quarters. Such information should not be considered as a substitute for any measures calculated in accordance with GAAP, and may not be comparable to other similarly titled measures of other companies. Non-GAAP financial measures should not be considered in isolation from, or as a substitute for, financial information prepared in accordance with GAAP. Reconciliation of this information to the most comparable GAAP measures is included in this release in the tables which follow.

 

 

CONTACTS:

 

RadNet, Inc.

Mark Stolper, 310-445-2800

Executive Vice President and Chief Financial Officer

 

 

 

 

 6 

 

RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)

         

 

   June 30, 2024   December 31, 2023 
   (unaudited)     
ASSETS          
CURRENT ASSETS          
Cash and Cash equivalents  $741,679   $342,570 
Accounts receivable   195,288    163,707 
Due from affiliates   29,221    25,342 
Prepaid expenses and other current assets   38,536    47,657 
Total current assets   1,004,724    579,276 
PROPERTY, EQUIPMENT AND RIGHT-OF-USE ASSETS          
Property and equipment, net   652,882    604,401 
Operating lease right-of-use assets   624,081    596,032 
Total property, equipment and right-of-use assets   1,276,963    1,200,433 
OTHER ASSETS          
Goodwill   708,980    679,463 
Other intangible assets   84,049    90,615 
Deferred financing costs   2,505    1,643 
Investment in joint ventures   100,844    92,710 
Deposits and other   51,358    46,333 
Total Assets  $3,229,423   $2,690,473 
           
LIABILITIES AND EQUITY          
CURRENT LIABILITIES          
Accounts payable, accrued expenses and other  $353,898   $342,940 
Due to affiliates   32,375    15,910 
Deferred revenue   4,462    4,647 
Current operating lease liability   59,251    55,981 
Current portion of notes payable   24,215    17,974 
Total current liabilities   474,201    437,452 
LONG-TERM LIABILITIES          
Long-term operating lease liability   632,385    605,097 
Notes payable, net of current portion   1,002,392    812,068 
Deferred tax liability, net   17,471    15,776 
Other non-current liabilities   10,134    6,721 
Total liabilities   2,136,583    1,877,114 
EQUITY          
RadNet, Inc. stockholders' equity:          
Common stock - $0.0001 par value, 200,000,000 shares authorized; 73,968,042 and 67,956,318 shares issued and outstanding at June 30, 2024 and December 31, 2023, respectively   7    7 
Additional paid-in-capital   974,355    722,750 
Accumulated other comprehensive loss   (8,057)   (12,484)
Accumulated deficit   (85,339)   (79,578)
Total RadNet, Inc.'s Stockholders' equity:   880,966    630,695 
Noncontrolling interests   211,874    182,664 
Total Equity   1,092,840    813,359 
Total liabilities and equity  $3,229,423   $2,690,473 

 

 

 7 

 

RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENT OF OPERATIONS

(IN THOUSANDS EXCEPT FOR SHARE AND PER SHARE DATA)

(unaudited)

 

 

   Three Months Ended June 30,   Six Months Ended June 30, 
   2024   2023   2024   2023 
                 
REVENUE                    
Service fee revenue  $422,745   $363,918   $819,934   $716,338 
Revenue under capitation arrangements   36,969    39,797    71,487    77,941 
Total service revenue   459,714    403,715    891,421    794,279 
OPERATING EXPENSES                    
Cost of operations, excluding depreciation and amortization   389,724    345,147    777,313    697,012 
Depreciation and amortization   34,475    32,180    66,843    63,495 
Loss (gain) on sale and disposal of equipment and other   401    77    587    656 
Severance costs   268    1,870    493    2,004 
Total operating expenses   424,868    379,274    845,236    763,167 
INCOME (LOSS) FROM OPERATIONS   34,846    24,441    46,185    31,112 
OTHER INCOME AND EXPENSES                    
Interest expense   26,082    16,039    42,349    31,761 
Equity in earnings of joint ventures   (3,389)   (1,423)   (7,713)   (2,851)
Non-cash change in fair value of interest rate hedge   1,890    (4,159)   674    (66)
Debt restructuring and extinguishment expenses   8,762        8,762     
Other expenses (income)   (7,900)   40    (10,834)   1,472 
Total other (income) expenses   25,445    10,497    33,238    30,316 
INCOME (LOSS) BEFORE INCOME TAXES   9,401    13,944    12,947    796 
Provision for income taxes   (2,456)   614    (592)   (521)
NET INCOME (LOSS)   6,945    14,558    12,355    275 
Net income (loss) attributable to noncontrolling interests   9,927    6,189    18,116    12,911 
NET INCOME (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $(2,982)  $8,369   $(5,761)  $(12,636)
                     
BASIC NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $(0.04)  $0.14   $(0.08)  $(0.21)
                     
DILUTED NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $(0.04)  $0.12   $(0.08)  $(0.21)
WEIGHTED AVERAGE SHARES OUTSTANDING                    
Basic   73,419,124    59,880,803    71,795,080    59,221,453 
Diluted   73,419,124    60,916,985    71,795,080    59,221,453 

 

 

 

 8 

 

RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASHFLOWS

(IN THOUSANDS)

(unaudited)

 

 

   Six Months Ended June 30, 
   2024   2023 
CASH FLOWS FROM OPERATING ACTIVITIES          
Net income (loss)  $12,355   $275 
Adjustments to reconcile net income to net cash provided by operating activities:          
Depreciation and amortization   66,843    63,495 
Amortization of operating lease assets   30,006    31,601 
Equity in earnings of joint ventures   (6,713)   6,096 
Amortization deferred financing costs and loan discount   1,541    1,494 
Loss (Gain) on sale and disposal of equipment   587    656 
Loss on extinguishment of debt   2,080     
Amortization of cash flow hedge   7,256    1,844 
Non-cash change in fair value of interest rate hedge   674    (66)
Stock-based compensation   16,645    17,055 
Change in fair value of contingent consideration   1,974    3,098 
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:          
Accounts receivable   (31,581)   (8,124)
Other current assets   5,242    4,703 
Other assets   (5,553)   (6,590)
Deferred taxes   1,791    (2,249)
Operating lease liability   (27,707)   (28,582)
Deferred revenue   (185)   1,033 
Accounts payable, accrued expenses and other   57,835    14,952 
Net cash provided by operating activities   133,090    100,691 
           
CASH FLOWS FROM INVESTING ACTIVITIES          
Purchase of imaging facilities and other acquisitions   (32,771)   (10,315)
Purchase of property and equipment and other   (104,095)   (95,380)
Proceeds from sale of equipment   9    73 
Equity contributions in existing and purchase of interest in joint ventures   (1,421)   (288)
Net cash used in investing activities   (138,278)   (105,910)
           
CASH FLOWS FROM FINANCING ACTIVITIES          
Principal payments on notes and leases payable   (2,624)   (1,052)
Payments on Term Loan Debt   (682,438)   (7,376)
Proceeds from issuance of new debt, net of issuing costs   863,869     
Contribution from noncontrolling interests   4,169     
Payments on contingent consideration   (3,614)    
Distributions paid to noncontrolling interests   (2,423)   (3,523)
Proceeds from sale of economic interests in majority owned subsidiary, net of taxes   8,713     
Proceeds from issuance of common stock   218,385    246,202 
Proceeds from issuance of common stock upon exercise of options   367    51 
Net cash provided by financing activities   404,404    234,302 
           
EFFECT OF EXCHANGE RATE CHANGES ON CASH   (107)   (266)
NET DECREASE IN CASH AND CASH EQUIVALENTS   399,109    228,817 
CASH AND CASH EQUIVALENTS, beginning of period   342,570    127,834 
CASH AND CASH EQUIVALENTS, end of period   741,679    356,651 
           
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION          
Cash paid during the period for interest  $34,203   $39,301 
Cash paid during the period for income taxes  $705   $201 

 

 

 10 

 

RADNET, INC. AND SUBSIDIARIES

RECONCILIATION OF GAAP NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS TO ADJUSTED EBITDA

(IN THOUSANDS)

 

 

   Three Months Ended June 30,   Six Months Ended June 30, 
   2024   2023   2024   2023 
                 
Net income (loss) attributable to Radnet, Inc. common stockholders  $(2,982)  $8,369   $(5,761)  $(12,636)
Income taxes   2,456    (614)   592    521 
Interest expense   26,082    16,039    42,349    31,761 
Severance costs   268    1,870    493    2,004 
Depreciation and amortization   34,475    32,180    66,843    63,495 
Non-cash employee stock-based compensation   4,749    4,871    16,646    17,056 
Loss (gain) on sale and disposal of equipment and other   401    77    587    656 
Non-cash change in fair value of interest rate hedge   1,890    (4,159)   674    (66)
Other expenses (income)   (7,900)   40    (10,834)   1,472 
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   3,317        6,632     
Loss (gain) on extinguishment of debt and related expenses   8,762        8,762     
Non-cash change to contingent consideration       1,014    1,974    2,630 
Non-operational rent expenses   809    759    1,832    1,718 
                     
Adjusted EBITDA Including EBITDA from Digital Health  $72,327   $60,446   $130,789   $108,611 
                     
EBITDA from Digital Health   3,269    1,390    6,789    1,410 
                     
Adjusted EBITDA excluding EBITDA from Digital Health  $69,058   $59,056   $124,000   $107,201 

 

 

 

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PAYMENTS BY PAYOR CLASS

  

   Second Quarter 
   2024 
     
Commercial Insurance   58.5% 
Medicare   22.1% 
Capitation   8.0% 
Medicaid   2.4% 
Workers Compensation/Personal Injury   2.4% 
Other*   6.5% 
Total   100.0% 

 

* Includes management fee, teleradiology and Digital Health financial reporting unit revenue.

 

PAYMENTS BY MODALITY

 

   Second Quarter   Full Year   Full Year   Full Year 
   2024   2023   2022   2021 
                 
MRI   37.2%    36.8%    36.8%    36.0% 
CT   15.8%    16.8%    17.5%    17.2% 
PET/CT   7.1%    6.4%    5.8%    5.5% 
X-ray   6.2%    6.5%    6.7%    3.9% 
Ultrasound   13.9%    12.9%    12.6%    12.7% 
Mammography   16.1%    16.0%    15.3%    16.1% 
Nuclear Medicine   1.0%    0.8%    0.9%    1.0% 
Other   2.7%    3.9%    4.5%    4.6% 
    100.0%    100.0%    100.0%    100.0% 

 

PROCEDURES BY MODALITY*

 

   Second Quarter   Second Quarter 
   2024   2023 
         
MRI   449,781    387,619 
CT   269,939    235,138 
PET/CT   18,107    15,036 
Nuclear Medicine   9,610    9,463 
Ultrasound   664,043    620,660 
Mammography   483,510    450,747 
X-ray and Other   890,814    832,719 
Total   2,785,804    2,551,382 

* Volumes include wholy owned and joint venture centers.

 

 

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RADNET, INC. AND SUBSIDIARIES

SCHEDULE OF ADJUSTED EARNINGS AND EARNINGS PER SHARE (3)

(IN THOUSANDS EXCEPT SHARE DATA)

(unaudited)

 

 

   Three Months Ended June 30, 
   2024   2023(iv) 
         
NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS   (2,982)  $8,369 
           
Add/Subtract non-cash change in fair value of interest rate swaps (i)   1,890    (4,159)
Non-cash interest expense from extraordinary interest rate swap OCI amortization   5,559     
Non-operational rent expenses (iii)   809    759 
Contingent consideration       1,014 
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   3,317     
Debt restructing and extinguishment expenses (v)   8,762     
Total adjustments - loss (gain)   20,337    (2,386)
Subtract tax impact of Adjustments (ii)   (5,308)   (105)
Tax effected impact of adjustments   15,029    (2,491)
           
TOTAL ADJUSTMENT TO NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS   15,029    (2,491)
           
ADJUSTED NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS   12,047    5,878 
           
WEIGHTED AVERAGE SHARES OUTSTANDING          
Diluted   74,944,366    60,916,985 
           
ADJUSTED DILUTED NET INCOME PER SHARE          
ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS   0.16   $0.10 

 

(i) Impact from the change in fair value of the swpas during the quarter.  Excludes the recurring amortization of the accumulation of the changes in fair value out of Other Comprehensive Income that existed prior to the hedges becoming ineffective.
(ii) Tax effected using 26.1% and (4.40)% blended federal and state effective tax rate for the second quarter of 2024 and 2023, respectively.
(iii) Represents rent expense associated with de novo sites under construction prior to them becoming operational.
(iv) Restated from what was presented in 2023 to include the losses of the AI businesses (ie, not add the losses back to earnings as was the case in 2023). The restated Adjusted Earnings for 2023 is due to the fact that AI is no longer its own reportable operating segment and is now embedded in the Digital Health reportable operating segment.
(v) Extraordinary expense related to the Company's successful April 2024 debt refinancing transaction.

 

 

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Footnotes

 

(1) The Company defines Adjusted EBITDA as earnings before interest, taxes, depreciation and amortization, each from continuing operations and adjusted for losses or gains on the sale of equipment, other income or loss, debt extinguishments and non-cash equity compensation. Adjusted EBITDA includes equity earnings in unconsolidated operations and subtracts allocations of earnings to non-controlling interests in subsidiaries, and is adjusted for non-cash or extraordinary and one-time events taken place during the period.

 

Adjusted EBITDA is reconciled to its nearest comparable GAAP financial measure. Adjusted EBITDA is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance, and is a measure of leverage capacity and ability to service debt. Adjusted EBITDA should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

 

(2) As noted above, the Company defines Free Cash Flow as Adjusted EBITDA less total Capital Expenditures (whether completed with cash or financed) and Cash Interest Expense. Free Cash Flow is a non-GAAP financial measure. The Company uses Free Cash Flow because the Company believes it provides useful information for investors and management because it measures our capacity to generate cash from our operating activities. Free Cash Flow does not represent total cash flow since it does not include the cash flows generated by or used in financing activities. In addition, our definition of Free Cash Flow may differ from definitions used by other companies.

 

Free Cash Flow should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

 

(3) The Company defines Adjusted Earnings (Loss) Per Share as net income or loss attributable to RadNet, Inc. common stockholders and excludes losses or gains on the disposal of equipment, loss on debt extinguishments, bargain purchase gains, severance costs, loss on impairment, loss or gain on swap valuation, gain on extinguishment of debt, unusual or non-recurring entries that impact the Company’s tax provision and any other non-recurring or unusual transactions recorded during the period.

 

Adjusted Earnings (Loss) Per Share is reconciled to its nearest comparable GAAP financial measure. Adjusted Earnings (Loss) Per Share is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance. Adjusted Earnings Per Share should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted Earnings Per Share should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted Earnings Per Share is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

 

 

 

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