Tactile Systems Technology (TCMD) 10-Q 5 Aug 24 2024 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2024	Aug. 01, 2024
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
Document Transition Report	false
Entity File Number	001-37799
Entity Registrant Name	Tactile Systems Technology, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	41-1801204
Entity Address, Address Line One	3701 Wayzata Blvd, Suite 300
Entity Address, City or Town	Minneapolis
Entity Address, State or Province	MN
Entity Address, Postal Zip Code	55416
City Area Code	612
Local Phone Number	355-5100
Title of 12(b) Security	Common Stock, Par Value $0.001 Per Share
Trading Symbol	TCMD
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		23,966,748
Entity Central Index Key	0001027838
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 73,618	$ 61,033
Accounts receivable	41,935	43,173
Net investment in leases	13,551	14,195
Inventories	18,846	22,527
Prepaid expenses and other current assets	3,909	4,366
Total current assets	151,859	145,294
Non-current assets
Property and equipment, net	5,691	6,195
Right of use operating lease assets	17,828	19,128
Intangible assets, net	44,883	46,724
Goodwill	31,063	31,063
Accounts receivable, non-current	4,511	10,936
Deferred income taxes	19,408	19,378
Other non-current assets	3,541	2,720
Total non-current assets	126,925	136,144
Total assets	278,784	281,438
Current liabilities
Accounts payable	5,094	6,659
Note payable	2,956	2,956
Accrued payroll and related taxes	12,090	16,789
Accrued expenses	6,702	5,904
Income taxes payable	496	1,467
Operating lease liabilities	2,799	2,807
Other current liabilities	4,075	4,475
Total current liabilities	34,212	41,057
Non-current liabilities
Note payable, non-current	24,698	26,176
Accrued warranty reserve, non-current	1,561	1,681
Income taxes payable, non-current	495	446
Operating lease liabilities, non-current	17,142	18,436
Total non-current liabilities	43,896	46,739
Total liabilities	78,108	87,796
Commitments and Contingencies (see Note 9)
Stockholders' equity:
Preferred stock, $0.001 par value, 50,000,000 shares authorized; none issued and outstanding as of June 30, 2024 and December 31, 2023
Common stock, $0.001 par value, 300,000,000 shares authorized; 23,966,748 shares issued and outstanding as of June 30, 2024; 23,600,584 shares issued and outstanding as of December 31, 2023	24	24
Additional paid-in capital	179,669	174,724
Retained earnings	20,983	18,894
Total stockholders' equity	200,676	193,642
Total liabilities and stockholders' equity	$ 278,784	$ 281,438

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2024	Dec. 31, 2023
Condensed Consolidated Balance Sheets
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	50,000,000	50,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares, issued	23,966,748	23,600,584
Common stock, shares, outstanding	23,966,748	23,600,584

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Total revenue	$ 73,218	$ 68,339	$ 134,306	$ 127,185
Total cost of revenue	19,115	20,040	36,774	37,418
Gross profit	54,103	48,299	97,532	89,767
Operating expenses
Sales and marketing	28,608	28,206	55,965	54,508
Research and development	2,234	1,833	4,377	4,066
Reimbursement, general and administrative	16,779	14,991	33,040	30,425
Intangible asset amortization and earn-out	633	1,211	1,265	2,516
Total operating expenses	48,254	46,241	94,647	91,515
Income (loss) from operations	5,849	2,058	2,885	(1,748)
Other income (expense)	225	(838)	380	(1,831)
Income (loss) before income taxes	6,074	1,220	3,265	(3,579)
Income tax expense (benefit)	1,776	1,320	1,176	(1,593)
Net income (loss)	$ 4,298	$ (100)	$ 2,089	$ (1,986)
Net income (loss) per common share
Basic	$ 0.18	$ 0	$ 0.09	$ (0.09)
Diluted	$ 0.18	$ 0	$ 0.09	$ (0.09)
Weighted-average common shares used to compute net income (loss) per common share
Basic	23,873,379	23,352,530	23,769,604	22,323,856
Diluted	24,099,047	23,352,530	24,073,986	22,323,856
Sales revenue
Total revenue	$ 64,267	$ 59,802	$ 117,574	$ 112,593
Total cost of revenue	16,263	16,865	31,207	31,507
Gross profit	48,004	42,937	86,367	81,086
Rental revenue
Total revenue	8,951	8,537	16,732	14,592
Total cost of revenue	2,852	3,175	5,567	5,911
Gross profit	$ 6,099	$ 5,362	$ 11,165	$ 8,681

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Common Stock	Additional Paid-In Capital	Retained Earnings (Accumulated Deficit).	Total
Balances at the beginning at Dec. 31, 2022	$ 20	$ 131,001	$ (9,621)	$ 121,400
Balances at the beginning (in shares) at Dec. 31, 2022	20,252,677
Increase (Decrease) in Stockholders' Equity
Stock-based compensation		3,831		3,831
Exercise of common stock options and vesting of performance and restricted stock units		11		11
Exercise of common stock options and vesting of performance and restricted stock units (in shares)	209,809
Sale of common stock from follow-on public offering, net of offering expenses	$ 3	34,622		34,625
Sale of common stock from follow-on public offering, net of offering expenses (in shares)	2,875,000
Common shares issued for employee stock purchase plan		882		882
Common shares issued for employee stock purchase plan (in shares)	120,816
Net loss for the period			(1,986)	(1,986)
Balances at the end at Jun. 30, 2023	$ 23	170,347	(11,607)	158,763
Balances at the end (in shares) at Jun. 30, 2023	23,458,302
Balances at the beginning at Mar. 31, 2023	$ 23	167,646	(11,507)	156,162
Balances at the beginning (in shares) at Mar. 31, 2023	23,235,065
Increase (Decrease) in Stockholders' Equity
Stock-based compensation		1,808		1,808
Exercise of common stock options and vesting of performance and restricted stock units		11		11
Exercise of common stock options and vesting of performance and restricted stock units (in shares)	102,421
Common shares issued for employee stock purchase plan		882		882
Common shares issued for employee stock purchase plan (in shares)	120,816
Net loss for the period			(100)	(100)
Balances at the end at Jun. 30, 2023	$ 23	170,347	(11,607)	158,763
Balances at the end (in shares) at Jun. 30, 2023	23,458,302
Balances at the beginning at Dec. 31, 2023	$ 24	174,724	18,894	193,642
Balances at the beginning (in shares) at Dec. 31, 2023	23,600,584
Increase (Decrease) in Stockholders' Equity
Stock-based compensation		3,899		3,899
Exercise of common stock options and vesting of performance and restricted stock units		2		2
Exercise of common stock options and vesting of performance and restricted stock units (in shares)	258,257
Common shares issued for employee stock purchase plan		1,044		1,044
Common shares issued for employee stock purchase plan (in shares)	107,907
Net loss for the period			2,089	2,089
Balances at the end at Jun. 30, 2024	$ 24	179,669	20,983	200,676
Balances at the end (in shares) at Jun. 30, 2024	23,966,748
Balances at the beginning at Mar. 31, 2024	$ 24	176,764	16,685	193,473
Balances at the beginning (in shares) at Mar. 31, 2024	23,761,897
Increase (Decrease) in Stockholders' Equity
Stock-based compensation		1,860		1,860
Exercise of common stock options and vesting of performance and restricted stock units		1		1
Exercise of common stock options and vesting of performance and restricted stock units (in shares)	96,944
Common shares issued for employee stock purchase plan		1,044		1,044
Common shares issued for employee stock purchase plan (in shares)	107,907
Net loss for the period			4,298	4,298
Balances at the end at Jun. 30, 2024	$ 24	$ 179,669	$ 20,983	$ 200,676
Balances at the end (in shares) at Jun. 30, 2024	23,966,748

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Cash flows from operating activities
Net income (loss)	$ 2,089	$ (1,986)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	3,345	3,269
Deferred income taxes	(30)
Stock-based compensation expense	3,899	3,831
Loss on disposal of property and equipment and intangibles	54	3
Change in fair value of earn-out liability		1,230
Changes in assets and liabilities, net of acquisition:
Accounts receivable	1,238	8,273
Net investment in leases	644	2,911
Inventories	3,681	2,809
Income taxes	(922)	(3,967)
Prepaid expenses and other assets	(364)	(697)
Right of use operating lease assets	(2)	50
Accounts receivable, non-current	6,425	7,631
Accounts payable	(1,592)	(696)
Accrued payroll and related taxes	(4,699)	(3,300)
Accrued expenses and other liabilities	300	(5,954)
Net cash provided by operating activities	14,066	13,407
Cash flows from investing activities
Purchases of property and equipment	(982)	(1,043)
Proceeds from sale of property and equipment	12
Intangible assets expenditures	(57)	(99)
Net cash used in investing activities	(1,027)	(1,142)
Cash flows from financing activities
Payments on earn-out		(5,000)
Payments on note payable	(1,500)	(1,500)
Proceeds from exercise of common stock options	2	11
Proceeds from the issuance of common stock from the employee stock purchase plan	1,044	882
Proceeds from issuance of common stock at market		34,625
Net cash (used in) provided by financing activities	(454)	29,018
Net increase in cash and cash equivalents	12,585	41,283
Cash and cash equivalents - beginning of period	61,033	21,929
Cash and cash equivalents - end of period	73,618	63,212
Supplemental cash flow disclosure
Cash paid for interest	1,099	1,925
Cash paid for taxes	2,177	2,415
Capital expenditures incurred but not yet paid	$ 27	$ 8

Nature of Business and Operatio

Nature of Business and Operations	6 Months Ended
	Jun. 30, 2024
Nature of Business and Operations
Nature of Business and Operations	Note 1. Nature of Business and Operations Tactile Systems Technology, Inc. (“we,” “us,” “our,” and the “Company”) manufactures and distributes medical devices for the treatment of patients with underserved chronic diseases at home. We provide our Flexitouch® Plus and Entre™ Plus systems, which help control symptoms of lymphedema, a chronic progressive medical condition, through our direct sales force for use in the home following receipt of prescriptions from vascular, wound and lymphedema clinics throughout the United States. On September 8, 2021, we acquired the assets of the AffloVest airway clearance business (“AffloVest Acquisition”). AffloVest is a portable, wearable vest that treats patients with chronic respiratory conditions. We sell this device through home medical equipment and durable medical equipment (“DME”) providers throughout the United States. We were originally incorporated in Minnesota under the name Tactile Systems Technology, Inc. on January 30, 1995. During 2006, we established a merger corporation and subsequently, on July 21, 2006, merged with and into this merger corporation, resulting in our reincorporation as a Delaware corporation. The resulting corporation assumed the name Tactile Systems Technology, Inc. In September 2013, we began doing business as “Tactile Medical”. On August 2, 2016, we closed the initial public offering of our common stock, which resulted in the sale of 4,120,000 shares of our common stock at a public offering price of $10.00 per share. We received net proceeds from the initial public offering of approximately $35.4 million, after deducting underwriting discounts and approximately $2.9 million of transaction expenses. On February 27, 2023, we closed on a public offering of 2,875,000 shares of our common stock at a public offering price of $13.00 per share. We received net proceeds from this offering of $34.6 million after deducting underwriting discounts, commissions, and offering expenses. Our business is affected by seasonality. In the first quarter of each year, when most patients have started a new insurance year and have not yet met their annual out-of-pocket payment obligations, we experience substantially reduced demand for our products. We typically experience higher revenue in the third and fourth quarters of the year when patients have met their annual insurance deductibles, thereby reducing their out-of-pocket costs for our products, and because patients desire to exhaust their flexible spending accounts at year end. This seasonality applies only to purchases and rentals of our products by patients covered by commercial insurance and is not relevant to Medicare, Medicaid or the Veterans Administration, as those payers either do not have plans that have declining deductibles over the course of the plan year and/or do not have plans that include patient deductibles for purchases or rentals of our products.

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2024
Basis of Presentation
Basis of Presentation	Note 2. Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) for interim financial reporting and pursuant to the rules and regulations of the SEC. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments (including those which are normal and recurring) considered necessary for a fair presentation of the interim financial information have been included. The results for the six months ended June 30, 2024, are not necessarily indicative of results to be expected for the year ending December 31, 2024, or for any other interim period or for any future year. The condensed consolidated interim financial statements should be read in conjunction with the audited financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2023. Principles of Consolidation The accompanying unaudited condensed consolidated financial statements include the accounts of Tactile Systems Technology, Inc. and its wholly owned subsidiary, Swelling Solutions, Inc. All intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and to disclose contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. ​

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2024
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	Note 3. Summary of Significant Accounting Policies Significant Accounting Policies There were no material changes in our significant accounting policies during the six months ended June 30, 2024. See Note 3 – “Summary of Significant Accounting Policies” to the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2023, for information regarding our significant accounting policies. Accounting Pronouncement Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2023-07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures” which requires entities to enhance disclosures around segment reporting. The guidance is effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. In December 2023, the FASB issued ASU No. 2023-09, “Income Taxes (Topic 740): Improvements to Income Tax Disclosures” which requires entities to enhance disclosures around income taxes. The guidance is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures .

Inventories

Inventories	6 Months Ended
	Jun. 30, 2024
Inventories
Inventories	Note 4. Inventories Inventories consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ (In thousands) At June 30, 2024 At December 31, 2023 Finished goods ​ $ 6,365 ​ $ 7,979 Component parts and work-in-process ​ 12,481 ​ 14,548 Total inventories ​ $ 18,846 ​ $ 22,527 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets
Goodwill and Intangible Assets	Note 5. Goodwill and Intangible Assets Goodwill In the third quarter of fiscal 2021, we completed the AffloVest Acquisition. The purchase price of the AffloVest product line exceeded the net acquisition-date estimated fair value amounts of the identifiable assets acquired and the liabilities assumed by $31.1 million, which was assigned to goodwill. ​ Intangible Assets ​ Our patents and other intangible assets are summarized as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ At June 30, 2024 ​ ​ Average ​ Gross ​ ​ ​ ​ ​ ​ Amortization ​ Carrying ​ Accumulated ​ Net (In thousands) Period ​ Amount ​ Amortization ​ Amount Definite-lived intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Patents ​ 12 years ​ $ 1,060 ​ $ 290 ​ $ 770 Defensive intangible assets ​ 1 year ​ ​ 1,125 ​ ​ 993 ​ ​ 132 Customer accounts ​ — ​ ​ 125 ​ ​ 125 ​ ​ — Customer relationships ​ 10 years ​ ​ 31,000 ​ ​ 6,704 ​ ​ 24,296 Developed technology ​ 8 years ​ ​ 13,000 ​ ​ 3,322 ​ ​ 9,678 Subtotal ​ ​ ​ ​ 46,310 ​ ​ 11,434 ​ ​ 34,876 Unamortized intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Tradenames ​ ​ ​ ​ 9,500 ​ ​ — ​ ​ 9,500 Patents pending ​ ​ ​ ​ 507 ​ ​ — ​ ​ 507 Total intangible assets ​ ​ ​ $ 56,317 ​ $ 11,434 ​ $ 44,883 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ At December 31, 2023 ​ ​ Average ​ Gross ​ ​ ​ ​ ​ ​ Amortization ​ Carrying ​ Accumulated ​ Net (In thousands) Period ​ Amount ​ Amortization ​ Amount Definite-lived intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Patents ​ 12 years ​ $ 1,018 ​ $ 248 ​ $ 770 Defensive intangible assets ​ 1 year ​ ​ 1,125 ​ ​ 920 ​ ​ 205 Customer accounts ​ — ​ 125 ​ 125 ​ — Customer relationships ​ 11 years ​ ​ 31,000 ​ ​ 5,511 ​ ​ 25,489 Developed technology ​ 9 years ​ ​ 13,000 ​ ​ 2,731 ​ ​ 10,269 Subtotal ​ ​ ​ ​ 46,268 ​ ​ 9,535 ​ ​ 36,733 Unamortized intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Tradenames ​ ​ ​ ​ 9,500 ​ ​ — ​ ​ 9,500 Patents pending ​ ​ ​ ​ 491 ​ ​ — ​ ​ 491 Total intangible assets ​ ​ ​ $ 56,259 ​ $ 9,535 ​ $ 46,724 ​ Amortization expense was $1.0 million for each of the three months ended June 30, 2024 and 2023, and $1.9 million for each of the six months ended June 30, 2024 and 2023, of which $0.3 million in each of the three months ended June 30, 2024 and 2023, and $0.6 million in each of the six months ended June 30, 2024 and 2023, were recorded in cost of sales revenue. Future amortization expenses are expected as follows: ​ ​ ​ ​ ​ (In thousands) ​ ​ ​ 2024 (July 1 - December 31) $ 1,899 2025 ​ ​ 3,708 2026 ​ 3,643 2027 ​ 3,635 2028 ​ 3,632 Thereafter ​ 18,359 Total ​ $ 34,876 ​ In the third quarter of 2023, we performed our annual goodwill impairment test utilizing both the qualitative and quantitative approach described in FASB ASU No. 2021-03, “Intangibles—Goodwill and Other (Topic 350) – Accounting Alternative for Evaluating Triggering Events.” Based on the testing using the qualitative approach, it was determined that it was not more likely than not that the fair value of the reporting unit was less than the carrying value. As a result, it was not deemed necessary to proceed to the quantitative test and no impairment was recognized.

Accrued Expenses

Accrued Expenses	6 Months Ended
	Jun. 30, 2024
Accrued Expenses
Accrued Expenses	Note 6. Accrued Expenses Accrued expenses consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ (In thousands) At June 30, 2024 At December 31, 2023 Warranty ​ $ 2,131 ​ $ 2,357 Legal and consulting ​ ​ 1,161 ​ ​ 611 In-transit inventory ​ ​ 1,102 ​ ​ 401 Travel ​ ​ 933 ​ ​ 1,038 Clinical studies ​ ​ 339 ​ ​ 363 Sales and use tax ​ ​ 108 ​ ​ 183 Other ​ 928 ​ 951 Total ​ $ 6,702 ​ $ 5,904 ​

Warranty Reserves

Warranty Reserves	6 Months Ended
	Jun. 30, 2024
Warranty Reserves
Warranty Reserves	Note 7. Warranty Reserves The activity in the warranty reserve during and as of the end of the reporting periods presented was as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 2023 2024 2023 Beginning balance ​ $ 3,836 ​ $ 4,000 ​ $ 4,038 ​ $ 4,212 Warranty provision ​ 902 ​ 1,026 ​ 1,742 ​ 1,900 Processed warranty claims ​ (1,046) ​ (1,198) ​ (2,088) ​ (2,284) Ending balance ​ $ 3,692 ​ $ 3,828 ​ $ 3,692 ​ $ 3,828 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Accrued warranty reserve, current ​ $ 2,131 ​ $ 1,871 ​ $ 2,131 ​ $ 1,871 Accrued warranty reserve, non-current ​ ​ 1,561 ​ ​ 1,957 ​ ​ 1,561 ​ ​ 1,957 Total accrued warranty reserve ​ $ 3,692 ​ $ 3,828 ​ $ 3,692 ​ $ 3,828 ​

Credit Agreement

Credit Agreement	6 Months Ended
	Jun. 30, 2024
Credit Agreement
Credit Agreement	Note 8. Credit Agreement On April 30, 2021, we entered into an Amended and Restated Credit Agreement (the “Restated Credit Agreement”) with the lenders from time to time party thereto, and Wells Fargo Bank, National Association, as Administrative Agent. The Restated Credit Agreement amended and restated in its entirety our prior credit agreement. On September 8, 2021, we entered into a First Amendment Agreement (the “Amendment”), which amended the Restated Credit Agreement (as amended by the Amendment, the “Credit Agreement”) with the lenders from time to time party thereto and Wells Fargo Bank, National Association, as administrative agent. The Amendment, among other things, added a $30.0 million incremental term loan to the $25.0 million revolving credit facility provided by the Restated Credit Agreement. The term loan is reflected on our condensed consolidated financial statements as a note payable. The Credit Agreement provides that, subject to satisfaction of certain conditions, we may increase the amount of the revolving loans available under the Credit Agreement and/or add one or more term loan facilities in an amount not to exceed $25.0 million in the aggregate, such that the total aggregate principal amount of loans available under the Credit Agreement (including under the revolving credit facility) does not exceed $80.0 million. On September 8, 2021, in connection with the closing of the AffloVest Acquisition, we borrowed the $30.0 million term loan and utilized that borrowing, together with a draw of $25.0 million under the revolving credit facility and cash on hand, to fund the purchase price. ​ On February 22, 2022, we entered into a Second Amendment Agreement (the “Second Amendment”), which further amended the Credit Agreement. The Second Amendment modified the maximum leverage ratio, the minimum fixed charge coverage ratio and the minimum consolidated EBITDA covenants under the Credit Agreement, and added a minimum liquidity covenant, through the quarter ended June 30, 2023. The Second Amendment also increased the applicable margin for LIBOR rate loans under the Credit Agreement during the period commencing on the date of the Second Amendment and ending on the last day of the fiscal quarter ending June 30, 2023. Pursuant to the Second Amendment, we made a mandatory principal prepayment of the term loan of $3.0 million on February 22, 2022. ​ On June 21, 2023, we entered into a Third Amendment Agreement (the “Third Amendment”) that replaced the interest rate benchmark under the Credit Agreement from LIBOR to the term Secured Overnight Financing Rate (“SOFR”). All tenors of term SOFR are subject to a credit spread adjustment of 0.10% (“Adjusted Term SOFR”). Following the Third Amendment, the term loan and amounts drawn under the revolving credit facility bear interest, at our option, at a rate equal to (a) the highest of (i) the prime rate, (ii) the federal funds rate plus 0.50% and (iii) Adjusted Term SOFR for a one-month tenor plus 1% (the “Base Rate”) plus an applicable margin or (b) Adjusted Term SOFR for an interest period of one, three or six months, at our option, plus the applicable margin. The applicable margin is 0.75% to 2.25% on loans bearing interest at the Base Rate and 1.75% to 3.25% on loans bearing interest at Adjusted Term SOFR, in each case depending on our consolidated total leverage ratio; except that, pursuant to the Second Amendment and the Third Amendment, during the period commencing on February 22, 2022 and ending on the last day of the fiscal quarter ending June 30, 2023, the applicable margin for LIBOR rate loans and Adjusted Term SOFR loans, as applicable, was 3.50% . ​ On August 1, 2023, we entered into a Fourth Amendment Agreement (the “Fourth Amendment”), which further amended the Credit Agreement. The Fourth Amendment, among other things, decreased the commitment fees payable under the revolving credit facility under the Credit Agreement such that the undrawn portions of the revolving credit facility are subject to an unused line fee at a rate per annum from 0.125% to 0.200% , depending on our consolidated leverage ratio, and eliminated the language providing that the applicable margin for Adjusted Term SOFR loans was 3.50% , such that the interest rates are in effect as set forth in the above paragraph. The Fourth Amendment also eliminated the liquidity financial covenant and modified the remaining financial covenants to reflect the termination of the temporary covenant relief period that was in place until June 30, 2023 pursuant to the Second Amendment, such that the financial covenants now include a maximum consolidated total leverage ratio covenant, a minimum consolidated EBITDA covenant and a minimum fixed charge coverage ratio covenant. In addition, the Fourth Amendment provided for an additional term loan in the amount of $8.25 million, which we used for a paydown of the revolving credit facility. The Fourth Amendment also extended the maturity date of the term loans and revolving credit facility under the Credit Agreement from September 8, 2024, to August 1, 2026. ​ On December 21, 2023, we made a payment of $16.8 million to repay in full the outstanding balance on the revolving credit facility. ​ As of June 30, 2024, we had outstanding borrowings of $27.8 million under the Credit Agreement, comprised entirely of the term loan. At June 30, 2024, all outstanding borrowings were subject to interest at a rate calculated at Adjusted Term SOFR plus an applicable margin, for an interest rate of 7.18% . The principal of the term loan is required to be repaid in quarterly installments of $750,000 . Maturities of the term loan for the next three years as of June 30, 2024, were as follows: ​ ​ ​ ​ ​ (In thousands) Amount 2024 (July 1 - December 31) ​ $ 1,500 2025 ​ ​ 3,000 2026 ​ ​ 23,250 Total ​ ​ 27,750 Less: Deferred financing fees ​ ​ (96) Net Note Payable ​ ​ 27,654 Less: Current portion of note payable ​ ​ (2,956) Non-current portion of note payable ​ $ 24,698 ​ Our obligations under the Credit Agreement are secured by a security interest in substantially all of our and our subsidiary’s assets and are also guaranteed by our subsidiary. As of June 30, 2024, the Credit Agreement contained a number of restrictions and covenants, including that we maintain compliance with a maximum consolidated total leverage ratio, a minimum fixed charge coverage ratio and a minimum consolidated EBITDA covenant. As of June 30, 2024, we were in compliance with all covenants under the Credit Agreement.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies
Commitments and Contingencies	Note 9. Commitments and Contingencies Lease Obligations We lease property and equipment under operating leases, typically with terms greater than 12 months , and determine if an arrangement contains a lease at inception. In general, an arrangement contains a lease if there is an identified asset and we have the right to direct the use of and obtain substantially all of the economic benefit from the use of the identified asset. We record an operating lease liability at the present value of lease payments over the lease term on the commencement date. The related right of use (“ROU”) operating lease asset reflects rental escalation clauses, as well as renewal options and/or termination options. The exercise of lease renewal and/or termination options are at our discretion and are included in the determination of the lease term and lease payment obligations when it is deemed reasonably certain that the option will be exercised. When available, we use the rate implicit in the lease to discount lease payments to present value; however, certain leases do not provide a readily determinable implicit rate. Therefore, we must estimate our incremental borrowing rate to discount the lease payments based on information available at lease commencement. We classify our leases as buildings, vehicles or computer and office equipment and do not separate lease and non-lease components of contracts for any of the aforementioned classifications. In accordance with applicable guidance, we do not record leases with terms that are less than one year on the Condensed Consolidated Balance Sheets. None of our lease agreements contain material restrictive covenants or residual value guarantees. Buildings We lease certain office and warehouse space at various locations in the United States where we provide services. These leases are typically greater than one year with fixed, escalating rents over the noncancelable terms and, therefore, ROU operating lease assets and operating lease liabilities are recorded on the Condensed Consolidated Balance Sheets, with rent expense recognized on a straight-line basis over the term of the lease. The remaining lease terms vary from approximately one to seven years as of June 30, 2024. We entered into a lease (“initial lease”) in October 2018, for approximately 80,000 square feet of office space for our new corporate headquarters in Minneapolis, Minnesota. In December 2018, we amended the initial lease to add approximately 29,000 square feet of additional office space, which is accounted for as a separate lease (“second lease”) in accordance with ASU No. 2016-02, “Leases” (Topic 842) (“ASC 842”). In December 2019, we further amended the lease which extended the expiration date of the initial lease, extended the expiration date of and added approximately 4,000 square feet to the second lease, as well as added approximately 37,000 square feet of additional office space, accounted for as a separate lease (“third lease”) in accordance with ASC 842. The portion of the space covered under the initial lease was placed in service in September 2019. The portion of the space covered under the second lease commenced in September 2020. Finally, the portion of the space covered under the third lease commenced in September 2021. The three portions were recognized as an operating lease and included in the ROU operating lease assets and operating lease liabilities on the Condensed Consolidated Balance Sheets. Computer and Office Equipment We also have operating lease agreements for certain computer and office equipment. The remaining lease terms as of June 30, 2024, ranged from less than one year to approximately four years with fixed monthly payments that are included in the ROU operating lease assets and operating lease liabilities. The leases provide an option to purchase the related equipment at fair market value at the end of the lease. The leases will automatically renew as a month-to-month rental at the end of the lease if the equipment is not purchased or returned. ​ Lease Position, Undiscounted Cash Flow and Supplemental Information The table below presents information related to our ROU operating lease assets and operating lease liabilities that we have recorded: ​ ​ ​ ​ ​ ​ ​ ​ (In thousands) At June 30, 2024 At December 31, 2023 Right of use operating lease assets ​ $ 17,828 ​ $ 19,128 ​ ​ ​ ​ ​ ​ ​ Operating lease liabilities: ​ ​ ​ ​ ​ ​ Current ​ $ 2,799 ​ $ 2,807 Non-current ​ 17,142 ​ 18,436 Total ​ $ 19,941 ​ $ 21,243 ​ ​ ​ ​ ​ ​ ​ Operating leases: ​ ​ ​ ​ ​ ​ Weighted average remaining lease term ​ 6.3 years ​ ​ 6.7 years Weighted average discount rate ​ ​ 4.3% ​ ​ 4.3% ​ ​ ​ ​ ​ ​ ​ ​ ​ Six Months Ended June 30, ​ ​ 2024 ​ 2023 Supplemental cash flow information for our operating leases: ​ ​ ​ ​ ​ ​ Cash paid for operating lease liabilities ​ $ 1,743 ​ $ 1,710 Non-cash right of use assets obtained in exchange for new operating lease obligations ​ $ 3 ​ $ — ​ The table below reconciles the undiscounted cash flows for the periods presented to the operating lease liabilities recorded on the Condensed Consolidated Balance Sheet for the periods presented: ​ ​ ​ ​ ​ (In thousands) ​ ​ ​ 2024 (July 1 - December 31) ​ $ 1,791 2025 ​ ​ 3,645 2026 ​ 3,716 2027 ​ 3,210 2028 ​ 3,185 Thereafter ​ 6,943 Total minimum lease payments ​ ​ 22,490 Less: Amount of lease payments representing interest ​ ​ (2,549) Present value of future minimum lease payments ​ ​ 19,941 Less: Current obligations under operating lease liabilities ​ ​ (2,799) Non-current obligations under operating lease liabilities ​ $ 17,142 ​ Operating lease costs were $0.9 million for each of the three months ended June 30, 2024 and 2023. Operating lease costs were $1.8 million for each of the six months ended June 30, 2024 and 2023. Major Vendors We had purchases from one vendor that accounted for 17% of our total purchases for the three months ended June 30, 2024, and purchases from one vendor that accounted for 20% of our total purchases for the six months ended June 30, 2024. We had purchases from two vendors that accounted for 30% of our total purchases for the three months ended June 30, 2023, and purchases from one vendor that accounted for 24% of our total purchases for the six months ended June 30, 2023. Purchase Commitments We issued purchase orders prior to June 30, 2024, totaling $28.8 million for goods that we expect to receive within the next year. Retirement Plan We maintain a 401(k) retirement plan for our employees in which eligible employees can contribute a percentage of their pre-tax compensation. We recorded an expense related to our discretionary contributions to the 401(k) plan of $0.4 million and $0.3 million for the three months ended June 30, 2024 and 2023, respectively, and $1.1 million and $0.7 million for the six months ended June 30, 2024 and 2023, respectively. Legal Proceedings F rom time to time, we are subject to various claims and legal proceedings arising in the ordinary course of business. Regardless of outcome, litigation can have an adverse impact on us because of defense and settlement costs, diversion of management resources and other factors. On May 24, 2022, a stockholder derivative lawsuit was filed in the United States District Court for the District of Minnesota, purportedly on behalf of the Company against certain of our present and former officers and directors and the Company (as a nominal defendant), captioned Jack Weaver v. Moen, et al., File No. 0:22-cv-01403-NEB-BRT (the “Weaver Lawsuit”). The Weaver Lawsuit generally arises out of the same subject matter as a previously settled securities class action captioned Brian Mart v. Tactile Sys. Tech., Inc., et al., File No. 0:20-cv-02074-NEB-BRT (D. Minn.) (the “Mart Lawsuit”), which alleged, inter alia, that we and eight of our former officers and directors made materially false or misleading statements about our business, operational and compliance policies. The Weaver Lawsuit alleges the following claims under the Exchange Act and common law: (1) that the director defendants made materially false or misleading public statements in proxy statements in violation of Section 14(a) of the Exchange Act; (2) that the director defendants’ stock and option awards should be rescinded under Section 29(b) of the Exchange Act; (3) that the officer defendants’ employment contract compensation should be rescinded under Section 29(b) of the Exchange Act; (4) that certain officer defendants are liable for contribution arising out of any liability incurred in the Mart Lawsuit, under Sections 10(b) and 21D of the Exchange Act; (5) that the individual defendants breached their fiduciary duties; and (6) that the individual defendants were unjustly enriched. The Weaver Lawsuit seeks unspecified damages. In August 2022, the matter was transferred to the United States District Court for the District of Delaware by order granting the Parties Stipulation to Transfer. On February 10, 2023, we filed a motion to dismiss the action. The plaintiff filed an Amended Complaint on March 3, 2023. On March 31, 2023, we filed a motion to dismiss the Amended Complaint. On July 31, 2023, the plaintiff filed a Joint Notice of Preliminary Settlement indicating that the parties had reached a non-binding settlement-in-principal on most of the material terms that would resolve all claims between the parties and requested that the Court temporarily stay all deadlines, hearings, and conferences while the parties continued to finalize settlement . On June 6, 2024, we entered into a Stipulation of Settlement in the Weaver Lawsuit. On June 7, 2024, the plaintiff filed an unopposed motion for preliminary approval of the settlement. On June 27, 2024, the Court entered an order granting the motion for preliminary approval of the settlement. The Court has scheduled a settlement hearing for August 28, 2024 to consider whether to grant final approval to the settlement. Pursuant to the settlement, we will adopt, implement and maintain certain corporate governance reforms and have agreed to pay approximately $0.5 million in fees and expenses related to this lawsuit. The settlement does not constitute an admission of liability or wrongdoing by us or any of our current or former directors or officers.

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 2024
Stockholders' Equity
Stockholders' Equity	Note 10. Stockholders' Equity Stock-Based Compensation Our 2016 Equity Incentive Plan (the “2016 Plan”) authorizes us to grant stock options, stock appreciation rights, restricted stock, stock units and other stock-based awards to employees, non-employee directors and certain consultants and advisors. There were up to 4,800,000 shares of our common stock initially reserved for issuance pursuant to the 2016 Plan. The 2016 Plan provides that the number of shares reserved and available for issuance under the 2016 Plan will automatically increase annually on January 1 of each calendar year, commencing in 2017 and ending on and including January 1, 2026, by an amount equal to the lesser of: (a) 5% of the number of common shares of stock outstanding as of December 31 of the immediately preceding calendar year, or (b) 2,500,000 shares; provided, however, that our Board of Directors may determine that any annual increase be a lesser number. In addition, all awards granted under our 2007 Omnibus Stock Plan and our 2003 Stock Option Plan that were outstanding when the 2016 Plan became effective and that are forfeited, expired, cancelled, settled for cash or otherwise not issued, will become available for issuance under the 2016 Plan. Pursuant to the automatic increase feature of the 2016 Plan, 1,180,019 shares were added as available for issuance thereunder on January 1, 2024. Our Board of Directors exercised its prerogative to forego the automatic increase on January 1, 2023. As of June 30, 2024, 6,615,454 shares were available for future grant pursuant to the 2016 Plan. Upon adoption and approval of the 2016 Plan, all of our previous equity incentive compensation plans were terminated. However, existing awards under those plans continue to vest in accordance with the original vesting schedules and will expire at the end of their original terms. We recorded stock-based compensation expense of $1.9 million and $1.8 million for the three months ended June 30, 2024 and 2023, respectively and $3.9 million and $3.8 million for the six months ended June 30, 2024 and 2023, respectively. This expense was allocated as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 2023 2024 2023 Cost of revenue ​ $ 103 ​ $ 121 ​ $ 186 ​ $ 224 Sales and marketing expenses ​ ​ 606 ​ ​ 810 ​ ​ 1,344 ​ ​ 1,562 Research and development expenses ​ ​ 48 ​ ​ 44 ​ ​ 81 ​ ​ 93 Reimbursement, general and administrative expenses ​ ​ 1,103 ​ ​ 833 ​ ​ 2,288 ​ ​ 1,952 Total stock-based compensation expense ​ $ 1,860 ​ $ 1,808 ​ $ 3,899 ​ $ 3,831 ​ Stock Options Stock options issued to participants other than non-employees typically vest over three or four years and typically have a contractual term of seven or ten years . Stock-based compensation expense included in the Condensed Consolidated Statements of Operations for stock options was $0.1 million and $0.2 million for the three months ended June 30, 2024 and 2023, respectively and $0.2 million and $0.5 million for the six months ended June 30, 2024 and 2023, respectively. At June 30, 2024, there was approximately $0.1 million of total unrecognized pre-tax stock option expense under our equity compensation plans, which is expected to be recognized on a straight-line basis over a weighted-average period of 1.0 years. Our stock option activity for the six months ended June 30, 2024, was as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ Weighted- ​ ​ ​ ​ ​ ​ ​ Average ​ Average ​ Aggregate ​ ​ Options ​ Exercise Price ​ Remaining ​ Intrinsic (In thousands except options and per share data) ​ Outstanding ​ Per Share (1) ​ Contractual Life ​ Value (2) Balance at December 31, 2023 ​ 429,960 ​ $ 40.74 ​ 3.8 years ​ $ 223 Exercised ​ (1,153) ​ $ 1.35 ​ ​ ​ $ 14 Cancelled/Expired ​ (12,995) ​ $ 41.17 ​ ​ ​ ​ ​ Balance at June 30, 2024 ​ 415,812 ​ $ 40.83 ​ 3.3 years ​ $ 125 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Options exercisable at June 30, 2024 ​ 392,239 ​ $ 42.19 ​ 3.2 years ​ $ 65 ​ (1) The exercise price of each option granted during the period shown was equal to the market price of the underlying stock on the date of grant. (2) The aggregate intrinsic value of options exercised represents the difference between the exercise price of the option and the closing stock price of our common stock on the date of exercise. The aggregate intrinsic value of options outstanding represents the difference between the exercise price of the option and the closing stock price of our common stock on the last trading day of the period. Options exercisable of 435,559 as of June 30, 2023, had a weighted-average exercise price of $44.67 per share. Time-Based Restricted Stock Units We have granted time-based restricted stock units to certain participants under the 2016 Plan that are stock-settled with common shares. Time-based restricted stock units granted under the 2016 Plan vest over one to three years . Stock-based compensation expense included in the Condensed Consolidated Statements of Operations for time-based restricted stock units was $1.5 million and $1.3 million for the three months ended June 30, 2024 and 2023, respectively, and $2.9 million and $2.6 million for the six months ended June 30, 2024 and 2023, respectively. At June 30, 2024, there was approximately $8.3 million of total unrecognized pre-tax compensation expense related to outstanding time-based restricted stock units that is expected to be recognized over a weighted-average period of 1.9 years. Our time-based restricted stock unit activity for the six months ended June 30, 2024, was as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ ​ Average Grant Aggregate ​ ​ Units ​ Date Fair Value ​ Intrinsic (In thousands except unit and per unit data) ​ Outstanding ​ Per Unit ​ Value (1) Balance at December 31, 2023 ​ 589,142 ​ $ 16.35 ​ $ 8,425 Granted ​ 464,145 ​ $ 13.87 ​ ​ ​ Vested ​ (224,149) ​ $ 18.02 ​ ​ ​ Cancelled ​ (107,363) ​ $ 14.62 ​ ​ ​ Balance at June 30, 2024 ​ 721,775 ​ $ 14.50 ​ $ 8,618 ​ (1) The aggregate intrinsic value of restricted stock units outstanding was based on our closing stock price on the last trading day of the period. Performance-Based Restricted Stock Units We have granted performance-based restricted stock units (“PSUs”) to certain participants under the 2016 Plan. These PSUs have both performance-based and time-based vesting features. The PSUs granted in 2023 have three separate performance periods, and one-third of each grant will be earned if and to the extent performance goals based on revenue change and adjusted EBITDA margin are achieved in each of 2023 and 2024 (ranging from 25% to 175% of target), and one-third will be earned if and to the extent performance goals based on revenue change and adjusted EBITDA change are achieved in 2025 (ranging from 25% to 175% of target). The PSUs granted in 2024 have three separate performance periods, and one-third of each grant will be earned if and to the extent performance goals based on revenue change and adjusted EBITDA margin are achieved in 2024 (ranging from 25% to 175% of target), one-third will be earned if and to the extent performance goals based on revenue change and adjusted EBITDA change are achieved in 2025 (ranging from 25% to 175% of target), and one-third will be earned if and to the extent performance goals to be established are achieved in 2026. All earned and vested PSUs will be settled in shares of common stock. Stock-based compensation expense recognized for PSUs was $0.2 million and $0.1 million for the three months ended June 30, 2024 and 2023, respectively, and $0.6 million and $0.3 million for the six months ended June 30, 2024 and 2023, respectively. At June 30, 2024, there was approximately $1.5 million of total unrecognized pre-tax compensation expense related to outstanding PSUs that is expected to be recognized over a weighted average period of 2.2 years. Our PSU activity for the six months ended June 30, 2024, was as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ ​ Average Grant Aggregate ​ ​ PSUs ​ Date Fair Value ​ Intrinsic (In thousands except unit and per unit data) ​ Outstanding ​ Per Unit ​ Value (1) Balance at December 31, 2023 ​ 198,232 ​ $ 18.93 ​ $ 2,785 Granted ​ 160,659 ​ $ 13.88 ​ ​ ​ Vested ​ (44,162) ​ $ 27.31 ​ ​ ​ Cancelled ​ (104,913) ​ $ 14.14 ​ ​ ​ Balance at June 30, 2024 ​ 209,816 ​ $ 15.70 ​ $ 2,505 ​ (1) The aggregate intrinsic value of PSUs outstanding was based on our closing stock price on the last trading day of the period. Employee Stock Purchase Plan Our employee stock purchase plan (“ESPP”), which was approved by our Board of Directors on April 27, 2016, and by our stockholders on June 20, 2016, allows participating employees to purchase shares of our common stock at a discount through payroll deductions. The ESPP is available to all of our employees and employees of participating subsidiaries. Participating employees may purchase common stock, on a voluntary after-tax basis, at a price equal to 85% of the lower of the closing market price per share of our common stock on the first or last trading day of each stock purchase period. The ESPP provides for six-month purchase periods, beginning on May 16 and November 16 of each calendar year. A total of 1,600,000 shares of common stock was initially reserved for issuance under the ESPP. This share reserve will automatically be supplemented each January 1, commencing in 2017 and ending on and including January 1, 2026, by an amount equal to the least of (a) 1% of the shares of our common stock outstanding on the immediately preceding December 31, (b) 500,000 shares or (c) such lesser amount as our Board of Directors may determine. Pursuant to the automatic increase feature of the ESPP, 236,003 shares were added as available for issuance thereunder on January 1, 2024. Our Board of Directors exercised its prerogative to forego the automatic increase on January 1, 2023. As of June 30, 2024, 1,497,964 shares were available for future issuance under the ESPP. We recognized stock-based compensation expense associated with the ESPP of $0.1 million for each of the three months ended June 30, 2024 and 2023, and $0.2 million and $0.3 million for the six months ended June 30, 2024 and 2023, respectively.

Revenue

Revenue	6 Months Ended
	Jun. 30, 2024
Revenue
Revenue	Note 11. Revenue We derive our revenue from the sale and rental of our products to our customers in the United States. The following table presents our revenue, inclusive of sales and rental revenue, disaggregated by product line : ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 ​ 2023 ​ 2024 ​ 2023 Revenue ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Lymphedema products ​ $ 64,683 ​ $ 59,999 ​ $ 116,996 ​ $ 109,751 Airway clearance products ​ ​ 8,535 ​ ​ 8,340 ​ ​ 17,310 ​ ​ 17,434 Total ​ $ 73,218 ​ $ 68,339 ​ $ 134,306 ​ $ 127,185 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Percentage of total revenue ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Lymphedema products ​ 88% ​ 88% ​ 87% ​ 86% Airway clearance products ​ ​ 12% ​ ​ 12% ​ ​ 13% ​ ​ 14% Total ​ 100% ​ 100% ​ 100% ​ 100% ​ Our revenue by channel, inclusive of sales and rental revenue, for the three and six months ended June 30, 2024 and 2023, are summarized in the following table: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 ​ 2023 ​ 2024 ​ 2023 Private insurers and other payers ​ $ 44,066 ​ $ 36,499 ​ $ 75,343 ​ $ 61,924 Veterans Administration ​ ​ 8,071 ​ ​ 7,121 ​ ​ 14,897 ​ ​ 12,944 Medicare ​ ​ 12,546 ​ ​ 16,379 ​ ​ 26,756 ​ ​ 34,883 Durable medical equipment distributors ​ ​ 8,535 ​ ​ 8,340 ​ ​ 17,310 ​ ​ 17,434 Total ​ $ 73,218 ​ $ 68,339 ​ $ 134,306 ​ $ 127,185 ​ Our rental revenue is derived from rent-to-purchase arrangements that typically range from three to ten months . As title transfers to the patient, with whom we have the contract, upon the termination of the lease term and because collectability is probable, under ASC 842, these are recognized as sales-type leases. Each rental agreement contains two components, the controller and related garments, both of which are interdependent and recognized as one lease component. The revenue and associated cost of revenue of sales-type leases are recognized on the lease commencement date and a net investment in leases is recorded on the Condensed Consolidated Balance Sheets. We bill the patients’ insurance payers monthly over the duration of the rental term. We record the net investment in leases and recognize revenue upon commencement of the lease in the amount of the expected consideration to be received through the monthly payments. Similar to our sales revenue, the transaction price is impacted by multiple factors, including the terms and conditions contracted by third-party payers. As the rental contract resides with the patients, we have elected the portfolio approach, at the payer level, to determine the expected consideration, which considers the impact of early terminations. While the contract is with the patient, in certain circumstances, the third-party payer elects an initial rental period with an option to extend. We assess the likelihood of extending the lease at the onset of the lease to determine if the option is reasonably certain to be exercised. As the lease is short-term in nature, we anticipate collection of substantially all of the net investment within the first year of the lease agreement. Completion of these payments represents the fair market value of the equipment, and as such, interest income is not applicable. Rental revenue for the three months ended June 30, 2024 and 2023, was primarily from private insurers. Sales-type lease revenue and the associated cost of revenue for the three and six months ended June 30, 2024 and 2023, was: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended June 30, ​ Six Months Ended June 30, (In thousands) ​ 2024 ​ 2023 ​ 2024 ​ 2023 Sales-type lease revenue ​ $ 8,951 ​ $ 8,537 ​ $ 16,732 ​ $ 14,592 Cost of sales-type lease revenue ​ 2,852 ​ 3,175 ​ 5,567 ​ 5,911 Gross profit ​ $ 6,099 ​ $ 5,362 ​ $ 11,165 ​ $ 8,681 ​

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2024
Income Taxes
Income Taxes	Note 12. Income Taxes We record our interim provision for income taxes by applying our estimated annual effective tax rate to our year-to-date pre-tax income (loss) and adjusting for discrete tax items recorded in the period. Deferred income taxes result from temporary differences between the reporting of amounts for financial statement purposes and income tax purposes. These differences relate primarily to different methods used for income tax reporting purposes, including for depreciation and amortization, warranty and vacation accruals, and deductions related to allowances for doubtful accounts receivable and inventory reserves. Our provision for income taxes includes current federal and state income tax expense, as well as deferred federal and state income tax expense. The effective tax rate for the three months ended June 30, 2024, was an expense of 29.2% , compared to an expense of 108.3% for the three months ended June 30, 2023. The primary driver of the change in our effective tax rate was attributable to the fact that we did not have a full valuation allowance on our deferred tax assets for the current year period, while the prior year period reported a full valuation allowance. We recorded income tax expense of $1.8 million and $1.3 million for the three months ended June 30, 2024 and 2023, respectively. ​ The effective tax rate for the six months ended June 30, 2024, was an expense of 36.0% , compared to a benefit of 44.5% for the six months ended June 30, 2023. The primary driver of the change in our effective tax rate was attributable to the fact that we did not have a full valuation allowance on our deferred tax assets for the current year period, while the prior year period reported a full valuation allowance. Additionally, in the prior year period we had year-to-date losses that we expected to realize, which drove a tax benefit. We recorded an income tax expense of $1.2 million and an income tax benefit of $1.6 million for the six months ended June 30, 2024 and 2023, respectively. We recognize the financial statement benefit of a tax position only after determining that the relevant tax authority is more-likely-than-not to sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount recognized in the condensed consolidated financial statements is the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement with the relevant tax authority. The Company currently is not under examination in any jurisdictions.

Net Income (Loss) Per Share

Net Income (Loss) Per Share	6 Months Ended
	Jun. 30, 2024
Net Income (Loss) Per Share
Net Income (Loss) Per Share	Note 13. Net Income (Loss) Per Share The following table sets forth the computation of our basic and diluted net income (loss) per share: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands, except share and per share data) 2024 2023 2024 2023 Net income (loss) ​ $ 4,298 ​ $ (100) ​ $ 2,089 ​ $ (1,986) Weighted-average shares outstanding ​ ​ 23,873,379 ​ ​ 23,352,530 ​ ​ 23,769,604 ​ ​ 22,323,856 Weighted-average shares used to compute diluted net income (loss) per share ​ ​ 24,099,047 ​ ​ 23,352,530 ​ ​ 24,073,986 ​ ​ 22,323,856 Net income (loss) per share - Basic ​ $ 0.18 ​ $ 0.00 ​ $ 0.09 ​ $ (0.09) Net income (loss) per share - Diluted ​ $ 0.18 ​ $ 0.00 ​ $ 0.09 ​ $ (0.09) ​ The following common stock equivalents were excluded from the computation of diluted net income (loss) per share for the periods presented because including them would have been anti-dilutive: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, ​ 2024 2023 2024 2023 Restricted stock units ​ 449,056 ​ 674,178 ​ 493,370 ​ 674,178 Common stock options ​ 381,187 ​ 526,047 ​ 387,298 ​ 526,047 Performance stock units ​ — ​ 216,291 ​ 166,457 ​ 216,291 Employee stock purchase plan ​ — ​ 59,509 ​ — ​ 71,253 Total ​ 830,243 ​ 1,476,025 ​ 1,047,125 ​ 1,487,769 ​

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2024
Fair Value Measurements
Fair Value Measurements	Note 14. Fair Value Measurements We determine the fair value of our assets and liabilities based on the exchange price that would be received for an asset or paid to transfer a liability (exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value maximize the use of observable inputs and minimize the use of unobservable inputs. We use a fair value hierarchy with three levels of inputs, of which the first two are considered observable and the last unobservable, to measure fair value. The fair value hierarchy gives the highest priority to quoted prices in active markets for identical assets or liabilities (Level 1). The next highest priority is based on quoted prices for similar assets or liabilities in active markets or quoted prices for identical or similar assets or liabilities in non-active markets or other observable inputs (Level 2). The lowest priority is given to unobservable inputs (Level 3). As of June 30, 2024, our obligations under the AffloVest Acquisition earn-out arrangements had been paid in full. Prior to the determination of the actual amount of the earn-out, the earn-out liability was valued by employing a Monte Carlo Simulation model in a risk-neutral framework, which is a Level 3 input. The underlying simulated variable included recognized revenue. The recognized revenue volatility estimate was based on a study of historical asset volatility for a set of comparable public companies. The model included other assumptions including the market price of risk, which was calculated as the weighted average cost of capital less the long-term risk-free rate. The earn-out liability was adjusted to fair value at each reporting date until the end of the earn-out period, which was September 30, 2023. Changes in fair value were included in intangible asset amortization and earn-out expenses in our Condensed Consolidated Statements of Operations. ​ Changes in the earn-out liability measured at fair value using Level 3 inputs were as follows: ​ ​ ​ ​ ​ (In thousands) ​ ​ Earn-out liability at December 31, 2022 ​ $ 13,050 Payment on earn-out ​ ​ (5,000) Fair value adjustments ​ ​ 1,230 Earn-out liability at June 30, 2023 ​ $ 9,280 ​ On May 25, 2023, the Company paid $5.0 million, plus an imputed interest payment of $250,000 , relating to the initial earn-out. Subsequent to September 30, 2023, it was determined that the calculated amount of the second earn-out payment was $5.6 million, which was paid by the Company on November 28, 2023. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ The carrying amounts of financial instruments such as cash equivalents, accounts receivable, other assets, accounts payable, accrued expenses and other liabilities approximate their related fair values due to the short-term maturities of these items. Non-financial assets, such as equipment and leasehold improvements, and intangible assets are subject to non-recurring fair value measurements if they are deemed impaired.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 4,298	$ (100)	$ 2,089	$ (1,986)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024 shares
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Kristie T. Burns
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On May 15, 2024 , Kristie T. Burns , our Senior VP Marketing and Clinical Affairs , adopted a pre-arranged trading plan that is intended to satisfy the affirmative defense of Rule 10b5-1(c) of the Exchange Act. This plan provides for the sale of up to 7,444 shares of our common stock in the aggregate and terminates on the earlier of the close of market on August 26, 2025 , or the date all shares are sold thereunder.
Name	Kristie T. Burns
Title	Senior VP Marketing and Clinical Affairs
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 15, 2024
Expiration Date	August 26, 2025
Aggregate Available	7,444
William W. Burke
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On May 28, 2024 , William W. Burke , Chairman of our Board of Directors , adopted a pre-arranged trading plan that is intended to satisfy the affirmative defense of Rule 10b5-1(c) of the Exchange Act. This plan provides for the sale of up to 7,013 shares of our common stock in the aggregate and terminates on the earlier of the close of market on December 31, 2025 , or the date all shares are sold thereunder.
Name	William W. Burke
Title	Chairman of our Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 28, 2024
Expiration Date	December 31, 2025
Aggregate Available	7,013
Elaine M. Birkemeyer
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On June 10, 2024 , Elaine M. Birkemeyer , Chief Financial Officer , adopted a pre-arranged trading plan that is intended to satisfy the affirmative defense of Rule 10b5-1(c) of the Exchange Act. This plan provides for the sale of up to 84,848 shares of our common stock in the aggregate and terminates on the earlier of the close of market on December 31, 2027 , or the date all shares are sold thereunder.
Name	Elaine M. Birkemeyer
Title	Chief Financial Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	June 10, 2024
Expiration Date	December 31, 2027
Aggregate Available	84,848
Daniel L. Reuvers
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On June 10, 2024 , Daniel L. Reuvers , former Chief Executive Officer and current member of our Board of Directors , adopted a pre-arranged trading plan that is intended to satisfy the affirmative defense of Rule 10b5-1(c) of the Exchange Act. This plan provides for the sale of up to 130,564 shares of our common stock in the aggregate and terminates on the earlier of the close of market on December 31, 2025 , or the date all shares are sold thereunder.
Name	Daniel L. Reuvers
Title	former Chief Executive Officer and current member of our Board of Directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	June 10, 2024
Expiration Date	December 31, 2025
Aggregate Available	130,564

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2024
Summary of Significant Accounting Policies
Basis of Presentation	The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”) for interim financial reporting and pursuant to the rules and regulations of the SEC. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments (including those which are normal and recurring) considered necessary for a fair presentation of the interim financial information have been included. The results for the six months ended June 30, 2024, are not necessarily indicative of results to be expected for the year ending December 31, 2024, or for any other interim period or for any future year. The condensed consolidated interim financial statements should be read in conjunction with the audited financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2023.
Principles of Consolidation	Principles of Consolidation The accompanying unaudited condensed consolidated financial statements include the accounts of Tactile Systems Technology, Inc. and its wholly owned subsidiary, Swelling Solutions, Inc. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and to disclose contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates.
Accounting Pronouncement Not Yet Adopted	Accounting Pronouncement Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2023-07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures” which requires entities to enhance disclosures around segment reporting. The guidance is effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. In December 2023, the FASB issued ASU No. 2023-09, “Income Taxes (Topic 740): Improvements to Income Tax Disclosures” which requires entities to enhance disclosures around income taxes. The guidance is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures .

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2024
Inventories
Schedule of inventories	​ ​ ​ ​ ​ ​ ​ ​ (In thousands) At June 30, 2024 At December 31, 2023 Finished goods ​ $ 6,365 ​ $ 7,979 Component parts and work-in-process ​ 12,481 ​ 14,548 Total inventories ​ $ 18,846 ​ $ 22,527 ​

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets
Schedule of finite lived intangible assets	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ At June 30, 2024 ​ ​ Average ​ Gross ​ ​ ​ ​ ​ ​ Amortization ​ Carrying ​ Accumulated ​ Net (In thousands) Period ​ Amount ​ Amortization ​ Amount Definite-lived intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Patents ​ 12 years ​ $ 1,060 ​ $ 290 ​ $ 770 Defensive intangible assets ​ 1 year ​ ​ 1,125 ​ ​ 993 ​ ​ 132 Customer accounts ​ — ​ ​ 125 ​ ​ 125 ​ ​ — Customer relationships ​ 10 years ​ ​ 31,000 ​ ​ 6,704 ​ ​ 24,296 Developed technology ​ 8 years ​ ​ 13,000 ​ ​ 3,322 ​ ​ 9,678 Subtotal ​ ​ ​ ​ 46,310 ​ ​ 11,434 ​ ​ 34,876 Unamortized intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Tradenames ​ ​ ​ ​ 9,500 ​ ​ — ​ ​ 9,500 Patents pending ​ ​ ​ ​ 507 ​ ​ — ​ ​ 507 Total intangible assets ​ ​ ​ $ 56,317 ​ $ 11,434 ​ $ 44,883 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ At December 31, 2023 ​ ​ Average ​ Gross ​ ​ ​ ​ ​ ​ Amortization ​ Carrying ​ Accumulated ​ Net (In thousands) Period ​ Amount ​ Amortization ​ Amount Definite-lived intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Patents ​ 12 years ​ $ 1,018 ​ $ 248 ​ $ 770 Defensive intangible assets ​ 1 year ​ ​ 1,125 ​ ​ 920 ​ ​ 205 Customer accounts ​ — ​ 125 ​ 125 ​ — Customer relationships ​ 11 years ​ ​ 31,000 ​ ​ 5,511 ​ ​ 25,489 Developed technology ​ 9 years ​ ​ 13,000 ​ ​ 2,731 ​ ​ 10,269 Subtotal ​ ​ ​ ​ 46,268 ​ ​ 9,535 ​ ​ 36,733 Unamortized intangible assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Tradenames ​ ​ ​ ​ 9,500 ​ ​ — ​ ​ 9,500 Patents pending ​ ​ ​ ​ 491 ​ ​ — ​ ​ 491 Total intangible assets ​ ​ ​ $ 56,259 ​ $ 9,535 ​ $ 46,724
Schedule of future amortization expense	​ ​ ​ ​ ​ (In thousands) ​ ​ ​ 2024 (July 1 - December 31) $ 1,899 2025 ​ ​ 3,708 2026 ​ 3,643 2027 ​ 3,635 2028 ​ 3,632 Thereafter ​ 18,359 Total ​ $ 34,876

Accrued Expenses (Tables)

Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2024
Accrued Expenses
Schedule of Accrued Expenses	​ ​ ​ ​ ​ ​ ​ ​ (In thousands) At June 30, 2024 At December 31, 2023 Warranty ​ $ 2,131 ​ $ 2,357 Legal and consulting ​ ​ 1,161 ​ ​ 611 In-transit inventory ​ ​ 1,102 ​ ​ 401 Travel ​ ​ 933 ​ ​ 1,038 Clinical studies ​ ​ 339 ​ ​ 363 Sales and use tax ​ ​ 108 ​ ​ 183 Other ​ 928 ​ 951 Total ​ $ 6,702 ​ $ 5,904 ​

Warranty Reserves (Tables)

Warranty Reserves (Tables)	6 Months Ended
	Jun. 30, 2024
Warranty Reserves
Schedule of warranty reserves	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 2023 2024 2023 Beginning balance ​ $ 3,836 ​ $ 4,000 ​ $ 4,038 ​ $ 4,212 Warranty provision ​ 902 ​ 1,026 ​ 1,742 ​ 1,900 Processed warranty claims ​ (1,046) ​ (1,198) ​ (2,088) ​ (2,284) Ending balance ​ $ 3,692 ​ $ 3,828 ​ $ 3,692 ​ $ 3,828 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Accrued warranty reserve, current ​ $ 2,131 ​ $ 1,871 ​ $ 2,131 ​ $ 1,871 Accrued warranty reserve, non-current ​ ​ 1,561 ​ ​ 1,957 ​ ​ 1,561 ​ ​ 1,957 Total accrued warranty reserve ​ $ 3,692 ​ $ 3,828 ​ $ 3,692 ​ $ 3,828 ​

Credit Agreement (Tables)

Credit Agreement (Tables)	6 Months Ended
	Jun. 30, 2024
Credit Agreement
Schedule of maturities of the term note payable	​ ​ ​ ​ ​ (In thousands) Amount 2024 (July 1 - December 31) ​ $ 1,500 2025 ​ ​ 3,000 2026 ​ ​ 23,250 Total ​ ​ 27,750 Less: Deferred financing fees ​ ​ (96) Net Note Payable ​ ​ 27,654 Less: Current portion of note payable ​ ​ (2,956) Non-current portion of note payable ​ $ 24,698

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies
Summary of lease-related assets and liabilities	​ ​ ​ ​ ​ ​ ​ ​ (In thousands) At June 30, 2024 At December 31, 2023 Right of use operating lease assets ​ $ 17,828 ​ $ 19,128 ​ ​ ​ ​ ​ ​ ​ Operating lease liabilities: ​ ​ ​ ​ ​ ​ Current ​ $ 2,799 ​ $ 2,807 Non-current ​ 17,142 ​ 18,436 Total ​ $ 19,941 ​ $ 21,243 ​ ​ ​ ​ ​ ​ ​ Operating leases: ​ ​ ​ ​ ​ ​ Weighted average remaining lease term ​ 6.3 years ​ ​ 6.7 years Weighted average discount rate ​ ​ 4.3% ​ ​ 4.3% ​ ​ ​ ​ ​ ​ ​ ​ ​ Six Months Ended June 30, ​ ​ 2024 ​ 2023 Supplemental cash flow information for our operating leases: ​ ​ ​ ​ ​ ​ Cash paid for operating lease liabilities ​ $ 1,743 ​ $ 1,710 Non-cash right of use assets obtained in exchange for new operating lease obligations ​ $ 3 ​ $ — ​
Summary of undiscounted cash flows	​ ​ ​ ​ ​ (In thousands) ​ ​ ​ 2024 (July 1 - December 31) ​ $ 1,791 2025 ​ ​ 3,645 2026 ​ 3,716 2027 ​ 3,210 2028 ​ 3,185 Thereafter ​ 6,943 Total minimum lease payments ​ ​ 22,490 Less: Amount of lease payments representing interest ​ ​ (2,549) Present value of future minimum lease payments ​ ​ 19,941 Less: Current obligations under operating lease liabilities ​ ​ (2,799) Non-current obligations under operating lease liabilities ​ $ 17,142

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	6 Months Ended
	Jun. 30, 2024
Schedule of allocation of total stock-based compensation expense	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 2023 2024 2023 Cost of revenue ​ $ 103 ​ $ 121 ​ $ 186 ​ $ 224 Sales and marketing expenses ​ ​ 606 ​ ​ 810 ​ ​ 1,344 ​ ​ 1,562 Research and development expenses ​ ​ 48 ​ ​ 44 ​ ​ 81 ​ ​ 93 Reimbursement, general and administrative expenses ​ ​ 1,103 ​ ​ 833 ​ ​ 2,288 ​ ​ 1,952 Total stock-based compensation expense ​ $ 1,860 ​ $ 1,808 ​ $ 3,899 ​ $ 3,831
Schedule of stock option activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ Weighted- ​ ​ ​ ​ ​ ​ ​ Average ​ Average ​ Aggregate ​ ​ Options ​ Exercise Price ​ Remaining ​ Intrinsic (In thousands except options and per share data) ​ Outstanding ​ Per Share (1) ​ Contractual Life ​ Value (2) Balance at December 31, 2023 ​ 429,960 ​ $ 40.74 ​ 3.8 years ​ $ 223 Exercised ​ (1,153) ​ $ 1.35 ​ ​ ​ $ 14 Cancelled/Expired ​ (12,995) ​ $ 41.17 ​ ​ ​ ​ ​ Balance at June 30, 2024 ​ 415,812 ​ $ 40.83 ​ 3.3 years ​ $ 125 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Options exercisable at June 30, 2024 ​ 392,239 ​ $ 42.19 ​ 3.2 years ​ $ 65 ​ (1) The exercise price of each option granted during the period shown was equal to the market price of the underlying stock on the date of grant. (2) The aggregate intrinsic value of options exercised represents the difference between the exercise price of the option and the closing stock price of our common stock on the date of exercise. The aggregate intrinsic value of options outstanding represents the difference between the exercise price of the option and the closing stock price of our common stock on the last trading day of the period.
Time-Based Restricted Stock Units
Schedule of stock-settled restricted stock unit activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ ​ Average Grant Aggregate ​ ​ Units ​ Date Fair Value ​ Intrinsic (In thousands except unit and per unit data) ​ Outstanding ​ Per Unit ​ Value (1) Balance at December 31, 2023 ​ 589,142 ​ $ 16.35 ​ $ 8,425 Granted ​ 464,145 ​ $ 13.87 ​ ​ ​ Vested ​ (224,149) ​ $ 18.02 ​ ​ ​ Cancelled ​ (107,363) ​ $ 14.62 ​ ​ ​ Balance at June 30, 2024 ​ 721,775 ​ $ 14.50 ​ $ 8,618 ​ (1) The aggregate intrinsic value of restricted stock units outstanding was based on our closing stock price on the last trading day of the period.
Performance-based stock-settled restricted stock units
Schedule of stock-settled restricted stock unit activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ ​ Average Grant Aggregate ​ ​ PSUs ​ Date Fair Value ​ Intrinsic (In thousands except unit and per unit data) ​ Outstanding ​ Per Unit ​ Value (1) Balance at December 31, 2023 ​ 198,232 ​ $ 18.93 ​ $ 2,785 Granted ​ 160,659 ​ $ 13.88 ​ ​ ​ Vested ​ (44,162) ​ $ 27.31 ​ ​ ​ Cancelled ​ (104,913) ​ $ 14.14 ​ ​ ​ Balance at June 30, 2024 ​ 209,816 ​ $ 15.70 ​ $ 2,505 ​ (1) The aggregate intrinsic value of PSUs outstanding was based on our closing stock price on the last trading day of the period.

Revenue (Tables)

Revenue (Tables)	6 Months Ended
	Jun. 30, 2024
Revenue
Summary of revenue disaggregated by product	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 ​ 2023 ​ 2024 ​ 2023 Revenue ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Lymphedema products ​ $ 64,683 ​ $ 59,999 ​ $ 116,996 ​ $ 109,751 Airway clearance products ​ ​ 8,535 ​ ​ 8,340 ​ ​ 17,310 ​ ​ 17,434 Total ​ $ 73,218 ​ $ 68,339 ​ $ 134,306 ​ $ 127,185 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Percentage of total revenue ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Lymphedema products ​ 88% ​ 88% ​ 87% ​ 86% Airway clearance products ​ ​ 12% ​ ​ 12% ​ ​ 13% ​ ​ 14% Total ​ 100% ​ 100% ​ 100% ​ 100% ​
Summary of revenue by channel	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands) 2024 ​ 2023 ​ 2024 ​ 2023 Private insurers and other payers ​ $ 44,066 ​ $ 36,499 ​ $ 75,343 ​ $ 61,924 Veterans Administration ​ ​ 8,071 ​ ​ 7,121 ​ ​ 14,897 ​ ​ 12,944 Medicare ​ ​ 12,546 ​ ​ 16,379 ​ ​ 26,756 ​ ​ 34,883 Durable medical equipment distributors ​ ​ 8,535 ​ ​ 8,340 ​ ​ 17,310 ​ ​ 17,434 Total ​ $ 73,218 ​ $ 68,339 ​ $ 134,306 ​ $ 127,185
Sales-type lease revenue and the associated cost of goods sold	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended June 30, ​ Six Months Ended June 30, (In thousands) ​ 2024 ​ 2023 ​ 2024 ​ 2023 Sales-type lease revenue ​ $ 8,951 ​ $ 8,537 ​ $ 16,732 ​ $ 14,592 Cost of sales-type lease revenue ​ 2,852 ​ 3,175 ​ 5,567 ​ 5,911 Gross profit ​ $ 6,099 ​ $ 5,362 ​ $ 11,165 ​ $ 8,681 ​

Net Income (Loss) Per Shar (Tab

Net Income (Loss) Per Shar (Tables)	6 Months Ended
	Jun. 30, 2024
Net Income (Loss) Per Share
Schedule of computation of the basic and diluted net income (loss) per share	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, (In thousands, except share and per share data) 2024 2023 2024 2023 Net income (loss) ​ $ 4,298 ​ $ (100) ​ $ 2,089 ​ $ (1,986) Weighted-average shares outstanding ​ ​ 23,873,379 ​ ​ 23,352,530 ​ ​ 23,769,604 ​ ​ 22,323,856 Weighted-average shares used to compute diluted net income (loss) per share ​ ​ 24,099,047 ​ ​ 23,352,530 ​ ​ 24,073,986 ​ ​ 22,323,856 Net income (loss) per share - Basic ​ $ 0.18 ​ $ 0.00 ​ $ 0.09 ​ $ (0.09) Net income (loss) per share - Diluted ​ $ 0.18 ​ $ 0.00 ​ $ 0.09 ​ $ (0.09)
Schedule of potentially dilutive securities outstanding	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Six Months Ended ​ ​ June 30, ​ June 30, ​ 2024 2023 2024 2023 Restricted stock units ​ 449,056 ​ 674,178 ​ 493,370 ​ 674,178 Common stock options ​ 381,187 ​ 526,047 ​ 387,298 ​ 526,047 Performance stock units ​ — ​ 216,291 ​ 166,457 ​ 216,291 Employee stock purchase plan ​ — ​ 59,509 ​ — ​ 71,253 Total ​ 830,243 ​ 1,476,025 ​ 1,047,125 ​ 1,487,769 ​

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2024
Fair Value Measurements
Schedule of changes in the earn-out liability	​ ​ ​ ​ ​ (In thousands) ​ ​ Earn-out liability at December 31, 2022 ​ $ 13,050 Payment on earn-out ​ ​ (5,000) Fair value adjustments ​ ​ 1,230 Earn-out liability at June 30, 2023 ​ $ 9,280

Nature of Business and Operat_2

Nature of Business and Operations (Details) - USD ($) $ / shares in Units, $ in Thousands			6 Months Ended
	Feb. 27, 2023	Aug. 02, 2016	Jun. 30, 2023
Nature of Business and Operations
Proceeds from Issuance of Common Stock			$ 34,625
IPO
Nature of Business and Operations
Number of shares of common stock sold		4,120,000
IPO price per share (in dollars per share)		$ 10
Net proceeds from the initial public offering		$ 35,400
Expense Relating To Initial Public Offering		$ 2,900
Follow-On Public Offering
Nature of Business and Operations
Number of shares of common stock sold	2,875,000
Stock price	$ 13
Proceeds from Issuance of Common Stock	$ 34,600

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Inventories
Finished goods	$ 6,365	$ 7,979
Component parts and work-in-process	12,481	14,548
Total inventories	$ 18,846	$ 22,527

Goodwill And Intangible Asset_2

Goodwill And Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2024	Sep. 30, 2023	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023	Sep. 30, 2021
Goodwill and Intangible Assets
Goodwill	$ 31,063			$ 31,063		$ 31,063
Impairment recognized		$ 0
Definite-lived intangible assets:
Gross Carrying Amount	46,310			46,310		46,268
Accumulated Amortization	11,434			11,434		9,535
Total	34,876			34,876		36,733
Unamortized intangible assets:
Total intangible assets (Gross)	56,317			56,317		56,259
Total intangible assets (Net)	44,883			44,883		46,724
Amortization expense	1,000		$ 1,000	1,900	$ 1,900
Future Amortization
2024 (July 1 - December 31)	1,899			1,899
2025	3,708			3,708
2026	3,643			3,643
2027	3,635			3,635
2028	3,632			3,632
Thereafter	18,359			18,359
Total	34,876			34,876		36,733
Tradenames
Unamortized intangible assets:
Gross Carrying Amount, Indefinite	9,500			9,500		9,500
Patents pending
Unamortized intangible assets:
Gross Carrying Amount, Indefinite	$ 507			$ 507		$ 491
Patents pending
Definite-lived intangible assets:
Weighted Average Amortization Period	12 years			12 years		12 years
Gross Carrying Amount	$ 1,060			$ 1,060		$ 1,018
Accumulated Amortization	290			290		248
Total	770			770		770
Future Amortization
Total	$ 770			$ 770		$ 770
Defensive intangible assets
Definite-lived intangible assets:
Weighted Average Amortization Period	1 year			1 year		1 year
Gross Carrying Amount	$ 1,125			$ 1,125		$ 1,125
Accumulated Amortization	993			993		920
Total	132			132		205
Future Amortization
Total	132			132		205
Customer accounts
Definite-lived intangible assets:
Gross Carrying Amount	125			125		125
Accumulated Amortization	$ 125			$ 125		$ 125
Customer relationships
Definite-lived intangible assets:
Weighted Average Amortization Period	10 years			10 years		11 years
Gross Carrying Amount	$ 31,000			$ 31,000		$ 31,000
Accumulated Amortization	6,704			6,704		5,511
Total	24,296			24,296		25,489
Future Amortization
Total	$ 24,296			$ 24,296		$ 25,489
Developed technology
Definite-lived intangible assets:
Weighted Average Amortization Period	8 years			8 years		9 years
Gross Carrying Amount	$ 13,000			$ 13,000		$ 13,000
Accumulated Amortization	3,322			3,322		2,731
Total	9,678			9,678		10,269
Future Amortization
Total	9,678			9,678		$ 10,269
Cost of revenue.
Unamortized intangible assets:
Amortization expense	$ 300		$ 300	$ 600	$ 600
AffloVest APA
Goodwill and Intangible Assets
Goodwill							$ 31,100

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Jun. 30, 2023
Accrued Expenses
Warranty	$ 2,131	$ 2,357	$ 1,871
Legal and consulting	1,161	611
In-transit inventory	1,102	401
Travel	933	1,038
Clinical studies	339	363
Sales and use tax	108	183
Other	928	951
Total	$ 6,702	$ 5,904

Warranty Reserves (Details)

Warranty Reserves (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Movement in Standard Product Warranty Accrual [Roll Forward]
Beginning balance	$ 3,836	$ 4,000	$ 4,038	$ 4,212
Warranty provision	902	1,026	1,742	1,900
Processed warranty claims	(1,046)	(1,198)	(2,088)	(2,284)
Ending balance	3,692	3,828	3,692	3,828
Accrued warranty reserve, current	2,131	1,871	2,131	1,871	$ 2,357
Accrued warranty reserve, non-current	1,561	1,957	1,561	1,957	$ 1,681
Total accrued warranty reserve	$ 3,692	$ 3,828	$ 3,692	$ 3,828

Credit Agreement (Details)

Credit Agreement (Details) - USD ($)						6 Months Ended
	Dec. 21, 2023	Aug. 01, 2023	Jun. 21, 2023	Feb. 22, 2022	Sep. 08, 2021	Jun. 30, 2024
Credit Agreement
Line of credit, threshold contingent increase in borrowing capacity					$ 25,000,000
Credit agreement, total aggregate principal amount					80,000,000
Long-term debt						$ 27,800,000
Credit facility outstanding amount					25,000,000
Basis spread (as a percent)			0.10%
SOFR
Credit Agreement
Basis spread (as a percent)			3.50%
Revolving credit facility
Credit Agreement
Line of credit					25,000,000
Debt instrument periodic payment	$ 16,800,000
Revolving credit facility | Federal Funds
Credit Agreement
Basis spread (as a percent)			0.50%
Revolving credit facility | Base Rate
Credit Agreement
Basis spread (as a percent)			1%
Revolving credit facility | SOFR
Credit Agreement
Basis spread (as a percent)		3.50%				7.18%
Revolving credit facility | Maximum
Credit Agreement
Unused line fee (as a percent)		0.20%
Revolving credit facility | Maximum | Base Rate
Credit Agreement
Basis spread (as a percent)			2.25%
Revolving credit facility | Maximum | SOFR
Credit Agreement
Basis spread (as a percent)			3.25%
Revolving credit facility | Minimum
Credit Agreement
Unused line fee (as a percent)		0.125%
Revolving credit facility | Minimum | Base Rate
Credit Agreement
Basis spread (as a percent)			0.75%
Revolving credit facility | Minimum | SOFR
Credit Agreement
Basis spread (as a percent)			1.75%
Term Loan
Credit Agreement
Debt instrument face amount					30,000,000
Long-term debt					$ 30,000,000	$ 27,654,000
Principal prepayment of term loan				$ 3,000,000
Increase in term debt		$ 8,250,000
Debt instrument frequency of periodic payment						quarterly
Debt instrument periodic payment						$ 750,000

Credit Agreement - Maturities o

Credit Agreement - Maturities of Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Sep. 08, 2021
Maturities of notes payable
Net Note Payable	$ 27,800
Term Loan
Maturities of notes payable
2024 (July 1 - December 31)	1,500
2025	3,000
2026	23,250
Total	27,750
Less: Deferred financing fees	(96)
Net Note Payable	27,654	$ 30,000
Less: Current portion of note payable	(2,956)
Non-current portion of note payable	$ 24,698

Commitments and Contingencies -

Commitments and Contingencies - Lease Obligations (Details) - ft²	6 Months Ended
	Jun. 30, 2024	Dec. 31, 2019	Dec. 31, 2018	Oct. 31, 2018
Minimum
Commitments and Contingencies
Lease terms	12 months
Building | Minimum
Commitments and Contingencies
Lease terms	1 year
Building | Maximum
Commitments and Contingencies
Lease terms	7 years
Equipment
Commitments and Contingencies
Option to renew	true
Equipment | Minimum
Commitments and Contingencies
Lease terms	1 year
Equipment | Maximum
Commitments and Contingencies
Lease terms	4 years
Initial lease
Commitments and Contingencies
Area of office space				80,000
Second lease
Commitments and Contingencies
Area of office space			29,000
Additional office space added to the lease		4,000
Third lease
Commitments and Contingencies
Additional office space added to the lease		37,000

Commitments and Contingencies_2

Commitments and Contingencies - Lease related assets and liabilities (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Lease-related assets and liabilities
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Right of use operating lease assets		Right of use operating lease assets
Right of use operating lease assets	$ 17,828		$ 19,128
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Operating lease liabilities, Current		Operating lease liabilities, Current
Operating lease liabilities, Current	$ 2,799		$ 2,807
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Operating lease liabilities, non-current		Operating lease liabilities, non-current
Operating lease liabilities, non-current	$ 17,142		$ 18,436
Present value of future minimum lease payments	$ 19,941		$ 21,243
Weighted average remaining lease term	6 years 3 months 18 days		6 years 8 months 12 days
Weighted average discount rate	4.30%		4.30%
Cash paid for operating lease liabilities	$ 1,743	$ 1,710
Non-cash right of use assets obtained in exchange for new operating lease obligations	$ 3

Commitments and Contingencies_3

Commitments and Contingencies - Undiscounted cash flows (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Undiscounted cash flows
2024 (July 1 - December 31)	$ 1,791
2025	3,645
2026	3,716
2027	3,210
2028	3,185
Thereafter	6,943
Total minimum lease payments	22,490
Less: Amount of lease payments representing interest	(2,549)
Present value of future minimum lease payments	19,941	$ 21,243
Less: Current obligations under operating lease liabilities	(2,799)	(2,807)
Non-current obligations under operating lease liabilities	$ 17,142	$ 18,436

Commitments and Contingencies_4

Commitments and Contingencies - Lease commitments and operating lease cost (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Commitments and Contingencies
Operating lease cost	$ 0.9	$ 0.9	$ 1.8	$ 1.8

Commitments and Contingencies_5

Commitments and Contingencies - Major Vendors (Details) - item	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Vendor One
Commitments and Contingencies
Number of vendors	1	1	1	1
Vendor Two
Commitments and Contingencies
Number of vendors		2		2
Purchases | Vendor | Vendor One
Commitments and Contingencies
Total purchases (in percentage)	17%		20%	24%
Purchases | Vendor | Vendor Two
Commitments and Contingencies
Total purchases (in percentage)		30%

Commitments and Contingencies_6

Commitments and Contingencies - Purchase Commitments (Details) $ in Millions	Jun. 30, 2024 USD ($)
Purchase commitments
Purchase orders issued	$ 28.8

Commitments and Contingencies_7

Commitments and Contingencies - Retirement Plan (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
401(k)
Retirement Plan
Discretionary contributions	$ 0.4	$ 0.3	$ 1.1	$ 0.7

Commitments and Contingencies_8

Commitments and Contingencies - Legal Proceedings (Details) - The "Weaver Lawsuit" $ in Millions	Jun. 27, 2024 USD ($)	May 24, 2022 item
Loss Contingencies [Line Items]
Number of former officers and directors | item		8
Litigation fees and expenses | $	$ 0.5

Stockholders' Equity - Stock-Ba

Stockholders' Equity - Stock-Based Compensation (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
	Jan. 01, 2024	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Stock-based compensation
Compensation expense		$ 1,860	$ 1,808	$ 3,899	$ 3,831
Cost of revenue.
Stock-based compensation
Compensation expense		103	121	186	224
Sales and marketing expenses
Stock-based compensation
Compensation expense		606	810	1,344	1,562
Research and development expenses
Stock-based compensation
Compensation expense		48	44	81	93
Reimbursement, general and administrative expenses
Stock-based compensation
Compensation expense		$ 1,103	$ 833	$ 2,288	$ 1,952
2016 Plan
Stock-based compensation
Number of shares authorized		4,800,000		4,800,000
Automatic annual increase to the number of shares reserved and available for issuance as a percentage of outstanding common stock (as a percent)		5%		5%
Automatic annual increase to the number of shares reserved and available for issuance		2,500,000		2,500,000
Increase in number of shares reserved and available for issuance	1,180,019
Shares available for future issuance		6,615,454		6,615,454

Stockholders' Equity - Stock Op

Stockholders' Equity - Stock Options and Restricted Stock (Details) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024 USD ($) $ / shares shares	Jun. 30, 2023 USD ($) $ / shares shares	Jun. 30, 2024 USD ($) item $ / shares shares	Jun. 30, 2023 USD ($) $ / shares shares	Dec. 31, 2023 USD ($)
Stock-based compensation, general disclosures.
Stock-based compensation expense | $	$ 1,860	$ 1,808	$ 3,899	$ 3,831
Employee Stock Option
Stock-based compensation, general disclosures.
Stock-based compensation expense | $	100	$ 200	200	$ 500
Total unrecognized pre-tax compensation expense related to nonvested stock option awards | $	$ 100		$ 100
Weighted-average period over which unrecognized compensation cost is expected to be recognized			1 year
Options Outstanding
Outstanding at beginning of period | shares			429,960
Exercised | shares			(1,153)
Cancelled/Expired | shares			(12,995)
Outstanding at end of period | shares	415,812		415,812
Weighted Average Exercise Price Per Share
Outstanding at beginning of period | $ / shares			$ 40.74
Exercised | $ / shares			1.35
Cancelled/Expired | $ / shares			41.17
Outstanding at end of period | $ / shares	$ 40.83		$ 40.83
Other information
Options exercisable number of shares exercisable | shares	392,239	435,559	392,239	435,559
Options exercisable, weighted-average exercise price | $ / shares	$ 42.19	$ 44.67	$ 42.19	$ 44.67
Weighted average remaining contractual life (in years)			3 years 3 months 18 days	3 years 9 months 18 days
Options exercisable, weighted-average remaining contractual life			3 years 2 months 12 days
Aggregate Intrinsic Value, Options outstanding | $	$ 125		$ 125		$ 223
Aggregate Intrinsic Value, Exercised | $			14
Aggregate Intrinsic Value, Options exercisable | $	65		$ 65
Employee Stock Option | Minimum
Stock-based compensation, general disclosures.
Vesting period (in years)			3 years
Term (in years)			7 years
Employee Stock Option | Maximum
Stock-based compensation, general disclosures.
Vesting period (in years)			4 years
Term (in years)			10 years
2016 Plan | Time-Based Restricted Stock Units
Stock-based compensation, general disclosures.
Stock-based compensation expense | $	1,500	$ 1,300	$ 2,900	$ 2,600
Total unrecognized pre-tax compensation expense related to awards | $	$ 8,300		$ 8,300
Weighted-average period over which unrecognized compensation cost is expected to be recognized			1 year 10 months 24 days
Units Outstanding
Restricted stock unit awards outstanding at the beginning of the period (in shares) | shares			589,142
Granted (in shares) | shares			464,145
Vested (in shares) | shares			(224,149)
Cancelled (in shares) | shares			(107,363)
Restricted stock unit awards outstanding at the end of the period (in shares) | shares	721,775		721,775
Weighted Average Grant Date Fair Value Per Unit
Restricted stock unit awards outstanding at the beginning of the period (in dollars per share) | $ / shares			$ 16.35
Granted (in dollars per share) | $ / shares			13.87
Vested (in dollars per share) | $ / shares			18.02
Cancelled (in dollars per share) | $ / shares			14.62
Restricted stock unit awards outstanding at the end of the period (in dollars per share) | $ / shares	$ 14.50		$ 14.50
Aggregate Intrinsic Value
Restricted stock unit awards, Average Intrinsic Value | $	$ 8,618		$ 8,618		8,425
2016 Plan | Time-Based Restricted Stock Units | Minimum
Stock-based compensation, general disclosures.
Vesting period (in years)			1 year
2016 Plan | Time-Based Restricted Stock Units | Maximum
Stock-based compensation, general disclosures.
Vesting period (in years)			3 years
2016 Plan | Performance-based stock-settled restricted stock units
Stock-based compensation, general disclosures.
Stock-based compensation expense | $	200	$ 100	$ 600	$ 300
Total unrecognized pre-tax compensation expense related to awards | $	$ 1,500		$ 1,500
Weighted-average period over which unrecognized compensation cost is expected to be recognized			2 years 2 months 12 days
Number of performance awards under share-based payment arrangement | item			3
Units Outstanding
Restricted stock unit awards outstanding at the beginning of the period (in shares) | shares			198,232
Granted (in shares) | shares			160,659
Vested (in shares) | shares			(44,162)
Cancelled (in shares) | shares			(104,913)
Restricted stock unit awards outstanding at the end of the period (in shares) | shares	209,816		209,816
Weighted Average Grant Date Fair Value Per Unit
Restricted stock unit awards outstanding at the beginning of the period (in dollars per share) | $ / shares			$ 18.93
Granted (in dollars per share) | $ / shares			13.88
Vested (in dollars per share) | $ / shares			27.31
Cancelled (in dollars per share) | $ / shares			14.14
Restricted stock unit awards outstanding at the end of the period (in dollars per share) | $ / shares	$ 15.70		$ 15.70
Aggregate Intrinsic Value
Restricted stock unit awards, Average Intrinsic Value | $	$ 2,505		$ 2,505		$ 2,785
2016 Plan | Performance-based stock-settled restricted stock units | Minimum
Stock-based compensation, general disclosures.
Performance goals revenue change and adjusted EBITDA margin			25%
2016 Plan | Performance-based stock-settled restricted stock units | Maximum
Stock-based compensation, general disclosures.
Performance goals revenue change and adjusted EBITDA margin			175%
2016 Plan | 2025 PSUs | Minimum
Stock-based compensation, general disclosures.
Performance goals revenue change and adjusted EBITDA margin			25%
2016 Plan | 2025 PSUs | Maximum
Stock-based compensation, general disclosures.
Performance goals revenue change and adjusted EBITDA margin			175%
2016 Plan | 2024 PSUs | Minimum
Stock-based compensation, general disclosures.
Performance goals revenue change and adjusted EBITDA margin			25%
2016 Plan | 2024 PSUs | Maximum
Stock-based compensation, general disclosures.
Performance goals revenue change and adjusted EBITDA margin			175%
2016 Plan | 2023 PSUs
Stock-based compensation, general disclosures.
Number of performance awards under share-based payment arrangement | item			3
2016 Plan | Tranche one | 2024 PSUs
Stock-based compensation, general disclosures.
Award vesting percentage			33.33%
2016 Plan | Tranche one | 2023 PSUs
Stock-based compensation, general disclosures.
Award vesting percentage			33.33%
2016 Plan | Tranche two | 2025 PSUs
Stock-based compensation, general disclosures.
Award vesting percentage			33.33%
2016 Plan | Tranche three | 2026 PSUs
Stock-based compensation, general disclosures.
Award vesting percentage			33.33%

Stockholders' Equity - Employee

Stockholders' Equity - Employee Stock Purchase Plan (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Jan. 01, 2024	Apr. 27, 2016
Stockholders' Equity
Stock-based compensation expense	$ 1,860	$ 1,808	$ 3,899	$ 3,831
2016 Plan
Stockholders' Equity
Shares reserved	6,615,454		6,615,454
Employee Stock Purchase Plan
Stockholders' Equity
Purchase price of common stock under plan (as a percent)			85%
Offering period (in months)			6 months
Shares reserved	1,497,964		1,497,964		236,003	1,600,000
Incremental share increase (as a percent)			1%
Incremental share increase (in shares)			500,000
Stock-based compensation expense	$ 100	$ 100	$ 200	$ 300

Revenue (Details)

Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenue
Revenue	$ 73,218	$ 68,339	$ 134,306	$ 127,185
Percentage of total revenue (in percent)	100%	100%	100%	100%
Revenue from sale type lease
Sales-type lease revenue	$ 8,951	$ 8,537	$ 16,732	$ 14,592
Cost of sales-type lease revenue	2,852	3,175	5,567	5,911
Gross profit	6,099	5,362	$ 11,165	8,681
Minimum
Revenue from sale type lease
Rental period of rent-to-purchase arrangements			3 months
Maximum
Revenue from sale type lease
Rental period of rent-to-purchase arrangements			10 months
Private insurers and other payers
Revenue
Revenue	44,066	36,499	$ 75,343	61,924
Veterans Administration
Revenue
Revenue	8,071	7,121	14,897	12,944
Medicare
Revenue
Revenue	12,546	16,379	26,756	34,883
Durable medical equipment distributors
Revenue
Revenue	8,535	8,340	17,310	17,434
Lymphedema products
Revenue
Revenue	$ 64,683	$ 59,999	$ 116,996	$ 109,751
Percentage of total revenue (in percent)	88%	88%	87%	86%
Airway clearance products
Revenue
Revenue	$ 8,535	$ 8,340	$ 17,310	$ 17,434
Percentage of total revenue (in percent)	12%	12%	13%	14%

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Taxes
Income tax expense (benefit)	$ 1,776	$ 1,320	$ 1,176	$ (1,593)
Effective Income Tax Rate Reconciliation, Percent
Net effective rate	29.20%	108.30%	36%	(44.50%)

Net Income (Loss) Per Share - B

Net Income (Loss) Per Share - Basic and Diluted Net income (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Net Income (Loss) Per Share
Net Income (Loss)	$ 4,298	$ (100)	$ 2,089	$ (1,986)
Weighted-average shares outstanding	23,873,379	23,352,530	23,769,604	22,323,856
Weighted-average shares used to compute diluted net income (loss) per share	24,099,047	23,352,530	24,073,986	22,323,856
Net income (loss) per share - Basic	$ 0.18	$ 0	$ 0.09	$ (0.09)
Net income (loss) per share - Diluted	$ 0.18	$ 0	$ 0.09	$ (0.09)

Net Income (Loss) Per Share - A

Net Income (Loss) Per Share - Antidilutive Securities Excluded From Computation of Earnings Per Share (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Net Income (Loss) Per Share
Antidilutive securities excluded from computation of earnings per share	830,243	1,476,025	1,047,125	1,487,769
Restricted stock units
Net Income (Loss) Per Share
Antidilutive securities excluded from computation of earnings per share	449,056	674,178	493,370	674,178
Common stock options
Net Income (Loss) Per Share
Antidilutive securities excluded from computation of earnings per share	381,187	526,047	387,298	526,047
Performance stock units
Net Income (Loss) Per Share
Antidilutive securities excluded from computation of earnings per share		216,291	166,457	216,291
Employee stock purchase plan
Net Income (Loss) Per Share
Antidilutive securities excluded from computation of earnings per share		59,509		71,253

Fair Value Measurements - Earn

Fair Value Measurements - Earn out liability (Details) - USD ($) $ in Thousands			3 Months Ended	6 Months Ended
	Nov. 28, 2023	May 25, 2023	Mar. 31, 2023	Jun. 30, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Payments on earn-out	$ (5,600)	$ (5,000)		$ (5,000)
Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Earn-out liability, beginning balance			$ 13,050	$ 13,050
Payments on earn-out			(5,000)
Fair value adjustments			1,230
Earn-out liability, ending balance			$ 9,280

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Hierarchy (Details) - USD ($)			6 Months Ended
	Nov. 28, 2023	May 25, 2023	Jun. 30, 2023
Fair Value Measurements
Earn-out liability payment	$ 5,600,000	$ 5,000,000	$ 5,000,000
Imputed interest payment		$ 250,000