MDXG - Earnings call 4 2023 | MiMedx Group, Inc.

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Operator

Greetings, and welcome to the MiMedx Group Inc. Fourth Quarter and Full-Year 2023 Operating and Financial Results Conference Call. [Operator Instructions] As a reminder, this conference is being recorded.It is now my pleasure to introduce, Matt Notarianni, Head of Investor Relations. Thank you.

You may begin.

Matthew Notarianni

good and operator, you, afternoon, everyone. Thank the and financial to MiMedx fourth operating XXXX full-year and results quarter Welcome conference call. With Officer, are and me Chief Executive Officer, call on Joe Chief Doug Financial Rice. today's Capper;

can today's webcast, simultaneously that As part follow. we of displaying are slides you

You Doug our Relations then will highlights summary our mimedx.com. slides provide website goals. with some and from us with some a conclude including our operating for will and will a Joe kick off the the financial opening can at access updates, Investor Joe remarks, quarter, of results and of additional discussion financial

in our that, which Joe? to financial include www.mimedx.com.With our non-GAAP could over the access results Risk other sales, will to environment, delays, pleased expenses, subject to, free release, are reimbursement measures of cash and including sizes and GAAP may we factors.Additional your of due customers, growth, products.These our and and remind for section Actual and press include questions.Before to cash actual factors, for will today materially results turn risks Joe to Factors future measures reconciliation be our available Form from comments balance website like outcomes market now margins unforeseen and Also, that factors on future circumstances would expected results today our to a comments on a competition, I those XX-K. the including EBITDA, number and We provide described is you I'm anticipated statements, depend then include at our Capper. call on flow to we available and those the forward-looking factors. that differ uncertainties, begin, impact our and expectations in regarding sizes many will report and annual statements market

Joseph Capper

another you pleased afternoon, in guidance. outstanding Thanks, report grew that everyone. Matt, us excellent out our had by very XX%, an for am Thank year we to today's surpassing QX, XXXX.Revenue call. closing full all I joining good quarterly for and the on performance

to to year high As When tech in to that mission stated a a to med continues facets company exceptional needed report make pivot, you for vision will am ago, no The all leadership into challenging hear, transform at pivot a improvements.I the fairly business, this was the the MiMedx. our MiMedx I strategic to of focused, level over parts expenses, business. order of that was restructure that highly goal, an feat. growth-oriented business. and company our I drive just team on achieve significant perform In joined rapid rationalize extremely the and productivity we profitable delighted delivered small

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million Full to closed margin over up outstanding of $XX sales for year. on or million, over $XX increase improved of of grew in touch to and EBITDA an year full million the prior XX% growth fourth the the to quarter the $XX sales in million another cash. by at with more the profit representing sales and noteworthy XX% in XX% million First, $XX a accomplishments XX% quarter quarter. year, the I'd Gross prior for of year-over-year sales full the XX% the was Adjusted year.QX handful $XX or like year net ended approximately million, quarter. $XXX year.We

than private Our with drove business of point, to there continued of ago.To improvements EPIEFFECT into are a the expand more a XXXX commercial launch the on momentum we successful far the a with multiple that we began setting. year made balance course the we result aspects And as attractive year, the the primary office of improvement. really this sheet had over X

operational prior quarter. on expense efficiency in consistent of fourth the of growth to to increase trading common performance generation B focus an led company's our led cash of our and business combined stock an our enough with the throughout conversion a a building of Series the flow discipline, year.Next, improved the at management culture to and course of balance preferred First, the close high the the just accelerated automatic to price trigger the stock into company's level stock the cash convertible

XX common of share company's As stock count. conversion, been added of diluted this approximately million fully a shares the have result to

cash to on the eliminated an with rate has facility over nearly of benefit lower net new market.Remarkably, service of annual interest cash outlay $X.X million America, deposits of we to burdened XXXX.Turning to with addition the success. new debt our a sheet, past put received refinancing and drivers was the with capacity more during to and of accrual higher previous The a year borrowing in the on being support on in far initiatives. institutions of the Bank comprised laser-focused was for conversion familiar dividend syndicate much the and with and a combined to primary company our balance simplifying debt at and been order new growth the expense the check have competitive associated the we interest progress a now through preferred our drive last, growth obtained X banks in high-quality us company facility, place stock.And X In with Citizens note January, the providing rate a of

enhancing Our highest product our our is continue leadership geographically. build and markets priority expanding the surgical portfolio on to in by wound position to and

For by support the resources fourth additional for sales in was a the research the Medical which to benefit in adding the we penetration to X% a office in Sales We growth the sector, focus grew primarily products into factors. This late are of year acceleration sequential grew XXXX.We company.Our suite, of continues continue investments and fourth essential service. team. again, from produced hospital the prior in this setting is private our quarter, invest these believe to in clinical XX%. Affairs introduced over are all surgical further X the which process by the quarter focus, in driven to sites

with benefit the believe Medicare the confusion had for phase advanced commercial or was by the we The local addition to newest wound as First, may EPIEFFECT; recall, as office Administrative of launch we quarter care fourth coverage we introduce or MACs. of for some LCDs, X our new QX in an moved use market. solutions portfolio to the in plan private was into abandoned. physicians adjusted.Second, attempt Contractors elevated by you the skin determinations marked associated And substitutes product

in of make with cases sutures to make country. or in configuration and to wounds our in product excited handling committed remain development innovation in developing we the product As thick progress our for future characteristics building continue a a desired.We place business we the during this tri-layer this revenue that we intermediate get quarter. deep Japanese market-leading, year, underway preferable to technology component important of reminder, fourth great securing graft see and growth.We deal terms it as experienced EPIEFFECT as or organic Reflecting also accomplished chorion, is nice option layers amnion, a attributes a of our the uptick in offers central-drive and as are and another this an foundation treatment with on tunneling product launch our

including have our of opportunities the study. adjacent growth for We enrolled are are to key surveillance next over post-market patients of top about including XXX care to beyond.Our now wound of accelerating the we in and the create Sales have nicely, additional And more X/X all are XXXX physicians, drivers opinion priority leaders. We is whom us XX making company. develop than of of for optimistic EPIEFFECT.We markets established the routine Many accounts, trained users hospitals. in reimbursement. all

leverage our our During we offering quarter, complementary way the substitute portfolio xenografts qualities to improve externally if compete will addressable expand be commercial market the to most as of amniotic allografts, business, infrastructure. where on impossible, the as to skin segments us it to up of current beyond of and/or we tissue our continued to include to for our drive approach today.We highly market to options the advantageous we work this difficult, us superior breadth opportunity internally our and allowing handling see increasing is placental believe not open entire the synthetics.Notwithstanding our

how I spent XXXX, few I of X the hope last quickly this variety and fall time in impressive of to quarters, company get improvement. expense you growing has the that in while EBITDA level continuous realized QX more management, in you the year, objective quarter, XX%.If something results as fair margins objectives. a impressed that discipline establishment margin earlier were much execution that am evaluating the a these given XX% be had But to would would driver. fourth allow of the on accelerate we culminating to of job corporate of We clearly less this unlikely process to and area have place have the to me all last been truly demonstrate team's the even discuss delivering returns in build if again growth us in of may finally, relationships business.During surprised potential highly in During and the to done. that a than our still products the have gross Efforts to have did with our maximize improved detail an we near to year by considered that excellent ask a rationalization, amount led the case. the able this a the adjusted margin progressed, around And me. could to EBITDA would to get adjusted we in margin strategic things they an future.And

drivers want ensure for I As calls, order for and the commentary mentioned business Doug, execute will I we I've all have over our value path in relevant and and turn on performance to to create most growth our continue sustained provide MiMedx we forward. against previous call to long-term identify the to stakeholders.Before on AXIOFILL

late a only AXIOFILL regulatory recall, agency's position the classification that requirements fourth as were in the enforcement as quarter, XXX a of the to from product the of is not designation receipt or AXIOFILL.Specifically, is RFD XXX to letter, of Section midst product. the in the to we FDA's and letter you relating As and of Prior FDA Section the meet request we subject process warning therefore in receipt the the will a filing AXIOFILL. the announced AXIOFILL does for

somehow is consistent not do and when not biologic transformed a the particulate position transform we damaged into modify responded QX, or at since the culminate our can the when it for the the into tissue been XXX the human-derived that what to physician product its longer RFD the be this is is we position in flexibility intended a process are a to which wounds. integument have geometrically tissue does forward.At clarity AXIOFILL have result, for use Transforming as disagree Section point, particulate. or letter with when treatment more towards particulates. purpose intended drug, no of into treating than complex this We intended homologous provides a tissue. And the path use.We minimally to by more functions of agency's to the and inadequate used believe on to increased end sheet It regulate.AXIOFILL FDA has is is other tissue the homologous manipulating not issue and comes heart will warning this the in how place which it of expect supplementing certainly we certain

the AXIOFILL regulatory situation continued which access an of safety down legal users excellent. AXIOFILL, imagine, of this can safe unfortunate intend our from and effective the given product.Feedback product. and is options adoption to benefits the derived all impeccable you ensure We from of to profile patient has been and intent to and has As the exhaust slowed its physician

turn the the our on reach our product.Now let the more with some associated FDA for over important not is AXIOFILL to products if that on results. it we And for call of can't agreement the However, to revenue company. is detail sale note it we with or an we me of with of the believe can Doug? financial sale all other material Doug replace

Douglas Rice

able to everyone our with and Thank report us. you, all great today's joining strong It's quarter for good call. year Thank Joe, results and afternoon today. on be full to you to you fourth

many As a of non-GAAP are basis. financial call measures a the on covered reminder, in today's

So our financial information on recently reconciliations further current historical please results of are in reporting earnings results. to of on discontinued unit, regarding December Medicine Medicine refer XX, the GAAP operations the late to our filing Regenerative disbanded Regenerative cost continuing for quarter, was and discussion during the line quarter of today's the ended please XXXX.For the and year the full impact comments results 'XX and operations, historical as operations. discontinued a basis June a XX-K release refer disclosures.Additionally, our we made my period reflect on exclude our beginning bifurcated disbanded top XXXX.Moving fourth full for to to segment today and fourth Accordingly, these our non-GAAP business which of

the a period.You'll of and we across our launched growth XX% a strong Joe and quarter capped as in of strong As prior our launch. quarter have the a latest nice level to organization compared in first $XX sites adoption respective our the of fourth product portfolio to year.In and noted, post-acute by and of the growth market to EPIEFFECT and of represented $XXX case quarter of uptake our double-digit year XX% net XX% physician seen QX, of recall, office the to addition end service we quarter strong sales year we beginning commercial million fifth periods in at growth began the see of our the our high very XXXX full and was million the rate off execution the sales the of demonstrates the the channel product consecutive each year-over-year fourth

the in growth channel and solid sites $XX comps was profit other anniversary of see to of to launched $XX compared face of products year. XXXX.Our impact in quarter gross million tougher continue We even service the about late fourth we hospital million last the in XXXX as

XXX products.Our a in scale began Our with demand sales come trend teams' due basis keep margin than manufacturing from improvements gross and XX%, reflecting operations order of we reversing more of ago. profile was These a gross efforts of to in efficiently the as fourth a capabilities our our have product than quality margin as improvement a well regulatory as in were way possible mix point XXXX. of for to more a our as continuation quarter we XXXX saw levels to up has the and that beneficial certainly with margin our trend year degradation elevated long seen a team improving the early

administrative products.Selling, or percentage period. Our in the gross $XX focus general, current compared margin or the of prior maintain our and XX% mix was $XX is fourth quarter million moving our XX% to the the with or expenses, term million in in year long over forward to mid-XXs SG&A,

Although due $X improved increase fourth company.Our in sales result to ongoing $X of and primarily the of an year a in partially basis a higher period. increased million SG&A remained on compared operating offset to management efforts, commissions on million we've expense in by basis dollar relative higher prior quarter the made which primarily compensation ongoing were expenses our priority a expense, the leverage, levels our stock-based the R&D due quarter was to

of the development also portfolio, studies XXXX into stages team for build evidence craniectomy other specific a peer-reviewed commitment potential well serve to in continue products combination this a of head products us paper of of executing using has and largest published beyond, has on the our generating additionally EPIEFFECT, and our our of R&D number been our body including recent example used the We out various product was we of and and late pipeline to As products robust year applications.One our this believe and within will the our body beyond. last surgical would year. that investments and of be evidence innovation

a increase a quarter, R&D results Moving we benefit, to reflects excluding long-term which into substantially allowance, be of historical the to mid-single-digits.During XXXX our coming balance sheet discontinued I during our and modestly tax assets. reevaluation our relative a in operating results, roughly provision of operations. deferred be the continue cash our to tax which deferred a recognized would These on footprint our tax rate will our will fourth was XXXX, effective reversal in valuation liability.From XX%, with $XX tax noncash tax the our million which model. operating concert on primarily lower geographic expect basis non-GAAP utilized years reversal positive spend income assets the previously reflects against recorded of expected all to our reflects adjusted the This perspective,

result operations or benefit, quarter inclusive a prior $XXX,XXX of to tax net GAAP million was results income, of As a of million our net year adjusted discontinued $XX of XXXX the of previously the the fourth our quarter this of in million or which provision leverage to about an period.Fourth as was EBITDA compared as $XX loss reflects sales mentioned.Turning XX% the EBITDA well liquidity. sales our about prior success top XX% to both adjusted year areas net line in of period, our that I net compared operating $X

the company quarter expenditures the with executed exceeds ending previously financial above million in full considering XXXX. we the million, October.Capital our goal QX, of of share which $X cash million million XXXX $XX made At fourth profile. Hayfin $X.X cash, in the had year we stated were our late repurchase improvements $XX year in and and meaningful cash results reflect Our flow have of end the

and cash facility, be systems and earlier our However, December $XX pleased took Series and the announce regarding repaid facilities will we be refinancing.In portion long-term expect million stock our XXXX $XX we the am of in strong balance XXXX credit conversion revolving of our an the finally, our outstanding. cash position our the week debt outstanding we and with expenditures higher.And that this year investment meaningfully continued to the our improve preferred only the that steps growth. to Joe to sheet January, and I capital B generation, we as of mentioned, loan leaving of million light expect flow Accordingly, enable to term strengthen strength

cash $XX sheet Joe? solid We balance or were and million will new have the turn in line growth free moving combined to top America, expansion, revolver to refinanced will take footing, financial and the deploy grateful to to us for now provides.To of capital top enable partners, continue availability access back a $XX this on Bank on XX% our opportunities to margin million major XX% million over $XX flexibility my We advantage lending EBITDA And to should facility recently which believe points for Citizens nearly close of arise are Bank basis ability to noted, our transform line, our on momentum, flow gross of year which and remarks exit results, Joe we cash we with basis, XXX achievements strengthen expected Joe. forward. XXXX for adjusted featured company.I our this out flow our the XXXX and generation company. full the opportunities as this call of

Joseph Capper

Doug. Thanks,

outstanding once Gross million margin in grew EBITDA XX% had quarter XX% to quarter, again in $XX year. XX%. XX% to profit expectations. was Adjusted Revenue we the or heard, increased the exceeding and full another just you As for the quarter. up

profile. consistently just and launch the took commercial our posted XXXX, of We into financial we the cash strong other course highlighted. continue to improve we've And moved performance with QX build steps improving full the EPIEFFECT.Over culminating of to overall we results

will for our look with momentum, increasingly positioned last the margin year Naturally, to very progress low established the this percentage we become such double achieving full growth year believe we horizon, prior outstanding EBITDA at into as success. well digits we on challenging an company in the given As year.However, adjusted our build XXXX after comps be the is expect XXXX. we least to results XX% above revenue to

on countless day every struggling made progress And I meaningful we of our in never that, Additionally, plan point is date.Most excellence. question. continue to I we MiMedx people of closing, as would I the putting lose impact proceed. like of this together to out next a to Throughout wound our in healing. strategic an the it of Operator, questions. first several rates chronic strive and chapter proud story.With the build ready for look importantly, into quarter capable steps now we XXXX to remains, benchmark the future.In this industry. lives thank for We fully open enter Much team our work truly for that team fourth company transformation exceptional by and of a we but expect work one to the fashion. business positive like for past Please motivates to sustaining entire is crucial our deny acute closing took to we exclamation grand the necessary cannot and year, call sight with I growth the execute for that make foreseeable to these the our are forward will congratulate that to mission. us commence continuing MiMedx the of would

Operator

Our question Knickerbocker Instructions] Craig-Hallum. [Operator comes from line of Chase with the first

Chase Knickerbocker

on great quarter. Congrats the

hold of from year the Can confusion think the tailwind that then the First, sense office here? you to we around way half in turn you quarter. mentioned XXXX, me the portion you've you from the in sustainable gained this give take as can in growth the confusion the physician that of is volume in on was back that kind LCD that kind do we you if of growth a the of what look this And at of XX% into a EPIEFFECT?

Douglas Rice

QX care. This at is we Doug, I'll was sites all -- start provide But and can of then grew color. Joe

would continued to of we We going while adoption EPIEFFECT, and enjoyed the strong give not say physician are numbers excited execution. EPIEFFECT. I we're that just launch certainly on super about

a launch. We also after saw continued AMNIOEFFECT to grow its year

capture also the enjoy So we share growth we're market position continue we're and in that with to the experiencing. that market

Joseph Capper

typically EPIEFFECT. momentum It's But of lift would Yes. down we tailwind noise the of don't But to converting amount the patterns publish versus got settling LCD and between much back bifurcate, with we it to associated or into ordering how of tough right, was the kind routine office by setting the the in say SKU. revenue about course out throughout product year. I think we had of of the private that

as So shift a to down just of or lot in was the of that CMS of that as sort portion behavior. in a a the LCD that on the year, disruption created marketplaces some in were well. crack of of dynamics market Later started proposed some rates But that the down the pretty throughout year. types of course consistent and growth us we had those for settled the

have momentum we and good year So pretty tailwinds in all that setting.

Chase Knickerbocker

with playing do of that that that all then in opportunity think XXXX that growth think Are the opportunity the And through? companies as we halfway a we of rates about in kind are mean standpoint seen still more core we're we've private that at mentioned in from in ASPs of leads the and reporting I kinds into kind ask just you kind those 'XX sustainable I kind of leveling. ASPs? of my office? growth private of in of into growth kind of Where that just field there if question. reporting next And you office briefly companies kind

Joseph Capper

price whether a like list, to say big like have something outside -- that the rates frankly, it private that's office of movement The that in continue. really, from see the products because part continued companies I of control. be the rollout But register of the that's a the trend still probably would -- a EPIEFFECT. we with it's of And of their the more CMS a of lot associated, last movement our would as we year. growth of going was to first over pretty year, that's or course think ASP on hard behavior

So hard would much movement on of got to more we you predict have. how a Matt, that? anything

Matthew Notarianni

XX are other Chase, know, other there's I We that obviously the published now numbers, think there on probably out the SKUs know only to so rough list. the SKUs of or in about and is probably, Yes. I thing are mean, documents think the category. LCDs I about so don't maybe from the there some that XXX or ASP

halfway quite added ASP quarter, refresh not each each get with X, there, accordingly you're X the list, X, seeing but time. So

Chase Knickerbocker

you Maybe to for SG&A. just 'XX, of for that, future Doug. expect in range, kind market? commentary growth additional last the one sort talk kind G&A most the for on through Maybe year and of make scrapped one the in me just to after the then, pickup had me, any like guidance Joe, EBITDA kind year. XX% more towards from LCD what it you've EBITDA any you've margin about, CMS you, to in engagement got Any model of reimbursement looks with look of got the for And to Doug, changes just of pretty decent

Joseph Capper

we of kind easy happen. to going is what's mine know, frankly, Well, don't -- because Chase, we really

something of been there's to between in CMS the last of do all in about cost bundling know, sort to from second doing category way address this talk like to lot you in some the measure As of they a the year. attempted enacting half

regardless not better all think most the our -- competitors we're should be, that of setting. the than people, though positioned of message for outcome, the sure.I if not are we in really you good So probably

versus market to sensitivity payer in return be option run to LCD And think in I of the say.So that price not approach another is may never this opinion, just where game. channel had and we're We setting another, played tried we're we we analysis We positioned. maximize near-term regardless should maximize versus cause. think in -- bundled. stability I disruption by it our have the well my if gaining a particular payer that we've position. Frankly, pretty And good worst-case fairly on scenarios welcome the one would

Douglas Rice

on of QX half the to certainly X Chase, feel great we but quality percent regulatory we're EBITDA improve improve. up some out XXXX, EBITDA in both we to from gross back should efficiencies. see We in our pick that with with room that the then, to think like our the pleased benefit And year work QX. We of X were operations We'll there's way the P&L lines. to going get mix, margin doing and with is XX-plus and with regards exited providing team

do year to So training expect there. just continuing force I both our the EPIEFFECT ops comments would relatively X% be for continue in medical our around provided some continue and pickup my line on we invest to and that that I would we comments basis expect we for our constituents. with differentiate other growth, top Japan big basis. script invest the and places R&D perspective, journals R&D. digits sales and exit to as in education my physicians we're is be a R&D to XXXX on product an provide expect discipline expect for at improvement a with in some relative peer-reviewed the I we studies however, in and getting of I our payer on bodies to mid-single evidence provide help SG&A.From us. would and We mid-XXs spending SG&A our to going But in from leverage

all So to guidance of really next for XX-plus leads EBITDA that percent year.

Operator

line next comes Our Northland of Carl from the Capital with Byrnes question Markets.

Carl Byrnes

Congratulations.

I or the flow? think, have free $XX flow cash at think cash a the million for EBITDA to respect about of with, look in with million quarter And to free we well. I about should as follow-up EBITDA, rate conversion $XX then how First,

Douglas Rice

and cash summer Knee our us program, our really, Yes. for last when execution. And Again, the we cash big really was our improved pleased with profile suspended generation. event OA late

Our went million $XX EBITDA of year, we're free cash conversion roughly free half from really XX%. to in QX back flow was cash as XX% flow we of for the at the

last -- as million his of cash move the efficiencies we around improvements So XXXX, expect we $X $X while there.Joe guide flow, sort was over comments expense we to interest million into year. alluded don't in

to will legal fee expect legacy our got down. behind year. a and be so on, professional of We've We that this go issues lower lot spent us, much

line improve. and conversion continue top margins, growth strong our -- to we to we free EBITDA So together expect and cash with flow

Carl Byrnes

an and would then develop respect it new be combination or into all? Or to where a M&A-driven potentially to of xenografts area with that And synthetics, you would look getting products? be

Joseph Capper

More than of likely combination both. a

externally portfolio internally and you expand include substitute just mentioned. at to efforts skin we products ongoing have So the both to

Carl Byrnes

the at question, additional respect 'XX? products you last and this X year new product are add of be on and looking in to track With a thanks vision an products, we additional Should then again. couple per to And to year? X new products still

Joseph Capper

have we get out we're that's multiple we X I ongoing. an I good. pretty And on -- aspirational the focused you have year, think think other If But a when kind a goal. X when function ready that's and you to to into products launch it's right now, of when process, of may have. is in them you move you they're them based if development, then on a really in When priorities will. commercial stage want launch you

aspirational goal. an it's yes, I think So

Operator

with Our next H.C. from question of the RK comes Wainwright. line

Swayampakula Ramakanth

This A questions. is of H.C. Wainwright. from couple RK quick

trying you on for in And see launch give become if the will that of Japan. also would think color when additional Just you meaningful folks? that EPIEFFECT to can you market

Joseph Capper

talked really because for numbers about activity-based We kind the are mainly of relatively today us. Yes. still small results was

first we've we're in in you As as spoken the about this know, past, a mover market.

to missionary that from of year. the with we an of We from done of made centers essentially, we the kind the have And that largest most work physicians is of in some opinion reimbursement course hospitals a are or touching standpoint, product just the largest in be lot needs a wound the stage. that board; of country leaders the ordering education early were the care really training, started we're to product product. prestigious the reimbursement progress it's The key throughout all cetera. number reordering there's now et of are pleased the bring on standpoint, the place.So that So number product, and the

Whenever to to doctors at money to with even get longer, business used the a results using doing to it what a in It least it breakeven. come or it's to, a used and where you're a be at new different for potentially a takes so it pace have product. while. launching And wait takes the bit product, you a Now to point And won't a for culture first-of-its-kind we product, than we lot whenever cost it longer. takes you're were launching before at accretive that of a we're pleased long us doesn't activity.It moves there. back take

I can the you about So when don't material take think investment terms we we number. revenue it's a not smart in know. contribution. a tell I talking of going that It's off to given big are it is where probably phenomenal. a percent be a can a we will us of contributor, resource longer bit terms and increases for start increase training are.In percent still before it's The small it

it's RK. going a take to So while,

Swayampakula Ramakanth

question, question. the Then another other strategy

You adjacent market now. strategy about couple quarters have of been this a talking for

organically that So And to current in products of trying this you've we happen region? momentum gets leg field, is or gained office would how private the have some like to a to we figure once plateau when out that inorganically. a growth that -- expect in tangible either different the should

Joseph Capper

So I that. of got most

it think xenos right? have external around we timing agreements product around was when would with associated introductions synthetics, I potential on or new

Swayampakula Ramakanth

Yes.

Joseph Capper

than a areas it. skin of total So of market. We less we that because as prioritize the half substitute that of market today, know, amniotic those we're the prioritize which space, why skin about only X up substitute you And make that? little bit the is in the is market half

commercial natural good have place So channel. us entire for and more makes the it through we that infrastructure to just sense move leverage in

timing, can't -- than basic terms hopefully than that. but the you So rather give specific later, I there.In any of rationale anything more sooner specific that more was

Operator

from comes Petrone question of Mizuho. the Anthony next Our with line

Anthony Petrone

wound Maybe another bit on solid U.S. office physician start a quarter care. Congrats on little with here. Joe,

Going back in bit from ordering saw First terms a to shifts Novitas, was patterns. and some there of confusion the that the there we trends other some Coast MACs local of of little of sort that last quarter that given

of reimbursement an months care.So where, for I little sort extent of transition kind patterns And as And we here those a follow-up to us to fourth bit you we of on in update guess, are can to of ordering give are it quarter? how sit in I'll a few probably there's the normalize wound Now, more let this this sit in some in patterns? questions. then here exiting ordering Did have couple February? a importantly, as

Joseph Capper

as our we an trends Yes, -- -- started XXXX. bit we've comps ordering a part we in patterns bit first did start normalize. Obviously, a We be product Year. say. the going the new And of then about. see the got we did seen as first are to accelerate in similar we the New a more a of should I But quarter, had through talked similar year because physician office the launch we trends challenging very little also part year of

Douglas Rice

well, Doug. Anthony, is this

While QX top just benefited increases as seasonality -- we're on cadence saw returning. procedural a -- a as as we let's also and say company of this sort line topic, from I'll volume that say we is that perspective,

with everybody think guidance, And think I back of wanted traditional our to quarter. benefited you be our about QX, deductibles quarter going we'll our if XXXX that. remind of will lowest and finish But seasonality to be also strongest that vis-a-vis we reset our QX sort there, that and I certainly as the so being from like QX and to sort cadence, of QX where things is

Anthony Petrone

from think horizons CMS they healthy. couple they a recap proposal there. M&A the be Local just be be balance thoughts Joe and and/or Doug a quick the the last certainly of off-cycle, And about Or just sort just latest June-July? next we follow-ups. season, when from Cash on wallet. updates MACs, with will One is one, maybe of And just will the would

obviously credit markets. tap can the You

about should be side. size inorganic the the about of thinking Just acquisition from thinking targets we that

Joseph Capper

is if the would will I as my annual to they changes, be we about cycle. stuff year. see But they really But last given on it's to probably Yes. the As cycle tied more anything that to the can off any guess off to can probably talk there's indicated, want know, going where or we're we be My MACs going anything Else potential it. the do annual the ended right? CMS cycle. guess way that's don't up, probably saw cycle do

this year. see we'll how So it unfolds

M&A, The or over of the you're course the sheet profile terms balance right. In much has of year. financial improved

plan. restrict in accelerate gives of it we of little be At a M&A, of Obviously, wouldn't we size terms flexibility anything ourselves. terms deals. if So strategic this it point, us in did would to a

organization. It in and to accretive amount lead to strategically would it a A, and have we accretion overburden of given or have wouldn't time fit So culturally. would be to

scale over behavior fairly to back that would revert months at if more to to flexibility our don't Anthony, P&L tend there. and this that because and kind approach it's discipline we a around look I very a run balance think it way the give the you're It's wouldn't even of it So that have joined point. at and the the structure Doug put we you hard financial sense, say. has I like wouldn't be greater And hard the just team, both around we'll we've brackets sheet. will the that's productive. XX makes to certainly and the a say seeing, since it.So to business disciplined change out a we take so object does last the to business And over it time.But hopefully, new company

Operator

Our the John next of with comes from Vandermosten question line Zacks.

John Vandermosten

another that than revenue the quarters the guidance? Thank we wanted double-digit I little Should to on for ask be. a double-digit others a bit year? how that should expect Or basis expect low the on guidance. you even low be we some stronger trend regarding with And year-over-year might increase growth to question over

Douglas Rice

the But sort no can John. year is slow at question, exit obviously, of and the good growth we low sort XX%. XX% ramp, the get to start quarter would be a as seasonality that headline knew It's I as XXXX excited new provide to and effect growth a year products Doug. to majority that I accelerating at we traditional of From rate were growth would I rate not exception. to year double-digits expect about But certainly last color. would through anniversary EPIEFFECT, of and This of expect back whole expect we revenue going first as there. revenue. sustainable and the our be our new would for products, the we've will of about continue going amino into lowest us that to talked we returning be be But in a cadence And with will and closed XXXX. I half talked -- the rate we've year the perspective,

John Vandermosten

looking then at And sheet. the balance

-- just I by we'll And sound first that the movement million You that we are? especially had Is replace with line. the probably based of end million right, some debt the $XX think in where on does $XX there, that quarter.

Douglas Rice

more for the cash if the net to on or $XX of ability need. sort with a excited revolver $XX there million million. it a when term be the with new just cash like few And facility we us positive outstanding. finished the $XX we're of of loan We debt powder and reach that were million We have over and And year and net more would of ago. $XX $XX the repaid excited $XX back to million basis. Well, million days out leaves capacity with that million dry

John Vandermosten

like sounds of it available that as be the much the the that it first fourth at same the at end have $XX the cash end balance and was the pretty quarter. will you'll million And of quarter,

Douglas Rice

$XX repaid we million. Well,

in we So quarter, I typically too. Well, burn more on would expect. the net basis, yes, a first cash

Joseph Capper

point. important it's -- an So important

John Vandermosten

quarter then going? MediWound that? and how collaboration And they been forward. that on them at working that the about and you Has any putting is how -- what updates a looking there with And announced were ago, on progress any and it is that study

Joseph Capper

I think get running. we're the and starting just sites up to

stage. early it's So

John Vandermosten

if correct? a And on my reading remember Is that Phase I that. was that III

Joseph Capper

It that's Yes, right. was.

John Vandermosten

there. more And then question that. a did have on We one just Japan, looking few at

penetrated. those I rate? suppose, mentioned think physician you rate? wondering you terms trained. how I and penetration supply, that penetration much that I the can relatively But further or in is low also available were go that know I'm just there training of What physicians physicians? over being have What's are to XX supply formularies, were you XXX And accounts sales.

Joseph Capper

access we key into go low. accounts. big product. facilities are penetration that relatively we patients gotten the the usage, the greater still terms the need of to to getting It deeper We've to a in to here. need opinion number drive these of to start of leaders But and And lot

the through working dynamics. still normal So

You in it's terms can else reimbursement anything they're a imagine, care, of standard of to higher used than care.

going So to that to on want that. to see that they're a bit digest ROI takes

it so And just takes time.

Operator

for no There closing to hand it are remarks. the Capper, back queue. to I'd further questions you, in Joe like

Joseph Capper

speaking Thank look you, operator, be and thank you, your your a quarter, continued the forward company. you to which the Have everybody. We great of everybody, to first in Thanks, again a evening. will for and questions few at interest months. in the end

Operator

Ladies and conclude gentlemen, this participation. your does Thank today's teleconference. you for

day. have may this your lines time. at a wonderful And You disconnect

MiMedx (MDXG) 28 Feb 242023 Q4 Earnings call transcript