RadNet(RDNT) - 2025 Q1 - Quarterly Results

RadNet Q1 2025 Financial Results and Revised Guidance Executive Summary and Highlights RadNet's Q1 2025 revenue grew 9.2% to $471.4 million, but Adjusted EBITDA fell 20.6% due to weather, prompting revised 2025 guidance and the iCAD acquisition Q1 2025 Key Financial Metrics vs. Q1 2024 | Metric | Q1 2025 | Q1 2024 | Change | | :--- | :--- | :--- | :--- | | Total Company Revenue | $471.4 million | $431.7 million | +9.2% | | Total Company Adjusted EBITDA | $46.4 million | $58.5 million | -20.6% | | Digital Health Revenue | $19.2 million | $14.7 million | +31.1% | | Adjusted Diluted EPS | $(0.35) | $0.07 | - | - First quarter results were negatively impacted by approximately $22 million in Revenue and $15 million in Adjusted EBITDA due to Southern California wildfires and severe winter weather conditions[3][4] - On April 15, 2025, RadNet announced a definitive agreement to acquire iCAD, Inc. to accelerate AI-powered early detection and diagnosis of breast cancer[4][6] - The company revised its full-year 2025 guidance, increasing its outlook for both Revenue and Adjusted EBITDA[1][4] Operational and Strategic Developments RadNet expanded TechLive to 255 MRI systems, achieved over 40% EBCD AI adoption, saw strong PET/CT volume growth, and plans to acquire iCAD, maintaining a strong balance sheet - The TechLive remote scanning capability has been implemented on approximately 255 MRI systems, with testing now extending to ultrasound systems[5] - The EBCD AI-powered breast cancer diagnostic program has reached a blended adoption rate of over 40% nationwide, and the company is progressing in discussions with payors for reimbursement[5] - Advanced imaging procedural volume grew, with PET/CT volume increasing by almost 23% compared to the same quarter last year, driven by prostate and brain imaging[5] - The acquisition of iCAD is expected to add over 1,500 healthcare provider locations and accelerate RadNet's global leadership in AI-powered breast cancer screening[6] - RadNet ended the quarter with a strong balance sheet, featuring a cash balance of $717 million and a Net Debt to Adjusted EBITDA leverage ratio slightly above 1.0x[6] Detailed Financial Results Q1 2025 Total Revenue grew 9.2% to $471.4 million, but Adjusted EBITDA fell 20.6% to $46.4 million, resulting in a $37.9 million net loss due to one-time charges Q1 2025 Performance vs. Q1 2024 | Metric | Q1 2025 (Million USD) | Q1 2024 (Million USD) | Change | | :--- | :--- | :--- | :--- | | Total Company Revenue | $471.4M | $431.7M | +9.2% | | Total Company Adjusted EBITDA | $46.4M | $58.5M | -20.6% | | Total Company Net Loss | $(37.9)M | $(2.8)M | - | | Net Loss Per Share | $(0.51) | $(0.04) | - | Q1 2025 Digital Health Segment Performance | Metric | Q1 2025 (Million USD) | Q1 2024 (Million USD) | Change | | :--- | :--- | :--- | :--- | | Revenue | $19.2M | $14.7M | +31.1% | | Adjusted EBITDA | $3.7M | $3.5M | +5.4% | - Adjusted Diluted Loss Per Share was $(0.35) for Q1 2025 after accounting for one-time items such as $5.4 million in lease abandonment charges and $3.6 million in non-capitalized R&D expenses[10] Q1 2025 Procedural Volume Growth vs. Q1 2024 | Volume Type | Aggregate Growth | Same-Center Growth | | :--- | :--- | :--- | | MRI | +8.4% | +3.4% | | CT | +8.3% | +3.0% | | PET/CT | +22.9% | +12.2% | | Overall | +3.6% | -0.3% | 2025 Revised Guidance RadNet increased its full-year 2025 guidance for the Imaging Center segment's Revenue and Adjusted EBITDA, while Digital Health guidance remains unchanged Revised 2025 Guidance - Imaging Center Segment | Metric | Original Guidance Range (Million USD) | Revised Guidance Range (Million USD) | | :--- | :--- | :--- | | Total Net Revenue | $1,825 - $1,875 million | $1,835 - $1,885 million | | Adjusted EBITDA | $265 - $273 million | $268 - $276 million | | Capital Expenditures | $140 - $150 million | $145 - $155 million | 2025 Guidance (Unchanged) - Digital Health Segment | Metric | Guidance Range (Million USD) | | :--- | :--- | | Total Net Revenue | $80 - $90 million | | Adjusted EBITDA Before Non-Capitalized R&D | $15 - $17 million | Financial Statements This section presents unaudited condensed consolidated financial statements for Q1 2025, including the Balance Sheet, Statement of Operations, and Statement of Cash Flows Condensed Consolidated Balance Sheets As of March 31, 2025, RadNet's total assets were $3.336 billion, with total liabilities at $2.200 billion and cash at $717.3 million Balance Sheet Highlights (in thousands) | Account | March 31, 2025 | December 31, 2024 | | :--- | :--- | :--- | | Cash and Cash equivalents | $717,323 | $740,020 | | Total current assets | $1,015,861 | $1,019,252 | | Total Assets | $3,336,264 | $3,286,690 | | Total current liabilities | $505,399 | $479,712 | | Total liabilities | $2,199,747 | $2,153,280 | | Total Equity | $1,136,517 | $1,133,410 | Condensed Consolidated Statement of Operations Q1 2025 total service revenue was $471.4 million, but higher expenses led to a $24.1 million loss from operations and a $37.9 million net loss Statement of Operations Highlights (in thousands) | Account | Q1 2025 | Q1 2024 | | :--- | :--- | :--- | | Total service revenue | $471,399 | $431,707 | | Income (Loss) from Operations | $(24,101) | $11,339 | | Net Income (Loss) | $(29,737) | $5,410 | | Net Loss Attributable to RadNet, Inc. | $(37,926) | $(2,779) | | Diluted Net Loss Per Share | $(0.51) | $(0.04) | Condensed Consolidated Statements of Cash Flows Q1 2025 net cash from operations was $41.5 million, with $56.8 million used in investing and $7.5 million in financing, resulting in a $22.7 million cash decrease Cash Flow Highlights (in thousands) | Activity | Q1 2025 | Q1 2024 | | :--- | :--- | :--- | | Net cash provided by operating activities | $41,481 | $17,088 | | Net cash used in investing activities | $(56,751) | $(60,938) | | Net cash (used in) provided by financing activities | $(7,510) | $228,296 | | Net (Decrease) Increase in Cash | $(22,697) | $184,410 | | Cash and Cash Equivalents, end of period | $717,323 | $526,980 | Supplementary Data and Non-GAAP Reconciliations This section provides supplementary operating data, including payor and procedural volumes, and reconciles GAAP Net Loss to Adjusted EBITDA ($46.4M) and Adjusted Diluted Loss Per Share ($(0.35)) Reconciliation to Adjusted EBITDA Reconciliation from GAAP Net Loss to Adjusted EBITDA for Q1 2025 shows a total of $46.4 million, with $42.7 million from Imaging Center and $3.7 million from Digital Health Adjusted EBITDA Reconciliation (in thousands) | Item | Q1 2025 | Q1 2024 | | :--- | :--- | :--- | | Net loss attributable to Radnet, Inc. | $(37,926) | $(2,779) | | Plus: Interest, Taxes, D&A, etc. | $84,325 | $59,487 | | Adjusted EBITDA - Radnet, Inc. | $46,399 | $58,462 | | Adjusted EBITDA - Imaging Center | $42,688 | $54,942 | | Adjusted EBITDA - Digital Health | $3,711 | $3,520 | Payments and Procedures Data In Q1 2025, commercial insurance was the largest payor at 58.0%, with MRI leading modalities, and total procedural volume increased 3.6% year-over-year Payments by Payor Class - Q1 2025 | Payor Class | Percentage | | :--- | :--- | | Commercial Insurance | 58.0% | | Medicare | 23.0% | | Capitation | 6.8% | | Other | 12.2% | Procedures by Modality | Modality | Q1 2025 (count) | Q1 2024 (count) | Change | | :--- | :--- | :--- | :--- | | MRI | 447,330 | 412,821 | +8.4% | | CT | 271,170 | 250,365 | +8.3% | | PET/CT | 20,389 | 16,594 | +22.9% | | Total | 2,742,973 | 2,646,951 | +3.6% | Reconciliation to Adjusted Earnings Per Share After adjustments for non-recurring items, Q1 2025 Adjusted Net Loss was $26.2 million, resulting in an Adjusted Diluted Loss Per Share of $(0.35) Adjusted EPS Reconciliation (in thousands) | Item | Q1 2025 | Q1 2024 | | :--- | :--- | :--- | | Net (Loss) Income Attributable to RadNet | $(37,926) | $(2,779) | | Total Adjustments (pre-tax) | $13,070 | $5,096 | | Adjusted Net Loss / Income | $(26,196) | $4,992 | | Adjusted Diluted (Loss) / Earnings Per Share | $(0.35) | $0.07 | Company Information and Disclosures This section provides Q1 2025 earnings call details, RadNet's operational overview, and important legal disclosures regarding the iCAD transaction, forward-looking statements, and non-GAAP measures - RadNet will host a conference call on May 12, 2025, at 10:30 a.m. Eastern Time to discuss the first quarter results[16][17] - RadNet is a leading national provider of diagnostic imaging services with a network of 401 owned/operated outpatient centers and over 11,000 employees[18] - Important information regarding the proposed merger with iCAD, Inc. has been filed with the SEC in a Form S-4 registration statement, which investors are urged to read[20] - The press release contains forward-looking statements that are subject to risks and uncertainties, including those related to the iCAD merger, economic conditions, and healthcare reform[22][23] - The company uses non-GAAP financial measures like Adjusted EBITDA and Adjusted Earnings Per Share to assist in measuring cash-based performance, and provides reconciliations to the most comparable GAAP measures[26]