Financial Data and Key Metrics Changes - The company reported a revenue growth of 22% year-over-year, reaching $169 million, with surgical revenue growing by 24% to $152 million [4][9] - Adjusted EBITDA for the first quarter was $11 million, marking a 6% margin and an improvement of over 800 basis points compared to the previous year [13][14] - Non-GAAP gross margin was 70%, down 50 basis points year-over-year but up 70 basis points sequentially [11] Business Line Data and Key Metrics Changes - Surgical revenue grew by 24% year-over-year, driven by a 17% increase in procedural volume and an 18% increase in the number of surgeons utilizing ATEC procedures [6][10] - EOS revenue increased by 8% year-over-year, with a record order volume leading to a 28% year-over-year increase in the order book [11][12] Market Data and Key Metrics Changes - Established territories saw a revenue growth of 23%, indicating strong surgeon and territory penetration [6] - Same store sales from sales agents in territories for over a year grew by 23% year-over-year, reflecting significant growth in established markets [12][84] Company Strategy and Development Direction - The company is focused on creating clinical distinction through innovative procedural solutions that improve patient outcomes [24][25] - ATEC aims to expand its sales force and enhance operational efficiency to drive growth and profitability [6][23] - The strategy includes leveraging informatics to reduce surgical variables and improve predictability in spine surgery [26][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving cash flow positivity for the full year 2025, with expectations of continued strong revenue growth [19][17] - The company anticipates a revenue outlook of approximately $734 million for 2025, with surgical revenue growth of 21% [19][21] - Management noted that the spine market remains resilient despite economic uncertainties, with high demand for their products [106][107] Other Important Information - The company successfully refinanced its 2026 convertible note, extending maturity and maintaining a low coupon rate [17] - The first quarter cash burn was at the low end of the expected range, indicating improved cash management [15][16] Q&A Session Summary Question: Market size and competitive dynamics for the new Corpectomy system - Management indicated that they are the only company offering this procedure in the prone position, which provides unique advantages [41][42] Question: Tariff exposure in 2025 - The company expects low single-digit million impacts on cost of goods sold due to tariffs, primarily affecting EOS equipment [54][55] Question: Update on robot launch plan - The robot is in the alpha phase, with plans for an end-of-year launch, and integration with navigation systems is underway [60][61] Question: Cash outlay trends - The company achieved a cash use of $15 million in Q1, with expectations for positive cash flow in subsequent quarters [65][66] Question: Salesforce productivity and opportunities - Same store sales grew by 23%, indicating strong performance from established sales agents [83][84] Question: EOS placements and portfolio pull-through - Most EOS placements are in new accounts, with a focus on expanding into complex procedures [88][90] Question: Overall volumes and ASC growth - The market is healthy, with surgical volumes growing significantly, and ASCs are expected to evolve over time [93][94] Question: International market expansion - The company remains bullish on international markets, particularly Australia and New Zealand, while maintaining a focused approach [110]

Economic Overview - Investors are concerned about the potential economic downturn due to new tariffs imposed by Trump, with Goldman Sachs raising its recession forecast from 20% to 35% [1][2] - Economists warn that these tariffs could lead to increased costs for businesses, a slowdown in hiring, and wage growth, prompting Wall Street firms to lower GDP growth projections [2] Medical Device Industry Outlook - The medical device industry is viewed as a stable investment during market volatility, with a promising long-term outlook despite short-term challenges such as tariffs and cost escalations [3] - Advancements in AI and predictive analytics are revolutionizing the medical device industry, enhancing diagnostics, patient monitoring, and personalized treatment [4] Company Highlights Masimo (MASI) - Masimo specializes in non-invasive patient monitoring systems and is benefiting from focused R&D efforts, with notable technologies like Measure-through Motion and Low Perfusion pulse oximetry [7] - MASI shares have increased by 1.4% year to date, outperforming the broader market, and the company is expected to report earnings growth of 20% in 2025 [8] Boston Scientific (BSX) - Boston Scientific is experiencing strength across its MedSurg and Cardiovascular lines, with strong demand and contributions from acquisitions driving growth [10] - BSX shares have risen 13.3% year to date, and the company is expected to report earnings growth of 13.6% in 2025 [12] Hims & Hers Health (HIMS) - Hims & Hers Health targets a $360 million U.S. total addressable market, focusing on mental health, weight loss, and dermatology, with over 2 million subscribers driving recurring revenues [15] - HIMS shares have surged 28.4% year to date, with an expected earnings growth of 133.3% in 2025 [16]

Financial Data and Key Metrics Changes - ProAssurance Corporation reported its fifth consecutive quarter of improved operating earnings, with full-year operating earnings of $0.95 per share and an operating ratio of 94.5% [6][30] - The Specialty P&C segment reported a combined ratio of 101% for the quarter, improving sequentially by nearly five points to 104% for the full year [7][21] - Net investment income rose 9% for the quarter and 12% for the year, with new purchase yields in the fourth quarter at approximately 5.8% [26][28] Business Line Data and Key Metrics Changes - The Specialty P&C segment's full-year combined ratio improved due to favorable development in prior accident years, with a net loss ratio of 76.9% [22] - Workers' compensation segment net written premiums increased by $4 million for the year, reflecting higher audit premiums and improved renewal pricing [13] - The combined ratio for the workers' compensation segment was 114%, with a current net loss ratio at 77%, four points below 2023 [24] Market Data and Key Metrics Changes - Renewal premium increases for the fourth quarter were 10% for standard MPL business and 8% for the specialty portion, totaling almost 70% cumulative increases since 2018 [9] - Retention of existing premiums was solid at 83% in the quarter, indicating strong retention in the standard book [10] Company Strategy and Development Direction - The company is focused on achieving rate adequacy and disciplined underwriting, prioritizing profitability over growth [38] - ProAssurance is leveraging predictive analytics and AI tools to enhance risk selection and pricing decisions [11][12] - The company is committed to operational discipline and innovation investments to address challenging market conditions [14][16] Management's Comments on Operating Environment and Future Outlook - Management acknowledged ongoing challenges from social inflation and eroding tort reform, but expressed confidence in achieving sustained underwriting profitability despite market headwinds [17][18] - The company plans to continue pushing for rate increases in 2025, similar to 2024, to address loss trends [43][49] Other Important Information - The company has excluded results from its previous participation in Lloyd's Syndicate from operating earnings, impacting fourth-quarter net income by $5.3 million [20][21] - Headcount declined by 6% in 2024, but incentive-based compensation costs increased due to improved consolidated results [25] Q&A Session Summary Question: How would you characterize the competition in the fourth quarter? - Management noted that competition remained consistent with previous quarters, with excess capital in the market leading to aggressive pricing strategies [36][38] Question: What accident years contributed to reserve development within Specialty? - Reserve development was spread across various years, with recent years contributing to NorCal business and legacy business primarily from 2020 and prior [40][41] Question: Any additional color on how to push rate in the workers' comp business? - Management indicated that while loss cost indications are declining, they believe severity trends should be considered, and they will continue to push for adequate rates [46][48] Question: Thoughts on capital management and stock buybacks? - Management emphasized balancing capital needs for underwriting goals with maintaining capital efficiency and considering stock buybacks in the context of other capital uses [58][63] Question: Can you provide additional color on the higher expense ratio? - The increase in the expense ratio was attributed to various factors, including higher incentive compensation and unusual items affecting the previous year's ratio [68][70]