Financial Data and Key Metrics Changes - In Q4 2024, the company reported revenue of $86.3 million, a 30% increase year-over-year, and total revenue for the full year reached $332.1 million, reflecting a 51% increase compared to 2023 [22][27] - The company achieved a net income of $9.6 million in Q4 2024, compared to a net loss of $2.6 million in Q4 2023, and a full-year net income of $18.2 million versus a net loss of $57.5 million in 2023 [26][27] - Adjusted EBITDA for Q4 was $21.3 million, up from $9.4 million in the same period of 2023, and for the full year, it was $75 million compared to a negative $4.4 million in 2023 [27][28] Business Line Data and Key Metrics Changes - The dermatology business saw a combined growth of 17% for DECISION DX melanoma and DECISION DX SCC tests over 2023, with DECISION DX melanoma reporting 36,008 test reports in 2024, an 8% increase [8][12] - The DECISION DX SCC test delivered 16,348 test reports in 2024, a 43% increase compared to 2023, with 1,510 new ordering clinicians [14][15] - The TissueCypher test reported 20,956 test reports in 2024, representing a 130% growth from 9,100 in 2023, with 1,234 new ordering clinicians [17] Market Data and Key Metrics Changes - The addressable market for DECISION DX melanoma is approximately 130,000 patients, with an estimated market penetration of 28% as of the end of 2024 [9] - The addressable market for DECISION DX SCC is around 200,000 patients, with an 8% market penetration [15] - The addressable market for Barrett's esophagus patients is approximately 415,000 per year, with a 5% market penetration for TissueCypher [19] Company Strategy and Development Direction - The company plans to focus on strong execution and sound capital allocation strategies, including exploring strategic opportunities for growth [30] - There is an emphasis on expanding the commercial team and increasing awareness and education regarding the TissueCypher test [19] - The company is considering reallocating resources towards the DECISION DX melanoma test in response to potential reimbursement changes for DECISION DX SCC [61] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in entering 2025 with strong financial and operational strength, driven by a science-driven approach to improve patient outcomes [31] - The anticipated loss of Medicare reimbursement for DECISION DX SCC is expected to impact future revenue, with guidance for 2025 total revenue projected between $280 million to $295 million [23][24] - Management noted that while there may be challenges, they expect to maintain positive net cash flow from operations for the full year of 2025 [29] Other Important Information - The company reported a cash balance of $293.1 million at the end of 2024, which is expected to support long-term growth initiatives [28] - Adjusted gross margin for the full year was 82%, with expectations of a decline in gross margins due to the loss of DECISION DX SCC coverage [23][24] Q&A Session Summary Question: Concerns about guideline updates affecting DECISION DX melanoma orders - Management noted substantial growth in new first-time ordering clinicians, indicating that guideline updates may not significantly impact individual treatment decisions [33] Question: Updates on the atopic dermatitis gene expression profile test - Management expects to launch the test by late 2025, with reimbursement strategies to be clarified in the coming quarters [34][35] Question: Market approval for TissueCypher and its addressable market - Management indicated that New York's population demographics would likely reflect the overall U.S. population in terms of market potential [38] Question: Commercial strategy for DECISION DX SCC amid reimbursement issues - Management plans to continue offering the test while assessing the potential for regaining Medicare coverage [39][40] Question: Strategic opportunities for capital allocation - Management is open to investing in both existing and new verticals, focusing on profitability and growth [44][45] Question: Adjusted EBITDA expectations for 2025 - Management reiterated expectations for positive adjusted EBITDA in 2025, without providing specific figures [46] Question: Residual coverage from non-Medicare payers for DECISION DX SCC - Management indicated that there is not significant private payer coverage for DECISION DX SCC [50] Question: M&A market conditions in diagnostics - Management noted that while there are many assets available, they maintain a disciplined approach to acquisitions [51] Question: Sales force expenditures and overhead for 2025 - Management confirmed plans to continue investing in the sales force, particularly for the TissueCypher test [52]