EX-99.1 2 radnet_ex9901.htm PRESS RELEASE

Exhibit 99.1

 

 

 

FOR IMMEDIATE RELEASE

 

RadNet Reports Fourth Quarter 2024 Results, Including Record Revenue and Adjusted EBITDA(1) and Releases 2025 Financial Guidance

 

·Total Company Revenue increased 13.5% to a quarterly record of $477.1 million in the fourth quarter of 2024 from $420.4 million in the fourth quarter of 2023; Revenue from the Digital Health reportable segment (inclusive of intersegment revenue) increased 28.1% to $18.9 million in the fourth quarter of 2024 from $14.7 million in the fourth quarter of 2023
   
·Total Company Adjusted EBITDA(1) was a quarterly record of $75.0 million in the fourth quarter of 2024 as compared with $65.8 million in the fourth quarter of 2023, an increase of 14.0%; Digital Health reportable segment Adjusted EBITDA(1) increased 61.6% to $4.5 million in the fourth quarter of 2024 from $2.8 million in the fourth quarter of 2023
   
·Adjusting for unusual or one-time items impacting Net Income in the quarter, Adjusted Earnings Per Share(3) was $0.22 for the fourth quarter of 2024; This compares with Adjusted Earnings Per Share(3) of $0.15 for the fourth quarter of 2023
   
·In the fourth quarter of 2024, aggregate procedural volumes increased 8.0% and same-center procedural volumes increased 4.0% compared with the fourth quarter of 2023
   
·At December 31, 2024, RadNet had a cash balance of $740 million and a net debt to Adjusted EBITDA(1) leverage ratio of under 1.0x

 

LOS ANGELES, California, February 27, 2024 – RadNet, Inc. (NASDAQ: RDNT), a national leader in providing high-quality, cost-effective, fixed-site outpatient diagnostic imaging services through a network of 398 owned and/or operated outpatient imaging centers, today reported financial results for its fourth quarter and full-year ended December 31, 2024.

 

Dr. Howard Berger, President and Chief Executive Officer of RadNet, commented, “I am very pleased with our performance in the fourth quarter and for full-year 2024. Relative to last year’s fourth quarter, Revenue increased 13.5% and Adjusted EBITDA(1) increased 14.0%. This performance was driven by strong aggregate procedural volume growth of 8.0% and same center procedural growth of 4.0%. This performance enabled us to meet or exceed guidance levels we set at the beginning of 2024 and revised upward throughout the year.”

 

Dr. Berger continued, “During the fourth quarter, we continued to experience increased demand in virtually all of our markets. This demand was the primary catalyst for the investments made to expand capacity by the opening of nine new centers during the year. Throughout 2024, the centers within health system partnerships grew from 130 at the beginning of 2024 to 153 by the end of the year. Joint venture facilities now represent 38.4% of the 398 locations.”

 

“During 2024, significant progress was made in the Digital Health division, culminating with the fourth quarter launch of DeepHealth OS, SmartMammoTM and TechLiveTM solutions in addition to expansion of the AI clinical tools in breast, lung, prostate and brain. We intend to implement these new solutions throughout the RadNet network during 2025, and they should create significant efficiencies in our operations that will help address challenges resulting from the shortage and rising cost of skilled labor. Furthermore, these solutions will enable us to expand capacity by streamlining workflow and automating processes that will improve the patient experience,” added Dr. Berger.

 

 

 

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“During 2024, liquidity and financial leverage were carefully managed, as highlighted by a $230 million stock offering completed in March, a debt refinancing completed in April which lowered our cost of capital and extended maturities through 2031 and a debt repricing transaction completed in November which lowered the interest cost on RadNet’s credit facility. As a result of these actions and a focus on margins and Adjusted EBITDA(1) growth, at year-end 2024, net debt to Adjusted EBITDA(1) fell below 1.0x, from approximately 2.0x at year-end 2023. The cash balance at the end of 2024 grew to $740 million, from $342 million at year-end 2023,” concluded Dr. Berger.

 

Financial Results

 

Fourth Quarter Report:

 

For the fourth quarter of 2024, RadNet reported Total Company Revenue of $477.1 million and Adjusted EBITDA(1) of $75.0 million. Revenue increased $56.7 million (or 13.5%) and Adjusted EBITDA(1) increased $9.2 million (or 14.0%) as compared with the fourth quarter of 2023.

 

For the fourth quarter of 2024, RadNet reported Digital Health Revenue of $18.9 million (inclusive of intersegment revenue) and Adjusted EBITDA(1) of $4.5 million. Revenue increased $4.1 million (or 28.1%) and Adjusted EBITDA(1) increased $1.7 million (or 61.6%) as compared with the fourth quarter of 2023.

 

There were a number of unusual or one-time items impacting the fourth quarter including: $1.1 million in severance expense related to cost-savings initiatives; $2.5 million impairment loss on lease abandonment; $1.1 million expense related to leases for de novo facilities under construction that have yet to open their operations; $462,000 of acquisition transaction costs; $2.4 million loss in conjunction with extinguishment of debt and related expenses as a result of the Company’s refinancing and repricing debt transactions; $5.0 million of non-capitalized research and development expenses related to the DeepHealth Cloud OS and generative AI; and $577,000 of non-cash loss from interest rate swaps. Adjusting for the above items, Total Company Adjusted Earnings(3) was $16.7 million and diluted Adjusted Earnings Per Share(3) was $0.22 during the fourth quarter of 2024. This compares with Total Company Adjusted Earnings(3) of $9.9 million and diluted Adjusted Earnings Per Share(3) of $0.15 during the fourth quarter of 2023.

 

Unadjusted for unusual or one-time items impacting the fourth quarter, Total Company Net Income for the fourth quarter of 2024 was $5.3 million as compared with a Total Company Net Loss of $1.9 million for the fourth quarter of 2024. Fully diluted Net Income Per Share for the fourth quarter of 2024 was $0.07, compared with a fully diluted Net Loss per share of $(0.03) in the fourth quarter of 2023, based upon a weighted average number of diluted shares outstanding of 75.5 million shares in 2024 and 67.9 million shares in 2023.

 

For the fourth quarter of 2024, as compared with the prior year’s fourth quarter, MRI volume increased 13.4%, CT volume increased 13.9% and PET/CT volume increased 23.9%. Overall volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 8.0% over the prior year’s fourth quarter. On a same-center basis, including only those centers which were part of RadNet for both the fourth quarters of 2024 and 2023, MRI volume increased 8.5%, CT volume increased 8.7% and PET/CT volume increased 16.3%. Overall same-center volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 4.0% over the prior year’s same quarter.

 

Annual Report:

 

For full-year 2024, RadNet reported Total Company Revenue of $1,829.7 million and Adjusted EBITDA(1) of $279.5 million. Revenue increased $213.0 million (or 13.2%) and Adjusted EBITDA(1) increased $47.1 million (or 20.3%) as compared with full-year 2023.

 

For full-year 2024, RadNet reported Digital Health Revenue (inclusive of intersegment revenue) of $65.7 million and Adjusted EBITDA(1) of $14.6 million. Revenue increased $16.1 million (or 32.5%) and Adjusted EBITDA(1) increased $8.1 million (or 124.0%) as compared with full-year 2023.

 

Unadjusted for one-time or unusual items, Total Company Net Income for 2024 was $2.8 million as compared with a Total Company Net Income of $3.0 million in 2023. Fully diluted Net Income Per Share for 2024 was $0.04, compared with a Net Income per share of $0.05 in 2023, based upon a weighted average number of diluted shares outstanding of 74.8 million shares in 2024 and 64.7 million shares in 2023.

 

 

 

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Actual 2024 Results vs. 2024 Guidance

 

Imaging Center Segment

 

   Original Guidance Range  Revised Guidance Range After Q1 Results  Revised Guidance Range After Q2 Results  Revised Guidance Range After Q3 Results  Actual 2024 Results
Total Net Revenue  $1,650-$1,700mm  $1,675-$1,725mm  $1,685-$1,735mm  $1,710-$1,760mm  $1,764.0mm
Adjusted EBITDA(1)  $250 - $260mm  $255 - $265mm  $257 - $267mm  $262 - $270mm  $264.9mm
Capital Expenditures(a)  $125 - $135mm  $130 - $140mm  $135 - $145mm  $145 - $155mm  $148.1mm
Cash Interest Expense(b)  $40 - $45mm  $37 - $42mm  $32 - $37mm  $25 - $30mm  $33.3mm
Free Cash Flow (2)  $65 - $75mm  $68 - $78mm  $72 - $80mm  $83 - $93mm  $83.5mm

 

(a)Net of proceeds from the sale of equipment ($886,000), New Jersey Imaging Network capital expenditures of $20.7mm and a one-time $6.6 million operating lease buyout from two equipment manufacturers.
(b)Includes payments to and from counterparties on interest rate swaps and nets interest income from our cash balance as recorded in Other Income.

 

Digital Health Segment

 

  

Original

Guidance

Range

 

Revised Guidance Range After

Q1 and Q2 Results

 

Revised Guidance Range After

Q3 Results

 

Actual

2024 Results

Total Net Revenue (inclusive of intersegment revenue)  $60 - $70mm  $60 - $70mm  $60 - $70mm  $65.7mm
             
Adjusted EBITDA(1) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI  $12 - $14mm  $13 - $15mm  $13 - $15mm  $14.6mm
             
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI  $11 - $13mm  $12 - $14mm  $13 - $15mm  $15.0mm
             
Capital Expenditures(a)  $3 - $5mm  $3 - $5mm  $3 - $5mm  $3.5mm
             
Free Cash Flow(2) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI  $8 - $10mm  $8 - $10mm  $8 - $10mm  $11.1mm
             
Free Cash Flow(2) After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI  $(2) - $(5)mm  $(2) - $(5)mm  $(2) - $(5)mm  $(3.9)mm

 

(a)Excludes a $9 million purchase of software code and other intellectual property from a vender.

 

 

 

 

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2025 Guidance

 

Dr. Berger highlighted, “In January and February of 2025, we experienced more severe winter weather conditions than last year in our East Coast and Texas operations as well as catastrophic fires in Southern California. These unanticipated events had a significant impact on the utilization of healthcare services in these regions, which resulted in an estimated loss of $22 million of Revenue and $15 million of Adjusted EBITDA(1) to the RadNet operations. These significant events have caused a revision to the first quarter of our initial 2025 Imaging Center segment budget, which is now reflected in our full-year 2025 guidance.”

 

RadNet reports 2025 guidance ranges as follows:

 

Imaging Center Segment

 

    

2025

Guidance Range

 
Total Net Revenue   $1,825 - $1,875 million 
Adjusted EBITDA(1)   $265 - $273 million 
Capital Expenditures(a)   $140 - $150 million 
Cash Interest Expense(b)   $35 - $40 million 
Free Cash Flow(2)   $70 - $80 million 

 

(a)Net of proceeds from the sale of equipment and New Jersey Imaging Network capital expenditures.
(b)Net of payments from counterparties on interest rate swaps and interest income from our cash balance recorded in Other Income.

 

Digital Health Segment

 

    

2025

Guidance Range

 
Total Net Revenue   $80 - $90 million 
      
Adjusted EBITDA(1) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   $15 - $17 million 
      
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   $16 - $18 million 
      
Capital Expenditures   $3 - $5 million 
      
Free Cash Flow(2) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   $11 - $13 million 
      
Free Cash Flow(2) After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   $(5) - $(8) million 

 

Dr Berger added, “Within the Imaging Center segment, 2025 performance will be impacted by continued focus on same-center performance, tuck-in acquisitions, increasing reimbursement efforts, expanded and new health system joint ventures and de novo center openings. Incorporated into 2025 guidance is continued increases in salaries, wages and benefits, which is indicative of broader industry conditions. To address the labor challenges, we will be focused in 2025 on the implementation of the Digital Health solutions intended to drive automation and efficiencies in the utilization of labor.”

 

“Within the Digital Health segment, 2025 growth will be driven by a variety of factors including, sales of the new DeepHealth OS Operating and Diagnostic software suites, sales and licensing revenue from the new SmartTechologyTM products (eg, SmartMammoTM), licensing fees from the TechLiveTM technologist remote-control and automation technology and further licensing and patient revenue from mammography, lung, prostate and brain AI solutions. In 2025, significant infrastructure investments will be made in building sales, marketing and implementation teams and we will pursue completing potential acquisitions, both of which will contribute to the long-term success in selling and licensing Digital Health solutions to external customers”, concluded Dr. Berger.

 

 

 

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Conference Call for Tomorrow

 

Dr. Howard Berger, President and Chief Executive Officer, and Mark Stolper, Executive Vice President and Chief Financial Officer, will host a conference call tomorrow, February 28th, at 10:30 a.m. Eastern Time. During the call, management will discuss the Company's 2024 fourth quarter and year-end results.

 

Conference Call Details:

 

Date: Friday, February 28, 2025

Time: 10:30 a.m. ET

Dial In-Number: 844-826-3035

International Dial-In Number: 412-317-5195

 

There will also be simultaneous and archived webcasts available at https://viavid.webcasts.com/starthere.jsp?ei=1708732&tp_key=80b765a1d9 or http://www.radnet.com under the “About RadNet” menu section and “News & Press Releases” sub-menu of the website. An archived replay of the call will also be available and can be accessed by dialing 844-512-2921 from the U.S., or 412-317-6671 for international callers, and using the passcode 10197109.

 

About RadNet, Inc.

RadNet, Inc. is the leading national provider of freestanding, fixed-site diagnostic imaging services and related information technology solutions (including artificial intelligence) in the United States based on the number of locations and annual imaging revenue. RadNet has a network of 398 owned and/or operated outpatient imaging centers. RadNet's markets include Arizona, California, Delaware, Florida, Maryland, New Jersey, New York, and Texas. Together with affiliated radiologists, and inclusive of full-time and per diem employees and technologists, RadNet has a total of over 11,000 employees. For more information, visit http://www.radnet.com.

 

Forward Looking Statements

This press release contains “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements are expressions of our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, and anticipated future conditions, events and trends. Forward-looking statements can generally be identified by words such as: “anticipate,” “intend,” “plan,” “goal,” “seek,” “believe,” “project,” “estimate,” “expect,” “strategy,” “future,” “likely,” “may,” “should,” “will” and similar references to future periods. Forward-looking statements in this press release include, among others, statements we make regarding response to and the expected future impacts of COVID-19, including statements about our anticipated business results, balance sheet and liquidity and our future liquidity, burn rate and our continuing ability to service or refinance our current indebtedness.

 

Forward-looking statements are neither historical facts nor assurances of future performance. Because forward-looking statements relate to the future, they are inherently subject to uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Therefore, you should not place undue reliance on any of these forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following:

 

·changes in general economic conditions nationally and regionally in the markets in which we operate, including their effects on the cost and availability of labor;
   
·our ability to service our indebtedness, make principal and interest payments as those payments become due and remain in compliance with applicable debt covenants, in addition to our ability to refinance such indebtedness on acceptable terms;

 

 

 

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·the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities;
   
·our ability to maintain our current credit rating and the impact on our funding costs and competitive position if we do not do so;
   
·volatility in interest and exchange rates, or credit markets;
   
·the adequacy of our cash flow and earnings to fund our current and future operations;
   
·changes in service mix, revenue mix and procedure volumes;
   
·delays in receiving payments for services provided;
   
·increased bankruptcies among our partner physicians or joint venture partners;
   
·the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act;
   
·the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof by federal and state regulators or related litigation result in a reduction in coverage or reimbursement rates for our services, or other material impacts to our business;
   
·closures or slowdowns and changes in labor costs and labor difficulties, including stoppages affecting either our operations or our suppliers' abilities to deliver supplies needed in our facilities;
   
·the occurrence of hostilities, political instability or catastrophic events;
   
·the emergence or reemergence of and effects related to future pandemics, epidemics and infectious diseases; and
   
·noncompliance by us with any privacy or security laws or any cybersecurity incident or other security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information.

 

Any forward-looking statement contained in this current report is based on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that we may make from time to time, whether as a result of changed circumstances, new information, future developments or otherwise, except as required by applicable law.

 

Regulation G: GAAP and Non-GAAP Financial Information

 

This release contains certain financial information not reported in accordance with GAAP. The Company uses both GAAP and non-GAAP metrics to measure its financial results. The Company believes that, in addition to GAAP metrics, these non-GAAP metrics assist the Company in measuring its cash-based performance. The Company believes this information is useful to investors and other interested parties because it removes unusual and nonrecurring charges that occur in the affected period and provides a basis for measuring the Company's financial condition against other quarters. Such information should not be considered as a substitute for any measures calculated in accordance with GAAP, and may not be comparable to other similarly titled measures of other companies. Non-GAAP financial measures should not be considered in isolation from, or as a substitute for, financial information prepared in accordance with GAAP. Reconciliation of this information to the most comparable GAAP measures is included in this release in the tables which follow.

 

CONTACTS:

 

RadNet, Inc.

Mark Stolper, 310-445-2800

Executive Vice President and Chief Financial Officer

 

 

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RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)

 

   December 31, 2024  December 31, 2023
       
ASSETS          
CURRENT ASSETS          
Cash and Cash equivalents  $740,020   $342,570 
Accounts receivable   185,821    163,707 
Due from affiliates   41,869    25,342 
Prepaid expenses and other current assets   51,542    47,657 
Total current assets   1,019,252    579,276 
PROPERTY, EQUIPMENT AND RIGHT-OF-USE ASSETS          
Property and equipment, net   694,791    604,401 
Operating lease right-of-use assets   639,740    596,032 
Total property, plant, equipment and right-of-use assets   1,334,531    1,200,433 
OTHER ASSETS          
Goodwill   710,663    679,463 
Other intangible assets   81,351    90,615 
Deferred financing costs   2,265    1,643 
Investment in joint ventures   104,057    92,710 
Deposits and other   34,571    46,333 
Total Assets  $3,286,690   $2,690,473 
           
LIABILITIES AND EQUITY          
CURRENT LIABILITIES          
Accounts payable, accrued expenses and other  $351,464   $342,940 
Due to affiliates   43,650    15,910 
Deferred revenue   3,288    4,647 
Current operating lease liability   56,618    55,981 
Current portion of notes payable   24,692    17,974 
Total current liabilities   479,712    437,452 
LONG-TERM LIABILITIES          
Long-term operating lease liability   655,979    605,097 
Notes payable, net of current portion   991,574    812,068 
Deferred tax liability, net   22,230    15,776 
Other non-current liabilities   3,785    6,721 
Total liabilities   2,153,280    1,877,114 
EQUITY          
RadNet, Inc. stockholders' equity:          
Common stock - $0.0001 value, 200,000,000 shares authorized; 74,036,993 and 67,956,318 shares issued and outstanding at December 31, 2024 and December 31, 2023, respectively   7    7 
Additional paid-in-capital   988,147    722,750 
Accumulated other comprehensive loss   (9,061)   (12,484)
Accumulated deficit   (76,785)   (79,578)
Total RadNet, Inc.'s Stockholders' equity:   902,308    630,695 
Noncontrolling interests   231,102    182,664 
Total Equity   1,133,410    813,359 
Total liabilities and equity  $3,286,690   $2,690,473 

 

 

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RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENT OF OPERATIONS

(IN THOUSANDS EXCEPT FOR SHARE AND PER SHARE DATA)

 

   Years Ended December 31,
   2024  2023  2022
          
REVENUE               
Service fee revenue  $1,693,089   $1,463,197   $1,278,016 
Revenue under capitation arrangements   136,575    153,433    152,045 
Total service revenue   1,829,664    1,616,630    1,430,061 
OPERATING EXPENSES               
Cost of operations, excluding depreciation and amortization   1,580,549    1,395,239    1,264,346 
Lease abandonment charges   2,478    5,146     
Depreciation and amortization   137,838    128,391    115,877 
Loss (gain) on sale and disposal of equipment and other   2,276    2,187    2,529 
Loss (gain) on contribution of imaging centers into joint venture       (16,808)    
Severance costs   1,902    3,778    946 
Total operating expenses   1,725,043    1,517,933    1,383,698 
INCOME (LOSS) FROM OPERATIONS   104,621    98,697    46,363 
OTHER INCOME AND EXPENSES               
Interest expense   79,849    64,483    50,841 
Equity in earnings of joint ventures   (14,472)   (6,427)   (10,390)
Non-cash change in fair value of interest rate hedge   8,006    8,185    (39,621)
Debt restructuring and extinguishment expenses   11,292        731 
Other expenses (income)   (24,916)   (6,354)   1,833 
Total other (income) expenses   59,759    59,887    3,394 
INCOME (LOSS) BEFORE INCOME TAXES   44,862    38,810    42,969 
Provision for income taxes   (6,026)   (8,473)   (9,361)
NET INCOME (LOSS)   38,836    30,337    33,608 
Net income (loss) attributable to noncontrolling interests   36,043    27,293    22,958 
                
NET INCOME (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $2,793   $3,044   $10,650 
                
BASIC NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $0.04   $0.05   $0.19 
                
DILUTED NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $0.04   $0.05   $0.17 
WEIGHTED AVERAGE SHARES OUTSTANDING               
Basic   73,037,237    63,580,059    56,293,336 
Diluted   74,762,332    64,658,299    57,320,870 

 

 

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RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(IN THOUSANDS)

(unaudited)

 

   Years Ended December 31,
   2024  2023  2022
CASH FLOWS FROM OPERATING ACTIVITIES               
Net income (loss)  $38,836   $30,337   $33,608 
Adjustments to reconcile net income to net cash provided by operating activities:               
Depreciation and amortization   137,838    128,391    115,877 
Amortization of operating lease assets   60,552    61,102    68,847 
Equity in earnings of joint ventures, net of dividend   (9,926)   9,176    (5,952)
Amortization deferred financing costs and loan discount   3,093    2,987    2,693 
Loss on sale and disposal of equipment   2,276    2,187    2,529 
Loss on extinguishment of debt   3,903         
Gain on contribution of imaging centers into joint venture       (16,808)    
Lease abandonment charges   2,478    5,146     
Amortization of cash flow hedge   9,352    3,576    3,687 
Non-cash change in fair value of interest rate hedge   8,006    8,185    (39,621)
Stock-based compensation   29,833    26,785    23,770 
Loss on impairment   1,275    3,949     
Change in fair value of contingent consideration   1,995    (3,880)   (325)
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:               
Accounts receivable   (21,767)   2,650    (30,078)
Other current assets   (32,790)   (8,441)   (3,327)
Other assets   10,723    (1,484)   (12,166)
Deferred taxes   6,454    6,056    13,356 
Operating lease liability   (54,866)   (54,763)   (68,943)
Deferred revenue   (1,359)   626    (7,316)
Accounts payable, accrued expenses and other   37,117    15,086    49,778 
Net cash provided by operating activities   233,023    220,863    146,417 
CASH FLOWS FROM INVESTING ACTIVITIES               
Purchase of imaging facilities and other acquisitions   (43,661)   (10,918)   (129,961)
Purchase of property and equipment   (188,070)   (176,600)   (119,451)
Proceeds from sale of equipment   157    83    3,904 
Equity contributions in existing and purchase of interest in joint ventures   (1,496)   (14,035)   (1,441)
Net cash used in investing activities   (233,070)   (201,470)   (246,949)
CASH FLOWS FROM FINANCING ACTIVITIES               
Principal payments on notes and leases payable   (5,989)   (2,930)    
Payments on Term Loan Debt   (692,437)   (41,063)   (53,750)
Proceeds from issuance of new debt, net of issuance costs   863,757        147,996 
Sale of noncontrolling interests   22,357    5,121     
Payments on contingent consideration and holdbacks   (4,268)   (5,495)    
Distributions paid to noncontrolling interests   (4,522)   (5,972)   (893)
Proceeds from issuance of common stock   218,385    245,832     
Proceeds from issuance of common stock upon exercise of options   667    142    294 
Net cash provided by financing activities   397,950    195,635    93,647 
EFFECT OF EXCHANGE RATE CHANGES ON CASH   (453)   (292)   113 
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS   397,450    214,736    (6,772)
CASH AND CASH EQUIVALENTS, beginning of period   342,570    127,834    134,606 
CASH AND CASH EQUIVALENTS, end of period  $740,020   $342,570   $127,834 
                
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION               
Cash paid during the period for interest  $84,601   $64,695   $39,151 
Cash paid during the period for income taxes  $4,170   $1,587   $587 

 

 

 

 9 

 


RADNET, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENT OF OPERATIONS

(IN THOUSANDS EXCEPT FOR SHARE AND PER SHARE DATA)

 

   Three Months Ended December 31,
   2024  2023
       
REVENUE          
Service fee revenue  $445,576   $384,932 
Revenue under capitation arrangements   31,525    35,451 
Total service revenue   477,101    420,383 
OPERATING EXPENSES          
Cost of operations, excluding depreciation and amortization   411,436    356,592 
Lease abandonment charges   2,478    5,146 
Depreciation and amortization   36,016    32,686 
Loss (gain) on sale and disposal of equipment and other   1,541    1,004 
Severance costs   1,105    621 
Total operating expenses   452,576    396,049 
INCOME (LOSS) FROM OPERATIONS   24,525    24,334 
OTHER INCOME AND EXPENSES          
Interest expense   18,073    16,607 
Equity in earnings of joint ventures   (3,164)   (2,492)
Non-cash change in fair value of interest rate hedge   577    7,236 
Debt restructuring and extinguishment expenses   2,383     
Other expenses (income)   (8,668)   (3,745)
Total other (income) expenses   9,201    17,606 
INCOME (LOSS) BEFORE INCOME TAXES   15,324    6,728 
Provision for income taxes   (1,099)   (732)
NET INCOME (LOSS)   14,225    5,996 
Net income (loss) attributable to noncontrolling interests   8,880    7,856 
NET INCOME (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $5,345   $(1,860)
           
BASIC NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $0.07   $(0.03)
           
DILUTED NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $0.07   $(0.03)
WEIGHTED AVERAGE SHARES OUTSTANDING          
Basic   73,574,262    67,904,999 
Diluted   75,537,595    67,904,999 

 

 

 

 10 

 


RADNET, INC. AND SUBSIDIARIES

RECONCILIATION OF GAAP NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS TO ADJUSTED EBITDA

(IN THOUSANDS)

 

   Three Months Ended December 31,  Years Ended December 31,
   2024  2023  2024  2023
             
Net income (loss) attributable to Radnet, Inc. common stockholders  $5,345   $(1,860)  $2,793   $3,044 
Income taxes   1,099    732    6,026    8,473 
Interest expense   18,073    16,607    79,849    64,483 
Severance costs   1,105    621    1,902    3,778 
Depreciation and amortization   36,016    32,686    137,838    128,391 
Non-cash employee stock-based compensation   8,465    5,404    29,834    26,785 
Loss (gain) on sale and disposal of equipment and other   1,541    1,004    2,276    2,187 
Non-cash change in fair value of interest rate hedge   577    7,236    8,006    8,185 
Other expenses (income)   (8,668)   (3,745)   (24,916)   (6,354)
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   5,018    1,308    14,995    1,308 
Lease abandonment charges   2,478    5,146    2,478    5,146 
Loss (gain) on contribution of imaging centers into joint venture               (16,808)
Loss (gain) on extinguishment of debt and related expenses   2,383        11,292     
Non-cash change to contingent consideration       (429)   1,974    (4,075)
Acquisition related non-cash intangible adjustment               3,950 
Non-operational rent expenses   1,114    881    4,233    3,629 
Acquisition transaction costs   462    222    879    222 
                     
Adjusted EBITDA - Radnet, Inc.  $75,008   $65,813   $279,459   $232,344 
                     
NOTE                    
Adjusted EBITDA - Imaging Center Segment   70,468    63,004    264,901    225,846 
Adjusted EBITDA - Digital Health Segment   4,540    2,809    14,558    6,498 

 

 

 

 

 11 

 

 

RADNET, INC. AND SUBSIDIARIES

SCHEDULE OF ADJUSTED EARNINGS AND EARNINGS PER SHARE (3)

(IN THOUSANDS EXCEPT SHARE DATA)

(unaudited)

 

   Three Months Ended
   December 31,
   2024  2023(iv)
       
NET (LOSS) INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $5,345   $(1,858)
           
Add severance costs   1,105    621 
Add loss on lease abandonment/impairment   2,478    5,146 
Add non-operational rent expenses (i)   1,114    880 
Add acquisition transaction costs   462    222 
Add loss on extinguishment of debt and related expenses   2,383     
Add valuation adjustment for contingent consideration       (429)
Add Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI   5,018    1,308 
Add/Subtract non-cash change in fair value of swap valuation (ii)   577    7,236 
Total adjustments - loss (gain)   13,137    14,984 
Subtract tax impact of Adjustments (iii)   1,766    3,271 
           
TOTAL ADJUSTMENT TO NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS   11,371    11,713 
           
ADJUSTED NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS   16,716    9,855 
           
WEIGHTED AVERAGE SHARES OUTSTANDING          
Diluted   75,537,595    67,904,999 
           
ADJUSTED DILUTED NET INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS  $0.22   $0.15 

 

   
  (i) Represents rent expense associated with de novo sites under construction prior to them becoming operational.
  (ii) Impact from the change in fair value of the swaps during the quarter. Excludes the amortization of the accumulation of the changes in fair value out of Other Comprehensive Income that existed prior to the hedges becoming ineffective.
  (iii) Tax effected using 13.44% and 21.83% blended federal and state effective tax rate for 2024 and 2023, respectively.
  (iv) Restated from what was presented in 2023 to include $4,973 of losses of the AI businesses (ie, this loss is not being added to earnings in the above as was the case in 2023). The restated Adjusted Earnings for 2023 is due to the fact that AI is no longer its own reportable operating segment and is now embedded in the Digital Health reportable operating segment.

 

 

 

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PAYMENTS BY PAYOR CLASS

 

   Fourth Quarter
   2024
    
Commercial Insurance  58.0% 
Medicare  23.5% 
Capitation  6.6% 
Medicaid  2.5% 
Workers Compensation/Personal Injury  2.2% 
Other*  7.2% 
Total  100.0% 

 

* Includes management fee and Digital Health financial reporting unit revenue.

 

RADNET PAYMENTS BY MODALITY

 

   Fourth Quarter  Full Year  Full Year  Full Year 
   2024  2024  2023  2022 
              
MRI  36.9%  37.1%  36.8%  36.8% 
CT  15.7%  15.9%  16.8%  17.5% 
PET/CT  7.6%  7.2%  6.4%  5.8% 
X-ray  5.7%  6.0%  6.5%  6.7% 
Ultrasound  13.5%  13.6%  12.9%  12.6% 
Mammography  16.9%  16.4%  16.0%  15.3% 
Nuclear Medicine  0.9%  1.0%  0.8%  0.9% 
Other  2.8%  2.7%  3.9%  4.5% 
   100.0%  100.0%  100.0%  100.0% 

 

PROCEDURES BY MODALITY*

 

   Fourth Quarter  Fourth Quarter
   2024  2023
        
MRI  452,063  398,625
CT  271,061  237,937
PET/CT  19,602  15,825
Nuclear Medicine  9,054  8,120
Ultrasound  655,531  617,301
Mammography  517,013  483,687
X-ray and Other  847,429  804,225
       
Total  2,771,753  2,565,720

 

* Volumes include wholly owned and joint venture centers.

 

 

 

 13 

 

 

Footnotes

 

(1) The Company defines Adjusted EBITDA as earnings before interest, taxes, depreciation and amortization, each from continuing operations and excludes losses or gains on the disposal of equipment, other income or loss, loss on debt extinguishments, bargain purchase gains and non-cash equity compensation. Adjusted EBITDA includes equity earnings in unconsolidated operations and subtracts allocations of earnings to non-controlling interests in subsidiaries, and is adjusted for non-cash and extraordinary events which took place during the period.

 

Adjusted EBITDA is reconciled to its nearest comparable GAAP financial measure. Adjusted EBITDA is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance, and is a measure of leverage capacity and ability to service debt. Adjusted EBITDA should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

 

(2) As noted above, the Company defines Free Cash Flow as Adjusted EBITDA less total Capital Expenditures (whether completed with cash or financed) and Cash Interest paid. Free Cash Flow is a non-GAAP financial measure. The Company uses Free Cash Flow because the Company believes it provides useful information for investors and management because it measures our capacity to generate cash from our operating activities. Free Cash Flow does not represent total cash flow since it does not include the cash flows generated by or used in financing activities. In addition, our definition of Free Cash Flow may differ from definitions used by other companies.

 

Free Cash Flow should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

 

(3) The Company defines Adjusted Earnings Per Share as net income or loss attributable to RadNet, Inc. common stockholders and excludes losses or gains on the disposal of equipment, loss on debt extinguishments, bargain purchase gains, severance costs, loss on impairment, loss or gain on swap valuation, gain on extinguishment of debt, unusual or non-recurring entries that impact the Company’s tax provision, pre-tax loss or gain from AI segment and any other non-recurring or unusual transactions recorded during the period.

 

Adjusted Earnings Per Share is reconciled to its nearest comparable GAAP financial measure (see table on prior page). Adjusted Earnings Per Share is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance. Adjusted Earnings Per Share should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted Earnings Per Share should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted Earnings Per Share is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.

 

 

 

 

 

 

 

 14