Tactile Systems Technology, Inc. Reports Fourth Quarter and Full Year 2020 Financial Results; Introduces Full Year 2021 Outlook


Fourth Quarter Revenue Increased 4% Year-Over-Year

MINNEAPOLIS, Feb. 23, 2021 (GLOBE NEWSWIRE) -- Tactile Systems Technology, Inc. (“Tactile Medical”) (Nasdaq: TCMD), a medical technology company focused on developing medical devices for the at-home treatment of chronic diseases, today reported financial results for the fourth quarter and full year ended December 31, 2020.

Fourth Quarter 2020 Summary:

  • Total revenue increased 4% year-over-year, to $59.2 million, compared to $57.1 million in fourth quarter 2019.
  • Operating income of $7.0 million, compared to $6.0 million in fourth quarter 2019.
  • Net income of $12.1 million, compared to $4.3 million in fourth quarter 2019.
  • Adjusted EBITDA of $10.8 million, compared to $10.4 million in fourth quarter 2019.
  • Cash, cash equivalents, and marketable securities of $47.9 million at December 31, 2020, compared to $45.2 million at December 31, 2019.

Full Year 2020 Summary:

  • Total revenue decreased 1% year-over-year, to $187.1 million, compared to $189.5 million in 2019.
  • Excluding the contribution to full year 2019 revenue related to the Company’s adoption of ASC 842, full year 2020 revenue reflects growth of 1% year-over-year on an operational basis.
  • Operating loss of $3.6 million, compared to operating income of $10.5 million in 2019.
  • Net loss of $0.6 million, compared to net income of $11.0 million in 2019.
  • Adjusted EBITDA of $16.0 million, compared to $25.3 million in 2019.

“We were pleased to close 2020 by returning to year-over-year growth in the fourth quarter, and ultimately exceeding the high end of our annual revenue guidance range, in spite of the business disruption that we experienced due to the COVID-19 pandemic,” said Dan Reuvers, President and Chief Executive Officer of Tactile Medical. “In the fourth quarter, the majority of the facilities that we serve continued to operate with constraints related to social distancing and safety protocols, and we experienced incremental headwinds during the month of December as the holiday wave of cases impacted clinicians, patients and our own team. In spite of these incremental headwinds, I am proud of the exceptional effort and dedication shown by our team during the quarter, which enabled us to deliver strong performance by continuing to support our existing customers while expanding our prescriber base.”

Mr. Reuvers added, “Despite the continuation of COVID-related headwinds as we enter 2021, we believe we are well-positioned to emerge with an enhanced sales and field support team in place to improve our coverage and the productivity of our representatives, as well as an expanded pool of prescribers and an updated approach for educating clinicians and training patients. We are focused on expanding our leadership position in the over $5 Billion U.S. lymphedema market through a combination of continued execution and strategic investment in our business with the goal of returning to sustained 20%+ revenue growth and improving profitability for the benefit of our patients, customers and shareholders.”

Fourth Quarter 2020 Financial Results

Total revenue in the fourth quarter of 2020 increased $2.2 million, or 4%, to $59.2 million, compared to $57.1 million in the fourth quarter of 2019. The increase in total revenue was attributable to an increase of $2.4 million, in sales and rentals of the Entre system, which was partially offset by a decrease of $0.3 million, in sales and rentals of the Flexitouch system in the quarter ended December 31, 2020. Fourth quarter revenue continued to be negatively impacted by COVID-19, primarily from social distancing requirements and safety protocols imposed within clinics. These headwinds were partially offset by the continued expansion of our commercial team, effective virtual educational events, and an increase in the number of Medicare patients served.

Gross profit in the fourth quarter of 2020 increased $0.8 million, or 2%, to $41.9 million, compared to $41.1 million in the fourth quarter of 2019. Gross margin was 71% of revenue, compared to 72% of revenue in the fourth quarter of 2019.

Operating expenses in the fourth quarter of 2020 decreased $0.2 million, or 1%, to $34.9 million, compared to $35.1 million in the fourth quarter of 2019. The decrease in operating expenses in the fourth quarter of 2020 was driven by a decrease in sales and marketing expense of $2.6 million, or 12%, to $19.8 million, primarily due to lower patient training costs, lower sales commissions and reduced travel and entertainment expenses. The decrease in sales and marketing expense was nearly fully offset by reimbursement, general and administrative expenses, which increased $2.2 million, or 19%, to $13.7 million, compared to $11.5 million in the fourth quarter of 2019. The increase in reimbursement, general and administrative expenses was driven by increased litigation defense costs and other professional fees, as well as personnel-related expenses due to increased headcount in our reimbursement and corporate functions.

Operating income in the fourth quarter of 2020 increased $1.0 million, or 16%, to $7.0 million, compared to $6.0 million in the fourth quarter of 2019.

Other income in the fourth quarter of 2020 increased $1.0 million to $1.2 million, compared to $0.2 million in the fourth quarter of 2019. The increase in other income was due to $1.2 million received under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Provider Relief Fund to provide relief for lost revenues from the COVID-19 public health emergency.

Income tax benefit in the fourth quarter of 2020 was $3.9 million, compared to income tax expense of $1.9 million in the fourth quarter of 2019. The year-over-year change in income tax benefit/expense was primarily due to changes in our effective tax rate, which was primarily attributable to a change in taxable income, including proportionately higher tax benefits for stock-based compensation as compared to the same period last year.

Net income in the fourth quarter of 2020 was $12.1 million, or $0.61 per diluted share, compared to net income of $4.3 million, or $0.22 per diluted share, in the fourth quarter of 2019. Weighted average shares used to compute diluted net income per share were 19.8 million and 19.7 million in the fourth quarters of 2020 and 2019, respectively.

Adjusted EBITDA was $10.8 million in the fourth quarter of 2020, compared to Adjusted EBITDA of $10.4 million in the fourth quarter of 2019.

Full Year 2020 Financial Results:

Total revenue for the twelve months ended December 31, 2020, decreased $2.4 million, or 1%, to $187.1 million, compared to $189.5 million for the twelve months ended December 31, 2019. Total revenue for the twelve months ended December 31, 2020, increased 1% on an operational basis, excluding the contribution to revenue in the twelve months ended December 31, 2019 related to the Company’s adoption of accounting standard, ASC 842. The decrease in total revenue on a reported basis for the twelve months ended December 31, 2020, was driven by a decrease of approximately $7.4 million, in sales and rentals of the Flexitouch system, offset in part by an increase of $5.0 million, in sales and rentals of the Entre system. Revenue in the first two months of 2020 was ahead of our expectations. Beginning in March 2020 and continuing through the fourth quarter, revenue was impacted by the COVID-19 pandemic, which limited our ability to access our clinician customers and their patients. Specifically, we saw healthcare facilities and clinics restricting access to their clinicians, reducing patient consultations, or closing temporarily due to COVID-19.

Net loss for the twelve months ended December 31, 2020 was $0.6 million, or $0.03 per diluted share, compared to net income of $11.0 million, or $0.56 per diluted share, for the twelve months ended December 31, 2019. Weighted average shares used to compute diluted net loss/income per share were 19.3 million and 19.6 million for the twelve months ended December 31, 2020 and 2019, respectively.

Adjusted EBITDA was $16.0 million in the twelve months ended December 31, 2020, compared to adjusted EBITDA of $25.3 million in the twelve months ended December 31, 2019.

Cash Position

At December 31, 2020, cash, cash equivalents and marketable securities were $47.9 million, compared to $45.2 million at December 31, 2019. The Company had no outstanding borrowings on its $10.0 million revolving credit facility at December 31, 2020.

2021 Financial Outlook

The Company expects full year 2021 total revenue in the range of $215.3 million to $224.5 million, representing an increase of 15% to 20% year-over-year, compared to total revenue of $187.1 million in 2020.   

Conference Call

Management will host a conference call at 5:00 p.m. Eastern Time on February 23, 2021, to discuss the results of the quarter with a question-and-answer session. Those who would like to participate may dial 877-407-3088 (201-389-0927 for international callers) and provide access code 13715783. A live webcast of the call will also be provided on the investor relations section of the Company's website at investors.tactilemedical.com.

For those unable to participate, a replay of the call will be available for two weeks at 877-660-6853 (201-612-7415 for international callers); access code 13715783. The webcast will be archived at investors.tactilemedical.com.

About Tactile Systems Technology, Inc. (DBA Tactile Medical)

Tactile Medical is a leader in developing and marketing at-home therapy devices that treat chronic swelling conditions such as lymphedema and chronic venous insufficiency. Tactile Medical’s Mission is to help people suffering from chronic diseases live better and care for themselves at home. The Company’s unique offering includes advanced, clinically proven pneumatic compression devices, as well as continuity of care services provided by a national network of product specialists and trainers, reimbursement experts, patient advocates and clinicians. This combination of products and services ensures that tens of thousands of patients annually receive the at-home treatment necessary to better manage their chronic conditions. Tactile Medical takes pride in the fact that our solutions help increase clinical efficacy, reduce overall healthcare costs and improve the quality of life for patients with chronic conditions.

Legal Notice Regarding Forward-Looking Statements

This release contains forward-looking statements. Forward-looking statements are generally identifiable by the use of words like “may,” “will,” “should,” “could,” “expect,” “anticipate,” “estimate,” “believe,” “intend,” “continue,” “confident,” “outlook,” “guidance,” “project,” “goals,” “look forward,” “poised,” “designed,” “plan,” “return,” “focused,” “prospects” or “remain” or the negative of these words or other variations on these words or comparable terminology. The reader is cautioned not to put undue reliance on these forward-looking statements, as these statements are subject to numerous factors and uncertainties outside of the Company’s control that can make such statements untrue, including, but not limited to, the impacts of the COVID-19 pandemic on the Company’s business, financial condition and results of operations; the course of the COVID-19 pandemic and its impact on general economic, business and market conditions; the Company’s inability to execute on its plans to respond to the COVID-19 pandemic; the adequacy of the Company’s liquidity to pursue its business objectives; the Company’s ability to obtain reimbursement from third party payers for its products; loss or retirement of key executives, including prior to identifying a successor; adverse economic conditions or intense competition; loss of a key supplier; entry of new competitors and products; adverse federal, state and local government regulation; technological obsolescence of the Company’s products; technical problems with the Company’s research and products; the Company’s ability to expand its business through strategic acquisitions; the Company’s ability to integrate acquisitions and related businesses; price increases for supplies and components; the effects of current and future U.S. and foreign trade policy and tariff actions; or the inability to carry out research, development and commercialization plans. In addition, other factors that could cause actual results to differ materially are discussed in the Company’s filings with the SEC. Investors and security holders are urged to read these documents free of charge on the SEC’s website at http://www.sec.gov. The Company undertakes no obligation to publicly update or revise its forward-looking statements as a result of new information, future events or otherwise.

Use of Non-GAAP Financial Measures

This press release includes the non-GAAP financial measures of Adjusted EBITDA, non-GAAP revenue change and Adjusted EBITDA margin, which differ from financial measures calculated in accordance with U.S. generally accepted accounting principles (“GAAP”).

Adjusted EBITDA in this release represents net income or loss, plus interest expense, net, or less interest income, net, less income tax benefit or plus income tax expense, plus depreciation and amortization, plus stock-based compensation expense, plus loss on termination of lease, plus impairment charges and inventory write-offs, less CARES Act funding, plus litigation defense costs and plus executive transition costs. Adjusted EBITDA margin in this release represents net margin (net income or loss divided by total revenue), plus or less the same items as with Adjusted EBITDA, but on a percentage of revenue basis. Reconciliations of Adjusted EBITDA to net income (loss), and Adjusted EBITDA margin to net margin, are included in this press release.

Non-GAAP revenue change in this release represents full year 2020 revenue compared to full year 2019 revenue less operating lease revenue that was recognized in 2019 in connection with the Company’s adoption of ASC 842. A reconciliation of GAAP revenue change to non-GAAP revenue change is included in this press release.

These non-GAAP financial measures are presented because the Company believes they are useful indicators of its operating performance. Management uses these measures principally as measures of the Company’s operating performance and for planning purposes, including the preparation of the Company’s annual operating plan and financial projections. The Company believes these measures are useful to investors as supplemental information and because they are frequently used by analysts, investors and other interested parties to evaluate companies in its industry. The Company also believes these non-GAAP financial measures are useful to its management and investors as a measure of comparative operating performance from period to period. In addition, Adjusted EBITDA is used as a performance metric in the Company’s compensation program.

Adjusted EBITDA, non-GAAP revenue change and Adjusted EBITDA margin are non-GAAP financial measures and should not be considered as an alternative to, or superior to, net income or loss, GAAP revenue change or net margin, respectively, as measures of financial performance or cash flows from operations as a measure of liquidity, or any other performance measure derived in accordance with GAAP, and they should not be construed to imply that the Company’s future results will be unaffected by unusual or non-recurring items. In addition, Adjusted EBITDA is not intended to be a measure of free cash flow for management’s discretionary use, as it does not reflect certain cash requirements such as tax payments, debt service requirements, capital expenditures and certain other cash costs that may recur in the future. Adjusted EBITDA contains certain other limitations, including the failure to reflect our cash expenditures, cash requirements for working capital needs and cash costs to replace assets being depreciated and amortized. In evaluating non-GAAP financial measures, you should be aware that in the future the Company may incur expenses that are the same as or similar to some of the adjustments in this presentation. The Company’s presentation of non-GAAP financial measures should not be construed to imply that its future results will be unaffected by any such adjustments. Management compensates for these limitations by primarily relying on the Company’s GAAP results in addition to using non-GAAP financial measures on a supplemental basis. The Company’s definition of these non-GAAP financial measures is not necessarily comparable to other similarly titled captions of other companies due to different methods of calculation.

 
 
Tactile Systems Technology, Inc.
Consolidated Balance Sheets
(Unaudited)
   December 31,    December 31,
(In thousands, except share and per share data)  2020    2019
Assets      
Current assets      
Cash and cash equivalents $47,855 $22,770
Marketable securities    22,464
Accounts receivable  43,849  33,444
Net investment in leases  10,708  8,147
Inventories  18,563  19,059
Prepaid expenses and other current assets  2,638  2,451
Total current assets  123,613  108,335
Non-current assets      
Property and equipment, net  6,957  7,408
Right of use operating lease assets  20,132  15,885
Intangible assets, net  1,680  5,312
Accounts receivable, non-current  9,433  4,184
Deferred income taxes  10,198  8,970
Other non-current assets  2,074  1,658
Total non-current assets  50,474  43,417
Total assets $174,087 $151,752
Liabilities and Stockholders' Equity      
Current liabilities      
Accounts payable $4,197 $3,843
Accrued payroll and related taxes  11,588  10,098
Accrued expenses  4,423  4,498
Income taxes payable  2,658  632
Operating lease liabilities  2,006  1,454
Other current liabilities  1,842  903
Total current liabilities  26,714  21,428
Non-current liabilities      
Accrued warranty reserve, non-current  3,235  2,541
Income taxes, non-current    54
Operating lease liabilities, non-current  19,388  15,134
Total non-current liabilities  22,623  17,729
Total liabilities  49,337  39,157
       
Stockholders’ equity:      
Preferred stock, $0.001 par value, 50,000,000 shares authorized; none issued
and outstanding as of December 31, 2020 and December 31, 2019
    
Common stock, $0.001 par value, 300,000,000 shares authorized; 19,492,718
shares issued and outstanding as of December 31, 2020; 19,152,715 shares
issued and outstanding as of December 31, 2019
  19  19
Additional paid-in capital  104,675  91,874
Retained earnings  20,056  20,676
Accumulated other comprehensive income    26
Total stockholders’ equity  124,750  112,595
Total liabilities and stockholders’ equity $174,087 $151,752
       


Tactile Systems Technology, Inc.
Consolidated Statements of Operations
(Unaudited)
             
  Three Months Ended Year Ended
  December 31,
 December 31,
(In thousands, except share and per share data) 2020
    2019
    2020
    2019
Revenue            
Sales revenue $51,784  $50,401 $161,497  $162,904
Rental revenue  7,458   6,662  25,633   26,588
Total revenue  59,242   57,063  187,130   189,492
Cost of revenue            
Cost of sales revenue  14,441   13,803  45,309   47,034
Cost of rental revenue  2,948   2,160  9,011   8,222
Total cost of revenue  17,389   15,963  54,320   55,256
Gross profit            
Gross profit - sales revenue  37,343   36,598  116,188   115,870
Gross profit - rental revenue  4,510   4,502  16,622   18,366
Gross profit  41,853   41,100  132,810   134,236
Operating expenses            
Sales and marketing  19,777   22,374  79,634   78,920
Research and development  1,373   1,192  5,264   5,174
Reimbursement, general and administrative  13,712   11,485  51,540   39,644
Total operating expenses  34,862   35,051  136,438   123,738
Income (loss) from operations  6,991   6,049  (3,628)  10,498
Other income  1,187   151  1,367   631
Income (loss) before income taxes  8,178   6,200  (2,261)  11,129
Income tax (benefit) expense  (3,935)  1,917  (1,641)  158
Net income (loss) $12,113  $4,283 $(620) $10,971
Net income (loss) per common share            
Basic $0.62  $0.22 $(0.03) $0.58
Diluted $0.61  $0.22 $(0.03) $0.56
Weighted-average common shares used to
compute net income (loss) per common
share
            
Basic  19,458,865   19,062,584  19,346,929   18,919,007
Diluted  19,830,970   19,700,882  19,346,929   19,641,143
               


       
Tactile Systems Technology, Inc.
Consolidated Statements of Cash Flows
(Unaudited)
  
  Year Ended December 31, 
(In thousands)  2020     2019 
Cash flows from operating activities      
Net (loss) income $(620) $10,971 
Adjustments to reconcile net (loss) income to net cash provided by operating activities:      
Depreciation and amortization  2,794   3,538 
Net amortization of premiums and discounts on securities available-for-sale  (91)  (307)
Deferred income taxes  (1,233)  (146)
Stock-based compensation expense  10,689   9,824 
Gain on other investments and maturities of marketable securities  (11)  7 
Impairment losses  4,025    
Loss on termination of lease     1,148 
Changes in assets and liabilities:      
Accounts receivable  (10,405)  (9,112)
Net investment in leases  (2,561)  (8,147)
Inventories  318   (7,870)
Income taxes  1,972   2,428 
Prepaid expenses and other assets  (528)  (1,166)
Right of use operating lease assets  559   625 
Medicare accounts receivable, non-current  (5,249)  (2,300)
Accounts payable  337   (1,389)
Accrued payroll and related taxes  1,490   2,677 
Accrued expenses and other liabilities  1,308   1,729 
   Net cash provided by operating activities  2,794   2,510 
Cash flows from investing activities      
Proceeds from sales of securities available-for-sale     1,493 
Proceeds from maturities of securities available-for-sale  22,500   25,000 
Purchases of securities available-for-sale     (22,840)
Purchases of property and equipment  (2,059)  (5,446)
Intangible assets costs  (232)  (542)
Other investments  (30)   
   Net cash provided by (used in) investing activities  20,179   (2,335)
Cash flows from financing activities      
Taxes paid for net share settlement of restricted stock units  (1,854)  (3,391)
Proceeds from exercise of common stock options  1,068   2,834 
Proceeds from the issuance of common stock from the employee stock purchase plan  2,898   3,053 
   Net cash provided by financing activities  2,112   2,496 
Net increase in cash and cash equivalents  25,085   2,671 
Cash and cash equivalents – beginning of period  22,770   20,099 
Cash and cash equivalents – end of period $47,855  $22,770 
       
Supplemental cash flow disclosure      
Cash paid for interest $  $ 
Cash paid for taxes $543  $344 
Capital expenditures incurred but not yet paid $17  $122 
         


The following table summarizes revenue by product for the three and twelve months ended December 31, 2020 and 2019:
 
Tactile Systems Technology, Inc.
Supplemental Financial Information
(Unaudited)
                         
  Three Months Ended   Year Ended  
  December 31, Change December 31, Change
(Dollars in thousands)    2020    2019    $    %    2020    2019    $    %
Flexitouch System $51,293 $51,556 $(263) (1)% $163,914 $171,323 $(7,409) (4)%
Other products(1)  7,949  5,507  2,442  44 %  23,216  18,169  5,047  28 %
Total Revenue $59,242 $57,063 $2,179  4 % $187,130 $189,492 $(2,362) (1)%
                             
 
(1) The “other products” line primarily includes revenue from our Entre system. The Actitouch system and Airwear wrap contributed immaterial amounts of revenue for the years ended December 31, 2020 and 2019.


The following table contains a reconciliation of the revenue change rate to the non-GAAP revenue change rate for the year ended December 31, 2020 compared to the year ended December 31, 2019:
 
Tactile Systems Technology, Inc.
Reconciliation of Revenue Change Rate to Non-GAAP Revenue Change Rate
(Unaudited)
         
         
  Year Ended  Year Ended Change Rate
(Dollars in thousands) December 31, 2020 December 31, 2019 % Change
Total revenue $187,130 $189,492  (1)%
Less: Operating lease revenue(1)  N/A  (5,018) 2 %
Total non-GAAP revenue $187,130 $184,474  1 %
            
(1)  The operating lease revenue excluded from revenue for the year ended December 31, 2019, in the adjustment was related to rental agreements commencing prior to December 31, 2018, which were recognized as month-to-month operating leases for the year ended December 31, 2019, and did not contribute to the Company’s revenue results in 2020.


The following table contains a reconciliation of net income (loss) to Adjusted EBITDA for the three and twelve months ended December 31, 2020 and 2019, as well as the dollar and percentage change between the comparable periods:
 
Tactile Systems Technology, Inc.
Reconciliation of Net Income (Loss) to Non-GAAP Adjusted EBITDA
(Unaudited)
                         
  Three Months Ended Increase Year Ended Increase
  December 31, (Decrease) December 31, (Decrease)
(Dollars in thousands)    2020     2019  $    %    2020     2019  $    %
Net income (loss) $12,113  $4,283  $7,830  183 % $(620) $10,971  $(11,591) (106)%
Interest expense (income), net  (14)  (81)  67  (83)%  (75)  (343)  268  (78)%
Income tax expense (benefit)  (3,935)  1,917   (5,852) N.M. %  (1,641)  158   (1,799) N.M. %
Depreciation and amortization  692   730   (38) (5)%  2,794   3,538   (744) (21)%
Stock-based compensation  2,401   2,437   (36) (1)%  10,689   9,824   865  9 %
Loss on termination of lease     1,148   (1,148) (100)%     1,148   (1,148) (100)%
Impairment charges and inventory write-offs           %  4,025      4,025   %
CARES Act Funding  (1,176)     (1,176)  %  (1,176)     (1,176)  %
Litigation defense costs  599      599   %  1,030      1,030   %
Executive transition costs  105      106   %  981      981   %
Adjusted EBITDA $10,785  $10,434  $352  3 % $16,007  $25,296  $(9,289) (37)%
                                 


The following table contains a reconciliation of net margin to Adjusted EBITDA margin for the three and twelve months ended December 31, 2020 and 2019, as well as the basis point change between the comparable periods:
Tactile Systems Technology, Inc.
Reconciliation of Net Margin to Adjusted EBITDA Margin
(Unaudited)
                   
  Three Months Ended    Year Ended   
  December 31, Increase December 31, Increase
(As a percentage of revenue)    2020    2019 (Decrease)    2020    2019 (Decrease)
Net margin 20.4 % 7.5 % 1,290 bps (0.3)% 5.8 % (610)bps
Interest expense (income), net 0.0 % (0.1)% 10 bps 0.0 % (0.2)% 20 bps
Income tax expense (benefit) (6.6)% 3.4 % (1,000)bps (0.9)% 0.1 % (100)bps
Depreciation and amortization 1.2 % 1.3 % (10)bps 1.5 % 1.9 % (40)bps
Stock-based compensation 4.1 % 4.3 % (20)bps 5.7 % 5.2 % 50 bps
Loss on termination of lease 0.0 % 1.9 % (190)bps 0.0 % 0.5 % (50)bps
Impairment charges and inventory write-offs 0.0 % 0.0 %  bps 2.2 % 0.0 % 220 bps
CARES Act Funding (2.0)% 0.0 % (200)bps (0.6)% 0.0 % (60)bps
Litigation defense costs 0.9 % 0.0 % 90 bps 0.6 % 0.0 % 60 bps
Executive transition costs 0.2 % 0.0 % 20 bps 0.4 % 0.0 % 40 bps
Adjusted EBITDA margin 18.2 % 18.3 % (10)bps 8.6 % 13.3 % (470)bps
 

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