Tactile Systems Technology, Inc. Reports Fourth Quarter and Full Year 2023 Financial Results; Introduces Full Year 2024 Outlook

Full Year Revenue Increased 11% Year-Over-Year; Full Year Net Income Increased 260%; Full Year Adjusted EBITDA Increased 62%


MINNEAPOLIS, Feb. 20, 2024 (GLOBE NEWSWIRE) -- Tactile Systems Technology, Inc. (“Tactile Medical”; the “Company”) (Nasdaq: TCMD), a medical technology company providing therapies for people with chronic disorders, today reported financial results for the fourth quarter and full year ended December 31, 2023.

Fourth Quarter 2023 Highlights:

  • Total revenue increased 5% over prior year to $77.7 million
  • Net income increased 77% over prior year to $8.2 million
  • Adjusted EBITDA increased 27% over prior year to $15.4 million
  • Retired $16.8 million revolving line of credit and completed final $5.6 million earnout payment
  • Welcomed Vindell Washington, M.D. to Board of Directors

Full Year 2023 Highlights:

  • Treated over 77,000 patients
  • Total revenue increased 11% over prior year to $274.4 million
  • Net income increased 260% over prior year to $28.5 million
  • Adjusted EBITDA increased 62% over prior year to $29.7 million
  • Generated $35.9 million of cashflow from operations, a $30.6 million increase over prior year
  • Accounts receivable, current and non-current, declined $23.8 million
  • Introduced Entre Plus and Flexitouch ComfortEase upper extremity garments

“2023 proved to be a year of significant progress for Tactile. We restored our lymphedema therapies to double-digit growth, introduced new products and demonstrated leverage in sales and marketing. We also grew total revenue over 11%, delivered record profitability and significantly strengthened our balance sheet,” said Dan Reuvers, President and Chief Executive Officer of Tactile Medical. “Our results clearly reflected the hard work throughout the company in 2023.”

Mr. Reuvers continued, “In 2024, we will continue investing to serve more patients, leverage technology solutions and improve our customer experience. We remain focused on delivering double-digit revenue growth, expanding operating margins and generating solid free cashflow as we seek to extend our leadership position in the treatment of patients with underserved chronic conditions.”

Fourth Quarter 2023 Financial Results

Total revenue in the fourth quarter of 2023 increased $3.8 million, or 5.1%, to $77.7 million, compared to $73.9 million in the fourth quarter of 2022. The increase in total revenue was attributable to an increase of $3.7 million, or 5.6%, in sales and rentals of the lymphedema product line and an increase of $0.1 million, or 0.6%, in sales of the airway clearance product line compared to the fourth quarter of 2022.

Gross profit in the fourth quarter of 2023 increased $3.9 million, or 7.5%, to $56.0 million, compared to $52.1 million in the fourth quarter of 2022. Gross margin was 72.1% of revenue, compared to 70.5% of revenue in the fourth quarter of 2022. Non-GAAP gross margin was 72.5% of revenue, compared to 71.2% of revenue in the fourth quarter of 2022.

Operating expenses in the fourth quarter of 2023 were $44.2 million, consistent with the fourth quarter of 2022.

Operating income was $11.8 million in the fourth quarter of 2023, compared to $7.9 million in the fourth quarter of 2022. Non-GAAP operating income in the fourth quarter of 2023 was $12.7 million, compared to $9.5 million in the fourth quarter of 2022.

Other expense was $36,000 in the fourth quarter of 2023, compared to $950,000 in the fourth quarter of 2022.

Income tax expense was $3.6 million in the fourth quarter of 2023, compared to $2.3 million in the fourth quarter of 2022.

Net income in the fourth quarter of 2023 was $8.2 million, or $0.35 per diluted share, compared to $4.6 million, or $0.23 per diluted share, in the fourth quarter of 2022. Non-GAAP net income in the fourth quarter of 2023 was $8.9 million, compared to $5.9 million in the fourth quarter of 2022.

Weighted average shares used to compute diluted net income per share were 23.8 million and 20.3 million for the fourth quarters of 2023 and 2022, respectively.

Adjusted EBITDA was $15.4 million in the fourth quarter of 2023, compared to $12.1 million in the fourth quarter of 2022.

Full Year 2023 Financial Results

Total revenue for the twelve months ended December 31, 2023, increased $27.6 million, or 11.2%, to $274.4 million, compared to $246.8 million for the twelve months ended December 31, 2022. The increase in revenue was attributable to an increase of $29.5 million, or 13.9%, in sales and rentals of the lymphedema product line, partially offset by a decrease of $1.8 million, or 5.3%, in sales of the airway clearance product line.

Net income for the twelve months ended December 31, 2023, was $28.5 million, or $1.23 per diluted share, compared to a net loss of $17.9 million, or $0.89 per diluted share, for the twelve months ended December 31, 2022. Non-GAAP net income for the twelve months ended December 31, 2023, was $29.5 million, compared to a non-GAAP net loss of $3.6 million for the twelve months ended December 31, 2022.

Weighted average shares used to compute diluted net income (loss) per share were 23.2 million and 20.1 million for the twelve months ended December 31, 2023 and 2022, respectively.

Adjusted EBITDA was $29.7 million in the twelve months ended December 31, 2023, compared to $18.3 million in the twelve months ended December 31, 2022.

Balance Sheet Summary

As of December 31, 2023, the Company had $61.0 million in cash and cash equivalents and $29.3 million of outstanding borrowings under its credit agreement, compared to $21.9 million in cash and cash equivalents and $49.0 million of outstanding borrowings under its credit agreement as of December 31, 2022.

2024 Financial Outlook

The Company expects full year 2024 total revenue in the range of $300.0 million to $305.0 million, representing growth of approximately 9% to 11% year-over-year, compared to total revenue of $274.4 million in 2023.

Conference Call

Management will host a conference call at 8:00 a.m. Eastern Time on February 20, 2024, to discuss the results of the quarter and fiscal year 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 13744163. 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 13744163. 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 therapies for people suffering from underserved, chronic conditions including lymphedema, lipedema, chronic venous insufficiency and chronic pulmonary disease by helping them live better and care for themselves at home. Tactile Medical collaborates with clinicians to expand clinical evidence, raise awareness, increase access to care, reduce overall healthcare costs and improve the quality of life for tens of thousands of patients each year.

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 inflation, rising interest rates or a recession; 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; adverse economic conditions or intense competition; price increases for supplies and components; wage and component price inflation; loss of a key supplier; entry of new competitors and products; compliance with and changes in federal, state and local government regulation; loss or retirement of key executives, including prior to identifying a successor; 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; 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 gross profit, non-GAAP gross margin, non-GAAP operating income (loss), and non-GAAP net income (loss), 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 impairment charges and inventory write-offs, plus or minus the change in fair value of earn-out, plus litigation defense costs and plus executive transition costs. Non-GAAP gross profit in this release represents gross profit plus non-cash intangible amortization expense and inventory write-offs. Non-GAAP gross margin in this release represents non-GAAP gross profit divided by revenue. Non-GAAP operating income (loss) in this release represents operating income (loss) adjusted for non-cash intangible amortization expense, inventory write-offs, change in fair value of earn-out, litigation defense costs and executive transition expenses. Non-GAAP net income (loss) represents net income (loss) adjusted for non-cash intangible amortization expense, inventory write-offs, change in fair value of earn-out, litigation defense costs and executive transition expenses, and adjusted for the income tax effect on reconciling items. Reconciliations of these non-GAAP financial measures to their most directly comparable GAAP measures are 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.

The non-GAAP financial measures presented in this release should not be considered as an alternative to, or superior to, their respective GAAP financial measures, 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
   At December 31,
(In thousands, except share and per share data)    2023    2022 
Assets     
Current assets      
Cash and cash equivalents $61,033 $21,929 
Accounts receivable  43,173  54,826 
Net investment in leases  14,195  16,130 
Inventories  22,527  23,124 
Prepaid expenses and other current assets  4,366  3,754 
 Total current assets  145,294  119,763 
Non-current assets      
Property and equipment, net  6,195  6,077 
Right of use operating lease assets  19,128  21,322 
Intangible assets, net  46,724  50,375 
Goodwill  31,063  31,063 
Accounts receivable, non-current  10,936  23,061 
Deferred income taxes  19,378   
Other non-current assets  2,720  3,335 
 Total non-current assets  136,144  135,233 
 Total assets $281,438 $254,996 
Liabilities and Stockholders' Equity      
Current liabilities      
Accounts payable $6,659 $9,984 
Note payable  2,956  2,968 
Earn-out, current    13,050 
Accrued payroll and related taxes  16,789  17,100 
Accrued expenses  5,904  9,240 
Income taxes payable  1,467  2,336 
Operating lease liabilities  2,807  2,500 
Other current liabilities  4,475  7,152 
 Total current liabilities  41,057  64,330 
Non-current liabilities      
Revolving line of credit, non-current    24,916 
Note payable, non-current  26,176  20,979 
Accrued warranty reserve, non-current  1,681  2,207 
Income taxes payable, non-current  446  298 
Operating lease liabilities, non-current  18,436  20,866 
 Total non-current liabilities  46,739  69,266 
 Total liabilities  87,796  133,596 
        
Stockholders’ equity:      
Preferred stock, $0.001 par value, 50,000,000 shares authorized; none issued and outstanding as of December 31, 2023 and 2022     
Common stock, $0.001 par value, 300,000,000 shares authorized; 23,600,584 shares issued and outstanding as of December 31, 2023; 20,252,677 shares issued and outstanding as of December 31, 2022  24  20 
Additional paid-in capital  174,724  131,001 
Retained earnings (accumulated deficit)  18,894  (9,621)
 Total stockholders’ equity  193,642  121,400 
 Total liabilities and stockholders’ equity $281,438 $254,996 


             
Tactile Systems Technology, Inc.
Consolidated Statements of Operations
             
             
  Three Months Ended Year Ended
  December 31, December 31,
(In thousands, except share and per share data)    2023     2022     2023     2022 
Revenue            
Sales revenue $67,407  $63,365  $239,493  $211,345 
Rental revenue  10,245   10,535   34,930   35,440 
Total revenue  77,652   73,900   274,423   246,785 
Cost of revenue            
Cost of sales revenue  18,190   18,253   66,713   59,619 
Cost of rental revenue  3,455   3,550   12,577   11,190 
Total cost of revenue  21,645   21,803   79,290   70,809 
Gross profit            
Gross profit - sales revenue  49,217   45,112   172,780   151,726 
Gross profit - rental revenue  6,790   6,985   22,353   24,250 
Gross profit  56,007   52,097   195,133   175,976 
Operating expenses            
Sales and marketing  26,581   27,083   107,119   106,418 
Research and development  1,793   2,139   7,823   7,088 
Reimbursement, general and administrative  15,200   13,427   62,074   60,796 
Intangible asset amortization and earn-out  633   1,598   76   14,432 
Total operating expenses  44,207   44,247   177,092   188,734 
Income (loss) from operations  11,800   7,850   18,041   (12,758)
Other expense  (36)  (950)  (2,271)  (2,715)
Income (loss) before income taxes  11,764   6,900   15,770   (15,473)
Income tax expense (benefit)  3,562   2,279   (12,745)  2,393 
Net income (loss) $8,202  $4,621  $28,515  $(17,866)
Net income (loss) per common share            
Basic $0.35  $0.23  $1.24  $(0.89)
Diluted $0.35  $0.23  $1.23  $(0.89)
Weighted-average common shares used to compute net income (loss) per common share            
Basic  23,551,388   20,204,479   22,925,497   20,067,969 
Diluted  23,771,490   20,293,825   23,176,169   20,067,969 


        
Tactile Systems Technology, Inc.
Consolidated Statements of Cash Flows
    
   Year Ended December 31, 
(In thousands)    2023     2022 
Cash flows from operating activities      
Net income (loss) $28,515  $(17,866)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:      
 Depreciation and amortization  6,539   6,268 
 Deferred income taxes  (19,378)  (32)
 Stock-based compensation expense  7,547   9,600 
 Loss on disposal of property and equipment and intangibles  3   20 
 Change in fair value of earn-out liability  (2,475)  11,850 
 Changes in assets and liabilities, net of acquisition:      
 Accounts receivable  11,653   (5,348)
 Net investment in leases  1,935   (3,648)
 Inventories  597   (3,907)
 Income taxes  (721)  2,270 
 Prepaid expenses and other assets  72   (950)
 Right of use operating lease assets  71   168 
 Accounts receivable, non-current  12,125   (10,214)
 Accounts payable  (3,853)  4,961 
 Accrued payroll and related taxes  (311)  4,961 
 Accrued expenses and other liabilities  (6,464)  7,076 
 Net cash provided by operating activities  35,855   5,209 
Cash flows from investing activities      
Purchases of property and equipment  (2,324)  (1,780)
Proceeds from sale of property and equipment     11 
Intangible assets expenditures  (157)  (140)
 Net cash used in investing activities  (2,481)  (1,909)
Cash flows from financing activities      
Proceeds from issuance of note payable  8,250    
Payments on earn-out  (10,575)  (5,000)
Payments on note payable  (3,000)  (6,000)
Payments on revolving line of credit  (25,000)   
Payments of deferred debt issuance costs  (125)  (39)
Proceeds from exercise of common stock options  14   153 
Proceeds from the issuance of common stock from the employee stock purchase plan  1,541   1,286 
Proceeds from issuance of common stock at market  34,625    
 Net cash provided by (used in) financing activities  5,730   (9,600)
Net increase (decrease) in cash and cash equivalents  39,104   (6,300)
Cash and cash equivalents – beginning of period  21,929   28,229 
Cash and cash equivalents – end of period $61,033  $21,929 
        
Supplemental cash flow disclosure      
Cash paid for interest $4,560  $2,186 
Cash paid for taxes $5,815  $44 
Capital expenditures incurred but not yet paid $528  $38 
         

The following table summarizes revenue by product line for the three and twelve months ended December 31, 2023 and 2022:

  Three Months Ended Year Ended
  December 31, December 31,
(In thousands)    2023  2022  2023  2022 
Revenue            
Lymphedema products $69,464  $65,764  $241,721  $212,266 
Airway clearance products  8,188   8,136   32,702   34,519 
Total $77,652  $73,900  $274,423  $246,785 
             
Percentage of total revenue            
Lymphedema products  89%  89%  88%  86%
Airway clearance products  11%  11%  12%  14%
Total  100%  100%  100%  100%
                 

The following table contains a reconciliation of GAAP gross profit and margin to non-GAAP gross profit and margin:

                 
Tactile Systems Technology, Inc.
Reconciliation of Gross Profit and Margin to Non-GAAP Gross Profit and Margin
(Unaudited)
                 
  Three Months Ended Year Ended
  December 31,December 31,
(Dollars in thousands)    2023    2022    2023    2022
Revenue $77,652  $73,900  $274,423  $246,785 
                 
Gross profit, as reported $56,007  $52,097  $195,133  $175,976 
Gross margin, as reported   72.1%   70.5%   71.1%   71.3%
Reconciling items:                
Non-cash intangible amortization expense $312  $314  $1,257  $1,247 
Inventory write-offs     215      215 
Non-GAAP gross profit $56,319  $52,626  $196,390  $177,438 
Non-GAAP gross margin   72.5%   71.2%   71.6%   71.9%
                 

The following table contains a reconciliation of GAAP operating income (loss) to non-GAAP operating income:

                 
Tactile Systems Technology, Inc.
Reconciliation of GAAP Operating Income (Loss) to Non-GAAP Operating Income
(Unaudited)
                 
  Three Months Ended Year Ended
  December 31,December 31,
(Dollars in thousands)    2023    2022    2023    2022
GAAP operating income (loss) $11,800  $7,850   $18,041   $(12,758) 
Reconciling items:                
Non-cash intangible amortization expense impacting gross profit $312  $314   $1,257   $1,247  
Inventory write-offs     215        215  
Non-cash intangible amortization expense impacting operating expenses  632   646    2,551    2,582  
Change in fair value of earn-out     952    (2,475)   11,850  
Litigation defense costs     (447)       2,830  
Executive transition expenses     (10)       280  
Non-GAAP operating income: $12,744  $9,520   $19,374   $6,246  
Non-GAAP operating margin   16.4%   12.9    7.1    2.5 
                    

The following table contains a reconciliation of GAAP net income (loss) to non-GAAP net income (loss):

                 
Tactile Systems Technology, Inc.
Reconciliation of GAAP Net Income (Loss) to Non-GAAP Net Income (Loss)
(Unaudited)
                 
  Three Months Ended Year Ended
  December 31,December 31,
(Dollars in thousands)    2023    2022    2023    2022
GAAP net income (loss) $8,202   $4,621   $28,515   $(17,866) 
Reconciling items:                
Non-cash intangible amortization expense impacting gross profit $312   $314   $1,257   $1,247  
Inventory write-offs      215        215  
Non-cash intangible amortization expense impacting operating expenses  632    646    2,551    2,582  
Change in fair value of earn-out      952    (2,475)   11,850  
Litigation defense costs      (447)       2,830  
Executive transition expenses      (10)       280  
Income tax expense on reconciling items*  (236)   (418)   (333)   (4,751) 
Non-GAAP net income (loss) $8,910   $5,873   $29,515   $(3,613) 
* The effect of income tax on the reconciling items is estimated using the Company's effective statutory tax rate.
 

The following table contains a reconciliation of net income (loss) to Adjusted EBITDA for the three and twelve months ended December 31, 2023 and 2022, 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)    2023    2022  $    %    2023     2022  $    %
Net income (loss) $8,202 $4,621  $3,581  77% $28,515  $(17,866) $46,381  260%
Interest expense, net  38  950   (912) (96)%  2,273   2,728   (455) (17)%
Income tax (benefit) expense  3,562  2,279   1,283  56%  (12,745)  2,393   (15,138) N.M. 
Depreciation and amortization  1,624  1,597   27  2%  6,539   6,267   272  4%
Stock-based compensation  1,950  1,919   31  2%  7,547   9,600   (2,053) (21)%
Impairment charges and inventory write-offs    215   (215) (100)%     215   (215) (100)%
Change in fair value of earn-out    952   (952) (100)%  (2,475)  11,850   (14,325) (121)%
Litigation defense costs    (447)  447  (100)%     2,830   (2,830) (100)%
Executive transition costs    (10)  10  (100)%     280   (280) (100)%
Adjusted EBITDA $15,376 $12,076  $3,300  27% $29,654  $18,297  $11,357  62%


 

 

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