• Total Revenue: $479.9 million for 2024, up 94% from $247.6 million in 2023.
• Adjusted EBITDA: Increased from $10.8 million in 2023 to $123.7 million in 2024, up over 1,000%.
• Net Income: $52 million for 2024 compared to a loss of $46 million in 2023.
• Patient Volume: Increased by 17% from 144,000 in 2023 to 168,000 in 2024.
• Long-term Debt: Current portion increased from $10.8 million in 2023 to $14 million in 2024; net long-term debt decreased from $26 million in 2023 to $22 million in 2024.
• Fourth-Quarter Revenue: $257.6 million, up 270% from $69.7 million in Q4 2023.
• Fourth-Quarter Net Income: $61.7 million compared to a net loss of $31.6 million in Q4 2023.
• Cash and Cash Equivalents: $44 million at the end of 2024, up from $22 million in 2023.
• Accounts Receivable: $232 million at the end of 2024, up from $58.6 million in 2023.
• Cash Flow from Operating Activities: Increased to $23.2 million in 2024 from $1 million in 2023.
• Hospital Network: Expanded to 24 hospitals across 11 states in 2024.

• Warning! GuruFocus has detected 5 Warning Signs with NUTX.

Release Date: April 01, 2025

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

• Nutex Health Inc (NASDAQ:NUTX) reported a significant revenue increase of 94% for the full year of 2024, reaching $479.9 million compared to $247.6 million in 2023.
• The company's adjusted EBITDA saw a remarkable growth of over 1,000%, rising from $10.8 million in 2023 to $123.7 million in 2024.
• Net income for 2024 was $52 million, a substantial improvement from a loss of $46 million in 2023.
• Patient volume increased by 17% in 2024, with mature hospitals contributing 6.5% to this growth.
• Nutex Health Inc (NASDAQ:NUTX) successfully opened four new hospitals in 2024, expanding its network to 24 hospitals across 11 states.

Negative Points

• The implementation of the No Surprises Act (NSA) has negatively impacted revenue per patient reimbursement, with insurer payments for emergency services dropping by roughly 30%.
• The arbitration process, while beneficial, is costly, labor-intensive, and time-consuming, posing a financial and operational burden.
• Despite the opening of new hospitals, the current portion of long-term debt increased from $10.8 million in 2023 to $14 million in 2024.
• The arbitration process requires significant upfront costs, including Medicare administrative fees and arbitrator fees, which can be a financial strain.
• The company faces challenges in maintaining low costs and aggressive debt management amidst expansion and operational adjustments.

Q & A Highlights

Q: Can you provide insights into the arbitration process and its impact on future revenue? A: Thomas Vo, CEO, explained that arbitration is a tool used to ensure fair payment rates, defined as the Qualifying Payment Amount (QPA). The company will continue using arbitration as long as it remains effective under the No Surprises Act. Jon Bates, CFO, added that while the process is still in early stages, they are optimistic about its benefits and are closely monitoring its impact on revenue.

Q: How is Nutex Health recognizing revenue at the time of service, and how does the IDR process affect this? A: Jon Bates, CFO, stated that each visit is analyzed based on historical data to estimate reimbursement. The arbitration process adds a new layer, and they adjust revenue estimates based on the latest data from arbitration outcomes.

Q: What is the expected impact of the IDR process on future quarters? A: Jon Bates, CFO, clarified that the IDR process will be integrated into monthly revenue estimates moving forward, rather than being a year-end adjustment. This approach aims to provide a more consistent reflection of arbitration outcomes throughout the year.

Q: Can you discuss the performance and ramp-up of the new hospitals opened in 2024? A: Thomas Vo, CEO, reported that two of the four new hospitals are performing better than expected, while the other two are meeting expectations. The Tampa hospital, opened in late December, is still too new for comprehensive data.

Q: How are mature hospitals expected to grow, and what strategies are in place to support this? A: Thomas Vo, CEO, indicated that they aim for single-digit growth in ER volume, complemented by expanding service lines and increasing specialist staffing to enhance patient care and hospital utilization.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.