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

February 20, 2024

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 %


 


Investor Inquiries:
Mike Piccinino, CFA
ICR Westwicke
443-213-0500
[email protected]

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Source: Tactile Systems Technology, Inc.