Taking a closer look at Q2/24
WELL reported revenues ahead of estimates with strong outperformance in US and CDN Patient Services. WELL reported Q2/24 revenues of $243.1MM (+5% q/q; +42% y/y), ~2.2% above RBCe ($237.9MM) and ~2.8% above consensus ($236.6MM). The revenue strength vs. RBCe was led by better-than-expected performance in US Patient & Provider Services segment and CDN Patient Services, partially offset by weaker-than-expected SaaS and Tech Services. US Patient and Provider Services revenues of $149.5MM (+45% y/y) were ~4% above estimates (RBCe: $144.0MM, consensus: $144.1MM). Within the segment, Circle Medical revenues were $32.0MM (+11% q/q; +53% y/y), ~7% ahead of RBCe ($29.9MM) and ~9% ahead of consensus ($29.3MM); Wisp revenues were $24.3MM (+15% q/q; +27% y/y), ~6% ahead of RBCe ($23.0MM) and ~2% ahead of consensus ($23.7MM); CRH and Radar combined revenues were $93.3MM (+3% q/q; +47% y/y), ~2% ahead of RBCe and consensus estimates. CDN Patient Services revenue of $76.7MM (+42% y/y) was ~1% ahead of RBCe ($75.9MM) and ~2% ahead of consensus ($75.5MM). SaaS and Technology revenue of $16.9MM (+27% y/y) was in line with consensus ($16.9MM) but ~6% below RBCe ($18.0MM). WELL reported organic growth of 21% y/y in Q2/24 (vs. 13.5% in Q1/24) including absorptions (16% y/y excluding absorptions vs. 10% in Q1/24). Organic growth at CDN clinics was 25.5% y/y including absorptions and 11.4% y/y excluding absorptions.
Q2 adj. EBITDA ahead of estimates. WELL reported Q2 adj. EBITDA of $30.9MM (+9% q/q; +11% y/y), ~4.2% above RBCe ($29.6MM) and ~4.6% above consensus ($29.5MM). Adj. GMs of 44.2% in the quarter increased q/q (44.1% in Q1/24) and were slightly below RBCe and consensus (~44.3%). Adj. EBITDA margin of 12.7% was up q/q (12.2% in Q1) and ahead of RBCe and consensus (~12.5%). Adj. EBITDA to shareholders of $23.0MM (+3% q/q; +8% y/y) was below RBCe ($24.3MM). Free cashflow attributable to WELL shareholders was $8.7MM during Q2/24 ($9.4MM during Q2/23). During the quarter, WELL paid down ~$14MM in debt and reduced its bank debt leverage ratio to 2.67x from 2.75x in Q1/24. Leverage including convertible debt was 3.45x as of Q2/24.
Updates on the clinic digitization and transformation program. For the 2023 cohort (which included loss-making clinics acquired from MCI and the Manitoba clinic), management noted that the digitization and transformation efforts at these clinics are running ahead of plan, and both Manitoba and MCI Ontario are running at positive adj. EBITDA. Management expects continued improvement in adj. EBITDA margins at these clinics over the next year.
As it relates to the recently acquired loss-making clinics from Shoppers Drug Mart (here), management highlighted that the digitization and transformation efforts at these clinics are also tracking ahead of plan, and these clinics are almost at breakeven.
In our view, the market is currently underappreciating the long-term value creation opportunity in transforming CDN primary/ Dx care, as underscored by our strong forecasted ROIC and IRR metrics for recent acquisitions. Previously, WELL has added >500bps in EBITDA margin, on average, to primary/Dx clinics post purchase, leading to strong ROIC metrics. Our work suggests that the recent MCI/Manitoba clinic acquisitions could generate ROIC of >30% in aggregate over time and an IRR of ~30%. For additional details, please see our initiation report on WELL Health (see pages 20–21, here).
M&A pipeline. WELL’s pipeline of new clinic opportunities consists of more than 50 clinics including absorption clinics (clinics are absorbed into the WELL network with minimal upfront payment). Under the clinic absorption model, WELL acquires clinics for nominal cash costs in the range of <0.02x revenue multiple, whereas for the regular M&A program, WELL pays up to ~0.5x revenue or ~3–5x EBITDA. Management also noted continued strong discussions with various players in the CDN diagnostic industry with potential expansion into more provinces as well as within Ontario. The company is also starting to establish a pipeline for the provider solutions, SaaS and Technology segment given the potential for a standalone public company. Management noted that the company is on track to achieve $1B in revenues by the end of 2024 including acquisitions that are currently in the pipeline.