Q4 2024 Ekso Bionics Holdings Inc Earnings Call

Greetings.

Operator: and welcome to the Ekso Bionics fourth quarter 2024 financial results conference. At this time, all participants are in a listen-only mode. The question and answer session will follow the formal presentation.

Speaker Change: And welcome to the <unk> Bionics fourth quarter 2024 financial results Conference call. At this time, all participants are in a listen only mode.

Speaker Change: A question and answer session will follow the full presentation.

Operator: If anyone should require operator assistance, please press star zero on your telephone keypad. As a reminder, this conference is being recorded.

Speaker Change: If anyone should require operator assistance. Please press star zero like a telephone keypad as a reminder, this conference is being recorded its now my pleasure to introduce Stephen Kim. Thank you may begin.

Stephen Kilmer: It is now my pleasure to introduce Stephen Kilmer. Thank you. You may begin. Thank you, Operator, and good afternoon, everyone.

Speaker Change: Thank you operator, and good afternoon, everyone.

Stephen Kilmer: Earlier today, Ekso Bionics released financial results for the quarter of the year and the December 31st, 2024. A copy of the press release is available on our website.

Speaker Change: Earlier today, <unk> Bionics released financial results for the quarter and year ended December 31st 2024.

Speaker Change: A copy of the press release is available on our website.

Stephen Kilmer: I would like to point out that management will make statements during this call that include forward-looking statements within the meaning of the federal securities laws, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements made during this call that are not statements of historical facts shall be deemed to be foreboding statements. All forward-looking statements, including statements regarding our business strategy, future financial or operational expectations, or our expectations of the regulatory landscape governing our products and operations, are based upon management's current estimates and various assumptions. These statements involve material risks and uncertainties that could cause actual results or events that materially differ from those anticipated or implied by these forward-looking statements.

Speaker Change: I would like to point out that management will make statements. During this call that include forward looking statements within the meaning of the federal Securities laws, which are made pursuant to the safe Harbor provisions of the private Securities Litigation Reform Act of 1995.

Speaker Change: Any statements made during this call that are not statements of historical facts shall be deemed to be forward looking statements.

Speaker Change: All forward looking statements, including statements regarding our business strategies future financial or operational expectations or our expectations of the regulatory landscape governing our products and operations are based upon management's current estimates and various assumptions. These statements involve material risks and uncertainties that could cause actual results or events.

Speaker Change: Apparently tougher from that was in Pennsylvania or implied by these forward looking statements.

Stephen Kilmer: Accordingly, you should not place undue reliance on these data. For a list and description of the risks and uncertainties associated with the company's business, please see its filings with the Securities and Exchange Commission.

Speaker Change: Accordingly, you should not place undue reliance on these statements.

Speaker Change: For a lesson description of the risks and uncertainties associated with the company's business. Please see <unk> filings with Securities and Exchange Commission.

Stephen Kilmer: Ekso disclaims any obligation, except as required by law, to update or revise any financial or operational projections, as regulatory outlook, or other forward-looking statements, whether because of new information, future events, or otherwise. Any forward-looking statements made on this call speak only as of the date of this call.

Speaker Change: <unk> disclaims any obligation except as required by law to update or revise any financial or operational projections, it's regulatory outlook or other forward looking statements, whether because of new information future events or otherwise.

Speaker Change: Forward looking statements made on this call speak only as of the date of this call.

Stephen Kilmer: Representing Ekso Bionics today are Scott Davis, our Chief Executive Officer, Jerome Wong, our Chief Financial Officer, and Jason Jones, our Chief Operating Officer. With that said, I will now turn the call over to Jerome. Thank you, Steve.

Scott Davis: Representing that's called Bionics today are Scott Davis, our Chief Executive Officer, Tara <unk>, our Chief Financial Officer, and Jason Jones, Our Chief operating Officer.

Joel: With that said I'll now turn the call over to Joel.

Joel: Thank you Steve Good afternoon, everyone and welcome to our fourth quarter and full year 2024 conference call.

Jerome Wong: Good afternoon, everyone, and welcome to our fourth quarter and full year 2024 conference. On behalf of the management team and everyone at Ekso Bionics, I would like to thank you for your interest in our company. And for those of you who are shareholders, we appreciate your support.

Joel: On behalf of the management team and everyone at except buying on it I would like to thank you for your interest in our company and for those of you who are shareholders. We appreciate your support.

Jerome Wong: For the benefit of those who are new to the Ekso Bionics story, I would like to take a moment to summarize our business. Ekso designs, develops, and markets exoskeleton products that augment human strength, endurance, and mobility. The primary end market for our exoskeleton technology is healthcare, where our technology primarily serves people with physical disabilities or impairment in both physical rehabilitation and mobility.

Joel: For the benefit of those who are new to the <unk> story I would like to take a moment to summarize our business XO designs develops and markets exoskeleton products that augment human strength endurance and mobility.

Joel: Mary and market for exoskeleton technology is health care, where our technology, primarily serves people with physical disabilities or impairment in both physical rehabilitation and mobility.

Jerome Wong: We operate as one operating and reportable segment with two markets. Enterprise Health and Personal. Our revenues are primarily generated through the sale and subscription of our Ekso NR device, our legacy wearable robotic exoskeleton specifically designed to be used in a rehabilitation setting. to assist individuals recovering from both acute and chronic conditions. our Ekso Indigo therapy device, our modular, adjustable, lightweight, lower limb powered exoskeleton that can be custom sized and fitted to patients for use in rehabilitation and wellness applications. Our Ekso Indigo personal device, which is a wearable lower extremity powered exoskeleton that enables certain individuals living with spinal cord injuries with the ability to stand and walk independently.

Joel: We operate as one operating and reportable segment with two market and.

Joel: Enterprise health and personal health.

Joel: Our revenues are primarily generated through the sale and subscription.

Joel: Our excellent in our device our legacy wearable robotic exoskeleton, specifically designed to be used in a rehabilitation setting.

Joel: To assist individuals recovering from both acute and chronic conditions.

Joel: Our XO indigo therapy device, our modular adjustable light weight lower limb powered exoskeleton that can be custom size and fit it to patients for use in rehabilitation and wellness applications.

Joel: Our XO indigo personal device, which is a wearable lower extremity powered exoskeleton that enables certain individuals living with spinal cord injuries with the ability to stand and walk independently along with the sale of support and maintenance contracts I will turn the call over to Scott in a moment for an update on our commercial activities and growth.

Jerome Wong: along with the sale of support and maintenance.

Jerome Wong: I will turn the call over to Scott in a moment for an update on our commercial activities and growth plans. However, before I do, I would like to provide a brief summary of our financial results. To streamline things, all of the numbers I will refer to have been rounded, so they are approximate. The company recorded revenue of $5.1 million in the fourth quarter of 2024, an increase of 5% compared to $4.8 million for the same period in 2023. Gross profit for the fourth quarter was $2.7 million, representing a gross margin of approximately 53% compared to a gross profit of $2.4 million and a gross margin of 49% for the same period of 2023.

Joel: However, before I do I would like to provide a brief summary of our financial results.

Joel: To streamline things all of the numbers that we referred to have been rounded so they are approximate.

Joel: The company recorded revenue of $5 $1 million in the fourth quarter of 2024, an increase of 5% compared to $4 $8 million for the same period in 2023.

Joel: Gross profit for the fourth quarter was $2 $7 million, representing a gross margin of approximately 53% compared to a gross profit of $2 $4 million and a gross margin of 49% for the same period of 2023.

Jerome Wong: The increase in gross profit and gross margin was primarily due to cost savings in supply chain and reduction in services. Operating expenses for the fourth quarter of 2024, which consists of R&D, G&A, and sales and marketing expenses, were $4.9 million, a 15% decrease compared to $5.8 million for the fourth quarter of 2023. This was primarily due to a decrease in headcount, discretionary payroll, and consultant costs. Net loss applicable to common stockholders for the fourth quarter was $3.4 million, or $0.14 per basic and diluted share, compared to a net loss of $3.2 million, or $0.22 per basic and diluted share for the same period of 2023.

Joel: The increase in gross profit and gross margin was primarily due to cost savings in supply chain and reduction in service costs.

Joel: Operating expenses for the fourth quarter of 'twenty, 'twenty, four which consist of R&D G&A and sales and marketing expenses were $4 9, million% to 15% decrease compared to $5 $8 million for the fourth quarter of 2023.

Joel: This was primarily due to a decrease in head count discretionary payroll and consulting costs.

Joel: Net loss applicable to common stockholders for the fourth quarter was $3 $4 million or 14 cents per basic and diluted share compared to a net loss of $3 $2 million or 22 cents per basic and diluted share for the same period of 2023.

Jerome Wong: For the fourth quarter of 2024, the company used $1.4 million of net cash in operations, compared to $1.6 million for the same period in 2023.

Joel: For the fourth quarter of 2024, the company used $1 $4 million of net cash in operations compared to $1 $6 million for the same period in 2023.

Jerome Wong: Turning now to our full-year 2024 resume. Revenue of $17.9 million was down from $18.3 million for the same period in 2023. I think it's fair to pause here for a moment to address the marginal year-over-year decline. It essentially came down to a difficult 2023 comparable, driven by two main factors. First, we were on the procurement cycle with several of the large independent delivery networks in 2023, but not in 2024. Second, 2023 was the first full year of having the Indigo personal product line, which we acquired from Parker Hannafin in late 2022. As part of that acquisition, we inherited an approximately $2 million pipeline that Parker Hannafin had with the VA but weren't able to fulfill due to the impact of COVID.

Joel: Turning now to our full year 2024 results.

Joel: Revenue of $17 $9 million was down from $18 $3 million for the same period in 2023, I think it's fair to pause here for a moment to address the marginal year over year decline.

Joel: It essentially came down to a difficult 2023 comparable driven by two main factors.

Joel: We were on the procurement cycle with several of the large independent delivery networks in 2020, three but not in 'twenty 'twenty four.

Joel: 2023 was our first full year of having the indigo personal product line, which we acquired from Parker Hannifin in late 2022.

Joel: As part of that acquisition, we inherited and approximately $2 million pipeline that Parker hannifin had with the VA, but weren't able to fulfill all due to the impact of Covid.

Jerome Wong: We delivered most of those devices in 2023, and we're rebuilding that pipeline in VA through 2025. Gross profit for the full year ended December 31, 2024 with $9.5 million, representing a gross margin of approximately 53% compared to a gross profit of $9.1 million for the same period in 2023, representing a gross margin of 50%. The increase in gross profit was a result of cost savings in supply chain and a reduction in service Operating expenses for the 2024 full year were $20 million, a 17% decrease from $24.2 million for the prior year period. The improvement was a result of lower headcount, discretionary payroll, consultant, legal, and accounting.

Joel: We delivered most of those devices in 2023, and we're rebuilding that pipeline NDA through 2024.

Joel: Gross profit for the full year ended December 31, 2024, with $9 $5 million, representing a gross margin of approximately 53% compared to a gross profit of $9 $1 million for the same period in 2023, representing a gross margin of 50%. The increase in gross profit was a result of cost savings.

Joel: In supply chain and a reduction in service costs.

Joel: Operating expenses for the 'twenty 'twenty four full year were $20 million, a 17% decrease from $24 $2 million for the prior year period. The improvement was a result of lower head count discretionary payroll consulting legal and accounting costs.

Jerome Wong: Net loss applicable to common stockholders for the 2024 full year was $11.3 million, or $0.56 per basic and diluted share, compared to a net loss of $15.2 million, or $1.10 per basic and diluted share for the 2023 full year. Cash used in operating activities in the 2024 fiscal year was $9.8 million, down from $12.1 million for the same 12-month period in 2023. As of December 31, 2024, the company had cash and restricted cash of $6.5 million.

Joel: Net loss applicable to common stockholders for the 'twenty 'twenty four full year was $11 $3 million or 56 cents per basic and diluted share compared to a net loss of $15 $2 million or $1.10 per basic and diluted share for the 2023 full year.

Joel: Cash used in operating activities in the 'twenty 'twenty, four and fiscal year was $9 $8 million down from $12 $1 million for the same 12 month period in 2023.

Joel: As of December 31, 2024, the company had cash and restricted cash of $6 $5 million.

Jerome Wong: That's it for my summary of the fourth quarter and full year 2024 results. Please see our Form 10-K for further details regarding the results.

Joel: That's it for my summary of the fourth quarter and full year 2024 results.

Joel: Please see our Form 10-K for further details regarding our results.

Scott Davis: I'll now turn the call over to Thank you, Jerome. While we're pleased to achieve record revenue in the 2024 fourth quarter, in many respects, our primary focus throughout those three months was on the future, particularly for Ekso Indigo Person. As many of you know, CMS established pricing determination for the device in Q2 2024. Our main focus previous to this event was on post-acute care, rehab hospitals, and selling capital equipment within the legacy enterprise health market, with some focus on Veterans Administration for at-home devices. So establishing an effective market access function to operate within the CMS reimbursement environment was new to Ekso Bionics.

Scott Davis: I'll now turn the call over to Scott.

Scott Davis: Thank you Jerome.

Scott Davis: While were pleased to achieve record revenue in the 2020 for fourth quarter in many respects our primary focus throughout those three months was on the future.

Scott Davis: Particularly for XO indigo personal.

Scott Davis: As many of you know CMS established pricing determination for the device in Q2, 'twenty 'twenty four or.

Scott Davis: Our main focus previous to this event was on post acute care rehab hospitals in selling capital equipment within the legacy Enterprise health market with some focus on veterans administration for at home devices.

Scott Davis: So establishing an effective market access function to operate within the CMS reimbursement environment was new to <unk> bionics.

Scott Davis: As we discussed on our last call, after CMS provided pricing determination last year, we immediately set out to establish a go-to-market strategy aimed at notifying as many early physician and provider adopters as possible of the new CMS benefit category redetermination and the fee schedule list. This regulatory change has created a significant opportunity to help Medicare enrollees living with a spinal cord injury by removing what has historically been a primary barrier to accessing our exoskeletons. Additionally, we began working closely with our extensive network of neurorehabilitation partners across the country, focused on education efforts on appropriate patient selection and process for patients prescribed an Ekso Indigo Personal for the home and community setting.

Scott Davis: As we discussed on our last call. After CMS provided pricing determination last year, we immediately set out to establish a go to market strategy aimed at notifying us many early physician and provider adopters as possible of the new CMS benefit category Redetermination and the fee schedule listing.

Scott Davis: This regulatory change has created a significant opportunity to help Medicare enrollees living with a spinal cord injury by removing what has historically been a primary barrier to accessing our exoskeleton.

Scott Davis: Additionally, we began working closely with our extensive network of neuro rehabilitation partners across the country focused on education efforts on appropriate patient selection and process for patients prescribed and XO indigo personal for the home and community setting.

Scott Davis: That good work was necessary, but only part of what is required to drive the compelling growth opportunity that we continue to see ahead for the Ekso Indigo Personnel starting in 2025. So throughout the year, we shifted our primary focus from building awareness and providing customer education to advancing our scalable go-to-market strategy for the personal channel.

Scott Davis: That good work was necessary, but only part of what is required to drive the compelling growth opportunity that we continue to see ahead for the XO indigo personal starting in 2025.

Scott Davis: So throughout the year, we shifted our primary focus from building awareness and providing customer education to advancing our scalable go to market strategy for the personal channel.

Scott Davis: Significantly in Q4, our earlier efforts led us to deciding to make some key changes, which we believe will expand access to our technology and accelerate revenues in 2025 and beyond.

Scott Davis: Significantly in Q4, our earlier efforts led us to deciding to make some key changes, which we believe will expand access to our technology and accelerate revenues in 2025 and beyond.

Scott Davis: One of these key changes was engaging Priya Healthcare, a leading full-spectrum reimbursement services and market access firm, which has been instrumental in the successful commercialization of over 300 medical device Let me provide some perspective on why that move is so important. Through a National Durable Medical Equipment, or DME, partner, we submitted our first Medicare claim at the end of May. In July, we saw our first claim reimbursed.

Scott Davis: One of these key changes was engaging preah healthcare, a leading full spectrum reimbursement services and market access firm, which has been instrumental in the successful commercialization of over 300 medical devices.

Scott Davis: Let me provide some perspective on why that move is so important.

Scott Davis: Through our national durable medical equipment or <unk> partner, we submitted our first Medicare claim at the end of May and July we saw our first claim reimbursed. All subsequent claims are currently being managed through the appeals process and in Q4, we elected not to submit additional claims, but that's not to say that we haven't been.

Scott Davis: All subsequent claims are currently being managed through the appeals process, and in Q4, we elected not to submit additional claims. But that's not to say that we haven't been busy. In fact, we've already built a backlog of more than 25 Medicare beneficiaries that we believe are great candidates for Ekso Indigo Personal. And through our retargeting efforts, are continually identifying new candidates who we believe are qualified. Moving forward with PREA's help throughout the submission process. We anticipate submitting those claims to CMS over the next six to nine months. While we obviously cannot guarantee those claims will be submitted in that time frame or ultimately be paid, we are confident that PREA has the ability to provide us with strategic guidance and leverage its expertise to help Ekso navigate the complexities of coding, coverage, and payment, ensuring that Ekso Indigo Personal reaches the individuals who need this potentially life-changing mobility-enhancing technology.

Scott Davis: Busy in fact, we've already built a backlog of more than 25 Medicare beneficiaries that we believe are great candidates for XO indigo personal and through our re targeting efforts are continually.

Scott Davis: Identifying new candidates, who we believe are qualified.

Scott Davis: Moving forward with pre has helped throughout the submission process, we anticipate submitting those claims to CMS over the next six to nine months.

Scott Davis: While we obviously cannot guarantee those claims will be submitted in that timeframe are ultimately be paid we are confident that preah has the ability to provide us with strategic guidance and leverage its expertise to help XO navigate the complexities of coding coverage and payment ensuring that XO indigo personal reaches the individuals who need this.

Scott Davis: Potentially life changing mobility enhancing technology quite.

Scott Davis: Quite frankly, we didn't have that confidence without them, thus our reluctance to submit Medicare claims in the fourth quarter.

Scott Davis: Quite frankly, we didn't have that confidence without them, thus a reluctance to submit Medicare claims in the fourth quarter.

Scott Davis: In another move designed to broaden access to Ekso Indigo Personal, a few weeks ago we named National Seating and Mobility as the company's exclusive distributor of the personal device within the Complex Rehabilitation Technology, or CRT, industry in the United States. This marks our first entrance into the large and growing CRT space. With a network of over 180 locations and more than 2,400 team members who support more than 250,000 mobility solutions each year, we believe NSM is ideally suited to help us expand the distribution of Indigo Personal through this new strategic partnership. We are also ramping up pilots and partnerships with both regional and national DME suppliers who focus on traditional orthotics and prosthetics, or O&P.

Scott Davis: In another move designed to broaden access to XO indigo personal a few weeks ago, we named National seating and mobility is the company's exclusive distributor of the personal device within the complex rehabilitation technology or CRT industry in the United States.

Scott Davis: This marks our first entrance into the large and growing CRT space with a network of over 180 locations and more than 2400 team members, who support more than 250000 mobility solutions. Each year, we believe N. S. M is ideally suited to help us expand the distribution of indigo personal through this new strategic partnership.

Scott Davis: We are also ramping up pilots and partnerships with both regional and National D&B suppliers, who focus on traditional orthotics and prosthetics or O N P.

Scott Davis: All that said, I want to reiterate that this is a go-to-market program for the Ekso Indigo personal that will continue to take time to scale and produce results. But the good news is, while the majority of our revenue in 2025 will still come from enterprise, we believe we will start to see increased contribution from our personal health products in 2025.

Scott Davis: All that said I want to reiterate that this is a go to market program for the XO Indigo personal that will continue to take time to scale and produce results, but the good news is while the majority of our revenue in 2025 will still come from enterprise. We believe we will start to see increased contribution from our personal health products in 2025.

Scott Davis: Now shifting briefly to operations, we are continuing to drive more efficiencies throughout our business. Our improvements in supply chain and inventory management, along with efficiencies gained in production, resulted in strong gross margins for the fourth quarter. Overall, we are pleased to have improved our operating margins in the quarter, and while gross margin may continue to vary some quarter over quarter, we believe that it will continue to trend up as 2025 progresses.

Scott Davis: Now shifting briefly to operations, we are continuing to drive more efficiencies throughout our business our improvements in supply chain and inventory management, along with efficiencies gained in production resulted in strong gross margins for the fourth quarter overall.

Scott Davis: Overall, we are pleased to have improved our operating margins in the quarter and while gross margin may continue to vary some quarter over quarter. We believe that it will continue to trend up as 'twenty twenty-five progresses.

Scott Davis: In summary, the fourth quarter was another period of tremendous change and significant progress for Ekso Bionics. Marked by record revenues, strong gross margins, and the building of a scalable go-to-market strategy for Indigo Personal. Supported by both established and new industry-leading DME and market access partners.

Scott Davis: In summary, the fourth quarter was another period of tremendous change and significant progress for <unk> bionics.

Scott Davis: By record revenues strong gross margins and the building of a scalable go to market strategy for indigo personal supported by both established and new industry, leading DMA and market access partners.

Operator: This ends our prepared remarks for today. With that, we are happy to take any questions you might have. Operator. Thank you. We will now be conducting a Q&A session. If you'd like to ask a question, please press star 1 on your telephone keypad. Confirmation tone will indicate your line is in the queue. You may press star 2 to remove yourself from the queue. For participants using speaker equipment, it may be necessary to pick up the handset before pressing the star key. One moment while we pause.

Scott Davis: This ends our prepared remarks for today with.

Scott Davis: With that we're happy to take any questions you might have.

Scott Davis: Operator.

Speaker Change: Thank you we will now be conducting a Q&A session if you'd like to ask a question. Please press star one on your telephone keypad confirmation tone will indicate your line is in the Q and the press star two to remove yourself from the queue for participants using speaker equipment. It may be necessary to pick up the handset before pressing the star keys.

Scott Davis: One moment, while we poll for questions.

Lee Chen: And our first question comes from Lee Chen with H.C. Wainwright. Please proceed with your question. Hello, this is Lee for RK. Thanks for the question.

Speaker Change: And our first question comes from Lee Chen with H C. Wainwright. Please proceed with your question.

Lee Chen: Hello. This is Lee in for RK. Thanks for the question. So my first question is would you mind talking about your confidence in securing multi order on multi unit orders for this year and then second is how should we think of the volume.

Scott Davis: So my first question is, would you mind talking about your confidence in securing multi-order, multi-unit orders for this year? And then second is, how should we think of the volume of illegal claims that you plan to submit this year? Lee, thank you. Thank you for your question. Thanks for joining us today. To answer your first question in terms of multi-unit orders, this is in reference to, I assume, our enterprise health business as it relates to some of our larger independent health delivery networks that are out there, our larger network providers. As we had said throughout 2024, it was an off-cycle year for those larger institutions as it related to their equipment purchases.

Lee Chen: Illegal claims do you plan to submit this year.

Speaker Change: Okay. Lee. Thank you. Thank you for your question and thanks for joining us today.

Speaker Change: To answer your first question in terms of multi unit orders. This is in reference to I assume our enterprise health.

<unk> business as it relates to some of our larger.

Speaker Change: Independent health delivery networks that are out there are a larger network providers.

Speaker Change: As we had said throughout.

Speaker Change: 'twenty 'twenty four we were it was an off cycle year for those.

Speaker Change: Larger institutions.

Speaker Change: As it related to there.

Scott Davis: And we expect and believe that in 2025, we are back within those standard procurement cycles for those larger customers. So, the short answer is that we do expect more multi-unit orders occurring, particularly back here in North America in 2025. Now, relative to the volume of claims, submissions for CMS, as we stay in the middle of the pandemic, we do expect to see an increase in the number of claims submitted. We have a a current customer pipeline of individuals who we believe have effective and suitable claims relative to Medicare of about 25 individuals that we expect we will be putting through this year.

Speaker Change: Equipment purchases and we.

Speaker Change: We expect and believe that in 2025.

Speaker Change: We are.

Speaker Change: Back within those standard procurement cycles for those larger customers. So the short answer is that we do expect more multi unit orders.

Speaker Change: During particularly back here in North America.

Speaker Change: In 2025.

Speaker Change: Now relative to the volume.

Speaker Change:

Speaker Change: Claims submissions for Ford.

Speaker Change: CMS as we stick to it.

Speaker Change: We have a.

Speaker Change: A.

Speaker Change: Current.

Speaker Change: Our customer pipeline.

Speaker Change: Pipeline.

Speaker Change: Of individuals who we believe.

Speaker Change: Have effective in suitable claims relative to Medicare that.

Speaker Change: Of about 25 individuals that we expect.

Speaker Change: We will be putting through this year. In addition to that we've really ramped up our marketing efforts throughout 2024, and we are getting individuals.

Scott Davis: In addition to that, we've really ramped up our marketing efforts throughout 2024, and we are getting individuals really daily who are coming into the queue and are interested in pursuing this technology. We do see growth as we move through the year, and we expect that it will be meaningful to the top line of our business as we move through the year. More importantly, we're really excited that we are starting to see individuals who can really benefit from using this technology in their day-to-day lives. So we remain quite excited about that. Okay, thanks for the question.

Speaker Change: Really daily.

Speaker Change: Who are coming into the queue and.

Speaker Change: Are interested in.

Speaker Change: Pursuing this technology, so we do see.

Speaker Change: Growth as we move through the year and we expect.

Speaker Change: That said it'll be meaningful to.

To the top line of our business as we move through through.

Speaker Change: Through the year and more importantly, we're really excited that.

Speaker Change: We are.

Speaker Change: Starting to see individuals who could really benefit from using this technology in their day to day lives.

Speaker Change: So we remain quite excited about that.

Speaker Change: Okay. Thanks for that thanks.

Lee Chen: Thanks for the color.

Speaker Change: Thanks for the color. Another question is I see that the revenue in Europe, and a P. A C or regions are currently very nicely can you provide additional color on the growth trajectory you see you think it will be in 2025 M. B L.

Ben Haynor: Another question is, I see that the revenue in the Europe and the APAC regions are growing very nicely.

Scott Davis: Can you provide additional color on the growth trajectory you see, you think will be in 2025 and beyond? Sure. Well, in APAC, generally speaking, we have growth inside of APAC generally year over year with our Ekso NR and our indigo therapy devices. We also believe that in 2025, there's an opportunity for growth within the indigo personal product line as well as there are reimbursement programs that exist in several of the regions in APAC. So, you know, we believe that that growth will continue to track.

Speaker Change: Sure.

Speaker Change: Well in in APAC generally speaking you know we have.

Speaker Change: Growth in inside of APAC.

Generally year over year, with our XO, and our and our indigo therapy.

Speaker Change: Devices, we also believe that in.

Speaker Change: 2025.

Speaker Change: There is an opportunity for growth within the <unk>.

Speaker Change: Indigo personal product line as well as there are reimbursement.

Speaker Change: Programs that exist.

Speaker Change: In several of the regions in APAC. So we believe that that growth will continue to track.

Scott Davis: In Europe, particularly in 2024, we had really just exceptional growth in Europe as we had a huge opportunity within the French hospital systems where they were adding this technology into their neurorehab programs. So as we are now in 2025, we believe that that will begin to taper off and we'll get back to sort of what we call normal growth in that region. But we are projecting growth in both. relative to our normal numbers in both of those regions in 2021. Got it.

Speaker Change: In Europe, particularly in 2024, we had.

Speaker Change: It really just exceptional growth in in Europe.

Speaker Change: As we had a huge opportunity within the.

Speaker Change: The French hospital systems.

Speaker Change: Where they were adding this technology.

Speaker Change: Into there.

Speaker Change: Neuro rehab programs. So as you know as we are now in in 2025, we believe that that will.

Speaker Change: Begin to taper off and we'll get back to sort of what we call normal growth.

Speaker Change: In in that region, but we are.

Speaker Change: We are projecting growth in both.

Speaker Change: Yeah.

Speaker Change: Relative to our normal numbers in both of those regions in 2025.

Speaker Change: Yeah.

Lee Chen: That's very helpful. Thank you very much and congratulations on the quarter. Thank you, Lee.

Speaker Change: Got it that's very helpful. Thank you very much and congratulations on the quarter.

Lee Chen: Thank you Lee.

Speaker Change: Thank you and our next question comes from Ben Hayner with Lake Street Capital. Please proceed with your question.

Ben Haynor: Our next question comes from Ben Haynor with Lake Street Capital. Please proceed with your question. Good afternoon, gentlemen. Thanks for taking the questions. First off for me, just think about the patient interest that you're generating via your marketing activities for the personal units. And I think you mentioned, you know, almost daily you're seeing folks enter the queue. You know, how many of those folks that you do you know, get into the queue ultimately are, you know, well qualified, if you will, or you think that would benefit from taking them through the next step. Sure. Thanks, Ben.

Good afternoon, gentlemen, thanks for taking the questions.

Speaker Change: First off for me just thinking about the patient interests that you're generating via your marketing activities for the personal units.

Speaker Change: I think you've mentioned them all.

Speaker Change: Almost daily Youre seeing folks enter the queue.

Speaker Change: You know how many of those folks the do you do.

Speaker Change: Julien that you ultimately are well qualified if you will are or you think that would benefit from taking through the next steps.

Speaker Change: Sure sure.

Scott Davis: I appreciate your question and you joining today. We process a large and growing number of leads that are coming into our website, so we have a lot of interest from individuals who are you know, many of whom are living with a spinal cord injury, but we have people who call us who have, you know, other mobility challenges related to, you know, other conditions as well. So, you know, our qualification process, you know, today is really, you know, taking individuals who are, you know, living with a spinal cord injury and, you know, meet the... required FDA indication for use for the technology.

Speaker Change: Thanks, Ben I appreciate your question and you joining today.

Speaker Change: We I mean, we we process.

Speaker Change: A large and growing number of leads that are that are coming into our website. So we have a lot of interest from individuals who are.

Speaker Change: You know many of whom are living with spinal cord injury, but we have people who call us who have you know other.

Mobility challenges related to other conditions as well. So you know our qualification process today is really.

Speaker Change: Taking individuals who are living with spinal cord injury and meet the.

Speaker Change: Required FDA indication for use for the technology.

Scott Davis: From there, those individuals are screened just to ensure that they have the right health background and no preexisting conditions that would prevent them from effectively using the technology. We also. are prioritizing individuals with Medicare coverage, with pure Medicare coverage today. You know, what that means is that, you know, we have really different tiers of individuals who come in prioritizing Medicare first, but we have individuals who have Medicare Advantage, who have private insurance, who are otherwise well-qualified for the technology. We continue to collect and foster those individuals' interest as we go forward and expect over time that we'll be able to, you know, have reimbursement through, you know, those private insurance carriers over time.

Speaker Change: From there you know.

Those individuals are are screened just to ensure that they have the.

Speaker Change: Right.

Speaker Change: Health background and.

No preexisting conditions that would prevent them from effectively using the technology.

Speaker Change: And.

Speaker Change: We also.

Speaker Change: Our prioritizing individuals' with Medicare.

Speaker Change: Coverage with pure Medicare coverage today.

Speaker Change: What that means is that you know we have really different.

Speaker Change: Tiers of individuals who who come in prioritizing Medicare first but we have individuals who have Medicare advantage, who have private insurance who.

Speaker Change: Who are otherwise well qualified for the for the technology.

Speaker Change: We continue to collect and foster those.

Speaker Change: Those individuals' interest as we go forward and expect over time that we'll be able to.

You know have a reimbursement through.

Speaker Change: You know, there's private insurance carriers over time, but today, we are prioritizing individuals' with.

Scott Davis: But today we're prioritizing individuals with Medicare who meet the, you know, the physical requirements and the health requirements, you know, for the technology. And, you know, in general, you know, we You know, our number of qualified individuals that we talked about is about 25 that we have identified right now, but the reality is that there's an exponentially larger number of individuals that we continue to work with that we believe, as this program becomes more mainstream and potentially moves into private insurance, that will be good candidates in the future.

With Medicare who meet.

Speaker Change: The physical requirements in the health requirements.

Speaker Change: For the technology and you know in general.

Speaker Change: You know we.

Speaker Change: You know our number of qualified individuals that we talked about is about 25 that we have.

Speaker Change: Our identified right now, but reality is that there is.

Speaker Change: And exponentially larger number of individuals that we continue to work with that we believe as this program.

<unk> becomes more mainstream and <unk>.

Speaker Change: And potentially moves into <unk>.

Speaker Change: Private insurance that will be good candidates in the future.

Scott Davis: For more information, visit www.FEMA.gov Okay, that's helpful. And then on the on that latter point for the private payers, I mean, is that something that you can have, you know, free to start helping with you with now? Or is that, you know, down the road? What's the, what's the right way to think about that? Well, I think the way we think about that today is, you know, we think about it today for down the road, you know, I think one of the most critical elements of this is ensuring that we have a good and consistent success with individuals with Medicare.

Speaker Change: Okay. That's helpful color and then on.

Speaker Change: On that latter point for the private payers.

Speaker Change: I mean is that something that you can have.

Speaker Change: Free to start helping with you with now or is that down the road, what's the what's the right way to think about that.

Speaker Change: Well I think the way we think about that today is you know we think about it today.

Speaker Change: For down the road.

Speaker Change: I think one of the most.

Speaker Change: Critical elements of this is ensuring that we have a good and consistent success with individuals with with Medicare and then we can build upon that.

Scott Davis: And then we can build upon that, you know, as we begin to engage with Medicare Advantage or with private insurance. It really kind of sets the precedent for those private payers down the road. Now, that being said, you know, the way we, uh, you know, work with PREA to, you know, understand, you know, coding and coverage and payment and, um, all of the various, um, required, uh, you know, medical letters of medical necessity and notes from physicians and all of this, this is all going, it all translates, um, into what will happen with, uh, with private insurance.

Speaker Change: As we begin to engage with Medicare advantage or with private private insurance.

Speaker Change: It really kind of sets the precedent for.

Speaker Change: For those.

Speaker Change: Divot payers down the road now that being said.

Speaker Change: The way we.

Speaker Change: Our work with <unk> to understand you know coding and coverage and payment and.

Speaker Change: All of the various.

Speaker Change: Required.

Speaker Change: Medical letters of medical necessity and notes from physicians and all of this this is all going it all translates into what will happen with.

Scott Davis: So a lot of what we're building today lends itself to those additional payers as we expand the program. But, you know, we're, we're really trying to be Consciousness as an organization. You know, it's a little more of a challenging road at this point with people who have private insurance and we really want to level set expectations of individuals who want and need access to the technology. We're trying to be very clear and forthright with people on, you know, that this is a new program and it will, as it is, taking a bit of time to develop, you know, as we predicted.

Speaker Change: With private insurance, so a lot of what we're building today lends itself to those additional payers as we expand the program, but you know where we're really trying to be.

Speaker Change:

Speaker Change: Conscientiousness setup as an organization.

Speaker Change: You know, it's it's a little more of a challenging road at this point with people who have.

Speaker Change: A private insurance and we really want us level set expectation individuals'.

Speaker Change: Who want and need access to the technology, where we're trying to be very clear and forthright.

Speaker Change: With people on that this is a new program and it will as it is taking a bit of time to develop.

Speaker Change: As we predicted but with pre at helping us.

Scott Davis: But, you know, with PREA helping us, it ensures that we're not taking missteps along the way and we're guiding people in the right direction. Okay, got it. And then on the 25 or so patients that are Medicare, are there any commonalities between them? I mean, are they, you know, whether it's the time since their spinal cord injury or age range or anything, male, female, anything like that, that stands out? You know, at this point, Ben, they really run the gamut. You know, we've had you know, successful candidates. You know, if we go back and we look at Vicki Garrison, I mean, she had been in a wheelchair for 20 years and, you know, had an incredibly positive experience and continues to with, you know, with our indigo personal.

Speaker Change: It ensures that we're not taking missteps along the way we're guiding people in the right direction.

Speaker Change: Okay got it.

Speaker Change: On the 25 or so locations that debt.

Speaker Change: Our Medicare.

Speaker Change: Are there any commonalities between them.

Speaker Change: Whether it's the time since their spinal cord injury or.

Speaker Change: H range or anything male female or anything like that that are.

Speaker Change: Stands out.

Speaker Change: At this point, Ben they really run that run the gamut.

Speaker Change: You know we've had.

Speaker Change: Successful candidates you know if we go back and we look at.

Speaker Change: At Vicki garrison I mean, she had been in a wheelchair for for 20 years.

Speaker Change: And you know had incredibly positive experience and continues to with.

You know with our indigo personal we have.

Scott Davis: We have, you know, it really It's difficult to point to any specific demographic at this point. It runs the gamut. I will say at this juncture, what we are really seeking out is that people fit the you know the the screening that they they get the appropriate health care screening and and and have the right coverage but in addition to that that, you know, they're motivated and self-advocating. Because this is a new program, it's not as straightforward as, you know, going out and, you know, just getting a wheelchair or a brace or, you know, a CPAP or something like that.

Speaker Change: It really.

Speaker Change: It's <unk>.

Speaker Change: Difficult to point to any specific demographic at this point it it runs the gamut I will say at this juncture what we.

Speaker Change: Are really seeking out is is that people fit the <unk>.

Speaker Change: You know the.

Speaker Change: The screening that they they get the appropriate health care screening and and.

Speaker Change: And have the right coverage, but in addition to that.

Speaker Change: That.

Speaker Change: The.

Speaker Change: Motivated and self advocating because this is a new this is a new program. It's it's not as straightforward as you know going out in <unk>.

Speaker Change: Getting a a wheelchair or embrace or.

Speaker Change: The CPAP or something like that this is this is a new program. So you know it does take a bit of time theres, a certain amount of training involved.

Scott Davis: This is a new program. So, you know, it does take a bit of time. There's a certain amount of training involved. There's a commitment by the individual for this. So, you know, we're very clear in the process as we are screening these individuals that they understand, you know, what that is and that we just do a good job with education and level setting expectations for how the program works. you know, today it really does run the gamut. We're really excited as these individuals, you know, start to get their devices at home and hearing their stories over time and we'll really be able to see the sort of myriad of individuals that wind up being able to benefit from this.

Speaker Change: There's a commitment by the individual for this so you know we're very clear in the process. As we are screening. These individuals that they understand what that is and that we just do a good job with education and level setting.

Speaker Change: Expectations for how the program works so.

Speaker Change: Today, It really does run the gamut and we're really excited as these individuals.

Speaker Change: Start to get their their devices at home and hearing their stories.

Speaker Change: Over time, we'll really be able to see that.

Speaker Change: Myriad of of individuals' that wind up being able to benefit from this.

Speaker Change: Okay got it.

Scott Davis: Lastly, for me, on the national CDN and mobility as the exclusive distributor within the complex rehab technology industry, can you tell us more about how that relationship came about? Maybe a little bit more on the CRT industry for folks that don't necessarily get into the weeds there, and anything else that you think might be helpful on that? Yeah, absolutely. So one of the one of the key elements to this program being successful, and, you know, we've been having these discussions quarter over quarter. you know, our view of, Ekso's view of The go to market strategy for this really involves working with best in breed players, individuals or companies that that have an expertise in.

Speaker Change: Lastly for me.

Speaker Change: National seating and mobility as the exclusive distributor within the complex complex rehab technology industry, you cannot tell us more about how that relationship came about.

Speaker Change: Maybe a little bit.

Speaker Change: More on CRT industry for folks that.

Speaker Change: Necessarily.

Speaker Change: I'll get into the weeds, there and anything else that you might see or that you think might be helpful on that.

Speaker Change: Yeah, absolutely. So one of the one of the key elements to this program being successful in.

Speaker Change: We've been having these discussions quarter over quarter.

Speaker Change: Our view of <unk> view of.

Speaker Change: The go to market strategy for this really involves working with best in breed players individuals or companies that.

Speaker Change: That have an expertise.

Speaker Change: In.

Scott Davis: as DMEs, and that is if they're used to working with payers with. with physicians, with healthcare providers, to be able to tie all these different elements together for reimbursement. It is a complicated process. So it was, you know, early in 2024 where we began to, you know, really classic business development of looking at who those top players were in the industry. And NSM is certainly one of the big players in this space. Now, CRT is, you know, I guess the simple way of looking at it is they do a lot with wheelchairs, with power wheelchairs, with mobility access for individuals who, you know, who need help there.

Speaker Change: As D M E's.

Speaker Change: And that is that they are used to working with.

Speaker Change: Payers with.

Speaker Change: With physician with health care providers to be able to tie all these different elements together for for reimbursement. It is a it is a complicated.

Speaker Change: Process.

Speaker Change: So it was early in in 2024, where we began to.

Speaker Change: <unk> really classic business development of looking at who those top players where in the industry and NSM.

Speaker Change: Is certainly.

Speaker Change: One of the one of the big players in this space.

Speaker Change: Now CRT is I guess, the simple way of looking at it is they do a lot with with wheelchairs with power wheelchairs with mobility access for individuals who.

Speaker Change: Who who need help there and these are generally larger ticket items complicated.

Scott Davis: And these are generally, you know, larger ticket items, complicated. You know, they all go through relatively complex reimbursement process. They work with Medicare as well as with private insurers. What is unique, we've had direct meetings with their CEO, I've met with him personally, and there's a common customer set here. The individuals who need power wheelchairs and need these mobility aids, this is the next evolution in that path for them is to be able to stand and to be able to walk. And starting with individuals with spinal cord injury, but over time, there's a belief that this can lend, this technology can lend itself to others with mobility challenges.

Speaker Change: They are they all go through relatively complex.

Speaker Change: Reimbursement process.

Speaker Change: They work with.

Speaker Change: With Medicare as well as with private insurers.

Speaker Change: Now.

Speaker Change: What is unique.

Speaker Change: We've had no direct meetings with with their with their CEO I've met with him personally and.

Speaker Change: There's a common theres a common customer set here the individuals who.

No need power wheelchairs and need these mobility AIDS. This is the next evolution.

In that path for them is to be able to stand and to be able to walk and starting with individuals with spinal cord injury, but over time. There is a belief that this can lend this technology can lend itself to others with mobility challenges so.

Scott Davis: So. You know, with this relationship, it really is sort of a natural evolution for for NSM and for Ekso, it was really important to us to, you know, be able to work with one of the leading providers in this space. And, you know, they really are, you know, the the biggest and the best we feel in that space. Now, at the same time, you know, we continue to work on business development with durable medical equipment providers who are focused also in O&P or orthotics and prosthetics. You know, we believe that that is, you know, effectively another targeted.

Speaker Change: With this relationship it really is sort of a natural evolution for for NSM and for XO. It was really important to us too.

Speaker Change: Be able to work with one of the leading.

Speaker Change: Providers in this space and they really are.

Speaker Change: You know that.

The biggest and the best we feel and in that space now at the same time.

Speaker Change: We continue to work on business development.

Speaker Change: With durable medical equipment providers, who were focused also in Owen P or orthotics and prosthetics.

Speaker Change: We believe that that is.

Speaker Change: Effectively another.

Speaker Change: Targeted.

Speaker Change: Distribution group to be able to work with so we are while we are.

Ben Haynor: distribution group to be able to work with so we're while we're you know, signed with with NSM exclusively in in their space. You know, we are also beginning work with some regional and national DMEs who focus in O&P as well. Okay, great. That's very helpful.

Speaker Change: Signed with with NSM exclusively in their space.

Speaker Change: We are also.

Speaker Change: Beginning work with some regional and National <unk>.

Speaker Change: Who focus on O&M as well.

Speaker Change: Okay, Great. That's very helpful. Thank you so much for taking the questions guys.

Scott Davis: Thank you so much for taking the questions, guys. Thank you, Ben. Thank you.

Ben Hayner: Thank you Ben.

Ben Hayner: Thank you.

Operator: And with that, there are no further questions at this time.

Speaker Change: And with that there are no further questions at this time I'd like to turn the call back to Scott Davis for any closing remarks.

Scott Davis: I'd like to turn the call back to Scott Davis for any closing remarks. Thank you, operator, and thank you to everyone for joining us today. As pleased as we are with the progress made in 2024 on the sales, distribution, reimbursement and operations front. We're now excited and energized by what we believe 2025 will bring in terms of overall commercial traction in both the enterprise and personal market. We look forward to updating you as we progress. Thank you.

Ben Hayner: Hi.

Scott Davis: Thank you operator and thank.

You to everyone for joining us today.

Scott Davis: As pleased as we are with the progress made in 2024 on the sales distribution reimbursement and operations fronts.

Scott Davis: We're now excited energized by what we believe 2025 will bring in terms of overall commercial traction in both the enterprise and personal markets.

Scott Davis: We look forward to updating you as we progress.

Speaker Change: Thank you. This does conclude today's teleconference. Thank you for your participation you may disconnect your lines at this time.

Operator: This does conclude today's teleconference. Thank you for your participation. You may disconnect your lines at this time. the

Speaker Change: Yeah.

Speaker Change: Yeah.

Speaker Change: Mhm.

Speaker Change: [music].

Speaker Change: Uh huh.

Speaker Change: Uh huh.