RadNet Reports Fourth Quarter 2024 Results, Including Record Revenue and Adjusted EBITDA(1) and Releases 2025 Financial Guidance

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  • Total Company Revenue increased 13.5% to a quarterly record of $477.1 million in the fourth quarter of 2024 from $420.4 million in the fourth quarter of 2023; Revenue from the Digital Health reportable segment (inclusive of intersegment revenue) increased 28.1% to $18.9 million in the fourth quarter of 2024 from $14.7 million in the fourth quarter of 2023
  • Total Company Adjusted EBITDA(1) was a quarterly record of $75.0 million in the fourth quarter of 2024 as compared with $65.8 million in the fourth quarter of 2023, an increase of 14.0%; Digital Health reportable segment Adjusted EBITDA(1) increased 61.6% to $4.5 million in the fourth quarter of 2024 from $2.8 million in the fourth quarter of 2023
  • Adjusting for unusual or one-time items impacting Net Income in the quarter, Adjusted Earnings Per Share(3) was $0.22 for the fourth quarter of 2024; This compares with Adjusted Earnings Per Share(3) of $0.15 for the fourth quarter of 2023
  • In the fourth quarter of 2024, aggregate procedural volumes increased 8.0% and same-center procedural volumes increased 4.0% compared with the fourth quarter of 2023
  • At December 31, 2024, RadNet had a cash balance of $740 million and a net debt to Adjusted EBITDA(1) leverage ratio of under 1.0x

LOS ANGELES, Feb. 27, 2025 (GLOBE NEWSWIRE) -- RadNet, Inc. (NASDAQ: RDNT), a national leader in providing high-quality, cost-effective, fixed-site outpatient diagnostic imaging services through a network of 398 owned and/or operated outpatient imaging centers, today reported financial results for its fourth quarter and full-year ended December 31, 2024.

Dr. Howard Berger, President and Chief Executive Officer of RadNet, commented, "I am very pleased with our performance in the fourth quarter and for full-year 2024. Relative to last year's fourth quarter, Revenue increased 13.5% and Adjusted EBITDA(1) increased 14.0%. This performance was driven by strong aggregate procedural volume growth of 8.0% and same center procedural growth of 4.0%. This performance enabled us to meet or exceed guidance levels we set at the beginning of 2024 and revised upward throughout the year.”

Dr. Berger continued, "During the fourth quarter, we continued to experience increased demand in virtually all of our markets. This demand was the primary catalyst for the investments made to expand capacity by the opening of nine new centers during the year. Throughout 2024, the centers within health system partnerships grew from 130 at the beginning of 2024 to 153 by the end of the year. Joint venture facilities now represent 38.4% of the 398 locations.”

"During 2024, significant progress was made in the Digital Health division, culminating with the fourth quarter launch of DeepHealth OS, SmartMammoTM and TechLiveTM solutions in addition to expansion of the AI clinical tools in breast, lung, prostate and brain. We intend to implement these new solutions throughout the RadNet network during 2025, and they should create significant efficiencies in our operations that will help address challenges resulting from the shortage and rising cost of skilled labor. Furthermore, these solutions will enable us to expand capacity by streamlining workflow and automating processes that will improve the patient experience,” added Dr. Berger.

"During 2024, liquidity and financial leverage were carefully managed, as highlighted by a $230 million stock offering completed in March, a debt refinancing completed in April which lowered our cost of capital and extended maturities through 2031 and a debt repricing transaction completed in November which lowered the interest cost on RadNet's credit facility. As a result of these actions and a focus on margins and Adjusted EBITDA(1) growth, at year-end 2024, net debt to Adjusted EBITDA(1) fell below 1.0x, from approximately 2.0x at year-end 2023. The cash balance at the end of 2024 grew to $740 million, from $342 million at year-end 2023,” concluded Dr. Berger.

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Financial Results

Fourth Quarter Report:

For the fourth quarter of 2024, RadNet reported Total Company Revenue of $477.1 million and Adjusted EBITDA(1) of $75.0 million. Revenue increased $56.7 million (or 13.5%) and Adjusted EBITDA(1) increased $9.2 million (or 14.0%) as compared with the fourth quarter of 2023.

For the fourth quarter of 2024, RadNet reported Digital Health Revenue of $18.9 million (inclusive of intersegment revenue) and Adjusted EBITDA(1) of $4.5 million. Revenue increased $4.1 million (or 28.1%) and Adjusted EBITDA(1) increased $1.7 million (or 61.6%) as compared with the fourth quarter of 2023.

There were a number of unusual or one-time items impacting the fourth quarter including: $1.1 million in severance expense related to cost-savings initiatives; $2.5 million impairment loss on lease abandonment; $1.1 million expense related to leases for de novo facilities under construction that have yet to open their operations; $462,000 of acquisition transaction costs; $2.4 million loss in conjunction with extinguishment of debt and related expenses as a result of the Company's refinancing and repricing debt transactions; $5.0 million of non-capitalized research and development expenses related to the DeepHealth Cloud OS and generative AI; and $577,000 of non-cash loss from interest rate swaps. Adjusting for the above items, Total Company Adjusted Earnings(3) was $16.7 million and diluted Adjusted Earnings Per Share(3) was $0.22 during the fourth quarter of 2024. This compares with Total Company Adjusted Earnings(3) of $9.9 million and diluted Adjusted Earnings Per Share(3) of $0.15 during the fourth quarter of 2023.

Unadjusted for unusual or one-time items impacting the fourth quarter, Total Company Net Income for the fourth quarter of 2024 was $5.3 million as compared with a Total Company Net Loss of $1.9 million for the fourth quarter of 2024. Fully diluted Net Income Per Share for the fourth quarter of 2024 was $0.07, compared with a fully diluted Net Loss per share of $(0.03) in the fourth quarter of 2023, based upon a weighted average number of diluted shares outstanding of 75.5 million shares in 2024 and 67.9 million shares in 2023.

For the fourth quarter of 2024, as compared with the prior year's fourth quarter, MRI volume increased 13.4%, CT volume increased 13.9% and PET/CT volume increased 23.9%. Overall volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 8.0% over the prior year's fourth quarter. On a same-center basis, including only those centers which were part of RadNet for both the fourth quarters of 2024 and 2023, MRI volume increased 8.5%, CT volume increased 8.7% and PET/CT volume increased 16.3%. Overall same-center volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 4.0% over the prior year's same quarter.

Annual Report:

For full-year 2024, RadNet reported Total Company Revenue of $1,829.7 million and Adjusted EBITDA(1) of $279.5 million. Revenue increased $213.0 million (or 13.2%) and Adjusted EBITDA(1) increased $47.1 million (or 20.3%) as compared with full-year 2023.

For full-year 2024, RadNet reported Digital Health Revenue (inclusive of intersegment revenue) of $65.7 million and Adjusted EBITDA(1) of $14.6 million. Revenue increased $16.1 million (or 32.5%) and Adjusted EBITDA(1) increased $8.1 million (or 124.0%) as compared with full-year 2023.

Unadjusted for one-time or unusual items, Total Company Net Income for 2024 was $2.8 million as compared with a Total Company Net Income of $3.0 million in 2023. Fully diluted Net Income Per Share for 2024 was $0.04, compared with a Net Income per share of $0.05 in 2023, based upon a weighted average number of diluted shares outstanding of 74.8 million shares in 2024 and 64.7 million shares in 2023.

Actual 2024 Results vs. 2024 Guidance

Imaging Center Segment
     
 Original Guidance RangeRevised Guidance Range After Q1 ResultsRevised Guidance Range After Q2 ResultsRevised Guidance Range After Q3 ResultsActual 2024 Results
Total Net Revenue$1,650-$1,700mm$1,675-$1,725mm$1,685-$1,735mm$1,710-$1,760mm$1,764.0mm
Adjusted EBITDA(1)$250 - $260mm$255 - $265mm$257 - $267mm$262 - $270mm$264.9mm
Capital Expenditures(a)$125 - $135mm$130 - $140mm$135 - $145mm$145 - $155mm$148.1mm
Cash Interest Expense(b)$40 - $45mm$37 - $42mm$32 - $37mm$25 - $30mm$33.3mm
Free Cash Flow (2)$65 - $75mm$68 - $78mm$72 - $80mm$83 - $93mm$83.5mm
      
(a) Net of proceeds from the sale of equipment ($886,000), New Jersey Imaging Network capital expenditures of $20.7mm and a one-time $6.6 million operating lease buyout from two equipment manufacturers.

(b) Includes payments to and from counterparties on interest rate swaps and nets interest income from our cash balance as recorded in Other Income.

 
Digital Health Segment
      
  Original

Guidance Range

Revised

Guidance Range After

Q1 and Q2 Results

Revised

Guidance Range After

Q3 Results

Actual 2024 Results
     
Total Net Revenue (inclusive of intersegment revenue)$60 - $70mm$60 - $70mm$60 - $70mm$65.7mm
     
Adjusted EBITDA(1) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$12 - $14mm$13 - $15mm$13 - $15mm$14.6mm
     
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$11 - $13mm$12 - $14mm$13 - $15mm$15.0mm
     
Capital Expenditures(i)$3 - $5mm$3 - $5mm$3 - $5mm$3.5mm
     
Free Cash Flow(2) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$8 - $10mm$8 - $10mm$8 - $10mm$11.1mm
     
Free Cash Flow(2) After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$(2) - $(5)mm$(2) - $(5)mm$(2) - $(5)mm$(3.9)mm 
     
(i) Excludes a $9 million purchase of software code and other intellectual property from a vender.
 

2025 Guidance

Dr. Berger highlighted, "In January and February of 2025, we experienced more severe winter weather conditions than last year in our East Coast and Texas operations as well as catastrophic fires in Southern California. These unanticipated events had a significant impact on the utilization of healthcare services in these regions, which resulted in an estimated loss of $22 million of Revenue and $15 million of Adjusted EBITDA(1) to the RadNet operations. These significant events have caused a revision to the first quarter of our initial 2025 Imaging Center segment budget, which is now reflected in our full-year 2025 guidance.”

RadNet reports 2025 guidance ranges as follows:

Imaging Center Segment
  
 2025

Guidance Range

  
Total Net Revenue$1,825 - $1,875 million
Adjusted EBITDA(1)$265 - $273 million
Capital Expenditures(a)$140 - $150 million
Cash Interest Expense(c)$35 - $40 million
Free Cash Flow(b)$70 - $80 million
  
(c) Net of proceeds from the sale of equipment and New Jersey Imaging Network capital expenditures.

(d) Defined by the Company as Adjusted EBITDA(1) less Capital Expenditures and Cash Interest Expense.

(e) Net of payments from counterparties on interest rate swaps and interest income from our cash balance recorded in Other Income.

 
Digital Health Segment
  
 2025

Guidance Range

  
Total Net Revenue$80 - $90 million
  
Adjusted EBITDA(1) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$15 - $17 million
  
Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$16 - $18 million
  
Capital Expenditures$3 - $5 million
  
Free Cash Flow(a) Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$11 - $13 million
  
Free Cash Flow(a) After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI$(5) - $(8) million
  
  
(a) Defined by the Company as Adjusted EBITDA(1) less Capital Expenditures and Cash Interest Expense.
 

Dr Berger added, "Within the Imaging Center segment, 2025 performance will be impacted by continued focus on same-center performance, tuck-in acquisitions, increasing reimbursement efforts, expanded and new health system joint ventures and de novo center openings. Incorporated into 2025 guidance is continued increases in salaries, wages and benefits, which is indicative of broader industry conditions. To address the labor challenges, we will be focused in 2025 on the implementation of the Digital Health solutions intended to drive automation and efficiencies in the utilization of labor.”

"Within the Digital Health segment, 2025 growth will be driven by a variety of factors including, sales of the new DeepHealth OS Operating and Diagnostic software suites, sales and licensing revenue from the new SmartTechologyTM products (eg, SmartMammoTM), licensing fees from the TechLiveTM technologist remote-control and automation technology and further licensing and patient revenue from mammography, lung, prostate and brain AI solutions. In 2025, significant infrastructure investments will be made in building sales, marketing and implementation teams and we will pursue completing potential acquisitions, both of which will contribute to the long-term success in selling and licensing Digital Health solutions to external customers”, concluded Dr. Berger.

Conference Call for Tomorrow

Dr. Howard Berger, President and Chief Executive Officer, and Mark Stolper, Executive Vice President and Chief Financial Officer, will host a conference call tomorrow, February 28th, at 10:30 a.m. Eastern Time. During the call, management will discuss the Company's 2024 fourth quarter and year-end results.

Conference Call Details:

Date: Friday, February 28, 2025

Time: 10:30 a.m. ET

Dial In-Number: 844-826-3035

International Dial-In Number: 412-317-5195

There will also be simultaneous and archived webcasts available at https://viavid.webcasts.com/starthere.jsp?ei=1708732&tp_key=80b765a1d9 or http://www.radnet.com under the "About RadNet” menu section and "News & Press Releases” sub-menu of the website. An archived replay of the call will also be available and can be accessed by dialing 844-512-2921 from the U.S., or 412-317-6671 for international callers, and using the passcode 10197109.

About RadNet, Inc.

RadNet, Inc. is the leading national provider of freestanding, fixed-site diagnostic imaging services and related information technology solutions (including artificial intelligence) in the United States based on the number of locations and annual imaging revenue. RadNet has a network of 398 owned and/or operated outpatient imaging centers. RadNet's markets include Arizona, California, Delaware, Florida, Maryland, New Jersey, New York, and Texas. Together with affiliated radiologists, and inclusive of full-time and per diem employees and technologists, RadNet has a total of over 11,000 employees. For more information, visit http://www.radnet.com.

Forward Looking Statements

This press release contains "forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements are expressions of our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, and anticipated future conditions, events and trends. Forward-looking statements can generally be identified by words such as: "anticipate,” "intend,” "plan,” "goal,” "seek,” "believe,” "project,” "estimate,” "expect,” "strategy,” "future,” "likely,” "may,” "should,” "will” and similar references to future periods. Forward-looking statements in this press release include, among others, statements we make regarding response to and the expected future impacts of COVID-19, including statements about our anticipated business results, balance sheet and liquidity and our future liquidity, burn rate and our continuing ability to service or refinance our current indebtedness.

Forward-looking statements are neither historical facts nor assurances of future performance. Because forward-looking statements relate to the future, they are inherently subject to uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Therefore, you should not place undue reliance on any of these forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following:

  • changes in general economic conditions nationally and regionally in the markets in which we operate, including their effects on the cost and availability of labor;
  • our ability to service our indebtedness, make principal and interest payments as those payments become due and remain in compliance with applicable debt covenants, in addition to our ability to refinance such indebtedness on acceptable terms;
  • the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities;
  • our ability to maintain our current credit rating and the impact on our funding costs and competitive position if we do not do so;
  • volatility in interest and exchange rates, or credit markets;
  • the adequacy of our cash flow and earnings to fund our current and future operations;
  • changes in service mix, revenue mix and procedure volumes;
  • delays in receiving payments for services provided;
  • increased bankruptcies among our partner physicians or joint venture partners;
  • the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act;
  • the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof by federal and state regulators or related litigation result in a reduction in coverage or reimbursement rates for our services, or other material impacts to our business;
  • closures or slowdowns and changes in labor costs and labor difficulties, including stoppages affecting either our operations or our suppliers' abilities to deliver supplies needed in our facilities;
  • the occurrence of hostilities, political instability or catastrophic events;
  • the emergence or reemergence of and effects related to future pandemics, epidemics and infectious diseases; and
  • noncompliance by us with any privacy or security laws or any cybersecurity incident or other security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information.

Any forward-looking statement contained in this current report is based on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that we may make from time to time, whether as a result of changed circumstances, new information, future developments or otherwise, except as required by applicable law.

Regulation G: GAAP and Non-GAAP Financial Information

This release contains certain financial information not reported in accordance with GAAP. The Company uses both GAAP and non-GAAP metrics to measure its financial results. The Company believes that, in addition to GAAP metrics, these non-GAAP metrics assist the Company in measuring its cash-based performance. The Company believes this information is useful to investors and other interested parties because it removes unusual and nonrecurring charges that occur in the affected period and provides a basis for measuring the Company's financial condition against other quarters. Such information should not be considered as a substitute for any measures calculated in accordance with GAAP, and may not be comparable to other similarly titled measures of other companies. Non-GAAP financial measures should not be considered in isolation from, or as a substitute for, financial information prepared in accordance with GAAP. Reconciliation of this information to the most comparable GAAP measures is included in this release in the tables which follow.

CONTACTS:

RadNet, Inc.

Mark Stolper, 310-445-2800

Executive Vice President and Chief Financial Officer

 
RADNET, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)
    
 December 31, 2024 December 31, 2023
    
ASSETS   
CURRENT ASSETS   
Cash and Cash equivalents$740,020  $342,570 
Accounts receivable 185,821   163,707 
Due from affiliates 41,869   25,342 
Prepaid expenses and other current assets 51,542   47,657 
Total current assets 1,019,252   579,276 
PROPERTY, EQUIPMENT AND RIGHT-OF-USE ASSETS   
Property and equipment, net 694,791   604,401 
Operating lease right-of-use assets 639,740   596,032 
Total property, plant, equipment and right-of-use assets 1,334,531   1,200,433 
OTHER ASSETS   
Goodwill 710,663   679,463 
Other intangible assets 81,351   90,615 
Deferred financing costs 2,265   1,643 
Investment in joint ventures 104,057   92,710 
Deposits and other 34,571   46,333 
Total Assets$3,286,690  $2,690,473 
    
LIABILITIES AND EQUITY   
CURRENT LIABILITIES   
Accounts payable, accrued expenses and other$351,464  $342,940 
Due to affiliates 43,650   15,910 
Deferred revenue 3,288   4,647 
Current operating lease liability 56,618   55,981 
Current portion of notes payable 24,692   17,974 
Total current liabilities 479,712   437,452 
LONG-TERM LIABILITIES   
Long-term operating lease liability 655,979   605,097 
Notes payable, net of current portion 991,574   812,068 
Deferred tax liability, net 22,230   15,776 
Other non-current liabilities 3,785   6,721 
Total liabilities 2,153,280   

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