GE HealthCare Technologies Inc. (GEHC) Earnings Call Transcript & Summary

Thanks for joining us here at the Jefferies Global Healthcare Conference, the JPMorgan of the East. So I'm Matt Taylor, the U.S. Medical supplies and devices analyst here at Jefferies, and I'm joined by the management team from GE Healthcare. Today, we have Jay Saccaro, the CFO; and Carolynne Borders, who runs Investor Relations for the company. And we'll have about 25 minutes for a fireside chat. So I'll kick things off here, Jay. Maybe I know a lot of these meetings, there are some newer investors in the room, and so it makes sense to start a little bit high level.

Can you talk about the evolution of GE as you've spun out? And maybe give us a sense for your portfolio across imaging and the other divisions and how they fit together and give you the right to win in your markets?

Great. Matt, first of all, thank you for the invitation to the conference. It's great to see you on this side of the Atlantic, and thanks to those for joining us to those new to the story, I appreciate your interest in our company, and we do see some familiar faces here as well. To your point, we spun off a couple of years ago, and we spun out with the mission to create a world where health care has no limits. And I have to say we've been incredibly excited about the progress that we've made over the last several years, really a durable financial profile with margin expansion, with durable sales growth. And then with the promise of an investment in innovation, which we've been hard at work at setting us up to unlock future growth. And so I would say, over the last several years, we've made tremendous progress advancing our portfolio across all 4 of our business segments, and we're now in a really interesting spot as we look to the future. So what do I mean? We start with -- we start as one of the leaders in imaging in the world. We're one of the largest imaging companies in the world, CT, MR. We have tremendous offerings in our existing product portfolio, but also a lot of exciting innovation, which we will talk more about. In our AVS business, which is our ultrasound along with our surgical business, we have a tremendous product offering, and we've started refreshing this already. If you look at our third quarter sales growth, you would have seen our AVS business grow 6% in the quarter. one of the faster growth rates that we've seen in a number of quarters. And what that really comes down to is a lot of the innovation investments that we've made over the last several years, refreshing our ultrasound platform, launching a next-generation cath lab. So a lot of great progress underpins that growth rate. In our PDx business, so excited to bring to market our Flyrcado product. We just recently announced another partnership as of yesterday in the U.S. and this represents a game change in myocardial perfusion imaging, which we're excited about to pay dividends for patients for years to come. And then finally, our PCS business. Listen, this business had some challenges in the third quarter. We saw a decline in sales really related to a product hold that we had, which we resolved. So we'll see that business resume a little bit more of a normal profile in the fourth quarter. But on the back of a number of important innovations in anesthesia and monitoring, we'll start to see an acceleration into the future. So it's a really durable broad-based portfolio of products that we sell, underpinned by favorable long-term dynamics and innovation that's going to lead us into the future.

Maybe we could start just by talking further about the CapEx environment. We get a lot of questions about this. And earlier in the year, there were some tariff concerns. There's sort of always some concerns that hospitals may be constrained. Can you talk about how that's impacting your demand, the customer appetite for your solutions? Do you see a healthy CapEx environment going forward? And because you're a global company, maybe highlight some differences between the U.S., EMEA and China.

Sure. Overall, the market has been robust and look no further than our order growth. While I think we performed well, it was in the context of a constructive market backdrop for imaging and other aspects of our equipment. We delivered 6% orders growth. Our backlog sits at a near record level. And our book-to-bill was 1.06x in the quarter, which these are all really healthy indicators about where the market currently sits. But here's the other interesting thing. Every quarter, we do a series of surveys of our primary customers. And we talked to them throughout the quarter, but formally, we look at this at the end of the quarter. And the market is robust. We've seen a real interest in radiology equipment. It's incredibly -- it's a real area of focus for hospitals today. We expect that to continue. Radiology departments in many hospitals are constrained today. They're also a very durable source of profits for hospitals. So having the latest equipment, having that equipment work well is crucially important. And so we're seeing interest in that in all markets. The U.S., it's been a very constructive environment. Interestingly, we're seeing tender activity in Europe pick up. We also had reported very strong growth in the quarter in EMEA, which was a nice turning point for us. We've seen some really good momentum in the EMEA markets. And again, the backdrop is constructive. And then in China, we are seeing tender activity pick up. I've said that. We said that on the call and the recovery is ongoing. That's been the most challenging market. And then developing markets outside of China, again, a lot of interest in expanding access to care, a lot of interest in adding capacity in radiology and areas like that. So we're seeing a very good environment there. Overall, the capital environment is a constructive one right now.

Great. And you mentioned the near record backlog, the trailing 12 order growth of about 6%. And I think that should give us some confidence you're moving towards your mid-single-digit goal. You've already committed to some acceleration next year off of the 3%. So maybe just talk about how the backlog could convert over the next 4 to 6 quarters from the trailing orders that you've seen?

No, that's exactly right. For us, we have said over the midterm, we expect to be a mid-single-digit growth company. So that means over the next several years, you're compounding 4% to 6% growth. Now last year was a disappointment. We had a China market challenge. So we grew 1% last year. This year, we'll grow 3%. But we are seeing very robust orders performance. And by the way, it's important not to overreact to a single quarter. Third quarter was -- second quarter was 3%; third quarter was 6%. We look at things over a trailing 4-quarter basis. I think that's a good way to kind of study the market. And what we see over that period of time is we're sitting at 6% trailing orders growth. which is exactly -- it's a great number for us to be at to support future revenue growth. And so normally, we don't comment on a third quarter call about future performance. But as we sit here today with the robust backlog that we have in place -- and by the way, with the robust backlog with dates to convert, a lot of the dates to convert are in the next 12 months, we feel very good about an acceleration versus this year's growth of 3%, which it's all supported by that. Then as we move forward, here's the interesting thing. At RSNA, we're going to talk about our product portfolio in detail. And everybody in the room is invited to join us in Chicago, Illinois in a few weeks. And what you will see at RSNA is a whole new set of products across our portfolio. We'll talk about a photon counting. We'll talk about whole body PET. We'll talk about a number of AVS launches, a next-generation MR device. We've been hard at work investing in R&D and also delivering on our time lines so that we can have the successful show, but more than that, start selling those products and see the impact next year. Now the reality is most of the impact from an order standpoint will be in the second half of the year, and the sales impact from this will start to accrue to 2027 versus '26. So we'll start to see an acceleration even beyond next year from these new products. But as we sit here looking at 2026, we were able to say we expect an acceleration on the back of the strong backlog and the performance that we've seen to date.

Great. And a big part of the story, I think, for investors on the margin side of things. And I guess I wanted you to talk a little bit about that. Q3 margins were down, but ex tariffs, they were up. And you continue to make progress on all the Kaizen initiatives that you like to talk about. There's a lot of productivity opportunity and innovation and pricing opportunities. So maybe you can unpack that and give us some flavor for how margins could ride alongside some of that growth improvement you're hoping for.

Sure. Going hand-in-hand with revenue acceleration is margin. I think from a company standpoint, we're focused really on 3 things: revenue growth, margin expansion and free cash flow conversion. All 3 of those are crucial metrics to us, and we intend to deliver on all aspects of that. From a sales standpoint, we've talked about getting to this mid-single digit over time. From a margin standpoint, we've talked about 17% to 20% plus in the midterm, which means we have a fair amount of work to do to get there. 2025 would have been a good year were it not for tariffs. Excluding tariffs, we'll see about 30 basis points of margin expansion this year. But obviously, this year, we were so focused on addressing tariffs and setting us up for tariff improvement next year. What do I mean by that? Well, in 2025, we experienced about $260 million, $265 million of tariff impact to our financials. Now the gross impact was roughly twice that. But through things like USMCA certification, through things like working with our suppliers to think about alternate sources of supply, using free trade zones and thinking carefully about where we supply different markets from what factory and facility, through all of those mechanisms, we were able to cut the impact in half from gross to net. As we move to next year, what you would normally expect to see is an increase in tariffs because this year, there's only really when you consider FIFO, approximately 2.5 quarters of impact in our numbers, something along those lines. So most folks would point to an increase next year. We expect tariff down next year because we will have more of the mechanisms that we've put in place. We will benefit from more of them. We'll think further about what we can do to improve our supply chain in the face of tariffs. So for all of these reasons, we'll see an enhancement next year and a reduction in tariff expense year-over-year. So not only -- so tariffs will be a source of earnings tailwind as it declines year-over-year. Now taking a step back, this idea of continued margin improvement even at an increasing rate relative to 30 basis points, that's really important to us. And so we look at every single lever. First of all, the new products that we're launching typically come at a higher price and lower cost than the predicate. And so the result of that is you have a natural margin uplift from new product launches. But even given the existing portfolio, we are intensely -- you talked about Kaizen. We are intensely focused on improving the productivity of our manufacturing facilities and our supply chain network to drive gross margin improvements through those initiatives, through pricing initiatives and then also generally through thinking carefully about SG&A spending. And I didn't say R&D because we'll continue to invest in R&D, hopefully at accelerated rates. But from an SG&A standpoint, we are very deliberate around SG&A spending, how we control this, use of AI to become more efficient. All of those things will come to bear on the SG&A line. So as we go forward, very compelled by the margin opportunity. And also as tariffs abate, that will be another accelerant.

And Matt, if I could just add, prior to the April tariffs that came into play, we did have a track record of delivering more than 100 basis points of margin expansion in each of the 2 years after we spun.

Maybe one just follow-up on the margins because you have so many new products coming out, and we didn't even talk about Flyrcado or the PDx growth path yet, which are also accretive. Could you talk about how mix could affect the margins in the next 2 years?

Yes. So that's exactly right. Mix to new products is absolutely helpful to the overall margin story. When we swap a version of the product that we sell today for a new product, typically, in some cases, not always, but typically, you have a higher price because it's a new product with new features and oftentimes, you have a lower cost, too. And so that mix shift will be an important aspect of what we do. The other thing, when we're launching new products, we've been very focused on simplification of platforms. It used to be that we would have many different CT platforms, many different MR platforms. And the result of that is higher cost simply. As we launch these new products, we're consolidating the number of platforms, leading to an enhanced cost position in that regard. So another driver related to mix and kind of R&D impact on margin.

And maybe we'll shift then to PDx, which has been a hot topic. I'd love to talk a little bit more about Flyrcado. You've talked a lot about this $500 million goal in 2028. And it was nice to see another announcement yesterday with a new partnership with a large cardiology group. So maybe talk about how you're setting up the infrastructure and these partnerships to be able to achieve and hopefully overachieve that goal.

We're very excited about the Flyrcado opportunity. And you see it in the partnerships that we've set up. I think now we're talking about 300,000 images with the partners that we've talked about specifically, which is a really exciting place to be. The one that we announced yesterday with Cardiovascular Associates followed a pilot study that they did. We worked very closely with them to assess the product -- to support them in their assessment of the product. They then sort of work through their internal mechanisms before they decided to roll out. So we were so thrilled with their assessment of not only the product, but our ability to help them as a customer deliver this to their patients and then roll it out. We sit here with a very compelling long-term opportunity. We've talked about if you converted 25% of the PET NPIs today, it's like -- it's a $1 billion opportunity. That's not even talking about SPECT conversion. That's PET only. And so for us, we're not limiting ourselves in any regard on this. But what's been very important in the rollout is being very measured in how we work with customers because it's one thing to say, we really like the image quality. But that's not the only thing that we do when we support a customer. If it was just about images, that would be very straightforward. It's how do we supply the customers consistently with the radiopharmaceutical -- radiopharmacy network that we set up. How do we support our customers in terms of optimizing workflow so that they can be efficient with this new model. And finally, how can we support them in their reimbursement. It's one thing to say, oh, we have reimbursement in place. It's quite another thing to actually have patients at this clinic get reimbursed for Flyrcado. And so we've worked very hard with our customers on all of those aspects and more. And I think that the recent partnerships that we've announced, which are reflective of successful pilot studies really are an indication of all that hard work that we've put in place that now sets us up to capitalize on this very attractive long-term growth opportunity.

Maybe just to try to put a finer point on it. I guess, does slightly missing or missing the $30 million goal at all change your view about whether you can do $500 million? And is the message really that now that you've signed these partnerships and have a better view of the funnel that you're even more confident in that?

Yes. I think what we said on the call is we're more confident today than we certainly were like 6, 9 months ago about the long-term opportunity. Look no further than the 2 partnerships that we put in place, look no further than the momentum. If you talk to -- and I think you did some very nice work on this and others do as well in terms of surveying doctors, they're very excited about this product offering and what we bring to bear and the quality of the images -- so from a -- I think the most important thing is, is the demand there? It absolutely is. Okay, once you have that, let's make sure we optimize supply and delivery to capitalize on this. And I would say that we're more excited about the demand side perhaps than we previously were.

Great. And maybe just to address this issue because it's come up in the last week or so, some discussion about a new generic entrant into the contrast space. And I would love for you to just talk about the outlook for contrast generally, how do you expect that underlying business to grow? And then maybe address the impact of the new entrant. I know you said it was not material, but be helpful, I think, for investors to understand how you've been able to defend in this market over time with all your other franchises.

Sure. So this area is -- has been an important and durable business for us for many years. And contrast agents are crucially important to our hospital systems, to our health care systems and folks have valued a lot of what we bring to bear, most notably consistency of supply. Because at the end of the day, sometimes these markets are very tightly constrained. Sometimes they're in shortage mode. And all of that creates a real premium on consistency of supply. We've seen that over the last several years. Over the last years, this has been a great and durable growth business for us, and we expect that to continue. Now what I would tell you is these are generic markets today in the sense that I think there are 3 or 4 competitors for our OmniPay product on the market today. We sell against them on a day in, day out basis. And they all enjoy some level of success. But what we're able to do is we have a broad portfolio of products, and this is included in that. We're able to -- we have a track record with consistency of supply, which is extremely important. We've been doing this for a long time. So we've climbed the experience curve in terms of getting product manufactured and to market. So for all of those reasons, despite the fact that we had 3 competitors and now we have 4 competitors, we've been able to succeed in this market, which we will expect to continue to do. We did have a competitor launch a generic version of Omnipaque that came out on Friday. And what I will say is they launched with 2 SKUs, which are a very, very small portion of our total PDx sales and a very trivial amount of the total company sales. So we don't expect a big impact from that. Now will they add incremental SKUs? Perhaps I expect that they would if you talk to them. But despite that, our view is we'll have our agreements in place. We'll emphasize what we do well. This is not -- these are not simple products to provide to the market. We will continue to do that with excellence and stand behind our product and our commitments there. So we don't expect this to be a large impact to our 2026 expectations or anything beyond that.

Maybe pivoting, we have a few minutes left. I did want to ask you a little bit about AI and software. And I think this is one of the first real and important use cases for AI in med tech really to see you've now got 100, I think, or so FDA-approved AI modules. Could you talk a little bit about the ones that are getting traction? Maybe give a few examples of how AI is really adding value to your portfolio. And investors ask a lot about sort of the size of that business or how do you monetize that? How does that really add to the recurring and high-margin opportunities that you have in the future?

Great. So we're incredibly excited about the impact of AI on our business. I think some aspects of AI will be table stakes for winning in imaging and ultrasound in the future. I think other aspects represent a real opportunity for us to differentiate our product offering. Look no further than AIR Recon DL. AIR Recon DL is essentially AI used to improve the signal-to-noise ratio of your standard MRI. And what it does is it improves image quality and it also reduces imaging time. And as you think about the constraints on hospitals today, suite utilization is one of them. To the extent that you can get people through an MRI faster, it's a really big and positive development for the hospital. So it's no wonder that we are selling a large number of AIR Recon DL software add-ons to our existing installed base and also even our new magnets. And what we're also seeing is this AI, people are choosing our product because of offerings like this. And so that's a great example of, I think around 30% of our installed base has AIR Recon DL attached to it today. So a great example of AI in the real world, driving better outcomes and also creating incremental economic value for us. Now I would say that across our product portfolio, we have very real and tangible examples beyond this. So for example, in our ultrasound business, we did a deal with a company called Caption Health. We acquired them a few years ago. And what Caption Health does is it uses artificial intelligence to help guide sonographers to more effectively, efficiently get ultrasounds performed. And interestingly, it actually does it in a way that allows them to an untrained sonographer to take an ultrasound. So incredibly exciting offering. We've incorporated this into our latest generation of a number of our products, and it's incredibly well received. As we think about all of the data in our PCS business, another rich area to use artificial intelligence to assess signal to identify opportunity for intervention or taking care of patients in different ways. I think artificial intelligence is crucially important for imaging companies. We've invested. Part of the reason why we've grown our R&D spending so much is investments in artificial intelligence. And I'm proud that we did have 100 FDA approvals of AI-enabled devices. We're going to continue to have more.

Great. I think we could talk for a long time, but we have to end there. But thank you so much for your time, and thanks, everybody, for your interest in GE.