Masimo Corporation (MASI) Earnings Call Transcript & Summary

Okay. Good afternoon, and thanks, everybody, for joining us for the next session of the UBS Virtual Global Healthcare Conference. I'm Matt Taylor, the U.S. medical supplies and devices analyst. And looking forward to hosting this session with management from Masimo. So we've got a few folks from the team joining us today. We've got Micah Young, who is the CFO; Eli Kammerman, who is the VP of Investor Relations and Business Development; and Mike Lazinski, who is the Head of FP&A. So guys, first, thanks so much for joining us. Welcome to the presentation and looking forward to the conversation today.

Thank you, Matt.

Okay. Super. So the format is going to be a fireside chat. And if folks who are listening have questions, you can always send me an e-mail or submit a question through the presentation app here.

But I'll get things kicked off. And I just want to get a sense for some of the recent trends to kind of level set. Maybe, Micah, you could talk about the business performance in Q1, some of the key things like sensor utilization and utilization in general recovery and how those things are kind of tracking through the quarter. And any comments on recent trends would be really helpful.

Absolutely. Thanks, Matt. So as we mentioned on the last earnings call, we've seen a nice, steady recovery in our sensor volumes, which track very closely with hospital admissions over the long term as well as those underlying procedural volumes. If you look at last year, if you go back to the second quarter of last year, our worldwide sensor volumes were down about 8%. We then grew 6% in Q3 and then 7% in Q4. Continue to see that rebound in recovery. And then in the first quarter of this year, in 2021, we grew about 3% sequentially to the fourth quarter of last year. So continue to see that nice rebound. It's hard to look at year-over-year comps this year just due to all the different cross currents we saw in the business last year, but continue to see that nice sequential rebound. And we saw, in March, continued strength. There was even stronger volumes in March and even very strong volumes in April as well. So we'll see how March is playing out now -- or sorry, May is playing out, but April has very strong volumes as well. So we were exiting the quarter, continuing to see that nice rebound in our sensor volumes, which means that there is a nice recovery in hospital admissions and procedures. And we expect -- I mean, we've had conversations with customers, and they're continuing to see that recovery as well. And I think things are opening up more as well with customers. If you think about our equipment installations and our contracting, it was very difficult to get any access to a hospital last year when we saw the peak of the pandemic and even all the way through the third quarter -- through early third quarter and throughout the third quarter. So we're seeing increasing access to hospitals, which means that we're able to get in and install equipment. We're able to continue with our contracting, which is important for us. And as we do that, that continues to -- as we install equipment, it gives us opportunity to drive that recurring sensor revenues moving forward as we look throughout the year. And in our guidance this year, we implied that we would have a nice steady rebound in sensor volumes. So things are tracking as we expected so far.

Great. And that's good to hear. The other thing, maybe just take inside -- take us inside the trends in some of the different businesses, different geographies. Could you talk about how recovery looks in the U.S. versus Europe, where you always also have a material business?

Yes. And when we talked about the first quarter being up 3% sequentially from Q4, the strength is really in the U.S. business. It outpaced that step-up as far as the recovery. And we saw softness in -- outside the U.S. And I think a lot of it has to do with the availability of vaccines and achieving that broader immunity. I think there's more confidence in the U.S. of returning back for surgery. And OUS, we've seen pockets of softness just in that recovery. So I think that that's kind of what we're seeing by geography, which is encouraging because once OUS starts to come back, that should be a nice incremental growth opportunity for us when we see the OUS returning. So that's kind of where it's at. If you look at our kind of more of a, instead of geography, more of a product breakdown, we've seen, of course, over the past year, a strengthened SET as COVID has highlighted the importance of pulse oximetry for managing such a disease that damages the lungs. We've also seen strong demand for capnography because it helps you assess the lung function. And -- but where we've had in the past year, where it's really impacted us negatively, was more around anything tied to procedures, as you know, like total hemoglobin, continuous hemoglobin with rainbow, or SedLine and O3, which are brain monitoring, which ties into procedures. So those have kind of been set-back, but those are recovering very well. We saw us recover nicely in Q1, and that's what's telling us that we are seeing procedural volumes return because we're seeing a nice recovery in those areas. So that kind of summarizes the geography and product view.

Great. And why don't we talk a little bit about this quarter. It's a tough comp, as you mentioned. And I think some investors are concerned about that. Maybe you could kind of parse out some of the moving parts from last year and how that compares to what growth will look like this year in different segments and how you can cover that tougher comp.

Absolutely. One thing that I look at, Matt, is more on a 2-year stack growth. If you go back and normalize off 2019, our guidance this year at $1.205 billion implies about 13.4% compound annual growth. And if you look at that over a 2-year basis, so the first quarter, if you look at it on a 2-year growth, it averaged about 14%. Our implied guidance for what's in the numbers for the rest of the year is about 13.5%. So we're already seeing strong results even in the first quarter, and it's given us confidence in our guidance for this year. And the comps are very tough, as you mentioned. Last year, in Q2, our sensors were down 8%. So we've got an easy comp on the sensor side to drive strong growth this quarter. But we also grew our instruments and boards last year in the second quarter by 175%. And we increased our driver shipments in the second quarter by 175%. So we shipped 165,000 or over 165,000 last quarter in terms of drivers. So that created that very tough comp. But again, what's most important to me is looking at it on a 2-year basis. Also, we have a stronger foundation today. Our installed base grew 17% last year. We're coming off of a record-breaking contract year in terms of winning new customers. And that means that our -- that should strengthen our recurring revenue stream of sensors as we move forward. And that's more important to me than some of these tough comps on the equipment and the hardware side.

All right. So it's important to note, the sensor is still a much bigger piece of the revenue there. And I see you're wearing a Masimo SafetyNet. Is that how you're going to make the quarter, or [ important to you ]? What's going on?

Yes. [ Buy a few of this ]. No, [ I'm kidding, Matt ]. No, this is -- this is our wearable wireless sensor, as you know, and has all of our medical-grade technologies in that can be used in the home for [ monitoring ].

Super. Yes. We'll get into that a little bit later. I did want to ask you about just the expansion of the monitoring on the larger installed base. So you've talked about that a little bit in the past. What are you seeing with customers that have adopted monitoring more broadly throughout the hospital? How is that continuing to play out as the pandemic is starting to subside?

Yes. Yes, Matt, I think not only has COVID really highlighted the importance of pulse oximetry and even capnography, but -- from a product standpoint, but it's highlighted the importance of broader monitoring in the hospital and as well as driving efficiencies into the hospital through more automation and streamlining workflows. But what we're seeing is with that installed base, we're seeing good utilization on our top customers. If you look at our top 30 customers who had equipment installations last year or purchased excess equipment on open purchase orders, we're seeing strong performance in those top 30 accounts. And a lot of those customers were increasing ICU bed capacity in the short term, but they're thinking about this more broadly and being able to monitor more patients on the -- in the lower acuity settings like the general floor moving forward. So we're seeing good utilization out of those accounts. They're performing at 2 to 3x what the growth rate has been in our sensors even over the years. So there -- it's a magnitude of higher revenue performance, and utilization is very strong so far. So that's been encouraging. And like I said, the general floor, we've started to see more and more monitors going to the bedside in that area of the hospital as well. So we think that there's been nice penetration. I think before COVID hit, we were probably seeing about 10% penetration in the market on the general floor. Now we're up about 2 to 3x, so closer to 20% to 30% penetrated today on the general floor, which is -- gives us an opportunity to SET as a large market opportunity already. It's about a $2 billion market today. But it also -- this gives an opportunity to expand that market by more monitoring from the hospital. So that's encouraging [ to me ].

Got it. Okay. Maybe we can fix the echo there. So I did want to ask a follow-up on that. And I think Joe has mentioned a couple of times that these new customers seem to be using even more sensors than some of the legacy ones. So why is that happening? Where are they seeing the value proposition that they really like? And how does that bode for your ability to add on more solutions and services as you're expanding this whole suite?

Yes. And I wouldn't say it's a higher utilization rate, I would say it's -- we're seeing stronger growth of -- in the adhesive sensors of those top customers. So it's not like they're consuming more sensors per driver. But we're seeing good utilization so far and see nice revenue growth in those adhesive sensors. But to your point, is we have a great opportunity here to -- not only we have a larger installed base, but we've connected a lot more beds today, which is allowing us to pull through more revenue, like subscription revenue for our Hospital Automation. And if you think about it, last year, I mentioned on the fourth quarter earnings call, that our connected beds last year grew about 28%. So we're up -- we've been installing -- or connecting beds since 2007, with Patient SafetyNet and Iris Gateway. So we have a very large installed base there. And we've only been out in the market really with Hospital Automation and that subscription, that Software as a Service-type contract for about 1.5 years or 2 years, so we're seeing very nice adoption and penetration of those connected beds already. We mentioned on the last call, for the first quarter earnings call, that our Hospital Automation revenues were up about 3x what they were a year ago. So we're getting closer to 3% of our revenues from Hospital Automation, which is very encouraging, given that we have only been out there for a couple of years. So all these things are leading us to more opportunities to not only drive to more premium-based sensors, but also pull through other revenue streams like Hospital Automation that can really impact that revenue per driver over time and then help us expand our revenues per driver.

And you're still running above your historical levels in Q1 in terms of board shipments despite having such a huge year last year. So maybe you could just talk about how hospitals continue to focus on patient monitoring and offer some thoughts on the current capital environment.

Yes. I think, for us, I think in patient monitoring, I think the current capital environment is stable. And I think it's probably, one, is the importance of patient monitoring in the hospital, but it's also a lower-cost line item. It's not the cost of a large MRI machine or CT machine. It's a lower-cost line item. It's important in terms of value to patients. And I think that what we're seeing is not only a stable capital cycle, but also continuous interest in broader monitoring across the hospitals. And I think that that's really what stabilized kind of the back-to-normal pattern of capital purchases this year. And that's why we're guiding to at least 60,000 drivers a quarter, and we're getting more and more confident because we are coming off a record contracting year, and a lot of those drivers will have to be installed this year. So it's giving us a lot more confidence in what we put out there at the beginning of the year.

Yes. And that might be an underappreciated point. A lot of your revenue is contracted. So maybe talk about the visibility that, that provides you in terms of the sales that you could see this year and in subsequent years, given how much you laid down after.

Yes, absolutely. So if you think about it, last year, with us having a record year in terms of laying new customers, that happened really July through December. So a lot of those installs will happen this year, a substantial amount will happen this year. And that generates a nice recurring revenue stream. And if you think about it, we contract over a 5- to 7-year period. So it's a very durable -- we have a very durable revenue stream with our business in terms of the recurring sensor revenues. And again, we're seeing what many were concerned with, was a pull-ahead in the last year of a replacement cycle, and that's not what we're seeing. We're seeing kind of a normal cycle this year and a lot of interest in connectivity, automation and expanding more monitoring in the hospital. So I think that, that durable revenue stream has continued to build up. And that's encouraging as you think about moving into 2022 and beyond as far as the growth profile of the company.

Okay. Let's pivot and talk a little bit more about SafetyNet and Hospital Automation. You mentioned that the sales were up really nicely there. How does that bode for your ability to start to tack on more of the solutions around HA, like UniView or [ a line of ] index and some of the future developments you might have planned?

Yes, great question. So if you think about it, right now, in the beds that we're penetrating, we're on the lower end of that range, $1,000 to $5,000 per bed at the high end. So if you think about it, that's combining hardware and subscription revenue, but we're probably around the lower end of the range. But even at the lower end of the range, starting out $1,000 per bed, if you compare that to our sensor revenues per bed, just to give you a sense of magnitude even at the low end, our sensor revenue per bed is anywhere between $400 and $500 per bed per year. So if you start to bring on even the low end of the range, which is where -- what we're doing right now, about $1,000 per bed, it's 2x the opportunity on that pull-through revenue. So what gives us the opportunity is you get the -- you get in the hospital system, then you prove the value of those other software modules. If you think about UniView, like you mentioned, it's an integrated data dashboard, where you can provide a display on a large monitor in the OR room. And you could take all those parameters coming off the connected devices in the room, and it's hard to see visually those monitors. What we try to do with automation, make the data accessible right in front of the clinicians and the care team. So putting on that large monitor, there's a software capability there where they can customize kind of a cockpit view for the surgery. And that's -- those are some of the upcharge opportunities that we have over time to pull through more revenue per bed. And a lot of these will be, if you start to go up the scale in terms of what we're able to do on revenue per bed, it's going to be more on the higher acuity-type areas, like the OR, the ICU. And then the general floor is going to be probably more towards the low end of that range in terms of revenue per bed. So it all depends on the software modules that you have and the capabilities there, but also, we'll have opportunities to upcharge as we come out with more advanced algorithms to provide decision support for clinicians in the hospital as well.

And just remind us, if a hospital gets like the Cadillac package today for automation, how much is that per bed? And then could you preview -- you don't have to give us the launch time lines. But what are the kinds of things you can add over time to move up to, I think, the high end of your range is $5,000 per bed?

Yes. I think you're getting into -- as we continue to deploy more and more advanced algorithms, you are going to be up in the higher end of that range. Kind of the midpoint is where -- we size the market at around the $2,000 to $2,500 as far as the addressable market opportunity. And that's going to be more adding on the UniView, adding on Replica, for mobile alarm data management reporting -- or sorry, alarm management. And then we start to bring on things like Halo ION. Those are going to be some opportunities to bring on more capability and upcharge as well. Halo ION basically helps you baseline a patient's trended data. You can bring in as many parameters as you can think of, baseline that data because it's got a learning capability in the software that learns a baseline in realtime. And then if the patient deviates from that baseline, it can detect whether or not that patient is deteriorating or they're stable or if they have a disease condition that we need to be thinking about. So those are some of the capabilities [ we can upcharge ]. So Halo ION, UniView, Replica, all those capabilities can kind of get you up closer to that midpoint. And then as we deploy more advanced algorithms down the road, those are going to be capabilities that go up towards the higher end of that range.

Got it. And we're still getting some feedback. Is this getting better when it's like this way or like [ show me back to like before ].

We're not hearing anything feedback.

Okay. Great.

Yes.

I'll deal with it then. Talking about Halo ION specifically, what are you seeing with customers that have started using that [ help articulately ]. I know this can work in a clinical situation. What can it save a patient from? What kind of impact can it have from a clinical [ and plus ] perspective?

Yes, I want to kick this one over to Eli. So Eli, [ you want to ]...

Yes. Well, I can give you a part of an answer there, Matt. We're not disclosing the numbers of customers per Hospital Automation installation or per Hospital Automation component installation unfortunately because it's still a very nascent effort. Suffice to say, our total Masimo-brand Hospital Automation customers today are likely under 100, but growing rapidly. That's complemented by the over 400 customers we have acquired with the Connected Care acquisition last year. So we've got a sizable customer base. But what we can talk about is the actual benefit of Halo ION and the deployment settings for it. The ideal setting for it is in the ICU, where you have a critical care patient who is at risk of suffering from some kind of additional symptoms that could lead to deterioration. And by setting up Halo ION when [ it was ] first brought into the room, you establish that baseline, and then through some pretty sophisticated software engineering, you can assemble a conglomerate index out of many different vital signs as well as other inputs from the medical record. So if patient starts to develop changes in respiration rate, heart rate, blood pressure, if there's a certain pattern there that's a signature for some disease-state like sepsis or pneumonia, it will be flagged early. That will enable an earlier-than-usual intervention and a higher probability of a positive outcome through administration of an antibiotic or some other palliative therapy. So that's what we're hoping to see with broad deployment of Halo ION. But at this stage, any installations we have would be considered pilot stage.

Okay. Great. And we all know about the work that Dartmouth did and really helped to enable the patient safety monitoring that show the value there. What kind of stuff are you doing on evidence development for Halo ION into Hospital Automation. Could we see data or studies coming out that we should be paying attention to over the next year or 2?

Well, the analog for potential success for Halo ION would be the manual method of compiling early warning scores known as EWS systems, which are essentially based on an algorithm that uses simple algebra to apply weightings to different vital signs changes. So that was a system that was broadly used, especially in the U.K., to do patient tracking. And it's very cumbersome, it's also not continuous, and it's not realtime. And that's where the advantages of an automated software module to do that really come into play. So EWS is something you could look at, that established some pretty good traction out there historically, but it's going to take a while for us to achieve the same rate of adoption for Halo ION because it does require the full installation of the hardware associated with hospital automation, namely Root and Iris Gateway server. Now with Halo ION, you can put the display for of all the patients on one large video screen, even something like a 60-inch video display. And in that way, the nurses in the ICU could be tracking the typical number, 10 to 20 patients, all simultaneously. But as far as promotional efforts, it's just part of the overall package of the Masimo-brand Hospital Automation, and that's actually now being cross-sold to the Connected Care customers.

And Matt, just at a high level, I mean, in addition to the data that we're continuing to build for Hospital Automation, more importantly or just as importantly, is going to be the reference sites. And I think we've been able to gain some large systems. And those are going to be very important for us as reference sites to gain more broad adoption moving forward. And we've already made great progress, but those reference sites are going to be critical. If we can point other customers to those large institutions or those large systems to see what they're doing with improving workflows, having better patient handoffs, if you think about UniView: 60, where you can kind of get [ a mirror ] that patient right before you walk in the room within 60 seconds, know all the key vitals and all the data coming from that patient, and then also, Replica, being able to effectively manage across your care teams how you escalate alarms and alerts and how you respond to that patient. Those are the types of things that I think are going to be important for people to visually see just as much as the data that we're collecting. But Dartmouth was a great example. I mean just with Patient SafetyNet combined [ with SedLine ], Dartmouth saw, over a 10-year period, 0 dead in bed from opioid use on the general floor. They went from 25 beds, I think, to over 250 beds. And when they expanded that study, 0 dead in bed over 10 years and over a 50% reduction in rapid response team activations and ICU transfers, which translated into significant millions of dollars of savings per year for that hospital system. So those are the -- and that's just using those 2 components. If you start to bring in all the workflow capabilities of our automation suite, that alone should sell it. But then you start to bring all these other improvements, I think it's a pretty compelling offering we have.

Got it. It is impressive. You've gotten to [ realize ] at less than 100, but over a relatively short period of time [ with the pandemic customers really today ], could you talk about the ongoing [ interest ] with the funnel that you're seeing?

Yes. I mean we're continuously seeing good demand for automation. I think, like I said, I think, if anything, COVID probably accelerated the efforts in automation as well as the general floor by probably 2 or 3 years and just getting that awareness and customers willing to adapt. So the pipeline is very strong. And I think this is something -- you've seen over 1 year how much that's improved. And I think we've got a lot of great momentum moving forward. And I think that we're positioned very well from a competitive standpoint. I think if you look at our main competitors, where their focus right now and what their capabilities are is really around the medical device integration and connectivity. And what we do that really differentiates us -- differentiate Masimo is, we bring in the reporting, the analytics, the ability to manage realtime information, not just send it to the EMR where it takes 15 minutes to 30 minutes to get data back, we're managing realtime high-fidelity data with low latency. And its waveforms, parameters, alarms and events, video, audio and all that stuff, the way we can do it in realtime and be able to provide decision support with that data, that's what really separates us from the competition.

Got it. Why don't we switch gears and talk a little bit about what's on your risk there? So Masimo SafetyNet was a really interesting development last year with COVID, helped hospitals kind of keep their census clear and then people could convalesce at home. Could you talk about its ongoing use, the funnel there and some other use cases that we might see for it in the future?

Yes, absolutely. And Matt, when we launched this, it's primarily around helping with COVID patients. And it really helped hospital systems not only manage patients that are in the home, but also even in the hospital. They were able to put this on the wrist of a patient. The patient can be mobile, but they can be in the room, and they brought a lot of the monitors outside the room that keep workers safe and not have to worry about transmission risk. So there is utility in the hospital and even greater utility, I guess, in the home because they were able to monitor these patients remotely. With the wireless sensor here, you got all the medical-grade benefits from SET in terms of accuracy through motion and low perfusion, and that can feed the data back through a clinician portal, which is a software model that sits on the smartphone. And that can feed the data back to where they can be monitored remotely. And what that did was hospitals can free up bed capacity and focus on more higher-risk COVID patients and bring in the patients from home when they became more severe. So that was important. The revenues there, we said, was not -- was in the low millions in terms of each quarter. It ebbs and flows with the number of case counts. Where we see the bigger opportunity though is in longer-term [ primary ] diseases. And if you look at it, we were able to gain about 200 -- or 200 customers to use Masimo SafetyNet. And what's more important is a lot of those customers see their value clinically to monitor their patient population in the home, whether it's COPD or CHF. And if you look at those patient populations, for those 2 disease states alone, there's over 20 million patients a year with those diseases. So if you price that at $150 a kit, which is what we price the kit for Masimo SafetyNet, that's a $3 billion market opportunity we can go after over the long term. So we're working right now with the hospital systems and trying to figure out how do we manage those with care programs and care pathways and hopefully broaden this even further beyond those 2 primary diseases.

Yes. I think there's a lot more talk about hospital at home. And hospitals are trying to figure this out in terms of where reimbursement will be, [ where they think it will stick ]. What are some of the models you see emerging? And can you talk about where Masimo could fit in as -- if we do see that evolution occur over the next few years?

I'm sorry, Matt, I missed it. On which areas?

Just talking about hospital at home, broadly speaking. So I think you've talked about doing some product disease management, some other things, but I've seen a lot of hospitals just trying to figure out how this fits, especially economically. Is the reimbursement going to be there? What models do [ you see ] developing that hospitals could use near-term and longer-term if the reimbursement rate does change?

Yes. So when we look at the management of these patients, a lot of this is going to go through the hospital channel. And they're already set up to manage these patients through DRG and that kind of pathway as far as reimbursement. So this becomes more of a cost line item for the hospital. We don't see this as being as dependent on reimbursement like we do with Opioid SafetyNet, where you're dealing with more of the self-pay of the patient, kind of moving them onto reimbursement. So we are -- there's a lot of interest already that we're seeing with hospital systems to manage this as an expense line item of their -- of kind of the DRG for those patients. So -- and it just depends. I mean we're looking at a lot of different care pathways and care programs that we can deploy in the future, that could go well beyond these disease states and work more broadly in telehealth. So I think there's going to be a lot of opportunity to expand in this space for us. And the most important thing is the utility of SET, and it's the most accurate technology in terms of reading the key vital signs of patients who are -- it removes the motion artifact. You can measure through motion and low perfusion. And you can do that now mobilely in the home, with these mobile patients in the home. So I think that that's the enabling platform that positions us very well to build upon this and add things to the health kits and different things like that as we move forward.

Great. And you brought up my next topic, which is Opioid SafetyNet. So I've been waiting for that for a little while in the U.S. I just wanted to get your expectations on the timing. And then you have now started to move towards the EU launch. Maybe you could cover how that's going and how material you expect that to be.

Yes. So Matt, we -- if you look at Opioid SafetyNet, of course, things got delayed over the course of the past year. We ended up going back, we originally submitted the 510(k), we went back and submitted it as a de novo filing to kind of raise the bar for us. And we started -- we had already submitted the data in the hospital. As you know, we've got a lot of great data even with Dartmouth, where we're trying to monitor those patients on the general floor using opioids. We've submitted more data -- we're asked to submit more data outside the hospital, which it's always challenging, getting the number of patients you need there. But -- and then we continue to have ongoing dialogue with the FDA, and that's why it's very difficult on when we kind of meet that threshold, of when we can get approval for it. So I can't predict it. It's been a very -- it's been challenging for us. But what I can tell you is we've learned from this. And one thing we've done historically was always launched things in the U.S. first and then moved outside the U.S. This kind of made us revisit our strategy, and we're looking at moving this and commercializing outside the U.S. They're CE marking and really driving this in core markets in Europe as well as Canada. And that's kind of where we're taking it right now. So we've already built out a reimbursement team, and we've been building a commercial team in the U.S. And now, we're starting to build that out outside the U.S. right now. So we're building out the reimbursement capabilities there to go after reimbursement and understand what the mechanism will be in terms of the market for self-pay versus a full reimbursed model. And we're going after high-prescribing physicians and rehab clinics as kind of where we're -- our initial targets will be. So we're excited about the opportunity. If you size the U.S. market today, especially now that we got pricing out there for Masimo SafetyNet, we're going after in the U.S., about 45 million prescriptions a year. And that is really post-surgical patients and long-term chronic pain patients. Those 45 million prescriptions, using $150 per kit, which will probably be our low end, that size is a market of about $7 billion in the U.S. we can go after. We think that the market outside the U.S. is just as big. And we've started sizing those market opportunities, and we think it's going to be just as big when you combine everything outside the U.S. that we're going after. So this should be a great opportunity. Like I've said before, it's very important reimbursement in this space. And if we don't have something like an MCIT rule that comes through and gives us some earlier reimbursement, it could take 2 to 3 years to really get the reimbursement we need here. So the adoption could be shallow if it's self-pay, but reimbursement will help to drive that adoption. But I think the way to think about it is, we did not include anything in our guidance this year for a launch outside the U.S. or in the U.S. And those would be potential tailwinds. And I think that even if it's self-pay, it will start to build some revenues into 2022, but it's going to be very dependent on the reimbursement landscape and the willingness to self-pay in those different countries.

Understood. Okay. So we have a few minutes left. I want to cover a couple more topics. One is maybe you could just give us an update on the Philips partnership, talk about how that's going, where you are in the journey there. And are you seeing the kind of uptake of advanced parameters now that they have been incorporated that you would like to see?

Yes, absolutely. In terms of the partnership, we're seeing it -- success through the sales contracts that we've seen, gaining new business and new share. I would say that the -- one of the things too is we've expanded our markets outside the U.S. even since we initiated that contract with Philips. So that's been going well, especially outside the U.S., expanding the markets we're entering into. And we've already integrated rainbow. We've integrated capnography and O3. SedLine, we were hoping to integrate last year. That got delayed, of course, during the pandemic. But hopefully, that will get integrated in the next 6 to 12 months as well. But where we've integrated, we've seen good success with rainbow. Rainbow has been growing faster than our long-term growth rate of 10%. Our advanced parameters are growing faster than the 20% per year so far in the long-term plan. And a lot of strength is coming from capnography, and that's where Philips is helping in that partnership as well. So I think we've seen very good success. We're seeing it in the installed base and how we're shipping more drivers to Philips over the past few years. And that's been building nicely. And I think, overall, it's been a great success. And I think there's a lot of runway still ahead to gain share. And we think that even in the pulse oximetry market alone, with the relationship with Philips being 50% of the [ multiprimer ] monitoring market, we think we have the ability to take our share up probably another 20%, 25% over the long term through this relationship. So everything is going -- tracking very well.

Understood. And have you seen anything change in the competitive environment for the core SET products? Anything coming out from your competitors that you're concerned about?

We haven't seen really anything in terms of pulse oximetry, even all the core parameters. If anything, where we see the most competitive landscape is more in automation, but it's still very greenfield. I think there's opportunities for competition here because everybody is going after building out this market, and it's still very early stages. So -- but in terms of the parameter side, we're not really seeing any new innovation there. But like I said, with automation, I think there's -- with Philips, Hill-Rom, they've acquired companies that have helped them build out their medical device integration connectivity platforms. Again, where we're differentiating is really in what we can do with all the data. But that's where we probably see the most competition.

Okay. Super. And there's a few others that I haven't asked about, like Lidco, TNI, NantHealth. Maybe a fun way to ask this question is which one of those are you most excited about or you think is most underappreciated by investors?

All 3 of them are great acquisitions, and we're lucky to say that because acquisitions are always tough. I would say, as far as synergies with our business, I would say probably, I think Lidco, with the capability moving forward, I would put Lidco probably at the top. And that's only because if you combine cardiac output monitoring and measurements with our rainbow, where you can measure oxygen delivery and PVi for fluid responsiveness, you've got a full solution set for hemodynamic monitoring. And that's a big market. We think this total addressable market can be $1 billion for us. So I think that's a big opportunity. Plus, it's right in the wheelhouse as far as leveraging our clinical and commercial footprint. We're already right there where the high-risk, high-blood loss surgeries are in terms of the -- how we can leverage that. So I think that's going to be a great opportunity as we move into 2022 and beyond, especially as we integrate the technologies into that solution set and make it more kind of a Masimo solution in terms of how the look and the feel, the hardware, the software, all those components. So I think that's number one. I'm excited about TNI, but Connected Care is a great acquisition because we increased the critical mass of our commercial footprint there. It's a different call point. You're going after the C-suite, you're going after the IT biomet areas of the hospital. That really helped fortify our position with our commercial team. And it also increased our device library. We now have the largest, what I believe, is the largest data libraries in the industry. We can connect over 1,000 devices now through bringing on the HBox platform, the former iSirona-type hub, and integrating that into our solutions. And actually, I've got the new iSirona with the Masimo brand here. This is what the hub looks like. A smaller version of Root, Root [ is a ] connectivity platform that has a lot more capability, but this gives us smaller-scale connectivity into the EMR. So...

You can see the ports right here where things get plugged in.

So yes. So I would say Lidco -- all 3 are great acquisitions for us. And I think what it really highlights is the importance of leveraging our commercial footprint with great technologies, and that's what we've been doing pretty well with these acquisitions.

Fantastic. Well, guys, we're almost out of time. [ Maybe I'll just ] give you a chance, [ if you want, to leave investors with any parting ] thoughts, what do you want them to take home about Masimo and your opportunities there.

Yes. I think what I would say is I think we're a stronger -- we have a stronger foundation than we did even pre-COVID. I mean a lot of people may have looked at us as we benefited a lot from COVID and in the moment, and I think it's more longer-term than that. I think we have a stronger foundation. Our installed base has grown substantially over the last year. That gives us a greater opportunity to drive recurring revenues in the future and pulling through more revenues across our solution set. And I think it's definitely advanced monitoring to the general floor and other lower acuity settings of the hospitals, which we will benefit in years to come. And automation, hospitals need to become more efficient, more productive, and I think that we've got the great solution set there to really drive that. And I think that that's driven more awareness of our capability as well as what's needed in the hospital systems. And I think, lastly, is I think what's -- the misperception of Masimo sometimes is that we are a pulse ox company or we're a hospital monitoring company. We are much more rich than that. And if you look at it, we can manage data across the continuum of care, whether it's in the hospital, all the way into the home. And I think that's what really sets us apart on top of the platforms and the products that we offer. So I'll close at that. But thank you, Matt. We appreciate the time and the opportunity to speak today.

Thanks, guys. Appreciate you being here, too. That's a great place to end. And good luck with the rest of the year here. I hope to see you in person soon.

All right. Sounds good. Thanks, Matt.

All right. So long.

All right.

[ And take care ]. Bye.