Nordhealth AS (NORDH.OL) Earnings Call Transcript & Summary

Hi, everyone, and welcome to the Nordhealth Investor Presentation for Q3 2025. As usual, we'll have myself, Charles MacBain, the CEO of Nordhealth; and my colleague, Alex, our CFO, go through this presentation. So we'll start off with the company update, then we'll go to Veterinary business unit update and Therapy business unit update, then Alex will go through the financial updates, and we'll leave some time at the end for questions. So please hold your questions until the Q&A session. On the company update. So the last couple of years, we have grown at a CAGR of 47% to a signed ARR of 46.5 million at the end of Q3 2025. As you can see, the majority of this growth has come from organic ARR growth, but some as well in 2019, 2021 and 2022 from M&A. Looking at the year-over-year growth, we grew 10.6% in the ending Q3 2025. 10.7% was net upsell, primarily driven by Provet expansion. Then you can also see that Provet Cloud signed non-implemented ARR is 1.6 million, which does not as well include the Vets 4 Pets and AmeriVet ARR from rollout, which is around EUR 4.5 million. Our churn rate is around 4% per annum. Looking at how we unpack growth over periods of time, you can see that this -- in the last 12 months ending Q3 2025, our implemented ARR growth was 10.6%. New customers accounted for 3.9%. Net upsell was 10.7%. Churn rate was 4%, and this leads to a net retention rate of around 107% and then lifetime value to CAC ratio of 16.4%. What's noticeable is that the net upsell is lower than historical as we have not rolled out any large veterinary enterprise customers this year, like we have, for example, in 2024 and 2023. From an EBITDA minus CapEx perspective, we actually have been reaccelerating our investments in R&D to take advantage of the growth opportunities. There are 2 specific growth opportunities we'll discuss later, but the primary one is investments in building up a DACH team to be able to migrate Vetera, but also win additional new customers in Germany, Austria and Switzerland. The second is investments in adding AI capabilities to all of our practice management softwares. On the Veterinary side, we signed about 0.5 million of new customer ARR in Q3. We actually implemented all of Pet Vet 365's 35 clinics, and this was completed in Q3 2025. Our clinical AI add-on was launched in August, and we've got already 122 paying vets signed up at the end of Q3 2025. And our priorities remain: one, winning enterprise deals in growth markets; second, continuing the implementation of large enterprise clients underway, notably AmeriVet and Vets 4 Pets. Three, it's migrating legacy platforms of Sanimalis and Vetvision. And soon, fourth will be the DACH localization. So we've got the team in place now to be able to localize the product for the DACH region, starting with Austria, then Germany, then Switzerland. And once those are done, we'll slowly be starting the migration of Vetra. We've already migrated a few clinics already in Austria, pilot customers, and then we'll go on to Germany. There's significant interest from enterprise in Germany for new cloud software. And last but not least, we've been investing a lot in modernizing and improving the user experience of our core products and adding AI features to be able to make workflows in vet clinics faster. Breaking down the growth over the last 12 months ending Q3 2025, we grew 13.3%. Our net retention rate was around 110%, and this is primarily driven by enterprise clients rolling out new clinics. Our churn remains very low at around 3% -- important to note, as I mentioned on the first few slides is that Vets 4 Pets and AmeriVet post-pilot rollout AR is not included in the EUR 1.6 million, and that's estimated around EUR 4.5 million. Breaking down the growth of 13.3% new customer account for 3.4%. This is lower than previous year's, but net upsell was 12.8%, again, lower than 2024, given the fact that we haven't implemented many new enterprise customers, but our churn remains very low and has dropped to 3% from 4.8% in 2024. Our net retention rate stays strong at around 110%. And LTV [indiscernible ] is incredibly strong at 24.4% Looking at profitability at Veterinary BU. We've invested a EUR 1.3 million additional in R&D and CAC, but that's been mostly offset by EUR 1.5 million in additional cash flow generated from growing our revenue base. The R&D activities have been mostly focused around AI investments and also the DACH localization. Breaking down the revenue by country over time, you can see that we have successfully been able to grow outside the Nordics, whereas the majority of our revenue in 2021 came from the Nordics, EUR 9.4 million of EUR 10 million. Now more than half our business is from outside the Nordics with the U.K. being a very strong growth driver. Now taking a look at the type of customers and that accounts for our growth, we can see that the majority of our growth has actually been powered by enterprise. And so Pro Vet is a very strong -- has a very strong value proposition for enterprise customers or consolidators in Europe, but also in the U.S. In addition, you can see that we've also built up a very strong partner ecosystem and payments infrastructure that enables us to have 3.3 million from those revenue sources. But despite the fact that we've got 12.1 million of enterprise revenue, our top 3 customers compose less than 22% of our ARR. So we've got quite low customer concentration risks. We discussed many times the migrations of Sanimalis, Vetserve and soon Vetvision this year and soon Vetera as well. And you can see that whereas the majority of our revenue was on non-cloud in 2021. Now the vast majority is on our Provet software. So we've successfully proven that we can actually migrate clinics that we've acquired historically. On the Therapy side, we've migrated at the end of September, 333 Aspit customers to the unified platform. The entire platform is a much faster and cleaner software for our users, and we continue to migrate Aspit users every week. 1,000 users, which is still less than 5% of practitioners have activated the AI assistant. And we've delivered over 60,000 AI-generated summaries over 27,000 hours of transcribed in Q3 2023. And what's been really impressive is that our conversion rate from free trials has been 20%. Our signed ARR in Q3 has been 307 and the priorities remain twofold. First is the Aspit user migration to the unified platform. Second, we've been continuously developing our AI product and be able to sign up new practitioners to AI product. Looking at the growth, our focus has been on migration and less so on growth beyond the AI products. We grew 6.4% year-over-year. What we can see is our net retention rate is just above 100% at 102% and our churn rate is decreasing at 5.6%. Breaking down that growth, you can see that, as I mentioned, one is our net upsell is up versus 2023 and 2024. This is mainly driven by the fact that we have an AI product now to upsell. We haven't been focusing much on growth, which you can see from the 4.7% growth in as we're focusing mostly on migration. And our churn rate has -- despite the fact that we're migrating, has remained at around 5.6%. For LTV to CAC is 9.1%. Here, you can see from EBITDA minus CapEx perspective that our growth generated EUR 0.7 million additional cash flow, but we spent EUR 1.9 million in additional R&D and customer acquisition costs to be able to accelerate the migration and the AI growth. The reason we decided to do that is that the faster we're able to migrate, the faster we're able to get EUR 2.8 million in annual savings and the more customers we can have to be able to upsell our AI Scribe features to. As you can see, we're starting to make dent on the migration, and you can see this in Q3 2025. Now over to Alex for the financial update.

Thanks, Charles, and hello, everyone. So jumping straight into reported revenue. In Q3 2025, we did EUR 12.9 million of revenue, which is a 15.2% increase versus the same quarter last year. Our underlying recurring revenue growth was 10.8%, going from EUR 10.4 million in Q3 2024 to EUR 11.5 million in Q3 2025. The Q3 year-on-year increase in other revenue comes from implementation revenue linked to current enterprise rollouts. By Q3 last year, we had completed most of the rollout of CVS and so the largest implementation revenues related to CVS were in Q1 and Q2 in 2024. This also explains why the Q3 2025 share of recurring revenue is 80.89%, slightly below the 92.6% share in Q3 2024. For Q3 year-to-date reported revenues, the total reported revenue grew by 14% on the next slide from EUR 33.6 million in 2024 to EUR 33.8 million in 2025. Year-to-date, our implementation revenue, if we can just move on to the next slide, please. Year-to-date, our implementation revenue has been relatively similar between 2024 and 2025. And so our increasing base of recurring revenue has meant that our share of recurring revenue has gone up from 87.8% in 2024 to 88.4% in 2025. I'd also like to highlight that our core Veterinary and Therapy business units continue to outperform our smaller other businesses. So when we strip out the other businesses, recurring revenue for the 2 core business units has actually grown by 16.6% year-on-year. Now on the next slide, quarterly adjusted EBITDA minus CapEx. In Q3 2025, we reduced by EUR 0.3 million year-on-year to an adjusted EBITDA minus CapEx of negative EUR 0.2 million. Recurring revenue grew by 1.1 million year-on-year. COGS and customer service also grew by EUR 0.9 million. The growth in these direct costs is higher than proportional to the revenue growth due to the temporary need for extra client support for the early migrated Therapy clients. The largest item impacting adjusted EBITDA minus CapEx is product development expenditure, which has grown by EUR 0.8 million year-on-year. As we announced earlier this year, we've taken the decision to step up our investments in product development for AI feature development and DACH localization. Year-to-date, for Q3 2025, total adjusted EBITDA minus CapEx was negative EUR 2 million compared to negative EUR 0.7 million in 2024. The year-to-date adjusted EBITDA minus CapEx changes are also related to increased product development spend, where we have spent EUR 2.6 million more year-to-date in 2025 than we did in 2024. We've also increased our sales and marketing investments by EUR 0.3 million to help accelerate growth in our target markets. Looking now at cash flow. In Q3 2025 year-to-date, we had a cash outflow of EUR 1.6 million, which is an improvement of EUR 0.5 million compared to 2024. The year-to-date improvement is primarily driven by the EUR 1.3 million adverse movement in adjusted EBITDA minus CapEx, offset by EUR 0.7 million of favorable movements in trade debtors as we've been improving collections and also by a EUR 1.1 million favorable sum of other working capital movements, including other items affecting profitability, noncash items and improved operating working capital. Finally, looking at the September 2025 balance sheet. Cash as at September is EUR 16.5 million, of which EUR 12.1 million is in money market funds. There were no changes to goodwill in Q3 2025, except amortization and changes due to FX. There was no external financing taken in Q3 2025. We did complete a share buyback in July, where we bought 300,000 shares for NOK 36. So this gave us an additional EUR 0.9 million of treasury shares. Nordhealth's equity balance remains healthy at EUR 65.4 million, and the company has no interest-bearing debt. The full detailed financial statements for Q3 2025, including the P&L, the balance sheet and the cash flow are all included in the appendices. So now on to guidance. We're reiterating our full year 2025 guidance on Vet plus Therapy recurring revenue based on December 2024 constant currency and excluding acquisitions of 12% to 17% growth. Our Q3 year-to-date 2025 actual is 16.6% growth. Similarly, for adjusted EBITDA minus CapEx, we're again reiterating our full year guidance of between negative EUR 4 million and negative EUR 2 million, excluding acquisitions. Our Q3 year-to-date 2025 actual is negative EUR 2 million. And we will be presenting guidance for 2026 at the Q4 2025 results presentation. Lastly, regarding the financial calendar, the Q4 and full year 2025 results will be presented on the 3rd of March 2026, and we'll publish the full financial calendar for 2026 on the website before the 31st of December. I'll now turn it back to Charles for Q&A.

Thank you very much, Alex. Now off to Q&A. So feel free to ask questions by raising your hand or just asking questions in the chat as well that we can answer. So we got one question now. I'll repeat the question, and then I'll either answer it or have Alex answer it on my behalf. The first question is, could you quantify the current revenue contribution from your newly launched AI features even if it's small at this stage? And looking ahead to 2026, how material do you expect AI-related upselling to be for overall ARR? We haven't broken down the ARR revenue yet by business units. As it comes more substantial, we might look to do that. The -- currently, if we look at the pricing of the AI Scribe loan relative to the pricing of the practice management software, it can be 50% higher than -- it can add 50% more to our ARR. That means if someone pays, for example, 100, they could pay EUR 150 for including the AI features. And that's just for the AI Scribe. In addition, we're looking at expanding beyond that into an AI receptionist where you'll be able to pay their tickets, but we see a significant opportunity to be able to grow average revenue per user over the coming years. Adoption will over time increase. And we don't see any reason why the vast majority of our users should not be using our AI tools. The only risk to that is that we've seen over time, the price for AI Scribes in the market going down, where they used to be at EUR 129 per user. Now we're seeing the average price go down a bit. It's somewhat stabilized, but it's between EUR 50 and EUR 75 now for stand-alone AI. Next question is, there have been reports of increased downtime of COVID in Europe recently, which has negatively impacted your customers' ability to run their operations. What have the issues been? And what are you doing to address them? Yes, AWS has had issues in -- which is our provider that we use for hosting on the product side. So there were 2 separate issues that happened. One was AWS East going down, which affected some of our integrations. And the second one was the AWS error. So these AWS took responsibility for those. What we've done is working with them to try to make sure that does not happen anymore. We've also -- in addition, just we split the database into multiple different smaller environments so that if ever there is an error again, it doesn't affect all environments. The next is regarding your 2023 Capital Markets Day targets, you guided around 20% EBITDA minus CapEx margins by 2027. Are you still confident in reaching that goal? And what are the main drivers supporting that confidence? Our targets for -- that we said in the Capital Markets Day, we have not updated those and those are still the current targets. Given the -- there's always a trade-off between growth and profitability. And with our investment in AI, we could be able to not only have more revenue, but also can have a huge impact in terms of operations as well. So for example, customer service costs as a percentage of revenue could go down. The amount of people we need to be able to develop the same amount of code is not as much. So we don't have to hire as many net new people. There's huge opportunities as well in implementation to be able to automate a lot of the work there. So yes, these are still valid targets. So a question on, are you considering any measures to improve liquidity of the Nordhealth share, for instance, through increased investor outreach, changing in listing [indiscernible] or other initiatives? We did mention during the IPO and we reiterated during the Capital Markets Day that we are looking to do an upmarket listing. Step one of that will be to shift from Norwegian GAAP to IFRS and step 2 will be to actually migrate an uplist. We haven't made a final decision yet on the market and that we would uplist, and we have not yet given timing on the uplisting. But that is still our intention. There's -- you own and control more than 50% of Nordhealth. Given the potential role conflicts impact on Board compensation, why would you accept 2.4 million shares option to be incentivized on share price? There is a -- first, I do not control 50%. I control around 40% of the Nordhealth shares. I'm not sure what the conflict is there. The -- I'm not on the -- actually the Board of Nordhealth. The Board is made up of intentionally Aviana, who is a major shareholder, Philippe Vimard and also Didier Breton. And there are 2 independent Board members in addition to [indiscernible], who works the company, and they make decisions on compensation. In terms of the why share-based is the -- given that I have had liquidity, I prefer to shift most of my compensation to shares, not to cash so I'm fully aligned with the shareholders. Next is a question from Torbjorn on quite a large sequential step down in gross margin. Is this solely driven by Aspit migrations? Or there are other contributing factors? How many customers remain on Aspit? And how should we think about timing with regard to finalization of migration? On the first one, there are 2 things affecting gross margins. One has been on Aspit. The legacy solution is increasingly more expensive to maintain as the cost to host it on Citrix, for example, the Microsoft license fees cost have increased quite substantially. The second has been on the Vetera side, we've also been increasing the amount that we're spending on customer service to be able to improve the quality of customer service. The -- on how many customers remain on Aspit, we have migrated, as we said, 333, and there's around over 7,000 users on Aspit. So there's still a significant amount of users still on the legacy platform. Our strategy for migration is to break up the customers in the different user segments and migrate one segment at a time, ensuring that each segment that we migrate are happy. We have not provided a final time on migration as it's really hard for us to assess exactly when each of these segments will be happy. Also, it's intentional that we don't set an end of life until we've got clear visibility on a full product market fit for each of the segments. Otherwise, it does worry the market where word of mouth is incredibly powerful. Why are Vets 4 Pets and AmeriVet not yet included in the signed ARR? For Vets 4 Pets and AmeriVet and all other enterprises, we only add them to sign the ARR when we have a pilot completion, and we've got a rollout plan agreed with them, just to be conservative. The next question is, what is your progress and status on the multiyear effort of making Provet best-in-class on user experience and efficiency in terms of number of clicks and for the most common operations? There are -- our goal for Provet is to make it the best software in terms of the speed at which a workflow is completing, right? So -- and there are 2 levers we have for this. I'll give you a good example. In the -- one is improving UX. So figuring out what is the most efficient path that a user can take to complete action. And second, with the new lever that we have in AI, we can also think about can we completely rethink this path. Good example is a consultation page where historically, you have the open consultation page, add clinical notes, add the weight, add vitals, add a diagnosis, now typing into different fields and so on. Now you can just press one button, activate the AI Scribe. It not only writes all your text, which is what's currently out now for customers, but the next version coming out, it figures out if you're adding medicines, adding diagnosis, titles and so on, and that can fully automate that process. So it would be one-click consultation. So it's a very exciting time and the ability for PIMS to be able to dramatically improve efficiency is heightened now. Yes. So there's a question on -- and you could also comment on the current competitive landscape, both from new AI native applications and from other EHR providers across your Veterinary and Therapy segments. Yes. So we -- in terms of AI native applications, there are 2 different types. There's AI Scribes and there's hundreds of AI Scribes in the market. In the end, they're just a wrapper over an AI model. They do have some good functionalities to make it specific for their specialties. But I do not believe that these AI Scribes in the end will become a standard part of practice management softwares. There won't be a separate software. We've seen this again and again historically. For example, online booking used to be a separate add-on with separate parties. Now it's a core part of any practice management software. Given the data is -- lives in the practice management software, AI scribe only has the history that it sees from this one consultation. We've got the full view of that patient's history. And so not only for the AI Scribe, but also, for example, patient history summarization, we're in a prime position to be able to win. However, there are some AI native practice management software, which are popping up. We're seeing some in the U.K., for example, and another one in Continental Europe on the Veterinary side. On the Therapy side, there is a lot of regulation and -- a lot more regulation on veterinary. And so we're not seeing as much AI native practice management software in the markets we operate in. There's a question, when do we plan to reignite the growth in the Therapy segment? So I learned a hard way to focus on one thing at a time to get that done. So when I first started the business, we were focusing on -- we went in too many countries at the same time, and so it diluted our efforts. And diluting your efforts mean when you face a localization means that you have to go after one user segment and make sure you're localized in the next one and the next one and so on. And so if you spread yourself too thin, you're very -- the pace at which you can fulfill a problem that you encounter is much slowed down because you're working on multiple fronts. So on Therapy, we want to make sure we nail this migration. And then once the migration is done, right, from a product perspective, we can focus on the next growth market. This is a very similar path that we took on the Veterinary side as well, where we're going into net new market one after the next. The issue we have in Therapy is that instead of spending sales and marketing dollars to actually acquire those customers, we pre-acquired them by the acquisition, and now we're rolling them out. So Great. Any other questions? Perfect. Well, thank you very much, and thanks for the engaging questions, and we will see you all next quarter. Thank you. Bye.