Integer Holdings Corporation (NYSE:ITGR) Q4 2023 Earnings Call Transcript
Integer Holdings Corporation (NYSE:ITGR) Q4 2023 Earnings Call Transcript February 15, 2024
Integer Holdings Corporation beats earnings expectations. Reported EPS is $1.39, expectations were $1.34. Integer Holdings Corporation isn’t one of the 30 most popular stocks among hedge funds at the end of the third quarter (see the details here).
Operator: Hello, and welcome to the Q4 2023 Integer Holdings Corporation Earnings Call. All lines have been placed on mute to prevent any background noise. After the speakers' remarks, there will be a question-and-answer session. [Operator Instructions]. I will now turn the conference over to Andrew Senn, Senior Vice President, Strategy and Business Development and Investor Relations. Please go ahead.
Andrew Senn: Good morning, everyone. Thank you for joining us, and welcome to Integer's fourth quarter 2023 earnings conference call. With me today are Joe Dziedzic, President and Chief Executive Officer; and Diron Smith, Executive Vice President and Chief Financial Officer. As a reminder, the results and the data we discuss today reflect the consolidated results of Integer for the periods indicated. During our call, we will discuss some non-GAAP financial measures. For reconciliation of these non-GAAP financial measures, please refer to the appendix of today's presentation, today's earnings press release and the trending schedules, which are all available on our website at integer.net. Please note that today's presentation includes forward-looking statements.
Please refer to the company's SEC filings for a discussion of the risk factors that could cause our actual results to differ materially. On today's call, Joe will provide his opening comments and an update on Integer's strategy, followed by an overview of how Integer will sustain above-market growth. Diron will then review our adjusted financial results for the fourth quarter and full-year 2023 and provide our full-year 2024 outlook. Joe will come back to provide his closing remarks, and then we'll open the call for questions. With that, I will turn the call over to Joe.
Joe Dziedzic: Thank you, Andrew and thank you to everyone for joining the call today. We had a strong fourth quarter and an even stronger full-year. 2023 sales were up 16%, and adjusted operating income grew by 26% over 2022. We were able to grow sales at a rate significantly above the market rate while expanding operating margin by 117 basis points. Adjusted operating income grew at 1.6x the rate of sales growth approaching our strategic target of 2x. We expect this strong performance to continue in 2024 with an outlook of 9% to 11% sales growth and adjusted operating income growth of 13% to 20%. We are confident in sustaining above-market sales growth in 2024 and beyond. We acquired Pulse Technologies on January 5, which deepens our precision micromachining capabilities and further strengthens our pipeline in high-growth markets like electrophysiology, structural heart and heart pumps.
Integer continues to execute our strategy to deliver sustained outperformance. Our portfolio and product line strategies position us for sustained above-market growth as we continue to shift the mix of our business to higher growth markets. The previously announced exit of our Portable Medical product line, which has limited technology differentiation and low growth is proceeding as planned. We continue to make targeted organic and inorganic investments in capabilities and capacity to enable our growth. The supply chain and labor environments have meaningfully improved, and we have refocused our organization to execute our operational strategy to expand margins. During the JPMorgan Healthcare Conference earlier this year, we publicly announced the acquisition of Pulse Technologies, our fourth tuck-in acquisition in 25 months.
The acquisitions of Oscor, Aran Biomedical, InNeuroCo and Pulse Technologies have strengthened Integer's position in high-growth markets while adding differentiated capabilities for our customers. Our acquisitions further our vertical integration strategy and help our customers consolidate and simplify their supply chains. In addition to the strategic benefits, these four acquisitions generate annualized sales of approximately $170 million with accretive margins. Oscor and Aran were meaningful contributors to our sales and profit growth in 2023, and I look forward to InNeuroCo and Pulse being equally as successful as we integrate these differentiated businesses. Integer acquired Pulse Technologies on January 5, 2024 for approximately $140 million, with the potential for an additional earnout in 2025 based on revenue growth.
We paid less than 13x trailing adjusted EBITDA multiple or just over 11x after considering the $15 million net present value tax benefit. Pulse deepens Integer's capabilities in precision micro machining and further strengthens our pipeline in high-growth markets. We welcome the 250 talented associates in Quakertown, Pennsylvania to the Integer family. Pulse has been a long-standing strategic supplier of critical components to leading MedTech OEMs. Their focus on high-growth markets and products, along with excellent customer relationships, aligned perfectly with Integer's strategy. We developed our portfolio strategy in 2017 and formed the growth teams in 2018. These market-focused teams have executed a structured and disciplined approach across the organization to shift our pipeline to high-growth products and markets, expand our capabilities and ensure our investments are aligned to our strategy.
These product line strategies have generated a strong product development pipeline that is delivering results and positions us for sustained above-market growth. This structured and disciplined process has been and will continue to be critical to Integer achieving sustained outperformance. We continue to invest in the highest growth C&V markets, the same markets where our customers are investing and the areas with the greatest unmet clinical need. Integer is uniquely positioned to serve our customers across all phases of the product life cycle because of our deep technology, breadth of capabilities and products, global manufacturing footprint and vertical integration. The products on the bottom of the slide highlight areas of continued investment in capabilities and capacity.
Our 2023 C&V growth and product development pipeline are concentrated in these high-growth end markets. We also continue to invest in the differentiated capabilities that serve both our traditional cardiac rhythm management and emerging neuromodulation products, including the high-growth subsegments within cardiac rhythm management. Integer is uniquely positioned to be able to bring full design, development and high-volume manufacturing to these customers, while also vertically integrating the most technologically advanced components with our own intellectual property from decades of innovation. Very few other companies have the breadth of design and development capabilities and even fewer offer the depth of component technology that Integer offers to our neuromodulation customers.
The products on the bottom of the slide highlight the high-growth areas of CRM&N that contributed to our growth in 2023. Our product development pipeline is concentrated in these same high-growth end markets. Integer partners with our customers to bring innovative medical technologies to market, and we are paid for this service throughout the product development cycle. As life-saving and life-enhancing products are introduced to the market and enter the manufacturing ramp phase, Integer benefits from accelerated sales growth. The amount of product development sales and the market growth rate of the products being developed are leading indicators for sustained above-market sales growth. Our product development sales have increased 230% since we developed our strategy in 2017, which means our pipeline of new programs has grown significantly and we are being designed into our customers' novel products.
We are confident that the current level of development revenue will continue to deliver sustained above-market growth. We have continued to strategically target product development opportunities in high-growth markets to accelerate our growth rate on a sustainable basis. 80% of our development sales are currently in high-growth markets, with the remaining 20% in more mature markets. We continue to believe the mix of 80% high growth and 20% mature markets is the appropriate balance to accelerate our sales growth rate while sustaining our mature products for the benefits they deliver to our customers and Integer. The development cycle in our industry is relatively long. So it is a meaningful milestone for us to achieve the level of product development sales and program mix necessary to sustain above-market growth.
We are excited to share our fourth annual update on emerging PMA customers. We presented this slide for the first time on our earnings call in the third quarter of 2020. These PMA customers are primarily single product, highly novel and innovative and bring emerging neuromodulation therapies to market. We have been investing in this pipeline of PMA products for many years, and the advancement of these programs is a key contributor to our above-market sales growth. The left-hand side of this slide shows the number of customers we are working with at each phase of the product development process. The right-hand side highlights the actual sales generated in 2018, 2020 and 2022 for the nine customers who are in either product introduction or launched since 2020.
We are increasing our 2024 sales projection to a range of $100 million to $120 million, which is the second consecutive year we have done so. This is the result of the success in the market for these novel therapies and demonstrates our strong pipeline of high-growth products that contribute to sustained above-market growth. In addition to our organic pipeline, we have just demonstrated that we can consistently execute tuck-in acquisitions that enhance our capabilities and are accretive to our sales growth rate and profit margins. We are very targeted in the companies that we pursue and have remained disciplined relative to our acquisition criteria. We continue to cultivate relationships with a robust pipeline of founder-led and privately owned businesses.
We are confident we can continue to add 200 to 400 basis points of inorganic sales growth on an annual basis by deploying $250 million to $300 million on acquisitions while maintaining a debt leverage of 2.5x to 3.5x adjusted EBITDA. Prior to the development and implementation of our strategy, Integer was growing at about the market growth rate of 5%. I have highlighted how growth starts with product development, which is our focused strategy to get designed in to our customers most strategic products in high-growth markets, which is demonstrated by our product development sales growth of 230%, and 80% of our development portfolio is in high-growth markets. These key metrics reinforce why we remain confident. We have the organic pipeline to deliver sustained organic growth of 200 basis points above the market.
Our acquisition strategy has added significant capability, depth and breadth so we can better serve our customers in high-growth markets. Our recent acquisitions have also added to our organic pipeline and provided sales and profit acceleration. Going forward, we expect to add 200 to 400 basis points of growth annually from acquisitions. Our focused strategy, combined with our organic and inorganic investments have generated a strong product development pipeline and the most vertically integrated provider to our customers in the fastest-growing end markets. This gives us confidence we can sustainably grow sales high single-digit to low-double-digit going forward. The strategy that we launched in 2018 is producing results and has helped Integer accomplish its vision of being our customers' partner of choice for innovative medical technologies and services.
I'll now turn the call over to Diron.
Diron Smith: Thank you, Joe. Good morning, everyone and thank you again for joining today's discussion. I'll provide more details on the fourth quarter and full-year 2023 adjusted financial results and provide our 2024 outlook. It is important to note, fourth quarter results are not impacted by our acquisition of Pulse Technologies, while the full-year 2024 outlook includes this acquisition. We ended our year strong and delivered fourth quarter results at the high end of our October 26, 2023 outlook. With sales of $413 million, Integer delivered 11% year-over-year sales growth on a reported basis and 9% on an organic basis which excludes the impact of our fourth quarter and InNeuroCo acquisition, the strategic exit of the portable medical market and foreign currency fluctuations.
Our sales performance reflects the continued strong customer demand across our targeted growth markets and the ongoing improvements in the supply chain environment. We delivered $86 million of adjusted EBITDA, up $13 million compared to the prior year or an increase of 18%. Adjusted operating income also increased 18% versus last year. We continue to make progress on our year-over-year margin expansion. Compared to the prior year, adjusted operating income as a percent of sales increased to 16.4%, a 97 basis point improvement driven by gross margin expansion, volume leverage and efficiencies gained from the continued improvement in the supply chain. With adjusted net income at $47 million, we delivered $1.39 of adjusted diluted earnings per share, up $0.28 or 25% from the fourth quarter 2022.
With our strong performance in the fourth quarter, our full-year financial results were at the high end of our 2023 earnings outlook. Sales were $1.597 billion which is a strong year-over-year increase of 16% or 15% organically. Adjusted EBITDA was $309 million, up 21% versus last year, and adjusted operating income was $241 million, up $50 million or 26% compared to the prior year. We delivered $158 million of adjusted net income and $4.67 of adjusted diluted earnings per share, up $0.79 or 20% from the prior year. I will touch on the year-over-year growth in adjusted net income in a few moments. Taking a closer look at our C&V and CRM&N product line sales, we delivered strong year-over-year growth on a trailing 4-quarter basis in the fourth quarter of 2023.
For our Cardio & Vascular product line, trailing 4-quarter sales increased 20% year-over-year with double-digit growth across all C&V markets. This was driven by strong demand, acquisition performance and supply chain improvements. Cardiac Rhythm Management & Neuromodulation's trailing 4-quarter sales increased 15% year-over-year. This was driven by double-digit CRM growth from strong customer demand, double-digit neuromodulation growth from emerging customers and supply chain improvements. Further product line details are included in the appendix of the presentation on our website at integer.net. To provide more color on our full-year 2023 performance, we increased adjusted net income by $28 million compared to 2022. Strong sales and operational improvements delivered $42 million equivalent to $1.19 per share, which was partially offset by foreign exchange as well as higher interest and taxes.
We incurred adjusted total interest expense of approximately $10 million or $9 million tax affected higher than last year. This is due to a combination of higher debt balance driven by $50 million in costs associated with the convertible notes issued in the first quarter of 2023 and overall higher effective interest rates. Our adjusted effective tax rate was 17.7% for the full-year 2023 compared to 16.1% in the prior year. As described in last quarter's earnings call, the primary driver of our higher adjusted effective tax rate compared to the prior year is the expiration of the 10-year Malaysian tax holiday. For 2024, we expect our adjusted effective tax rate to be between 19% to 21%. This increase is mostly driven by the recently enacted Pillar 2 legislation in Europe establishing a minimum effective tax rate of 15% and the residual effect of the Malaysian tax holiday expiration.
We delivered another quarter of strong conversion of income to cash in the fourth quarter of 2023 with $56 million of cash flow from operations. This strong performance was driven by high sales volumes and improving margins. In the fourth quarter, we generated $19 million in free cash flow, inclusive of $37 million of capital expenditures. On a full-year basis, this equates to $180 million in cash flow from operating activities, a 55% increase versus 2022. Our full-year free cash flow of $60 million reflects $120 million in capital expenditures, which is in line with our outlook throughout the year. Net total debt ended at $950 million for the fourth quarter of 2023, an increase of $26 million compared to the third quarter ending balance. This reflects an increase in debt of $42 million to fund our fourth quarter acquisition of InNeuroCo and another $8 million for earn-out payments on previous acquisitions, partially offset by other decreases of $24 million.
Net total debt leverage at the end of the fourth quarter 2023 was 3.1x trailing 4-quarter adjusted EBITDA, which is within our strategic target range and down from 3.5x at the end of 2022. We will now transition to providing more detail on our outlook for 2024, sales, profit and cash. The full-year outlook, as summarized earlier, reflects our strategy to deliver sustained above-market growth with expanding margins. We expect 2024 sales to be in the range of $1.735 billion to $1.770 billion, an increase of 9% to 11% versus last year. Our outlook reflects organic growth of 6% to 8% which is 200 basis points above our underlying market growth rate estimate of 4% to 6%, plus 3% inorganic growth from our InNeuroCo and Pulse acquisitions, partially offset by the portable medical exit.
Our outlook for 2024 adjusted EBITDA is between $355 million and $375 million, which is 15% to 21% growth year-over-year. And we expect 2024 adjusted operating income to be between $272 million and $290 million, reflecting growth of 13% to 20%, which is 1.9x our expected sales growth rate at the high end of our outlook. Adjusted net income is expected to be between $171 million and $185 million, reflecting year-over-year growth of 8% to 18%. This delivers an adjusted EPS outlook between $5.01 and $5.43, a growth of 7% to 16%. This assumes an adjusted effective tax rate between 19% and 21% and higher interest expense compared to 2023, primarily due to a higher debt balance to support the acquisitions of InNeuroCo and Pulse Technologies. We expect sales in the first quarter of 2024 to grow high-single-digit year-over-year, with sequential sales acceleration in the second quarter through the fourth quarter from new product introductions and emerging PMA customer growth.
We also anticipate our typical quarterly trend for product development revenue, which is generally at its lowest levels in the first quarter and at its highest levels in the fourth quarter. We expect adjusted operating income as a percent of sales to expand throughout 2024 from a significantly improved supply chain, direct labor attrition returning to pre-pandemic levels and the typical quarterly trend for product development revenue. To close our financial discussion, I would like to summarize our cash flow generation and our net total debt projection for 2024. We expect cash flow from operations between $185 million to $205 million, which represents an 8% year-over-year increase at midpoint of outlook. Our outlook for capital expenditures is $90 million to $110 million as we continue to invest in organic capabilities and capacity.
At midpoint, this is $15 million lower than 2023 capital expenditures as the spending on our average capacity investments was at its highest in 2023. As a result, we expect to generate free cash flow between $85 million and $105 million. Inclusive of our approximate $140 million acquisition of Pulse Technologies in January of this year, we expect our 2024 year-end net total debt to be between $1.010 billion and $1.030 billion, which is up $60 million to $80 million year-over-year. We expect to end the year with our leverage ratio within our target range of 2.5x and 3.5x trailing 4-quarter adjusted EBITDA. With that, I'll turn the call back to Joe. Thank you.
Joe Dziedzic: Thanks, Diron. We delivered a very strong 2023 with full-year sales up 16% and adjusted operating income improving by 26% over 2022. We expect this strong performance to continue in 2024 with an outlook of 9% to 11% sales growth and a 13% to 20% increase in adjusted operating income. The execution of our strategy, both organically and inorganically is producing results as we continue to demonstrate above-market sales growth with expanding margins. We remain focused on executing our strategy to create a premium valuation for our shareholders. I will now turn the call over to the moderator for the Q&A portion of our call.
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