Full Press Release Details
RadNet Reports Fourth Quarter 2021 Results and Releases 2022 Financial
LOS ANGELES, California, March 1, 2022 -
RadNet, Inc. (NASDAQ: RDNT), a national leader in providing high-quality, cost-effective, fixed-site outpatient diagnostic imaging
services through a network of 347 owned and/or operated outpatient imaging centers, today reported financial results for its fourth quarter
and full year ended December 31, 2021.
Fourth Quarter Report:
Dr. Howard Berger, President and Chief Executive
Officer of RadNet, commented "Despite being impacted from the Omicron surge of COVID-19 during the quarter, I am pleased that we
were able to increase our Revenue by 8.0% and our Adjusted EBITDA(1) by 7.5% from last year's fourth quarter. This was
the result of ongoing strong demand for our services and the continuing migration of patient procedures from hospitals to free-standing
ambulatory outpatient imaging centers. The improvement in our operating metrics during the quarter overshadowed the negative impact from
the Omicron surge, which reduced our Revenue by over $4 million and our Adjusted EBITDA(1) by approximately $3 million in the
fourth quarter. The COVID-19 surge not only disrupted normal patient volumes, particularly in December, but also created staffing issues
at our facilities. At the height of the Omicron surge in December, we had 565 employees out on COVID leave, representing 6.3% of our entire
work force. I am pleased to report that currently the percentage of our employee base out with COVID-19 has decreased to 1.2% and patient
volume is returning to normalized levels."
"Throughout the fourth quarter, we continued
to successfully manage our liquidity and financial leverage, while we made important investments to differentiate our facilities from
those of our competition. At year-end 2021, we had a cash balance of over $134 million and our net debt leverage ratio remained under
3.0 times Adjusted EBITDA(1). Our Days Sales Outstanding (DSOs) at December 31, 2021 was 34.0 days, the lowest in our Company's
history. The improvement in revenue cycle operations and collections has materially contributed to our ability to manage the challenges
presented by COVID-19 and to make important investments for our future," Dr. Berger noted.
"Moving into 2022, the demand for diagnostic
imaging remains robust and is growing. Our strong financial position and operating model has presented us with targeted opportunities
to expand our business, particularly through the construction of new centers to meet the growing demand and utilization in strategic markets.
Currently, we have 15 new sites in various stages of construction and development, with almost half of this expansion occurring within
existing health system joint ventures. We believe these sites should be positive contributors to our performance in the second half of
2022 and throughout 2023," added Dr. Berger.
Dr. Berger concluded, "Subsequent to the
end of the fourth quarter of 2021, we completed the acquisitions of Aidence Holding B.V. and Quantib B.V., two Netherlands-based Artificial
Intelligence ("AI") companies focused on creating population health screening tools primarily for lung cancer and prostate
cancer, respectively. During 2022, we will continue to develop the technical offerings and commercial expansion of these two businesses,
along with that of our DeepHealth's breast cancer AI screening algorithms. Though we have budgeted losses from these businesses
in 2022, we expect that they will be important to the growth and development of our network screening and population health strategies
in 2023 and beyond."
For the fourth quarter of 2021, RadNet reported
Revenue of $333.2 million and Adjusted EBITDA(1) of $54.5 million. Revenue increased $24.6 million (or 8.0%) and Adjusted EBITDA(1)
increased $3.8 million (or 7.5%) from the fourth quarter of 2020. Adjusted to remove $2.8 million of provider relief funding under the
CARES Act, Adjusted EBITDA(1) was $51.7 million during the fourth quarter, an increase of 2.0% from the fourth quarter of 2020.
Adjusted Diluted Net Income Attributable to RadNet,
Inc. Common Stockholders (Adjusted Net Income(3)) for the fourth quarter of 2021 was $6.9 million, or $0.13 per diluted share
("Adjusted Earnings Per Share") as compared with $10.2 million, or $0.20 per diluted share for the same period in 2020. The
decrease in Adjusted Net Income and Adjusted Earnings Per Share is primarily the result of an increase in depreciation and amortization
expense, non-cash stock compensation expense and the fully diluted share count in the fourth quarter of 2021.
Unadjusted for unusual or one-time items in the
quarter, Net Income (Loss) Attributable to RadNet, Inc. Common Shareholders ("Net Income" or "Net Loss") for the
fourth quarter of 2021 was $(3.8) million, or $(0.07) per diluted share. This compares to Net Income of $6.0 million, or $0.11 per diluted
share, in the fourth quarter of 2020. These per share values are based upon weighted average number of diluted shares outstanding of 54.0
million in the fourth quarter of 2021 and 52.2 million in the fourth quarter of 2020.
In addition to the provider relief funding under
the CARES Act, affecting Net Income in the fourth quarter of 2021 were certain non-cash expenses or non-recurring items including: $3.6
million of non-cash employee stock compensation expense; $29,000 of severance paid in connection with headcount reductions related to
cost savings initiatives; $1.5 million loss on the disposal of certain capital equipment; $7.5 million of non-cash gain from interest
rate swaps; $831,000 legal settlement; $1.2 million transaction costs associated with completing the Aidence Holding B.V. and Quantib
B.V. acquisitions; $646,000 of amortization of deferred financing costs and loan discount related to our existing credit facilities; and
$19.7 million loss from abandoning certain leases related to facility closures.
For the fourth quarter of 2021, as compared with
the prior year's fourth quarter, MRI volume increased 13.8%, CT volume increased 10.7% and PET/CT volume was flat. Overall volume,
taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 11.4% over the prior
year's fourth quarter. On a same-center basis, including only those centers which were part of RadNet for both the fourth quarters
of 2021 and 2020, MRI volume increased 8.0%, CT volume increased 6.6% and PET/CT volume decreased 0.4%. Overall same-center volume, taking
into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 7.3% from the prior year's
For full year 2021, RadNet reported Revenue of
$1,315.1 million and Adjusted EBITDA(1) of $218.9 million (inclusive of $9.1 million benefit from provider relief funding and
$7.7 million of benefit from the employee retention credit). Revenue increased $243.2 million (or 22.7%) and Adjusted EBITDA(1)
increased $79.5 million (or 57.0%) as compared with 2020. Adjusting to exclude the provider relief funding and employee retention credit
under the CARES Act, Adjusted EBITDA(1) was $202.1 million, an increase of $62.7 (or 44.9%) as compared with 2020.
Net Income for 2021 was $24.7 million, or $0.46
per diluted share. This compares to Net Loss of $14.8 million, or $(0.29) per diluted share, in 2020. These per share values are based
upon weighted average number of diluted shares outstanding of 53.4 million in 2021 and 50.9 million in 2020.
In addition to the provider relief funding and
employee retention credit under the CARES Act, affecting Net Income for 2021 were certain non-cash expenses or non-recurring items including:
$25.2 million of non-cash employee stock compensation expense; $744,000 of severance paid in connection with headcount reductions related
to cost savings initiatives; $1.2 loss on the disposal of certain capital equipment; $6.0 loss on extinguishment of debt and related expenses
in conjunction with our debt refinancing transaction in April; $21.7 million of non-cash gain from interest rate swaps; $831,000 legal
settlement; $1.2 million transaction costs associated with completing the Aidence Holding B.V. and Quantib B.V. acquisitions; $3.3 million
of amortization of deferred financing costs and loan discount related to our existing credit facilities; and $19.7 million loss from abandoning
certain leases related to facilities closed.
For the year ended December 31, 2021, as compared
to 2020, MRI volume increased 26.2%, CT volume increased 21.9% and PET/CT increased 8.6%. Overall volume, taking into account routine
imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 25.2% for the twelve months of 2021 over 2020.
Actual 2021 Results vs. 2021 Guidance:
The following compares the Company's 2021
performance with previously announced revised guidance levels.
| Original Guidance Range | Revised Guidance Range After Q3 Results | 2021 Actual Results | ||||
| Total Net Revenue | $1,250 - $1,300 million | $1,300 - $1,350 million | $1,315.1 million | |||
| Adjusted EBITDA (1) | $180 - $190 million | $210 - $220 million | $218.9 million | |||
| Capital Expenditures (a) | $70 - $75 million | $85 - $90 million | $98.8 million | |||
| Cash Paid for Interest | $39 - $44 million | $35 - $40 million | $29.0 million | |||
| Free Cash Flow (b)(2) | $60 - $70 million | $80 - $90 million | $91.1 million |
Dr. Berger commented, "We finished 2021
within our revised Revenue guidance range and close to the high end of our revised Adjusted EBITDA(1) range, ranges we increased
from our initial guidance levels throughout 2021. Our Free Cash Flow (2) results slightly exceeded our revised guidance range
as a result of our strong Adjusted EBITDA(1) performance and lower than anticipated cash interest expense, driven by our debt
refinancing transaction in April. Our capital expenditures exceeded our revised guidance range primarily as a result of the construction
of certain de novo locations that are expected to be operational in 2022."
2022 Fiscal Year Guidance
For its 2022 fiscal year, RadNet announces its
guidance ranges as follows:
| Total Net Revenue | $1,350 million - $1,400 million | |
| Adjusted EBITDA (1) Excluding Anticipated Losses from Artificial Intelligence Businesses | $205 million - $215 million | |
| Capital Expenditures (a) | $85 million - $90 million | |
| Cash Paid for Interest (c) | $27 million - $32 million | |
| Free Cash Flow Generation (b)(2) | $80 million - $90 million |
| (a) | Net of proceeds from the sale of equipment, imaging centers and joint venture interests, and excludes New Jersey Imaging Network capital expenditures. | |
| (b) | Defined by the Company as Adjusted EBITDA (1) less Capital Expenditures and Cash Paid for Interest. | |
| (c) | Excludes payments to counterparties on interest rate swaps. |
Dr. Berger noted, "It is important to understand
that our 2021 Adjusted EBITDA(1) was positively impacted by $9.1 million of provider relief proceeds and $7.7 million of employee
retention credit under the CARES Provider Relief Act. Additionally, we are estimating an impact of $7.4 million of Medicare reimbursement
reductions for 2022, based upon Medicare's final rule released in November. Removing these three items from 2021 Adjusted EBITDA(1),