Abhishek Jain: I can quickly take the second part of your question on the cash flow, and that basically is also the reason that we have $235 million in cash. I can draw a quick parallel to our cash usage in operations in ’23, which I called out at about $18 million. So looking at the adjusted EBITDA losses in ’24, my sense is that the cash usage in operations would be very similar to those adjusted EBITDA losses without kind of thinking about any over collections or the improvement through the RCM initiative. So from that standpoint, if you’re talking about a $25 million at the midpoint, cash usage with $235 million in cash and basically having — basically having a foundation by the end of ’24 to get back to an adjusted EBITDA profitability in the next year, then you probably don’t need to raise cash. So that’s how we are kind of thinking from the management standpoint.
Andrew Cooper: Great.
Operator: Our next question comes from Matt Sykes with Goldman Sachs. Please proceed with your question.
Unidentified Analyst: Hey guys, congrats on the quarter. This is Prashant on for Matt. Can you hear me?
Abhishek Jain: Yes, Prashant, we can hear you very well.
Unidentified Analyst: Okay, great. Okay. Great. So are you — first off, are you still seeing any lingering impacts of the billing article across your business segments?
Alexander Johnson: Sure. Certainly, we are. I mean, our revenue and volumes and testing services are still significantly below what they were when the billing article was introduced in March. So we’re still — I mean that is just a numerical fact of our performance. What we are seeing though is certainly clinicians and centers getting much more comfortable with the billing article rules and coverage for their Medicare beneficiaries and for all their patients. And so what we’re seeing now is new protocols being put in place at these centers, and we’re seeing that. We saw that in Q4 in kidney. Multiple centers, putting in protocols that now allow them to manage patients in kidney with AlloSure in a way that’s consistent with the Medicare billing article.
Unidentified Analyst: Got it. And then could you just elaborate on the path to launching a multi-modality product and obtaining reimbursement? How long does that typically take? And specifically for kidney? Are you required to obtain Medicare coverage and then private payer coverage for AlloMap kidney before proceeding with kidney care?
Alexander Johnson: Sure. So there’s a couple of things to unpack there. And I think the pathway to ultimate out of reimbursement is a multi-step conversation. We can certainly give you some highlights of that. I think the headline is that we’ve done this now with HeartCare. It was a multi-year process. We were able to produce the evidence and data for Medicare to do that. And that’s not a trivial exercise. And as we go into kidney, it’s — we know the playbook. We know where the mine fields are, so to speak, in data analysis. It was a challenging effort, one that was ultimately extremely successful with Medicare. And now as we’ve talked about — our HeartCare still consistently has an attach rate of well over 90% for AlloSure and AlloMap being used together for patients. For a little more context, I’ll turn it to Robert to add some more on the process itself, which is, I think, part of your question as well.
Robert Woodward: I think one thing you asked was the coverage for both tests before multimodality, that’s not necessarily a requirement, but it’s certainly something that we’ll look at when we’re looking at the data from our OKRA study where we use both AlloSure and AlloMap Kidney and where we see that going next. I think you asked how long or what time I think it’s more about the data than the time. And so as we assess that and look towards the future, we’ll start to put together that plan.
Unidentified Analyst: Got it. That’s really helpful. And then my last question is, do you see UroMap cannibalizing AlloMap Kidney eventual sales at all? And how do these two tests complement each other in the kidney transplant space?
Alexander Johnson: They’re really — they come from different directions in the AlloMap kidney, the mechanism of looking at immune status and whether there’s activation of the immune system or whether it’s quiescent. And in urine the UroMap has a very different approach of being everything there can be about evaluating cellular mediated rejection and especially the — whether or not there’s an influence of BK virus. And so as we’re bringing these two and defining their paths and where they’ll be used in the market, and we work with clinicians, there’s really unique opportunities for each of them. So I think we’ll see them in parallel and not in each other’s way.
Unidentified Analyst: Thank you.
Operator: Our next question comes from Brandon Couillard with Jefferies. Please proceed with your question.
Unidentified Analyst: Thanks. This is Matt on for Brandon. Maybe going back to the guide. Can you help us a bit more in terms of the cadence as we move through ’24. I think historically, you’ve seen a bit of a step-up in 1Q. Do you expect that this year? And then is it kind of $66 million, $67 million a quarter evenly spread out? Or are there may be some initiatives or other items that kick in, in the back half that would make that a bit more weighted for the year? Any color there would be appreciated.
Abhishek Jain: Sure, Matt. And let me break this down by the business because of the billing article revisions last year. Things have been ups and downs, up and down throughout the year. So starting with the testing services business, what I would suggest, start with the Q4 actual revenue baseline there, and then based on the overall yearly guidance, I would basically suggest that you should bake in a sequential growth quarter-over-quarter for that particular business. And for the other two businesses, since they are a little bit more, I would say, seasonal, specifically our products business. You should be looking at the year-over-year growth starting in Q1 ’24, and you should basically model for the non-testing focus of business slightly differently and that will basically give you the cadence as to how the quarterly revenue number should look like.
