Exagen Inc. (NASDAQ:XGN) Q2 2023 Earnings Call Transcript

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Kyle Mikson: Hi, guys. Thanks for taking the questions. Congrats on the great quarter. I’m going to take a stab at something here. So ACR Convergence is coming up in early mid November, so the fourth quarter. Apart from these RCM changes, [indiscernible] relatively saw 3Q guidance at least on the surface reflect any kind of air pocket, I guess, among docs leading up to ACR? And in the past, ACR actually impacted the fourth quarter, but I just want to kind of ask a question around seasonality factors that we should be considering in the second half of the year.

John Aballi: Certainly. Thanks, Kyle, for joining the call. Maybe I can share a little bit regarding guidance, how we’re thinking about it with ACR a direct factor. I think in general — just to directly answer your question in general, it’s part of it. ACR certainly pulls — it’s an annual meeting for the rheumatology community. It pulls most of the rheumatology community out of their practice for approximately about a week. So you lose 12th or 13th of the patient flow productivity through any given quarter. And it’s occurring I believe in September-ish of this year. It’s in San Diego actually, local to us. So we’re excited for that meeting. It’s a productive meeting where we certainly get to engage with our customers.

But in terms of guidance, that wasn’t necessarily one specific driving factor in the guidance. Overall, we’re seeing very strong progress year-to-date in executing our strategy. I am not very encouraged by the results we’re seeing this year. I hope that’s coming across. We continue to change significant aspects of the business. And these changes can contribute to either a lack of visibility in the magnitude or timing or really both in terms of the ultimate impact to the business. So we’ve been consistently communicating that there will be some impact to our performance as we pursue more profitable business. And it’s just challenging to know the exact timing and extent. Obviously, when you make a change to the billing policy and you start to increase some of the cost share component related to the patient, we think that that is going to be a driving factor for some near-term impact.

And that was really what we took into account when making this guidance. As I mentioned, we do still have what we believe is some outsized impact from vacations of physicians, but it’s tough to exactly narrow in on proportionality there and quantify the magnitude of impact. We think we’ve done the best job we can with the information we have.

Kyle Mikson: Yes. Okay. That was great. Thanks for that, John. And then, Kamal, on the gross margins, almost 60%, getting flashbacks [indiscernible] in the presentation with 100% margin. How should we think about the gross margins going forward? Obviously, like tied to revenue and if that’s dipping in the third quarter, and I guess fourth quarter clearly margin should decline from here. But what’s a good way to think about this? It sounds like the high 50s is good. But should we expect low 50s or something like that going forward?

Kamal Adawi: Yes. Thanks for the question, Kyle. So in 2022, our gross margin percent was 47%. Year-to-date through the first two quarters of 2023, were 54%. Now keep in mind that 2 million or roughly 2 million that we’ve been talking about prior year collections, that does have an impact on the gross margin. A lot of that occurred in 2022. So if you back that out, that has about a 7% impact on year-to-date gross margin. So I’m very pleased with how the lab has been performing. As John has touched on, the company has been very focused on a path to profitability and just operating as a lean organization. That’s true across the entire company, but it’s definitely true in the lab. And we’re seeing a lot of improvements there. And they’re doing a fantastic job of focusing on driving that gross margin percentage up.

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