There are also emerging opportunities to distribute Sanara’s advanced wound and skin care products outside of that original channel. And finally, there is the Tissue Health Plus project that Sanara has spoken to on each of its last 3 earnings calls. Given the number and quality of the growth opportunities that are coming inbound to us, often from larger companies and involving initiatives far bigger than anything we might pursue ourselves. We have moved well past the old framework that had InfuSystem looking for additional therapies where we could extend our oncology model. We increasingly see ourselves as a platform services company possessing unique assets and skills that can be deployed to solve difficult problems for our partners. We have proven ability to provide solutions and revenue cycle, biomedical services, logistics, patient support and technology.
And all of these skills are backed by our culture of white glove service that puts the needs of the patient first. As always, I’d like to take this opportunity to thank the InfuSystem team for their unwavering commitment to our patients and for making all of this possible. Before Q&A, I’ll provide more color around our guidance for the year. As we said in the press release, our targets for high single-digit revenue growth and adjusted EBITDA for the year in the high teens remains unchanged from earlier this year. We have a lot of business coming forward, and we are confident in achieving these results. If business comes forward faster than our current models indicate, we will update our guidance in future quarterly calls. As we have emphasized in the past, we provide guidance only on things we can clearly see.
Accordingly, our guidance does not include anything for developing initiatives that could result in incremental revenue gains this year. Further, our current guidance does not include expenses related to the planned upgrades of the company’s financial and ERP software systems. Operator, we are ready to begin the Q&A portion of the call.
Operator: [Operator Instructions] And first up, it looks like we have Brooks O’Neil of Lake Street.
Brooks O’Neil: First, Rich, I just — I might have been distracted for a second thinking about questions. But would you repeat that very last comment you made about the expenses related to the ERP system and whether they were or were not included in the guidance?
Rich Dilorio : Barry, why don’t you answer it?
Barry Steele : Yes. So we did not include those expenses in the guidance. So we’re not sure whether we’ll be adding them back for our adjusted EBITDA disclosure. But when we look at the amount of EBITDA, we expect for the rest of the year, we don’t include those expenses.
Brooks O’Neil: And then just — I’m thinking about sort of a philosophical question. I understand what you said, Rich, about the guidance philosophy, and I appreciate that a lot. I think it makes a ton of sense. I’m just curious, though, as you think about the new vision you laid out and the opportunities you can envision, would you say the company’s long-term expectation is for mid- to high single-digit revenue growth? Or do you see opportunities conceptually? I’m not asking you to guide, but do you see opportunities conceptually where the company could grow at a — let’s call it, a faster pace than that.
Rich Dilorio : Can you guys hear me now? Good. The audio is fixed. So Brooks, I think overall long term, it should be high single digits, not every single year, right? It depends on what the comps are in the prior year, how fast we grow the prior year and kind of where the opportunities are in their development. I think moving forward with biomed now that we kind of have our feet under us with GE. And as I mentioned, there’s other opportunities coming. And with the Sanara relationship in Wound Care, I’m not going to put a number on our long-term growth, but getting into the double digits every year probably shouldn’t be a challenge for us kind of after this year. 2025 has a lot of things, right? Wound Care should really be up and running next year.
The NOPAIN Act for pain kicks in January 1, our Biomed opportunity should start flowing in by then. So starting in ’25 and beyond, getting to double digits shouldn’t be an issue. It doesn’t mean there won’t be another year where we grow 7%, 8%, 9%. But long term, our growth should be more accelerated than it has been. We’re just getting some of these things going, and I think they are long-term growth opportunities. It’s not like GE was a 1-year growth thing, right? We onboarded most of it last year. We saw most of the growth this year with a little bit this year coming in. But these other opportunities, it’s not a onetime hit. They’re just long-term markets we’re getting into and partnerships that we have that should drive growth for years to come pretty solidly in the double digits.
Brooks O’Neil: And then I’m just curious, obviously, over the past few years, you’ve thought about adding devices on the platform you described for oncology. And you were talking about a different business model today, which I assume means not so much adding devices to the mix. But would you say that these newer opportunities are going to come broadly within biomedical services and Wound Care? Or are you thinking that there could be opportunities to go in new directions that just leverage your capability?
Rich Dilorio : I think what we’re going to see in the future and what we’ve seen over the last couple of years, is as the businesses evolve. So if you rewind a few years ago, it started with Cardinal. I mean, we even talked about lymphedema at 1 point, right? The whole concept of that we can take a device, we can wrap our services around it, going to the market and try to win some market share is kind of what we’ve done in Pain, right? So let’s use a as an example. It costs quite a bit of money to stand up the sales team and go do that, right? You’re blazing new trails for the company. It can take a while, and there’s some risk to it. The real difference is with Sanara and GE, which really opened our eyes to this is those guys came to us with business models and products and said, we just need your support and your help, right, to get into the market.
We didn’t need to blaze a new trail. The trail is already built by these guys. The product was already there. They have already identified the market. And all we’re doing is supporting that, right? Whether that’s our revenue cycle team and leveraging our contracts, our biomed capabilities like with GE, our sales team like it would be great to put something into Oncology that we already have a team stood up right? And it’s just them talking about new products in that market. Those are the type of things that you’ll see more on. And we have — I think I said in my prepared remarks, there’s a lot of those inbound to us. We’re not — we don’t have to go hunt them. They’re already coming to us. Now it’s just a matter of Barry’s team modeling it out, making sure it makes sense financially, the sales team making sure we can get to the market and we have a team.
It’s just — it’s a very nuanced change, and it’s not something that was really purposely done. It’s just how it evolved from where we started. And where we started kind of brought us to this point with Cardinal, right? That brought Sanara to us. One of the acquisitions — the acquisition we made with OB Health brought us GE. And leveraging our capabilities with their business models, their plans, their products, I think, is a much better fit than us trying to build the entire building on our own. And I think that’s what you’re going to see more in the future.
Operator: Next up, we have Jim Sidoti of Sidoti & Company.
Jim Sidoti: Sorry, I had to join the call late as I was in a couple of the calls. But can you just — I don’t know if you said it or not already, but the Oncology business there 1%. What was really behind that? And where do you expect that to end up this year?
Barry Steele : Yes. So Jim, it was actually higher volume than last year. But this year, we had our gross-to-net model realizable revenue was a bit lower than last year, but only because last year was an anomaly. That net revenue adjustment was impactful more this year and more normalized this year. If that makes sense. So we expect a more normal pattern this year than the prior year, where we’re going to actually improve our gross-to-net as we go through the year because there’s less co-pays and deductibles that hit months after Q1.
Jim Sidoti: I mean, historically, it’s been a low single-digit growth business, do you think that’s where it ends up again this year?
Barry Steele : Yes, absolutely. That’s our plan. We’ll bounce back in terms of — and that affects our profitability in Q2 and beyond compared to Q1, and that’s normal.
Jim Sidoti: And I know you had a lot of auditing activity in the first quarter, you changed auditors. Is that one of the reasons why the G&A up over $18 million? And where do you think that come…
Barry Steele : These 3 main impacts to the first quarter generally for us that may give us a seasonality in the way of EBITDA hits our quarters because there’s some expenses in the first quarter that we don’t have as much of in other quarters. And the audits one of them we book our audit expenses as the audit incurs and that’s predominantly in the first quarter. And by the way, now that we’re doing a fully integrated audit with control being audited, that was more — that’s a higher amount just for us generally, and we had extra expenses because we had to get a consent from our old auditors because we switched auditors. So a pretty big impact just in Q1 of this year. The other thing is that some of our marketing activities, such as we have an annual sales meeting and other things hit us much more hard in the first quarter than other places.
So between the seasonality and gross-to-net for the TPP Oncology business, the higher amount of audit expenses in the first quarter and higher marketing expenses in the first quarter. We’re always going to show our lower first quarter result from an EBITDA and profitability perspective than other quarters. And that’s the pattern you see in the past as well.
Jim Sidoti: Those G&A expenses you think on a back in Q2 and Q3?
