iRhythm Holdings, Inc. (IRTC) Q2 2026 Earnings Call Transcript

Hello, everyone.

Thank you for joining us, and welcome to the iRhythm Holdings Inc. Q2 2026 Earnings Conference Call. After today's prepared remarks, we will host a question and answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Lisa Pecora, Senior Vice President, Finance and Investor Relations. Lisa, please go ahead.

Thank you, Operator, and thank you all for joining iRhythm's second quarter 2026 earnings call. With me today are Quentin Blackford, iRhythm's President and Chief Executive Officer, and Dan Wilson, our Chief Financial Officer. Before we begin, please note that management will make forward-looking statements within the meaning of federal securities laws under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements include, but are not limited to, statements regarding our intentions, beliefs, and expectations about future events, strategy, competition, products, operating plans, and performance. Forward-looking statements on this call are based on current estimates and assumptions, involve risks and uncertainties, and actual results may differ materially. These statements are made as of today, August 6, 2026, and are time-sensitive. We undertake no obligation to update or revise them, except as required by law. Accordingly, you should not place undue reliance on these statements. For a discussion of risks and uncertainties, please refer to our most recent annual report on Form 10-K, quarterly reports on Form 10-Q, and other filings with the SEC. Additionally, during the call, we will discuss certain financial measures that have not been prepared in accordance with GAAP. Unless otherwise noted, all references to financial measures on this call are presented on a non-GAAP basis. These non-GAAP measures should not be considered in isolation or as a substitute for, or superior to, GAAP results. Reconciliations to the most directly comparable GAAP measures can be found in our earnings release and the slides accompanying today's call. And with that, I'll turn the call over to Quinton.

Good afternoon, everyone, and thank you for joining us. We had another very strong quarter, and I'm pleased to be here to discuss both our second quarter 2026 performance and the progress we are making against our long-term strategy. I will begin with a brief overview of the quarter, then discuss today's announced agreement to acquire Vital Connect and finish with several key business updates. Dan will then talk about our financial performance and guidance in more detail. Second quarter revenue was $224.2 million, up 20.1% year-over-year. This marks our seventh consecutive quarter of growth above 20%. A meaningful accomplishment and a reflection of the durability of demand for Zio, the strength of our commercial execution, and breadth of our growth drivers. Momentum remains strong across cardiology, primary care, innovative channels, and international markets. We are particularly pleased to see that growth translate into exceptional margin expansion, demonstrating both the strength of our platform and the operating leverage inherent in our The combination of sustained top-line performance and increasing operating leverage gives us continued confidence in our strategy and the substantial opportunity ahead. Let me turn to our agreement to acquire Vital Connect, which we announced today. We have followed Vital Connect for some time and developed a great deal of respect for its technology, its people, and the platform the team has built. We are enthusiastic about bringing our organizations together because the combination meaningfully expands the ways we serve physicians, health systems, and patients, while remaining closely aligned with our mission to improve diagnosis, prevent disease, and ultimately enhance patient care. Vital Connect brings a complementary and comprehensive platform that supports four cardiac monitoring modalities, mobile cardiac telemetry, or MCT, event monitoring, long-term continuous monitoring, and short-term Holter. This technology is also FDA-cleared for continuous patient monitoring in the hospital, further expanding our capabilities beyond ambulatory cardiac monitoring and across the continuum of care. The strategic fit is compelling. Vital Connect reinforces our commitment to innovation in ambulatory cardiac monitoring and adds an FDA-cleared platform with a patient monitoring service up to 30 days, four-in-one device functionality, flexible service models, live-looking capabilities, and multivital monitoring. These features complement our existing portfolio and give us additional tools to meet different clinical, operational, and economic needs of customers and patients. This acquisition also expands our ability to participate in the MCT segment. This is a large market segment, and customer needs vary considerably by workflow, site of care, and patient population. Adding Vital Connect's proven platform to our national sales force will give physicians and health systems on a nationwide basis greater choice and flexibility. Together with ZOAT and ZOMCT, the acquisition of Vital Connect creates a complementary set of solutions to serve different MCT customers and patients. Vital Connect is also important to the broader evolution of our platform. Its biosensor can monitor up to 11 physiological parameters, including ECG, heart rate, respiratory rate, and body temperature, providing a robust foundation for our multivital strategy. Over time, these capabilities allow us to address a wider range of clinical needs and care settings, including inpatient monitoring and hospital-to-home programs, creating additional avenues for sustainable long-term growth. Financially, we expect the transaction to strengthen our long-term growth profile. We anticipate a positive contribution to revenue growth beginning in 2027 and thereafter. Combining VitalConnect's business with the meaningful progress we continue to make in our base business, we remain confident in the combined company achieving our previously communicated adjusted EBITDA margin target of 15% next year. I also want to be clear about what this means to our current MCT strategy. We remain committed to both ZOAT and ZO-MCT. Because the MCT market serves diverse physician workflows, sites of care, and patient preferences, we do not believe a single solution will address every need. Therefore, our objective is to provide a portfolio of complementary options. To that point, we continue to work towards a clearance for ZO-MCT in the first half of 2027. In parallel, we will allocate resources towards understanding and accelerating performance with Vital Connect to ensure a rapid and successful integration of Vital Connect's products into our commercial force, as well as evaluate and define a product roadmap that combines the best of both product platforms and brings continued innovation to the market that serves the needs of our customers and patients. Turning to another central element of our strategy, reaching patients earlier in their care journey. We believe that at least 27 million people in the U.S. are at risk for arrhythmias, and many of these individuals first engage with the health care system through primary care, value-based care, and population health settings. This creates a significant opportunity to expand access to Zio by embedding long-duration cardiac monitoring more directly into the clinical workflows where patients are first identified, evaluated, and referred. During the quarter, we advanced our predictive arrhythmia solution strategy with the signing of two commercial agreements through our partnership with LUSOM that combine predictive identification workflows with iRhythm Monitoring Solutions. These partnerships are intended to support earlier diagnosis and intervention, and our pipeline of additional opportunities continues to develop. We are also expanding our predictive arrhythmia solutions work with Desert Oasis Healthcare, using AI-driven analytics to identify patients who may benefit from cardiac evaluation and monitoring. We continue to see strong momentum in the Innovative Channels, which was our fastest-growing channel in the quarter. Demand remains robust across a growing network of value-based care, primary care, and population health partners. As these programs scale, utilization is expanding in both symptomatic and asymptomatic patient populations. Early pilot programs have demonstrated more than 85% accuracy in identifying patients with clinically relevant arrhythmias before they enter the diagnostic process. The early results of these programs are encouraging and support our conviction that earlier identification can improve outcomes and reduce total health care costs. Primary care is an important part of our upstream strategy, with the majority of the 27 million people in the U.S. at risk for arrhythmias entering the health care system through this pathway. To support that care journey, we recently launched our first-ever targeted direct-to-patient initiatives through the Patient Point Network, providing coordinated arrhythmia education for patients, physicians, and office staff. The goal is straightforward. Increase awareness of symptoms and risk factors, help patients seek evaluation sooner, and make the connection between primary care and cardiology more efficient. A key enabler of our growth strategy in verticals such as primary care is our strong commitment to technology integration. Approximately 60% of our volume now comes from EHR-integrated accounts, and nearly 80 of our top 100 customers are integrated today. By embedding cardiac monitoring more directly within provider workflows, these integrations reduce friction, improve efficiency, and help support earlier identification of patients who may benefit from monitoring. We believe this positions us well as cardiac care increasingly shifts upstream and towards earlier detection. International remains another emerging growth opportunity, supported by continued commercialization progress and clinical evidence generation during the quarter. For example, in the U.K., we are building momentum with the NHS, supported by award-winning Zio integration and expanding interest in primary care cardiac monitoring. In the Netherlands, we are deepening relationships with key opinion leaders as we position the business for future market expansion. And in Japan, the higher reimbursement rate we discussed last quarter became effective on June 1st. In each of these markets, we are staying disciplined in how we execute, investing to generate clinical evidence, advance reimbursement, and build scalable commercial capabilities. Globally, we also continue to expand the body of evidence supporting the clinical and economic value of our platform. Data presented at the European Heart Rhythm Association, the American Diabetes Association, and the International Society for Pharmaeconomics and Outcomes Research add to our body of clinical evidence on outcomes and economic benefits of early detection and disease management with long-term continuous monitoring. Turning to adjacent markets, sleep remains a large and underpenetrated opportunity with approximately 40 million sleep apnea patients in the U.S., many of whom overlap with arrhythmia populations. We continue to execute pilot programs and refine our strategy with a focus on simplifying fragmented workflows across the sleep ecosystem through a more integrated approach. Similar to cardiac monitoring, we believe streamlining these workflows can create meaningful value for patients, providers in the broader healthcare system. We are encouraged by the potential while remaining measured in how we invest in scale. Before turning it over to Dan, I'd like to address several business and regulatory updates. First, a positive development during the period on reimbursement were the final LCDs issued by Neridium, CGS, and Palmetto, which addressed key areas of ambiguity in the initial drafts and delivered a constructive outcome. Importantly, these LCDs clarify appropriate modality-specific coverage without introducing additional access restrictions. Overall, the final policy removes a source of uncertainty for the market. Second, we achieved an important milestone this quarter with FDA clearance of our third generation algorithm, which will be used across our entire platform. Once launched in the first half of 2027, we expected to reduce clinical technician review time by as much as 50%, driving meaningful productivity gains and approximately $100 million of cumulative cost savings over five years while supporting continued margin expansion. We're also excited by the incremental opportunity to leverage its capability on the Vital Connect platform over time. This is a strong example of how our investments in data and AI can improve both the customer experience and the efficiency of our operating model. Third, as you know, we remain subject to an FDA warning letter and continue to work through the agency's review process. We have updated the agency on the completion of our remediation activities in our self-initiated third-party audit and look forward to their return in anticipation of closing out the warning letter. While the timing of any action remains with the agency, we remain focused on supporting the process and responding to any requests from the FDA. Fourth, I'd like to acknowledge that on July 31st, we agreed to settle our outstanding litigation with Baxter and its subsidiaries, Welch Allen and Barty Diagnostics, for a settlement payment of $50 million. With this matter now resolved, we can move forward with greater clarity and focus, directing our attention and resources towards the strategic initiatives, innovation, and execution that drive long-term value creation. Finally, I'd like to provide a brief update on the recent cybersecurity incident we announced in June. On June 8th, we identified unauthorized activity in certain third-party hosted business applications. We promptly activated our response plan, engaging external experts and notifying law enforcement. The incident has been contained and the root cause identified. While certain data was exfiltrated, our investigation and remediation actions resulted in no material impacts to our products, patient care, business operations, or financial results. Looking forward, our priorities are clear. Sustained volume-led growth across cardiology, primary care, and innovative channels. Continuing to improve profitability through scale, productivity, and disciplined execution. Advancing key innovation initiatives, including next-generation MCT and predictive AI. Thoughtfully expanding into international and adjacent market opportunities and maintaining the strong operational and compliance foundation that supports long-term success in a rapidly evolving landscape. With that, I'll turn the call over to Dan.

Thank you, Quentin. We delivered another quarter of strong financial performance supported by sustained demand for our ambulatory cardiac monitoring services and continued operational discipline across the business. We generated robust year-over-year revenue growth while delivering record profitability, demonstrating our ability to to scale efficiently and translate growth into significant operating leverage. We remain encouraged by the momentum across the business and the consistency of our execution. Revenue for the second quarter was $224.2 million, up 20.1% year-over-year, reflecting healthy demand across our customer base and continued momentum in newer growth channels. Volume remained the primary driver of growth, complemented by modest pricing gains and continued strong execution in collections. Our broad and expanding prescriber base continues to underscore the strength and durability of demand, while new stores contributed approximately 45% of year-over-year volume growth. Moving down the P&L, gross margin in the second quarter was 72.8%, an increase of 160 basis points year-over-year. This sustainable improvement was driven by targeted operational efficiencies including manufacturing automation and workflow optimization as well as product mix and scale benefits from higher volumes second quarter 2026 adjusted operating expenses were 145 million compared to 145.2 million in the prior year period a decrease of 0.1 percent our expense performance also reflects a focused approach to investment as we funded key growth initiatives while thoughtfully managing costs across the broader organization. As a result, we kept operating expenses essentially flat while delivering strong revenue growth and operating leverage. On the bottom line, gap net loss for the second quarter was $0.4 million or net loss per diluted share of $0.01 compared to a gap net loss of $14.2 million or net loss per diluted share of $0.44 in the second quarter of 2025. Adjusted net income for the second quarter was $19.3 million or net income per diluted share of $0.58 compared to an adjusted net loss of $10.2 million or net loss per diluted share of $0.32 in the second quarter of 2025. These results highlight the progress we've made in building a more profitable business as operating leverage across the organization contributed to significant year-over-year improvement in earnings. Adjusted EBITDA for the second quarter was 43.3 million, or 19.3 percent of revenue, representing an improvement of more than a thousand basis points compared to the prior year. The year-over-year improvement reflects our disciplined spend management, moderating FDA remediation expenses, and timing of innovation and growth-related investments. This performance underscores the operating leverage we are building in our business model and our confidence in delivering against our longer-term target of 15% adjusted EBITDA margin in 2027. Free cash flow during the second quarter was positive $37.5 million, a record for the company and reflective of the inherent operating leverage in the business and disciplined working capital management. We ended the quarter with $591.3 million in cash, cash equivalents, and marketable securities, a strong cash position that provides us with substantial flexibility to fund future growth initiatives. Before turning to our guidance for the remainder of this year, I wanted to give a few comments on the financial aspects of the VitalConnect transaction. We expect the acquisition to positively contribute to revenue growth beginning in 2027 and thereafter, with Vital Connect currently at an approximately $65 million annual revenue run rate. For gross margin, we expect that the combined company will remain above 70% gross margin by leveraging the scale, operational infrastructure, and AI capabilities we have built. And finally, as previously noted, we remain confident in the combined company achieving our previously communicated adjusted EBITDA margin of 15% in 2027. We look forward to providing more detailed guidance following the closing of the transaction. Now turning to our updated financial outlook for Q3 and full year 2026, which does not include any contribution related to our pending acquisition of Vinyl Connect. We are raising full year 2026 revenue guidance to $880 million to $890 million, representing 18% to 19% year-over-year growth. this outlook reflects sustained demand across our core business while maintaining the same disciplined approach to forecasting newer and emerging channels on a full year basis we now expect a modest positive contribution from pricing relative to 2025 attributable to the price benefit we realized in the first half with revenue growth continuing to be driven primarily by volume growth across Zio Monitor, Innovative Channel, Zio AT, and International. In the third quarter of 2026, we anticipate revenue to be in the range of $221 million to $223 million, consistent with typical revenue seasonality. For gross margin, we remain confident in our ability to sustain the strong margin performance we've delivered year-to-date, while continuing to drive meaningful improvement relative to 2025. The efficiencies we've created across clinical operations and manufacturing combined with increasing scale and the adoption of AI-driven workflow tools support further reductions in our cost to serve over time. With respect to the broader macro and geopolitical environment, we've taken proactive steps to manage potential cost pressures and do not currently expect a material impact on our gross margin outlook. Based on our performance year-to-date and outlook for the remainder of 2026, we are raising our full-year adjusted EBITDA margin guidance to 13% to 14%. This reflects the benefits of continued scale, disciplined expense management, and a balanced investment approach across our key growth initiatives. We anticipate certain investments and growth initiatives, including targeted investments and primary care expansion, to ramp in the second half of the year. For the third quarter, we expect adjusted EBITDA margin of 12 to 13 percent. Excluding certain unique items such as litigation settlement payments and transaction costs, we continue to expect free cash flow to increase year over year in 2026 with stronger cash generation in the back half of the year driven by the normal operating cadence of the business. Before closing, I'd like to briefly address the preliminary physician fee schedule proposed by the Centers for Medicare and Medicaid services, or CMS. We view the proposed reimbursement rates up low single digits across both long-term continuous monitoring and mobile cardiac telemetry as further validation of the healthcare industry's continued focus on earlier disease detection, preventative care, and evidence-based clinical decision-making. These trends align closely with Zio's strengths in delivering objective diagnostic insights through extended uninterrupted cardiac monitoring. We look forward to reviewing the final rule, which is expected later this year, and we'll provide additional commentary at that time. In closing, our second quarter results reflect the strength of our execution and the increasing profitability of our business model. Moving forward, we remain focused on expanding patient access, operating efficiently, and investing thoughtfully in the opportunities that position us for long-term success. With the addition of Vital Connect, we look forward to delivering profitable growth, where we will continue to balance profitability expansion with disciplined investments towards growth. I will now turn the call back to Quentin for closing remarks.

Thank you, Dan. This was an excellent quarter for iRhythm. We are encouraged by the momentum in our business and the opportunities we see to further expand our impact. We delivered our seventh consecutive quarter of revenue growth above 20%, expanded margins significantly, generated strong free cash flow, and raised our full-year outlook. Our results reflect the strength of the ZEO platform, the consistency of our execution, and most importantly, the work of our people. At the same time, today's agreement to acquire Vital Connect represents an important next step in the evolution of iRhythm. It adds complementary monitoring capabilities, expands our presence in MCT, and provides a foundation for multivital monitoring and additional care settings that will meaningfully benefit patients and customers over time. We're enthusiastic about the strategic potential of the combination, but we will remain disciplined in how we integrate the business, prioritize investments, and pursue the opportunities ahead. Our strategy is clear. Expand access, advance innovation, and execute with discipline. Before we move to Q&A, I want to thank the entire iRhythm team. Over the past month, Newsweek recognized iRhythm as both one of America's greatest workplaces and one of the world's greenest companies. Those recognitions belong to our employees. Their talent, dedication, and commitment to our mission are what make our performance possible, and our culture remains one of the most important competitive advantages we have. With that, we're now happy to take your questions.

We will now begin the question and answer session. Please limit yourself to one question. If you would like to ask a question, please press star one to raise your hand. To To withdraw your question, press star one again. We ask that you pick up your handset when asking a question to allow for optimum sound quality. If you are muted locally, please remember to unmute your device. Please stand by while we compile the Q&A roster. Your first question comes from the line of John Young with Canaccord. John, your line is open. Please go ahead.

Great. Congratulations on the strong quarter, and congratulations on the Vital Connect acquisition. I know it's a high-quality company that we've known for several years. Could you walk through the synergies you expect with the MCT business specifically? How will you position their existing MCT offerings versus upcoming Zio MCT? How do you expect this will accelerate the MCT category overall for iRisk?

Yeah, thanks, John. I appreciate that question. Look, we've followed Vital Connect for quite some time at this point and understand their technology really well. And I think we understand the MCT category really well as well. I think what we've come to realize is that there's going to have to be multiple product offerings in that category to ultimately succeed. And so we remain committed to AT, to MCT, and now the Vital Patch. If you look at it, you know, ZO-AT for us was a product that could really serve about 50% of that MCT market, just given the short duration, 14 days, not being able to get out to 30 days, not having the live-looking capability, the downgradable, you know, 4-in-1 capability. Those were all things that were sort of shortcomings with AT, yet it still served a good part of the market. Vital Patch opens up the remaining 50% of that market. Even our own Zio MCT product would only open up probably another 20% to 30%. So having Vital Patch in there gives us access to the entire market, which is probably a billion-dollar market growing in the high single digits. It's a probably incremental $500 million market opportunity for us. So we're excited with it. We're excited to get this through HSR review. We expect that to close by the end of the year, and our focus is going to be integrating this into the commercial team in the very first part of next year.

Your next question comes from the line of Joanne Wunsch with Citi. Your line is open. Please go ahead.

Good afternoon. This is Anthony on for Joanne. Thanks for taking our question. This was a pretty impressive quarter on EBITDA margins, keeping OPEX essentially flat. Any reason not to maybe raise EBITDA a bit more? And then also, just a quick follow-up, was there any tariff refund benefit this quarter? Thank you.

Thanks, Anthony. I appreciate the question. Maybe hitting the second part of your question there first. No, there was not a tariff benefit realized in the quarter, so that was not part of the 19 percent adjusted EBITDA margin that we delivered in the quarter. You heard in my prepared remarks, you know, there are some investments that we intend to make in the back part of the year. We are raising full year adjusted EBITDA guidance and are ready to deliver, call it over 400 basis points of improvement versus 2025. So, we're really excited about that leverage that's coming through in the business. At the same time, we see a lot of opportunities ahead of us to continue to grow the business and talked about primary care, continuing to open that up, innovative channel, sleep, other initiatives like that. So we always want to be thoughtful and drive towards profitable growth and really balance those investments in the business to drive growth, but also deliver profitability expansion. So excited about what is showing through in the business, excited about the setup for the rest of the year, and really excited about what the investments can mean for future growth for the business.

Your next question comes from the line of Alan Gong with J.P. Morgan. Your line is open. Please go ahead.

Hi, thanks for the quarter and congrats on the good quarter and deal. I guess I want to dive a little bit deeper into a question I was like just asked. So, you know, I understand that Vital Connect helps expand, you know, the remaining 50% of the market. But, you know, arguably it could also handle the 50% of the market that is currently, you know, addressed with AT. And with Vital Connect, a big value to the technology is the additional markets that it seems to open. I think we've talked to them, they've valued the transition care and patient monitoring hospital at home as markets in the billions of dollars as well. So I guess just again on the positioning, should we think of this as more of a new product to target those opportunities and unlock the remaining 20 to 30 percent? And then when we think about technologies that you've talked about, you know, maybe being a stepping stone into other modalities like sleep apnea, is this the deal that we should have been looking for?

Okay, Alan, thanks for the question. You know, and I think you go back to my prepared remarks. We certainly hit on those exciting new opportunities that come via the Vital Connect transaction. They are exciting to us, and honestly, they're part of sort of the roadmap that we've been focused on for some time now. In-hospital monitoring is certainly interesting to us. They've done a nice job of entering into that space already and beginning to make inroads there. The hospital-to-home segment is something that we've talked about in the past, particularly as we build out our own multivital product capability. Now Vital Connect accelerates that capability, having multivital capabilities already on their platform. So those are nice synergies in the transaction and very synergistic relative to the overall strategy of our company. I wouldn't leave out RPM as well. Remote patient monitoring is another area of focus that they've built out a capability very nicely around. That's something that we've also had on our roadmap as well. So this certainly goes well beyond just the MCT market. It absolutely opens up incremental opportunity within MCT, and I think we're going to be able to benefit patients and customers meaningfully more as a result of it. But MCT alone is not the only reason that we're interested and excited about Vital Connect. So you hit the nail on the head with respect to those incremental ancillary market opportunities that I do think can be valued in the billions of dollars in terms of market potential. We're in the early stages. We're going to be thoughtful and measured in how we continue to lean into those. But we certainly want to lean into the experience of Vital Connect and what they've learned there and capitalize on the inroads that they've already made.

Your next question comes from the line of Marie Thibault of U.S. Bank Corp BTIG. Your line is open. Please go ahead.

Hi, thanks for taking the question. I just wanted to quick check in on the direct-to-patient marketing that you've started, I think, in some select zip codes. Can you give us an early read on what you're learning from those efforts, and should we expect that you'll plan to expand that program here in the quarters to come? Thanks for taking the question.

You certainly, Marie, should expect that we're going to continue to lean into and expand it, And that's part of the incremental spend in the back part of the year that Dan was alluding to. We know that direct-to-patient, direct-to-consumer, primary care, these are all areas that have real potential behind them, and early indicators are that they are real opportunities. So we will continue to invest in those. They'll be measured as we go to make sure that we're seeing the sort of returns that we expect to around them before we just, you know, lean into them even harder. But we're excited by those. We are in the very early stages of the initial DTP efforts and the in-clinic, in-physician office marketing that we're doing with patients. So, it's a little bit early to measure those results, but I will tell you that the confidence is high enough right now that we're going to continue to lean into it and excited about what we're going to see out of it. So, we're a little early, but we're excited by it.

Your next question comes from the line of Stephanie Algazi with B of A. Your line is open. Please go ahead.

Hi. Thanks for taking the question, and congrats on a good quarter in the deal. I just wanted to check on ZOMCT and how that's tracking relative to previous expectations for the launch in the first half of next year, and anything, any progress you would share on the mobile gateway data submission to the FDA. Thank you.

Yeah, thanks, Stephanie. So, we continue to make progress on ZOMCT. It continues to be a priority for us and an area that our teams are focused on. As you'll note, you know, in my prepared remarks, I commented on the fact that we remain focused on getting clearance on that product in the first half of next year. I think it's important for you to realize, though, that we expect Vital Connect will close before the end of the year, which means we are going to be focused on integrating that Vital Patch into our commercial team's hands right around the turn of the year, the very early part of next year, which requires training and launching across a nationwide platform. So that will be our number one focus as we enter into this deal and transaction and look to close it here in the near term. At the same time, we're going to continue to focus on the submission of MCT and getting that clearance so that we do have optionality as we go into the future.

But I think it's important for folks to realize Vital Connect is the primary focus here in the near term as we look to launch a new product into the mct space which will be that vital patch your next question comes from the line of david saxon with needham your line is open please go ahead great uh good afternoon quentin and dan thanks for taking my questions and i'll echo the congrats on the quarter and the the deal so yeah i just have a multi-parter um on the vital connect here deal so you talked in the script 65 million dollar run rate, I think that reflects a slowdown they saw in the first quarter due to a transition. And my understanding is they recovered from that and are kind of ramping and targeting about 100 million next year. So is that a fair way to think about, you know, what they could do from a revenue contribution perspective in 27? And then the second part of the question is just, I mean, my math, um you know you're you have a leader in the extended holter category obviously you'll probably get a couple points there from uh their platform and i mean i would guess your your mct share is going to have a two handle in front of it so just you know talk about your confidence in in getting it through kind of the the you know regulators and whatnot thanks so much yeah there's a lot in there and I'll ask Dan to jump in and help if I miss on anything or just remind me of what we've missed because I want to try to hit all of it for you.

I'll come back to, you know, this is a company that we've spent a lot of time getting to know over the years and certainly have really come to appreciate their technology and frankly the teams behind the company that have been building it. But there have been some structural considerations over the years that made it very difficult to step in and acquire the company. And we've had those conversations with the teams over the years, and Peter and that team did a nice job of addressing those right towards the end of last year and into the beginning of this year, which did create a little bit of a hiccup in that business. They've come out of it really nicely. They're growing quite nicely now, and we're excited by what we're seeing in that business. So they have addressed that, and I see that as temporal, and the recent business trends would certainly indicate that was the case as well. But having addressed that particular issue now opened up the opportunity, together with nice gross margin improvements that we were seeing in that business to step in and acquire the company. And so we're excited to be at the point now to be able to do that. In terms of run rate revenue, you know, what that looks like for next year, we're not going to get out and guide to 2027 at this point in time. Some of that's going to be contingent upon exactly when the deal does close, and we're going to wait until that happens to give you sort of a forward look and a guidance of the combined companies. Again, our idea is that this thing will close by the end of the year, but until it does close, we're going to hold back on providing combined company guidance. At the last point on HSR review or getting through the FTC, this is very much about the MCT product category. It's a very competitive transaction. I mean, there's a tremendous amount of competition that remains in the MCT category. The largest players in this space really focus and MCT between Viotel and Preventus and others.

And I think that, you know, the combination of our company and Vital Connect doesn't change that competitive dynamic within the MCT category.

So we're excited by the opportunity, feel very good about the ability to get through the FTC and the HSR review, and we'll keep you updated on how we progress through that.

David, I'll just add on the revenue. I can't necessarily speak to what they've quoted historically, the $65 million run rate that I had in my prepared remarks. That does contemplate our revenue accounting, which, as you know, we essentially report a net revenue that follows a contractual allowance. And so that is our revenue recognition. That's how we derive that $65 million. Hopefully that's helpful.

Your next question comes from the line of Nathan Trabeck with Wells Fargo. Your line is open. Please go ahead.

Great. Good evening. Congrats on strong quarter and on the deal. Quentin, are you seeing any sign that the very strong growth you've seen in innovative channels is beginning to normalize? Or do you still believe those channels are still in early innings? and then you could just talk about the cadence of new partner ads in the quarter and I guess what's implied in the second half relative to the first half.

Yeah, we continue to be excited with the innovative channel opportunity, and I just think whether it's primary care, whether it's value-based care, population health, there's so many different angles in that innovative channel business that has us excited, and the teams continue to add new partners as we go. We saw another healthy quarter of new partners coming on board. I think that, you know, the reality is they all come on board at different paces and in different ways, and that gets a little bit hard to forecast and predict, and so we've not changed our way of thinking about how we look at innovative channels into the back half of the year and in our guidance. It's more of a wait-and-see approach with that business, but it has been encouraging. It continued to grow incredibly well in the second quarter. You know, it was exciting to see our very first employer-sponsored plan sign up within the innovative channel business. I continue to think that, you know, employer sponsor plans remains a meaningful opportunity in the self-insured population. So I'm excited to see that door begin to open. I just, I think we're still in the very early innings here and we'll continue to lean into it, focus on it, but we're also going to be measured in how we think about it in our guidance and we'll let those results play through before we get ahead of Your next question comes from the line of Vijay Kumar of Evercore ISI.

Your line is open. Please go ahead.

Hi, guys. Thank you for taking my question. Quentin, I want to go back on the deal. I just want to make sure we understand the dual rationale. This feels like a dual product strategy, right, with an MCT. and I know you have a 2.0 product that's going to address the other part of the market. So it just feels like, is this going to be cannibalistic? Like how is Vital Connect going to fit in? Does this reduce your enthusiasm for 2.0? I know there's been some questions about delays on 2.0 submission to the FDA. Has it been submitted to the FDA? And I think on the stock issuance, Do we know the number of shares that are expected to be issued to fund the deal?

Yeah, I'll let Dan hit on the stock issuance piece. It very much is a dual product strategy within the MCT category.

Back to my prior comments, I think it's going to take multiple products to really serve that MCT category as effectively as possible.

There are just so many different preferences when it comes to physician needs and expectations in that category, patient needs and expectations. There's some that like the longer wear duration that can get out to, you know, what will be 21 days in our MCT product as a single wearable patch. There's others that don't mind replacing a patch every seven days or so, and getting out to 30 days, you know, of monitoring is more important to them. Sometimes the downgradable aspect is more important to physicians or to patients or having the live look-in as they're wearing the device, being able to peek in and see what's going on. Those are all different requirements that our customers, physicians, and patients ultimately have in this category. So I do think a dual product strategy is the right one. You mentioned Zio MCT 2.0. I think maybe you're referring to MCT 1.0, which is what we're working to get you know clearance with the FDA that continues to progress and then we continue to seek that but there ultimately would have been a pathway in our own product roadmap that would have taken MCT 1.0 onto MCT 2.0 that would have introduced many of the features that you're seeing in the vital patch as well so now we've accelerated that into our product portfolio and frankly we'll have multiple product offerings to serve this segment sooner than what we had ever anticipated in the organic roadmap pathway that we had.

And Vijay, on your question on number of shares issued, just as a reminder, $50 million in equity and calculated with a 30-day volume-weighted average price, that equates to just a little more than 420,000 shares, which is less than 1.5% dilution.

Your next question comes from the line of David Rescott with Baird. Your line is open. Please go ahead.

So great. Thanks for taking the question. Congrats on the quarter and the deal. I wanted to ask maybe a two-parter on the deal itself. I totally appreciate the MCT angle, But you called out some of these multi-parameter sensing capabilities that can, you know, open the door to some additional markets longer term. I recall, you know, two years ago or so, you did this licensing agreement with BioIntellisense for some of their sensor capabilities. So curious if you could paint us maybe a picture around, you know, what these additional parameters get you beyond what you've been working on so far today, maybe not necessarily the timelines, but how we should think about some of these additional opportunities to break into multi-parameter monitoring, you know, could come about. And then when you think about the, you know, either cost synergies or investments that you've made that Vital Connect has made, you know, is there anything in particular that you can call out there when you think about more of the cost energy side of it?

Sure. So let me hit on the first one and then take the second part of that. When you think about the multi-vital opportunity or the incremental sensing parameters that are out there, there is some overlap in what Vital Connect has already been able to achieve on their vital patch, along with what we were looking to do in our own efforts internally. So it does speed us up in terms of bringing some of those incremental sensing capabilities onto an iRhythm platform or a combination of iRhythm and Vital Connect's platform now. But there are also some incremental capabilities that we were focused on and that we acquired through that IP license with BioIntellisense, and those are important. As an example, we really like the PPG capability that BioIntellisense has. We find it to be very differentiated, unique, like our freedom to operate in and around that. You would ultimately see that come together in our platform, including the vital patch. And so those are important and complementary to each other as we think about the future. They don't obsolete each other. They just help build an even stronger product into the future that we think can serve, you know, many more patients, obviously open up new markets. I think multivital monitoring is going to be very important in the whole hospital into the home segment. It's going to be important with RPM capabilities.

These are all, you know, new markets that aren't contributing to our revenue or growth profile today but in the future I believe have the potential to do that so we're excited by it there's still work to be done to be honest with you on the whole product roadmap and so you'll hear more and you know from that from us into the future but early thoughts around it are are exciting and David on the second part of your question there I will say you know growth really is the primary focus of the of the acquisition we see a real opportunity there to leverage the commercial engine that we've built and the reach that we have there the clinical service capabilities we've built and I'm excited about seeing that come to come to life as we bring vital connect into into the combined company on the cost side you know I would say we've built kind of operational capabilities and scale that we really believe will allow the two companies to operate you know more efficiently than than they would kind of independently much like our core business, our focus is on profitable growth as we think about this deal. So a lot to leverage there in terms of the capabilities that we've built. And if you think about it, you know, they're really call it kind of 10 years, you know, 10 years behind us in terms of the build out of capabilities and operational infrastructure. And that's exactly what we're going to bring to bear as we welcome them to iRhythm.

Your next question comes from the line of Mike Pollark with Wolf Research. Your line is open. Please go ahead.

Hey, this is Geron from Mike. Thanks for taking the question. I think if I heard correctly, you mentioned that new stores contributed 45% to volume growth, which is down from previous quarters. So maybe what's driving that decel and how should we think about that and the cadence in the coming quarters. Thanks.

Yeah, appreciate the question there. You know, we have commented previously that that number can kind of fluctuate, you know, and vary quarter to quarter. You have heard us speak to a number of the large accounts that we opened up in 2025. And if you recall, that was in the early part of 2025. So those accounts and in addition to those, you know, a few innovative channel partners kind of rotated out of new store into same stores as we define it there. And so we saw that flip a little bit to the same store side. I would say importantly, you know, still seeing solid growth from both sides of the business and would likely expect that to stay a little more weighted towards same store, given that the dynamics that I just mentioned.

Your next question comes from the line of Richard Newiter of Truist Securities. Your line is open. Please go ahead.

Hi, thanks for taking the questions, guys. Great quarter.

Congrats on the deal. I actually have two questions on the deal. I'll ask them both front. First one is, Quinton, what exactly is, you know, the top priority or the biggest thing you need to do or entail in integrating vital into your infrastructure? And is there anything that's kind of, you know, you got to get this right or this is kind of the heaviest lift? So if you just answer that and where the biggest kind of focus is there. And then the second question is, You mentioned earlier, you said heading into 27, you know, VITAL is your key priority, and it sounds like you were talking about that relative to ZOMCT. I just want to clarify if that's the case, because in any way, is this a signal that you're deprioritizing ZOMCT in favor of VITAL?

Thanks, Rich. So, let me hit the first one. You know, in terms of what needs to happen to make sure this is successful right out of the gate, I think there's really two things that I'm most focused on and will be driving as an organization of the team. One is introducing the Vital Patch across a nationwide commercial team, increasing access of this product for patients and physicians alike across the entire country. This is, you know, a company that began, grew, scaled sort of in the northeast, north central, a bit of southeast, taking it from, call it, 30 reps under their control to, you know, a commercial force of 200 plus on our side. We're going to make sure that that goes off well, that we're trained up well, and that our customers have a great experience with this as it makes its way into the market. Along with that, from an operational perspective, that means we need to be able to scale the volumes quite quickly to support what we think will come with a nationwide launch. And so think about that from an inventory, supply chain, distribution, logistics, intake capability. Those are all things that we're very much focused on and we'll be spending time really ensuring that we're able to meet that demand as the two companies come together. With respect to prioritization and MCT, you know, it's important to realize we are continuing our efforts on MCT. We're not backing away from MCT. I do believe that you need a multi-product strategy in this MCT category to ultimately be able to go after the entire marketplace. ZOMCT will be a superior product to ZOAT. And over time, we need to move away from ZOAT and onto a ZOMCT platform. We know it has a better cost profile. There's more automation that we can put to it in our manufacturing centers as a longer wear profile. These are all very important things to us. And so I think if you go back to my prepared remarks, you see our focus is on continuing to be on getting that product cleared with the FDA and ensuring we have optionality in that MCT product space or market space. However, just given where we think that we're going to close with Vital Connect, we're going to be in a situation where that product is going to be available to our commercial team ahead of clearance with MCT or at least that's our belief because we think that we'll get through the FTC by the end of the year that means we need to be prepared for an integration of vital patch onto our commercial force as quickly as possible so I'm just trying to lay out for you sort of how we think about things coming together I think vital patch and vital connect you know gets closed earlier and we're not going to wait around for an NCT clearance to then, you know, figure out, do you introduce one product versus the other? We're going to lean right into Vital Patch, get that out there and get going with it.

Your next question comes from the line of Suraj Kalia with Oppenheimer. Your line is open. Please go ahead.

Hi, Quentin. Can you hear me all right?

We got you.

Gentlemen, congrats on the quarter. So, Quentin, forgive me, many calls going on at the same time, so I must have probably missed this. Is the value proposition for Vidal Connect really about the Vidal Connect MCT product? And partly the question, within the question, is the algorithm is going to be different for Vidal Connect versus the Zio MCT, even if we keep the bridge devices and everything aside for now. I'm just talking about the software component. So maybe if you can help us understand that if the logic's here to keep, you know, to push VitalConnect initially till ZioNCT comes online, I'm just trying to understand the need for VitalConnect at this time, especially on the NCT side. And apologies again if you've already talked about this.

Yeah, well, I think VitalConnect brings, and the VitalPatch in particular, brings incremental features beyond ZOMCT that are very interesting to us and are important to be able to compete in the entire MCT category. Again, the four-in-one capability, the live looking capability, getting out to 30 days, as an example, opens up a remaining part of the market that ZOMCT can't get to. That's a meaningful market opportunity. That's another $200 to $300 million market opportunity that, frankly, Zio MCT just could never have gotten to. So back to my point of needing to have, you know, various products and feature sets, I think that's very important to be able to compete in the entire MCT category. So yes, we do like what Vital Patch brings to us within MCT, and I do, the MCT product, or sorry, the MCT market, I do think, you know, opens up incremental opportunity on our own ZOMCT product. But beyond that, it also opens up things like inpatient monitoring, in-hospital monitoring that they have clearance for. It opens up opportunities like hospital into the home, RPM capabilities. Those are all unique capabilities of their product and their platform that we're excited about and believe open up new revenue opportunities into the future. Your final... I'm sorry, but you had one last point on the software algorithms. Look, we're going to be able to bring the best of both companies together in this respect. We've done a good amount of work around the clinical side of it. We feel good about their product. Obviously, we as iRhythm have invested tremendously over the years in clinical data. We'll continue to do that in the future on the combined platform and I think leverage our learnings and put the best products into the market.

Thank you. Your final question comes from the line of Mason Carrico with Stevens, Inc. Your line is open. Please go ahead.

Hey, guys. Thanks for fitting me in here. A lot's been asked, but I guess I think you guys mentioned the potential for a publication or some data later this year showcasing real-world economics within the Innovative Partner Channel. Is that still on track? What other initiatives are you deploying to help potentially accelerate these partners moving from pilot to more enterprise-wide deployment?

That's a great question, and you're exactly right. We commented on that. In the past, we do continue to expect to see some of that real-world data make its way into the marketplace in the back half of this year. We expect one of our innovative channel partners to continue to work to publish information. We've had one that has begun to speak about it from the podium, We expect more to come, but we also have some work that we're doing with one of these innovative channel partners, too, that we'll likely publish. So I do expect you're going to see some real-world data, cost-benefit data, cost-savings data make its way into the market.

Your next question comes from the line of Brandon Vasquez with William Blair. Your line is open. Please go ahead.

Hey, everyone. Thanks for the question, and congrats on the quarter and on the deal. So I'll just leave it to one question, maybe a big-picture question. As you bring in kind of this complementary technology from Vital Connect, do you think as you look down in the future, you know, sleep or maybe even we've had discussions in the past about diagnosing valve disease, et cetera, does this expedite or make a clear line of pathway to some of the future TAM expansion opportunities?

And if so, you know, does that look like a co-mingling of the two products, maybe on back end at least or does the hardware eventually merge do you always keep two pathways just talk a little bit about that what this deal might look like in three to five years instead of just in the next couple of years thanks yeah it's a great question and that's part of what really excites us about the opportunity when you start to look out three four or five years you think about the new markets that are starting to come into reality at that point in time whether it is you're you're in hospital you know monitoring monitoring in the med-surg you know ward within the hospitals as an example you can start to see the whole hospital into the home monitoring really trying to bend the cost curve of readmission back into the hospital I think we're going to be able to monitor all the appropriate modalities off of this sensor that are important and importantly we have an IDTF capability in the background that is providing monitoring for a lot of these health systems that just don't have the capacity to do it And so I love the way we're positioned to be able to get after some of those new market opportunities out into the future. I do think other disease states are going to continue to grow and become more prevalent. You've heard us talk about sleep. Sleep continues to be important to us. We'll continue to lean into it. I like what we're learning there. It's going to be a real opportunity for us. Heart failure is another one that I think has a real opportunity to be impacted. And I think the combination of our two companies gives us a platform with a lot of flexibility on it where we can take the best from both sides over time and really improve what is available to patients and physicians in the marketplace. So a lot yet to come, but there's a lot of capabilities on our own platform that I think would be terrific on their platform, and I think there's a lot of things in their platform that could be terrific on ours, and that's what we'll be focused on bringing together over time. So we're excited by the combination, and we think it opens up a lot of incremental market opportunities and a lot of incremental product features that ultimately millions and millions of patients are going to get the benefit of.

There are no further questions at this time. I will now turn the call back to Quentin for closing remarks.

Well, in closing, I'd like to take an opportunity to recognize our employees on a terrific quarter, in many respects, a record quarter across so many measures for us. And it's really their commitment and execution that has made this possible for the company. We continue to deliver strong results while continuing to invest in the opportunities that are going to drive the growth of the company into the future. And with a differentiated market position, expanding capabilities, the strategic addition of Vital Connect, we believe we're well positioned to extend our leadership and create long-term So as we celebrate our 20th anniversary, I couldn't be more proud of the team, more optimistic of the future. And I thank all of you guys for joining us today. See you soon.

This concludes today's call. Thank you for attending. You may now disconnect.