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WELL Health Technologies Corp reported disappointing earnings for Q4 2024, with a significant miss on expected earnings per share (EPS) and revenue. The company posted an EPS of -$0.07, falling short of the forecasted $0.0619. Revenue also missed expectations, coming in at $234.76 million against a forecast of $262.61 million. The stock reacted negatively, dropping 6.67% in pre-market trading. According to InvestingPro data, the company maintains a market capitalization of $94.09 billion and shows a strong financial health score of 3.01, rated as "GREAT" despite the recent earnings miss.
Key Takeaways
- WELL Health reported an EPS loss, missing the forecast by a wide margin.
- Revenue was also below expectations, contributing to the stock’s decline.
- The company’s Canadian operations and acquisitions remain a focus for future growth.
- Market sentiment was negative, with stock prices falling significantly post-earnings.
Company Performance
WELL Health Technologies experienced a challenging quarter, with its financial performance not meeting market expectations. Despite the miss, the company reported a 19% year-over-year increase in annual revenue, reaching $919.7 million. Net income saw substantial growth of 75% from the previous year, indicating underlying business strength despite the quarterly setbacks. InvestingPro analysis reveals impressive revenue growth of 21.58% in the last twelve months, with EBITDA reaching $2.96 billion. The company’s current ratio of 2.22 suggests strong liquidity position, though InvestingPro’s Fair Value analysis indicates the stock may be currently overvalued.
Financial Highlights
- Annual revenue: $919.7 million (19% increase year-over-year)
- Net income: $29.1 million (75% increase year-over-year)
- Free cash flow: $49.3 million (16% increase)
- Adjusted EBITDA: $46.7 million, affected by revenue recognition delays
Earnings vs. Forecast
WELL Health’s EPS of -$0.07 was a stark contrast to the expected $0.0619, representing a significant miss. The revenue shortfall of $27.85 million further exacerbated the disappointment. This performance diverges from the company’s historical trend of meeting or exceeding expectations, raising concerns about future quarters.
Market Reaction
The stock price of WELL Health dropped by 6.67% following the earnings announcement, reflecting investor disappointment. The stock’s fall to $3.99 places it closer to its 52-week low of $3.41, highlighting the market’s negative sentiment in response to the earnings miss.
Outlook & Guidance
Looking ahead, WELL Health remains optimistic, providing a revenue guidance range of $1.4 to $1.45 billion for 2025, with adjusted EBITDA expected between $190 and $210 million. The company aims to achieve $800 million in revenue and $100 million in adjusted EBITDA in Canada by the end of 2025. InvestingPro subscribers have access to 8 additional exclusive ProTips and comprehensive analysis, including detailed growth projections and valuation metrics. The analyst consensus recommendation stands at 1.63, indicating a strong buy signal, with price targets ranging from $134 to $242. WELL Health’s strategic initiatives, including the expansion of its Wellstar platform, are expected to drive future growth.
Executive Commentary
CEO Hamed Shabazzi expressed confidence in the company’s growth prospects, stating, "Well’s growth engine has never been stronger." He emphasized the potential for Canadian M&A opportunities to enhance performance, noting, "Our guidance does not include any in-house acquisitions, and we have a tremendous pipeline of potential acquisitions that could significantly boost guidance upwards."
Risks and Challenges
- Revenue recognition issues, particularly with Circle Medical, could continue to impact financial results.
- The competitive landscape in healthcare technology remains intense, posing challenges to market share expansion.
- Macroeconomic factors, such as changes in healthcare regulations or economic downturns, may affect growth.
Q&A
During the earnings call, analysts raised concerns about the revenue recognition challenges with Circle Medical. The management addressed potential outperformance through Canadian acquisitions and highlighted the international expansion potential for Wellstar products.
Full transcript - WELL Health Technologies Corp (WELL) Q4 2024:
Operator: Welcome to the Well Health Technologies Corp fourth quarter two thousand twenty four and fiscal year two thousand twenty four financial results conference call. My name is Kim, and I will be your operator for today’s call. At this time, all participants are in listen only mode. We will conduct a question and answer session later in the call, which will be restricted to analysts only. Please note that this conference is being recorded.
I will now turn the call over to Tyler Baba, Manager, Investor Relations. Mr. Baba, you may begin.
Tyler Baba, Manager, Investor Relations, Well Health Technologies: Thank you, operator, and welcome, everyone, to Well Health’s fiscal fourth quarter and full year twenty twenty four financial results conference call for the three months and full year ended 12/31/2024. Joining me on the call today are Hamed Shibazi, Chairman and CEO and Eva Phong, the company’s CFO. I trust that everyone has received a copy of our financial results press release that was issued earlier today. Portions of today’s call, other than historical performance, include statements of forward looking information within the meaning of applicable securities laws, including future oriented financial information and financial outlook information. These forward looking statements involve known and unknown risks, uncertainties, assumptions and other factors, many of which are outside of control, that may cause the actual results, performance or achievements of Wells to differ materially from the anticipated results, performance or achievements implied by such forward looking statements.
These factors are further outlined in today’s press release and in our management discussion and analysis. We provide forward looking statements solely for the purpose of providing information about management’s current expectations and plans relating to the future. We do not undertake or accept any obligation or undertaking to release publicly any updates or revisions to any forward looking statements to reflect any change in our expectations or any change in events, conditions, assumptions or circumstances on which any such statement is based, except if it is required by securities law. We may use terms such as adjusted gross profit, adjusted gross margin, adjusted EBITDA, adjusted shareholder EBITDA, adjusted net income and adjusted free cash flow attributable to shareholders on this conference call, all of which are non GAAP and non IFRS measures. For more information on how we define these terms, please refer to the definitions set out in today’s press release and in our management’s discussion and analysis.
The company believes that adjusted EBITDA is a meaningful financial metric as it measures cash generated from operations, which the company can use to fund working capital requirements, service future interest and principal debt repayments and fund future growth initiatives. Adjusted EBITDA should not be construed as an alternative to net income or loss determined in accordance with IFRS. And with that, let me turn the call over to Mr. Hamid Shabazzi, Chairman and CEO.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Thank you, Tyler. Good day, everyone. We appreciate everyone for joining us today as we discuss our Q4 and annual 2024 financial results. Before we get into our discussion, I’d like to address two exceptional items that impacted our 2024 results, which impacted two of our US subsidiaries. One circle medical, which is a non wholly owned subsidiary and medical, which is wholly owned.
Let’s start with circle medical first, as previously disclosed, just a couple of weeks ago on March 29, Circle Medical received a request from US regulators investigating certain of Circle Medical’s billing practices in The United States. In the annual consolidated financial statements for the year ended 12/31/2024, the company recognized an expense of US2.8 million dollars for the year ended 12/31/2024 for estimated settlement costs on its audited financial statements. As the company was finalizing its annual filings for fiscal twenty twenty four, it was determined that Circle Medical had billed and received payment for patient services that had been delivered during 2024 for which had not yet met all of the required criteria to recognize such revenue under applicable IFRS standards. As a result, the company has recorded a revenue reduction of $56,600,000 for fiscal twenty twenty four and recognized cash received from customers of $53,900,000 as deferred revenue as at year end. The company expects to recognize substantially all of this deferred revenue during fiscal twenty twenty five with the remainder recognized in fiscal twenty twenty six.
As of 04/11/2025, Well has already satisfied the criteria for revenue recognition in fiscal twenty twenty five for approximately $6,700,000 of this deferred revenue. The company expects to recognize substantially all of this deferred revenue during fiscal twenty twenty five with the remainder in ’twenty six. As of April 14, as I mentioned, we’ve recognized already 12% of this deferred revenue. Note that when the revenue is recognized, there won’t be any costs recognized against this revenue resulting in full contribution to adjusted EBITDA in 2025. Therefore, we expect a significant boost in our reported adjusted EBITDA in 2025.
And that has been embedded in our guidance. I want to stress here that all the revenue that is being deferred is related to patient care that was already delivered in 2024. It is expected that we will not lose any revenue here. Circle Medical had thousands of patient visits in 2024, where we provided care for patients related to these patient visits. We billed for them and consequently received payment for them.
The impact is a revenue recognition policy where a portion of CIRCLE’s revenues being deferred to the future, even though the delivery and payment happened in 2024. Hence, we are seeing revenue and EBITDA decline in 2024, but will have the positive impact of increasing both revenue and EBITDA accordingly in 2025. The billing errors relate only to Circle Medical and have no effect on the rest of Wells business. Circle Medical has since made changes to its billing practices and revenue recognition policies to remediate the issues causing this deferral. As previously disclosed, we had initiated a process last year to seek strategic alternatives for Circle Medical.
The company is committed to carrying out this process in due course. I’ll discuss this further later on in the call. And now an update on Change Healthcare cybersecurity impact on CRH. As previously discussed last year, CRH Anesthesia’s primary billing partner Change Healthcare experienced a cybersecurity attack in February of twenty twenty four, which sidelined the Change Healthcare Revenue Cycle Management Service relied upon by the company for billings and collections. This resulted in the company experiencing delayed billing and cash collections on claims processed for several months during 2024.
Due to this business interruption affecting a significant number of healthcare companies across The United States, which rely on Change Healthcare for revenue collection, Change Healthcare’s affiliate provided advanced funding to many of its customers, including CRH in lieu of the cash collections CRH would normally receive related to these claims. During the fourth quarter of twenty twenty four, CRH updated key assumptions in its revenue recognition model related to the Change Healthcare Cybers attack and determined that it would delay the recognition of approximately 24,500,000.0 Canadian dollars of revenue in the fourth quarter of twenty twenty four that otherwise would have been recognized during 2024 had the cyber attack not occurred. CRH expects to recognize these revenues if and when collections from patients and third party payers occur, and when settlement terms have been reached with Change Healthcare. Once this occurs, such earnings will result in almost 100 contribution to adjusted EBITDA Due to the uncertainty regarding the timing and the amount that will be recovered, this has been excluded from our 2025 guidance. Notwithstanding to our revenue from Circle Medical revenue deferral and the Change Healthcare Cyber Attack matters, we’re very proud of our overall achievements in 2024.
Simply put, the fundamentals and outlook of our business have never been stronger despite these two IFRS revenue impacts, Well delivered record annual revenue and free cash flow attributable to shareholders in fiscal twenty twenty four. Well achieved annual revenue of $919,700,000 in 2024, an increase of 19% compared to the prior year. As you can see here, revenue was negatively impacted by a delay in the recognition of earnings related to Circle Medical and CRH in the amounts of $56,600,000 and $24,500,000 respectively. All of the deferred Circle Medical revenues expected to be recognized as I mentioned earlier in 2025, and the CRH revenues will be considered recognized once collected or earned as other income when terms are confirmed with Change Healthcare. Excluding such impacts, the company was on track to achieve record revenue of $1,000,000,000 Canadian in 2024, which has been a clear beat on our consensus results and reflected an increase of 29% as compared to the prior year.
We think it’s important for shareholders to be aware of this as well management has a culture of being highly accountable to its guidance. And excluding, the two IFRS revenue impacts, we had beaten again. As you can see here, as a result of revenue recognition delays, related to Circle Medical and CRH, our adjusted EBITDA in 2025 was $46,700,000 as compared to adjusted EBITDA 113.4 in 2023. Adjusted EBITDA was impacted by 56,600,000.0 as a result of the Circle Medical revenue deferral and 23,800,000.0 as a result of the revenue deferral delay, pardon me, related to the Change Healthcare cyber attack. Although Circle Medical contributed a net loss to consolidated income and only contributed 2.7% to the company’s consolidated adjusted EBITDA in 2023, under IFRS for fiscal twenty twenty four, the company is required to recognize 100% of the expenses related to the $56,600,000 that was deferred, which results in a significant reduction in adjusted EBITDA for fiscal twenty twenty four and caused a significant positive contribution to adjusted EBITDA for fiscal twenty twenty five once the deferred revenue is recognized.
The graph on the right shows excluding the impacts from these two matters, adjusted EBITDA would have been 127,000,000, an increase of 12% as compared to 2023, which is within the range of our previously provided annual guidance for 2024. The company continues to seek strategic alternatives for Circle Medical, and we are committed to carrying out this process. Again, we will discuss this further. This slide shows some of our key annual financial highlights. For fiscal twenty twenty four, we achieved net income of $29,100,000 representing 75% year over year growth compared to $16,600,000 in 2023.
Free cash flow attributable to shareholders was $49,300,000 in 2024, an increase of 16% as compared to the prior year. We were trending to be higher than $50,000,000 in free cash flow, but had more significant CapEx at the end of the year, as we had suggested could happen in our Q3 conference call on a per share basis. Free cash flow attributable to shareholders was 20¢ per share. Our Canadian business continues its strong momentum with 30% year over year growth and 20% year over year organic growth and our adjusted EBITDA in Canada grew 22% year over year to 56,000,000. I will now share with you some of our operational highlights for 2024.
As of the end of Q4 twenty twenty four, Well had over 4,100 providers and clinicians delivering care across our entire network of physical and virtual clinics. Of that number, I’m proud to announce that we now have over 2,500 providers within well owned clinics in Canada, which includes approximately 1,000 physicians, which is over 1% of all physicians practicing in the country. We have a tremendous runway to continue to expand our footprint across Canada. In addition, there are more than 41,000 providers benefiting from our SaaS and technology services, most of which are physicians. We estimate that well over 40% of all physicians in Canada touch our Wellstar technology platform in some way.
As we enhance our digital offerings and provide leading AI products and services, we can see the increasing importance, relevance and role that our company is playing in the country’s healthcare ecosystem, and we’re determined to make a positive impact. Looking at our patient visits, as our revenues are generally underpinned by patient visits, as such, it’s very important to track them, especially in this quarter, as we are experiencing some delays in revenue recognition under IFRS. We delivered 5,700,000 patient visits in 2024, a 32% year over year increase from the prior year with strong organic growth of 30%. These results demonstrate our strong fundamentals and unique platform, which is winning in the marketplace. Canadian patient visit metrics continue to demonstrate that this is one of the most prominent growth drivers of the company as visits grew by 35% year over year with organic growth at 32% inclusive of absorptions and same clinic growth.
US patient visits grew by 28% year over year with all of it related to organic growth. Total care interactions, which is defined as total patient visits plus technology interactions, plus biller provider hours were over 8,700,000 in 2024, which was a 37% increase as compared to the last year and represented 34% organic growth. Turning to our guidance for 2025, Well is expecting its strong fundamentals and operational performance to continue into 2025 with a greater focus on leveraging all the product and corporate synergies he has access to, given its depths of product and technology at Wellstar and now HealWell. Moreover, the company continues to focus the substantial majority of its M and A and capital allocation activity in Canada where it is experiencing its strongest returns. Management will continue to pursue its focus on optimizing its operations for organic growth and profitability.
With that, well, as pleased to provide a positive outlook for 2025 with annual revenue guidance of between 1.4 and one point four five billion For adjusted EBITDA, we’re providing annual guidance in the range of 190,000,000 to $210,000,000 Note that we’ve included over 90% of the $56,600,000 deferred Circle Medical revenue in our 2025 guidance. This IFRS revenue associated with circle medical deferral will have a close to 100 percentage contribution as I noted to adjusted EBITDA. And it’s important to consider when evaluating the company’s performance. We expect Circle Medical deferred revenue will be recognized primarily in matters noted on a quarter by quarter basis. Note that as of today, the company has already recognized again, approximately $6,700,000 of this deferred revenue.
Our guidance does not include contribution from the $24,500,000 in delayed earnings on CRH until this matter is resolved through a more exhaustive collection effort performed by Change Healthcare or formal agreement with Change Healthcare itself as it relates to their advances. Our guidance includes 100% consolidation of Healwell Financial starting in Q2 twenty twenty five as per IFRS control requirements. We’re currently expecting this will add approximately $120,000,000 in annual revenue with positive adjusted EBITDA contribution. Note that Wells voting interest in HewWells currently approximately 4069%, pardon me, and its economic ownership of Heal Wells is currently at approximately 37%. Our guidance reflects healthy organic growth expectations in our Canadian operations.
Importantly, this guidance does not include any unannounced acquisitions and we have a very strong pipeline with a strong balance sheet. Separately, while this is not part of our official 2025 guidance, we’re pleased to note that with the strong outlook and fundamentals of our Canadian business, we are now targeting to reach $800,000,000 in revenues and $100,000,000 in adjusted EBITDA in Canada alone by the end of next year. We’re confident in our fundamentals and outlook and are expecting 2025 to be a great year for the company with record revenue, EBITDA and cash flow. I’d now like to provide the listeners today with an overall view of what Well Health family will look like in the future. We anticipate Well will be comprised of three operating subsidiaries and two publicly listed entities.
The three operating subsidiaries will include Canadian clinics, Well Health USA and our cybersecurity business unit. The two publicly listed entities will include Wellstar and HealWell. HealWell is currently listed on the TSX under the ticker AIDX and Wellstar is expected to debut with an IPO on the TSX by early twenty twenty six. Well Health is the largest shareholder in each of Wellstar and Healwell. We have a majority ownership position in Wellstar and a majority voting share ownership in Healwell.
Both Wellstar and Heal Well are independent companies that will have their own capital allocation strategies, fundraising plans and acquisition opportunities. However, both Wellstar and Heal Well will continue to work very closely with Well and our clinical footprint in Canada. Now that we’ve covered off some of the key results, I’d like to cover off a few key topics. We’ll do a deeper dive into Heal Well, our Wellstar and Buy Canadian theme, our Canadian clinics update, and as well an update on the Wissman circle sale processes. Let’s start with Healwell.
We’re very pleased with the progress of Healwell AI, a company that we developed a plan and took a major leadership role in recapitalizing and relaunching eighteen months ago after we acquired its MCI clinics and formed a pure play AI software company. With Healwell’s recent acquisition of Orion Health completed on April 1, Healwell’s building the world’s leading company in healthcare data interoperability and artificial intelligence. In conjunction with Healwell’s acquisition of Orion Health, Well increased its holdings in Healwell to an approximate 37%, economic interest and an approximate 69% voting interest. As a result, the company will begin to fully consolidate Healwell in its financial results, starting in Q2 twenty twenty five. We’re very excited about the progress made at Healwell and its future.
Healwell’s commercial success is underscored by its partnerships with seven of the top 10 pharmaceutical companies in the world. This robust client base reflects its ability to deliver unparalleled value to the healthcare ecosystem. Healwell is not just revolutionizing patient care through AI, but through building a scalable and sustainable platform that is shaping the future of healthcare. Healwell’s strategic acquisition of Orion Health significantly enhanced Healwell’s market position, accelerating its path to profitability. Orion Health was generating approximately $100,000,000 in annualized revenue run rate.
The majority of which coming from large enterprise staff with strong operating EBITDA margins. Orion Health provides significant strategic benefits to heal well and now well, which includes one financial benefits of its strong recurring revenues two, scale benefits as Orion Health currently services a total population of 150,000,000 lives throughout all of its customers worldwide. Three, a significant distribution opportunity for Healwell’s AI offerings, as well as Wellstar’s best in class provider focused tech. And four, data science and data interoperability expertise. Before public sector clients can use AI, which they really want to do in any meaningful manner, they must get their data normalized and organized and achieve interoperability.
This is not an easy task, and Orion is one of the best in the world at helping public sector healthcare groups organize their data. This is a very important thematic to be aware of. This map shows how Healwell has strengthened its position with the Orion Health acquisition as the global leader in AI driven healthcare solutions. Today, Orion operates across 11 countries delivering cutting edge software solutions to public and private sector customers globally. Its technology is deployed across 70 sites, more than 70 sites globally supporting healthcare systems that collectively manage again over 150,000,000 patient records.
This global presence combined with deep integration into healthcare ecosystems positions heal well for sustained growth. The company’s solutions are powered by 500 global employees working out of 15 global offices in 11 countries. As a leader in AI driven healthcare solutions, Healwell has large referenceable customers globally. Its ability to execute at scale is evident in the successful deployment of digital care records or DCR and digital front door or DSD solutions for major healthcare systems across the world. Some of these customer deployments include, for example, in Saudi Arabia, Healwell and Orion is powering the world’s largest digital health care records deployment globally covering 35,000,000 people.
This system integrates data from over 5,000 governmental and private healthcare providers, creating a single comprehensive view of each patient’s medical history. In Ontario, Canada, Healwell, or Orion has delivered a digital front door platform serving 15,000,000 people and is now executing on the deployment of a unified digital care record system to enhance clinical interoperability. In Abu Dhabi, Orion has deployed its first ever digital care record solution in The Middle East, seamlessly connecting 100% of all hospitals, clinics, and pharmacies to improve patient outcomes through real time data integration. This is an exceptional solution and result of which there are far very few examples in the world. And in The United States, EOL is delivering, or Orion’s delivering digital health care records for state and regional health information exchanges or HIEs in Maine, Minnesota, Pennsylvania, New Mexico, North Dakota and Idaho reinforcing its presence in The U.
S. Healthcare ecosystem. And now I’d like to talk a little bit about the strategic spinout of Wellstar. During Q4 we created Wellstar, a Well subsidiary which we intend to spin out as a publicly listed high growth profitable pure play software as a service or SAS healthcare technology company, which would still be majority owned by Well. Wellstar is the technology platform that powers Wells clinical ecosystem.
Wellstar is dedicated to empowering healthcare providers with innovative solutions that enhance patient care and optimize operational efficiency. Wellstar addresses the diverse needs of the healthcare providers by streamlining care delivery, integrating fragmented care systems, reducing burnout and improving patient care and experiences and outcomes. There are over 4,000 clinics across the country that are customers of Wellstar, and as we noted earlier, over 40% of all providers in the country touch the platform in some way. Wellstar is currently on a $70,000,000 annual revenue run rate, generates 80% gross margin, is operating as a rule of 40 or better business with 20% organic growth and 29 adjusted EBITDA margins before shared services. Wellstar is already one of the most relevant and consequential companies in the Canadian healthcare technology landscape, and has firmly established itself as a de facto market leader in technology enabling clinicians across the country.
We believe Wellstar will be a very strong IPO candidate on the TSX main board sometime in early twenty twenty six. We continue to believe that pursuing a spinout and public listing for Wellstar will accelerate the growth of the company, providing it with attractive cost of capital for M and A purposes and position it to be a multibillion dollar company itself in the pure healthcare software vertical. We’ve already completed the first step in the Wellstar Go Public Plans, which was to add significant capital to Wellstar’s balance sheet, so it can execute on its acquisition plans. As such, during Q4, Wellstar closed on a 50,400,000 equity placement, entirely supported by Mauer Investment Management, Edgepoint Wealth Management, and Pendra Fund Capital Management, three very reputable investment firms with a strong track record of investing in Canadian technology leaders. Well, and Wellstar management also participated in this financing to fund Wellstar’s pre spin out growth objectives.
Well, did not issue any shares as part of this transaction. Step two for Wellhealth and Wellstar is to acquire scale in its business. Wellstar completed acquisition of two healthcare technology companies, Microquest and Bluebird, which boosted Wellstar’s annualized revenue to approximately 70,000,000. Wellstar has a compelling pipeline of target acquisitions in portfolio before Wellstar does its public listing. Our plan is to build additional scale by completing additional acquisitions that will position Wellstar towards $100,000,000 in annual revenues.
Step three is the actual IPO, which we expect to occur in the next three to four quarters. As a majority voting shareholder, we expect to continue consolidating the financial results as I mentioned earlier. We’re now pleased to report that the by Canadian sentiment is presenting significant strategic advantages for Well Health, especially in the Well Start and Heal Well areas of our business. As policymakers across the federal and provincial levels increasingly prioritize domestic healthcare solutions, Well Health is uniquely positioned to benefit from this shift and further solidify our leadership in Canadian healthcare ecosystem. In recent months, we’ve had a 200% increase in the size of our public sector pipeline, as our deep rooted presence in the Canadian healthcare landscape has led to unprecedented engagement from various different federal and provincial governments.
We’re currently seeing over 70 opportunities across Canada representing 300,000,000 in deal value. In the past, despite there being high quality technology vendors available in Canada, Public Sector Procurement Managers were mostly buying US products and services to power many aspects of the Canadian healthcare ecosystem. The recent US tariff policies have completely changed this perspective and accelerated the demand for homegrown digital health solutions. This policy driven shift has created new revenue opportunities for Well Health as one of the few companies in the country with the technology depth to deliver on large projects, particularly in the areas such as digital health infrastructure, AI powered solutions, virtual care, and primary care enablement. Our acquisition of Orion Health through Healwell has further solidified our position as a leading provider of provincial health information exchange platforms, while the expansion of OceanMD’s eReferral platform in BC and other provinces is streamlining patient care coordination.
Our extensive network of healthcare providers, as well as our own and operated network, which is the largest in the country positions us very well to support policymakers in their efforts to enhance patient outcomes. We also believe that Well will benefit from a reduction in engagement from U. S. Companies internationally. Note that with Orion Health we now have boots on the ground in 11 countries globally, and we’ll be working with Orion to sell more of our Wellstar capabilities internationally.
This is a unique catalyst not previously considered before within Wells business. The third theme I’d like to discuss this morning is success of our Canadian business. As you can see from these charts, the historical performance of our Canadian clinics business has been exceptionally strong. Canadian clinics achieved revenue of $319,000,000 in 2024, handily beating our previous revenue guidance of 300,000,000. Over the past four quarters, our Canadian clinics business had exceeded 50% compound annual growth rate.
Adjusted EBITDA attributable to our Canadian clinic business has grown at a CAGR of 44% and achieved 40,700,000.0 in 2024. Our Canadian clinics network has grown to two ten clinics at the end of twenty twenty four, compared to 167 at the end of twenty twenty three. We expect this number will continue to increase in 2025, as we have a significant M and A pipeline. In Q4, we continued executing on our strategic growth plan through the expansion of our clinic network. We acquired 20 clinics generating over 30,800,000 in annual revenue.
This does not include our affiliate clinic acquisition from Jack Nathan Health, which would increase our total clinic count to 57, including both owned and affiliate clinics. We also, our owned and operated clinic network welcomed 111 new healthcare providers in Q4, further strengthening our capacity to deliver high quality care. We continued this momentum in Q1 in which we acquired 11 clinics generating $31,500,000 in annual revenue and added 71 providers. With a diversified clinic strategy and a growing physician base and a scalable expansion model, we’re well positioned to drive long term growth and operational efficiency. And now a little bit about our M and A pipeline.
We have a very healthy pipeline of clinic acquisitions, opportunities, which we believe is directly correlated with the challenges doctors are feeling in the marketplace. We continue to focus on acquiring Canadian clinics under both our absorption model and acquisition model. Our current pipeline of Canadian clinic acquisition opportunities is very active. In Canadian clinics, we currently have five signed LOIs representing five clinics and approximately $31,000,000 in annual revenue. In total across the entire organization, including Canadian clinics, Wellstar and WellUSA, we currently have seven signed LOIs representing approximately $40,000,000 in annualized revenue.
We have a very large pipeline of target acquisitions that we are in a pre LOI stage with. We have more than 130 targets engaged representing over $390,000,000 in annual revenue. This pipeline includes more than 130 clinics. Our Canadian business and including our Canadian clinics and Wellstar businesses are doing exceptionally well and is outperforming many many ways that I’ve already mentioned earlier on this call. Our pretax unlevered ROIC or return on invested capital in Canada is expected to rise, driven by growth, acquisition integration and cost optimization.
Meanwhile, our adjusted EBITDA continues to be driven by organic and inorganic growth. Now looking a little bit more closely at our ROICs, Wellstar currently operates at a ROIC of 11%. The Well Health Diagnostic Network has achieved a historic ROIC of 12%. Note that the diagnostic network has a lower ROIC than our primary care acquisitions, because we had not done any tuck in acquisitions after acquiring the platform in 2021 until quite recently. We expect that the diagnostic ROIC to improve as we just completed our first diagnostics tuck in with the acquisition of Alberta based C Health in late twenty twenty four.
Historical ROIC in our primary care business is approximately 22%, demonstrating our ability to create value. We expect our Canadian clinic ROIC figure should improve given that our costs have reduced and our ability to execute on clinic transformation has improved in recent years. This is also demonstrated by the primary care ROIC for the last three years at approximately 30% per year for each of the three year cohorts. The three year primary care ROIC also benefits from the absorption model, which we started post COVID and has an extremely high ROIC. Wells high pretax unlevered ROIC metrics indicate that the company’s consistently creating returns well above its cost of capital, demonstrating the company’s disciplined approach to capital allocation and operational execution.
Turning to adjusted EBITDA growth for Well Canada, as you can see from the graph on the right, our year over year adjusted EBITDA of Well Canada, including Canadian clinics and Wellstar has been accelerating, while achieved annual adjusted EBITDA of 56,300,000 in 2024, a 22% increase as compared to last year. In 2025, we’re expecting our adjusted EBITDA candidate to experience an over 25% growth inclusive of both organic and inorganic growth. We’re very confident in our Canadian business and are now targeting over 100,000,000 in adjusted EBITDA in Canada alone by the end of next year. We think this is very much an achievable goal and are focused on making it a reality. The fourth theme I’d like to talk about is our current strategic review process of WISP and Circle Medical.
First of all on WISP, we concluded the first phase of our strategic review process for WISP resulting in the receipt of numerous proposals from prospective acquirers. While interest in WISP was significant, the board has determined that none of these proposals adequately reflected exceptional operational performance, accelerating growth trajectory, and substantial market opportunity in women’s healthcare. Throughout the review process, WITS continue to demonstrate strong business fundamentals with consistent revenue growth and operating margin expansion. This performance reinforces the board’s conviction in WITS long term value potential beyond what was reflected in the proposals received. The company and its advisors continue to actively work on the strategic review process, and we remain committed to our strategy of divesting the company’s U.
S. Digital assets in order to allocate more capital into Canada, and we’ll continue to provide updates as appropriate. Operationally, we’ve had a very strong 2024 with record annual revenue of $101,000,000 an increase of 30% from 2023, And it achieved record adjusted EBITDA of $5,000,000 in 2024, a 235% increase from the previous year. WISP is performing very well, and we’re expecting WISP to have improved EBITDA performance in 2025, which we believe may assist in attracting a more favorable valuation. Moving on to Circle Medical, we’ve already discussed Circle extensively on this call, so we won’t go into it too much further, but we will remind shareholders that last year we engaged a global investment bank to consider strategic alternatives for Circle Medical.
We’re still relatively early in the process, which has recently slowed down due to the regulatory inquiry. Nonetheless, we’re still very committed to continue to move forward on the sale of Circle Medical and currently have a number of discussions and engagement occurring with prospective buyers. We do not necessarily believe that the regulatory matter needs to be fully resolved before a sale takes place. This is, of course, after consultation with US Legal Advisors. We continue to believe that unlocking the value from WISP and Circle could result in significant cash benefit to Well, which we would use in a variety of ways, including redeploying the capital into our expanding Canadian clinic footprint.
And now I will pass the mic over to Eva Fong.
Eva Phong, CFO, Well Health Technologies: Thank you, Hamed. Overall, our fiscal year twenty twenty four results were positive, excluding the revenue recognition impact Hamed discussed earlier on the call. As Hamed has already covered revenue and adjusted EBITDA results, I’ll focus on Wells net income. Wells reported net income of $29,100,000 or zero one three dollars per share in 2024, an increase of 75% as compared to a net income of $16,600,000 or $00 per share in 2023. The higher net income this fiscal year was primarily driven by the fair value gains on the company’s investment in Hillwell.
From the graph, you can see that the IFRS revenue recognition impact had a material impact on our 2024 net income figure. Excluding this impact, Well was on track to achieve approximately $90,000,000 in net income. Now looking at our balance sheet as at the end of Q4 twenty twenty four. Well ended 2024 with a solid balance sheet. As at 12/31/2024, Well had cash and cash equivalents of 131,700,000.0 Well continues to be in good standing and fully compliant with all covenants related with its two credit lines, JPMorgan in The U.
S. And Royal Bank in Canada. The debt from the two credit lines was approximately C292.4 million dollars as of 12/31/2024. Our balance sheet is strong and getting stronger as we continue to grow our free cash flow generation capabilities. We should see 2025 result again in a record year of free cash flow generation.
I’m also very pleased to report that we have the cash and available resources to continue to fund our M and A program. This is true for Canadian clinics, Wellstar, and CRH Medical, where substantially all our M and A pipeline is focused on. That is my financial update. And I now turn the call back to Hamed. Thank you, Eva.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: In final here, I’m very excited about our outlook for this year, which we expect to achieve record revenue, record adjusted EBITDA, record net income and record free cash flow. First of all, I want to reiterate that our 2025 guidance for revenue of 1,400,000,000.0 to $1,450,000,000 and adjusted EBITDA of $190,000,000 to $210,000,000 This guidance does not include any in house acquisitions, and we have a tremendous pipeline of potential acquisitions that could significantly boost guidance upwards. In addition, we have not included any amounts from the twenty four point five million dollars in delayed earnings on CRH until the claims affected are collected or there is formal agreement with Change Healthcare. Our guidance also includes fully consolidated financial statements from Healwell as we noted. We’re also very excited with the potential IPO of Wellstar.
We’re expecting Wellstar to reach $100,000,000 in annual revenues by 2026. Wellstar will continue to be a guiding light in the delivery of technology solutions technology and solutions to healthcare providers. Despite the challenging economic and backdrop of the geopolitical instability of tariff, we remain committed to the sale processes of our U. S. Digital assets.
These businesses continue to be desirable given their historical growth rates, and they both reflect the future of healthcare as telemedicine businesses. Divestment of these assets will allow us to redeploy the capital in attractive ways as we discussed. Our Canadian business, including Canadian clinics and Wellstar is outperforming, and we have many tailwinds in the Canadian healthcare market driving and supporting the business, including the strong buy Canadian sentiment that we talked about. And as I noted earlier, we’re expecting Well Canada’s adjusted EBITDA to grow by at least 25% in 2025. Our longer term view of the Canadian market remains bullish again, as I noted with our two year goal of achieving $800,000,000 in revenue and $100,000,000 in adjusted EBITDA inclusive of acquisitions just in Canada.
And in addition, our Wellstar as a technology leader in Canada, we believe its growth will only accelerate with a future IPO. So in summary, we’re very pleased with the strengthening fundamentals of our business and look forward to delivering strong results in 2025 and beyond. Wealth’s growth engine has never been stronger. Organic growth is operating at its optimal level while we are executing on a very healthy M and A pipeline. We have a strong balance sheet and are well positioned to improve shareholder value.
We have a committed and disciplined team to ensure we can execute on our objectives. I’d also like to thank WeL’s senior management team and all our employees and contractors for their tremendous effort. And in particular, I’d like to thank our team of healthcare practitioners and other frontline workers who continue to provide unbelievable patient care. They remind us every day why we’re here and we’re here to support them. I also want to thank you all for joining us on this call and thank our shareholders and investors for their continued support.
The capital markets have been very supportive of our vision and have provided us with the funding needed to pursue our goals. Finally, on behalf of the management team, we sincerely apologize for the lateness of today’s report. In my twenty seven years as a public company CEO, this was the first and only time I personally or we as a company have experienced anything like this. And I am extremely sure it will never happen again. And we very much appreciate your patience with us.
We are accountable to you and we look forward to delivering for you. And with that, we will now open the call to questions. Operator, would you please help us take questions?
Operator: Okay, thank you. Ladies and gentlemen, we will now begin the question and answer session. Should you have questions, please press star followed by one on your touch tone phone. You will hear a prompt that your hand has been raised. Should you wish to decline from the polling process, please press the star followed by two.
If you are using a speakerphone, please lift the handset before pressing any key. One moment please for your first question. And for your first question comes from Mr. Michael Freeman from Raymond James. Please go ahead.
Michael Freeman, Analyst, Raymond James: Hi. Good afternoon, Ahmed, Eva, Tyler. Thanks so much for the the extremely thorough, overview of, your 2024. I have a question and a follow-up both on Circle Circle Medical. I guess just to start, could you describe the service obligation under IFRS that Circle Medical didn’t meet in order to qualify this revenue for recognition during 2024?
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Thanks Michael for the question. We’re not able to go into a significant amount of detail, given that the conversations with the regulators are ongoing, but I can tell you this is more of an administrative matter in nature. Sort of deals with because as you know, delivered the service, we got paid, but in terms of our compliance with the actual contract, The view was we may have not met the IFRS requirement for recognizing revenue. So, we took the very conservative step in order to defer this revenue.
Michael Freeman, Analyst, Raymond James: Okay, that’s helpful. Then now very quickly. Could you provide some color on how you estimated the settlement amount related to the circle medical investigation?
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: This is done really with the help of advisors. This is a civil matter. There’s a lot of, I guess, track record in terms of how these things typically There’s specialized counsel that deals with these sorts of matters. This was sort of this was an element that we were able to get this advice through advisors and certainly, these figures were audited. And so auditors need to feel comfortable that these settlements were reasonable.
And so, expert kind of feedback was sought in order to substantiate that these are reasonable provisions to be taking.
Michael Freeman, Analyst, Raymond James: Okay, thank you very much. I’ll pass it on now.
Operator: Thank you. And your next question comes from Mr. Rob Koff from Ventum. Please go ahead.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Thank you very much. And, you know, we’re very pleased with the underlying performance. It’s just such a shame, but very pleased with the fundamental growth. Thank you, Rob. We feel the same way.
Now in terms of the buy Canadian, could you perhaps elaborate a bit more in terms of the 70 plus opportunities and the deal value of 300,000,000? Like, is that 300,000,000 the total deal value across say an average of the five year term? Are these deals lumpy like some are 50 and what sort of timing? Yes, yes. So we’ve effectively in fact, was sort of the lower part of our range.
I will tell you that the deal pipeline is we were conservative here when we sized the potential length of the different contracts. It’s more like 300,000,000 to $500,000,000 depending on how far some of these contracts would go out. But yeah, they effectively involve different types of implementations of technology at the public sector level, mostly provincial, working with provincial vendors. Of course, there’s federal procurement that occurs through the InfoWey entity, which is always promoting and driving digital health kind of advancement in Canada. So clear across all those opportunities we’re seeing at least 70 plus opportunities.
Mind you, this does not include Orion. This is really important to note because Orion already has very significant installations within Canada. In fact, it’s the largest market that they operate in of all their different countries. And so they are incredibly prominent in terms of their work in not only Ontario, but also Alberta and a number of other provinces. So we think that the door opens here for, again, more opportunity for non US Vendors of which there’s not many of them that can deliver these types of solutions.
So, we’re talking about more of ocean and these type products and services are ambient scribe services, various different digital products and services across the country. Thank you very much.
Operator: You. And our next question is from Daniel Rosenberg from Paradigm. Please go ahead.
Daniel Rosenberg, Analyst, Paradigm: Hi. Thanks for taking my question. I wanted to continue on the theme of Circle. I was wondering, given the delayed revenue, if you had to make any changes to process or operations at the division? And has it changed your thoughts on the growth potential within the asset as it’s been a big driver in the past?
Effectively what that value, what kind of value you could crystallize from the asset as well?
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Yeah, look, we don’t anticipate any sustained impact over the long term. In the short term, we expect growth to slow a bit as the company focuses on reviewing compliance and transitioning to a new revenue cycle management vendor. This was one of the real keys that was, you know, resulted in some of these administrative challenges. This work will position the company for the next phase of growth. And look, there continues to be strong interest in circle.
We believe the current compliance focus may delay things a little bit, but we don’t think that it necessarily has to have a big impact on value.
Daniel Rosenberg, Analyst, Paradigm: Okay, good to hear. And then just turning to the guidance. Those are some big numbers, even when I think of all the activity that you guys have executed on with Orion and heal well etcetera. So I was curious if you could dive a little deeper on, it sounds like the Canadian business is humming just the drivers and the confidence you have in being able to achieve those results.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Yeah, I will say, our elevated organic growth is one factor. And then of course, our deep M and A pipeline. I think we are very much expecting over the next couple of years that we will have some liquidity from our US assets and that will help us. The pipeline is effectively more than we can prosecute right now with the cash resources that we have, which are strong. And so we’ll continue to be quite industrious and committed and demonstrative of what you’re seeing quarter over quarter.
That growth will continue with these sort of continued tuck ins. But liquidity occurs, we do think that that will just again help us drive additional opportunities. We also see some chunkier opportunities in the landscape and we’re very much bearing down on those opportunities. And we think that there’s some opportunities here to potentially close some bigger deals while we go after that long tail in a very systematic manner.
Daniel Rosenberg, Analyst, Paradigm: Thanks for that. And if I could squeeze one more in. I was interested in your comments around Wellstar and pursuing kind of global opportunities. Are there any specific product sets that you think scale better internationally or how are you thinking about the product suite at Wellstar and those plans?
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Yeah, absolutely. Well, look, we think OceanMD, we’ve always thought OceanMD has tremendous international potential. I mean, just the quality of product and the product portfolio that we have there with the e referral, e order, and just kind of the whole provider network tools there. These are exceptional products. There’s a reason why they’re winning a lot of the RFPs that they participate in.
And I think they would resonate very well with international audiences that need these products as they build more accountable healthcare ecosystems. And look, we’ve just never tried because we’ve been focused on Canada because just going out and building that global sales force and getting into the right places. I mean, that’s what Orion’s done over a, I think close to thirty year period in building the types of relationships that they have with, you know, the NHS and these very significant countries, you know, France, Spain, you know, Saudi Arabia, United Arab Emirates, Australia, New Zealand. I mean, these are all candidates for us. I mean, there’s no doubt that we have opportunities to have them resell some of our capabilities, which we think are meaningful.
Daniel Rosenberg, Analyst, Paradigm: Thanks for taking my questions. I’ll pass the line.
Operator: Thank you. And our next question is coming from Kevin Krishnaratnev from Scotiabank. Please go ahead.
Kevin Krishnaratnev, Analyst, Scotiabank: You know, if you I think it looks like if you if you exclude the Healwell contributions and then the Circle Medical deferrals and compare margins on a normalized basis from 24 to 25, it looks like they’re going down a little bit. Just want to clarify if that’s the way you’re thinking about it and what might be some of the reasons for a slight dilution year over year.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Yeah, that’s good question. I think if you look at, we’re not expecting significant EBITDA from Healwell and so I think that may be part of it. Also, I think as you know, as we grow organically, and as we take on these absorptions, you know, there’s sometimes a timing difference in, you know, relative to our profitability on those. So I generally don’t think that we will have a significant difference over time in terms of our margins. In fact, I think margins on a whole will improve over time because of higher margin revenues coming in through wall star and heal well, as those platforms continue to gain momentum.
Kevin Krishnaratnev, Analyst, Scotiabank: Makes sense. Maybe just one more again on the guidance on the top line, just the range. Can you talk about sort of the assumptions there broadly, what gets to the low end, the high end and where do you see the best opportunities for sort of outperformance towards the high end?
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Yeah, there’s a lot going on in our guidance as you can see. I think that the real potential for outperformance really comes from Canada, frankly. Think this is why we’re sort of throwing out that two year target. We think it’s very demonstrative of our confidence and the opportunities that we’re seeing for capital allocation. And so I would think that as some of that M and A kind of gets fulfilled, we could see and I think some of the margin profile of that M and A could also impact things.
So I would say that depending on that M and A, could see certainly being at the top end or even exceeding that top end of the range.
Kevin Krishnaratnev, Analyst, Scotiabank: Okay. Okay, thanks a lot. I’ll leave it there. I also wanted to say thank you for, you know, giving the full color and description for everything that happened in the quarter on the accounting changes. It was much appreciated.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Thank you actually for helping people understand that this is a very noisy quarter and hopefully everyone recognizes that this does not impact our fundamentals. Our patient visits grew. Our fundamentals are strong. Some of these administrative matters, we will, you know, we will have full control of those and are working very hard at that. And certainly, hopefully people recognize the CRH matter is really something that was completely out of our hands.
A lot of people are dealing with these collection issues. And this is just a fact of our collection policy and revenue recognition policy under IFRS that we had to take these steps. But again, there is some upside to the guidance range as well coming from future potential revenue recognition from collections. So thank you. Thank you to all the analysts and all your support.
Operator: That concludes the question and answer session for today. I will now hand the call back to Mr. Hamed Shabazzi for the closing comments. Please continue.
Hamed Shabazzi, Chairman and CEO, Well Health Technologies: Again, we want to really thank everyone for joining us today. And again, apologize for the delay in getting this report out. We look forward to speaking to you again, I think in about a month. And we look forward to a much more orderly process. And again, have wonderful day and be well.
Thank you.
Operator: Ladies and gentlemen, this concludes today’s conference call. Thank you for your participation. You may now disconnect.
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