Get the session started. Hello everyone and welcome to day two of the Jefferies London Healthcare Conference. Very pleased to be joined by management from Accuray. We have Suzanne Winter, President and CEO, and Ali Pervaiz, CFO. My name is Young Li. I'm one of the MedTech analysts on the U.S. team. So this will be a hybrid session, so we'll start with a presentation and afterwards I'll host a moderated Q&A session. All right, with that I'll turn it over to Suzanne. Thanks, and thanks a lot, Young. And thank you to Jefferies for inviting us to the conference. It's great to be here. Yeah, Accuray, we're based in Madison, Wisconsin. We are in radiation therapy. We've got a few slides. We're just gonna give you a quick overview of the company and then again we'll answer some questions. In radiation therapy, you know, when a patient is diagnosed with cancer, you know, it's a multidisciplinary approach to the therapy. They can go to surgery. They can go to medical oncology. In 60% of all cancer cases, radiation therapy is either the therapy or in combination with other therapies. And our vision at Accuray has always been about, you know, pushing technology, so that we are advancing care as much as possible to extend lives, but also improve the quality of those lives. So that's really what Accuray is all about. We have a tremendous leadership team that is at the helm, and most of these folks have extensive experience in MedTech. They're also relatively new. So I would say from 2019 and forward, this team has been put in place. They come with a wealth of experience and operational experience from big companies like GE HealthCare, like Medtronic. They have really come to Accuray because we believe in the technology, but we also saw an opportunity to do things better, to make a difference in the operations and also the trajectory of the company. You know, cancer still is a leading killer for people worldwide. Cancer incidence continues. 20 million folks are diagnosed with cancer each year, and 10 million will die from the disease. Additionally, there's a global disparity in the access to radiation therapy. Again, 60% need radiation therapy but not all areas of the world have access to that. You know, the overall global radiation therapy landscape first of all it's an exciting time because there's tremendous progress that's being made in radiotherapy and radiosurgery techniques, but it's really dominated by three companies. You know, there are very high barriers to entry in this space. There have been a number of niche players that have come and gone in this space and that is because there's tremendous infrastructure needed to support customers both, you know, from their journey to placing the order, till the 10-to-15-year life cycle of customer within this space. There's a clinical trend that really favors Accuray technology and that is about radiation therapy treatments that are shorter, shorter in sessions, but more powerful. That really lends itself very well to the Accuray technology that is highly focused on precision therapy, making sure that the radiation dose is going to the tumor and we are sparing the healthy tissue around that. There's some tremendous clinical data, that is long-term clinical data that has been shown that the shorter duration treatments, they're better for the patient, less cost to the healthcare system, and equally as effective. Installed base growth, an incredibly important part of our business model, getting systems in the ground because what that then triggers is an annuity of service for the next 10-15 years. Installed base growth is a key performance indicator for us as a company. In terms of the markets, it's really broken down into the developed markets like the U.S., like Western Europe, Japan, where radiation therapy has been fairly well penetrated. And then the emerging markets where again access to radiation therapy is not as high as needed and there are a tremendous patient backlogs of cancer patients needing radiation therapy treatments. So we are addressing both with our strategy, and really our core strategy is around closing these gaps to care, not only in generating, you know, additional market share in the markets that we serve, in the premium markets, advancing care, taking a look at what are those still pain points in those markets that are fairly developed. There's labor shortages in radiation therapy departments, so it's an equal emphasis on advancing care through innovation but also making sure that workflow, department efficiency is also at the highest level. Then driving patient access, going after those markets and developing products that are specific to those emerging markets where throughput is the number one criterion for purchase of a system. And then finally overall we have a long life, a long partnership with our patients, and so making sure that the systems are at the highest level of function. At the very highest level we have tremendous momentum now. FY23, you know, we had a fantastic year, about $450 million in overall revenue. What we're really seeing is the growth in new systems and this is a direct result out of the clinical trends and also the innovation investment that we have made back into our products. We're really based with two precision platforms, the CyberKnife and the RadXact system, which is based on TomoTherapy. We're very, very pleased with our results as we're going into this year. Our strategic growth plan really focused on four pillars: outpacing the market, continuing to invest, and advancing care, with innovations. We also think there's a tremendous opportunity in service revenue. This is an area that we've been primarily focused mainly on break/fix but we see a tremendous opportunity to grow the service beyond the installed base growth rate, through value-added service and support to these customers and really focusing again on uptime. At the same time Ali and I are laser-focused on execution, operational efficiencies within the business as well as in making this P&L much more profitable, and strengthening our balance sheet so that we have the greatest opportunity and flexibility for strategic options. Innovation is part of our DNA here at Accuray and we will continue to invest in R&D as a percentage of sales higher than our competition on an overall basis. That really differentiates our technology. We just came back from the American Society of Radiation Oncology. We had a number of innovations that were very, very well received. It was great to see the attendance at the ASTRO meeting, really the best it's been since coming out of COVID. But our latest one is the Cenos. Part of our core technology and what why our systems are so precise is because we have technology that adapts to patient changes both during the procedure as well as between treatment sessions and also now with Cenos on the day of a treatment when a scan is done, a CT scan come, and the patient comes in. If there is a dramatic change to either their weight or the tumor size, we can adjust the plan on the fly now with Cenos. In terms of the total, the TAM, the total addressable market, you know, we have been primarily competing since the inception of the company in the premium and specialty markets, which is about half of the overall, radiation therapy market potential. We now are starting to participate in the value segment portion of the market, which again are these emerging markets like China, like India. We're doubling the TAM for our business and this also is a segment of the business that is a higher growth part of the business. So we're very excited about our potential to gain market share in these areas. We have two new systems that we have just introduced, the Tomo C for China. We just got NMPA approval and so with our China joint venture partner we're very excited about the potential to go after the Type B segment within China and then the Helix, which is for our global, so non-China markets. We're gonna be very laser-focused on high-potential emerging markets like India, we just introduced at the Indian Cancer Congress here in November. With that I'm gonna hand it over to Ali who's gonna talk a little bit about the P&L. All right. Good morning everyone and thank you for joining us at the Jefferies Conference. I'd really like to start off by recapping our fiscal 2023, which ended June 30th of this year. We had a very strong performance both from an operational and a financial standpoint despite all the macroeconomic headwinds related to supply chain constraints, inflation, and foreign exchange headwinds. You know, in FY23 we hit a historic revenue milestone with $448 million of revenue, which represents a 24% growth in system unit volume versus the prior year. Had it not been for the impact of foreign exchange, our revenue in FY23 would have been approximately $18 million higher at $465 million, almost all of which would have contributed to Adjusted EBITDA. You know, we had an impressive 5% growth in our global installed base, which is in line with our service revenue. Growth, once adjusted for the impact of foreign exchange headwinds, which is really a good indicator that our efforts focused on our service business are starting to take shape as we believe this business will be a positive revenue and margin contributor going forward. In FY23 we had a strong focus on working capital optimization and came out of the year with a healthy cash balance of $90 million and positive free cash flow. This, along with strong OpEx management focused on a return on investment, will really contribute to our margin expansion efforts over the next three years, which I'll speak to in greater detail. Lastly, we delivered Adjusted EBITDA of $24 million, representing a 5% growth. It's important to note that if we adjust this number for the impact of foreign exchange, which again was roughly $18 million on the top line, and inflation, which was a $5 million headwind, we would have delivered an additional $15-$20 million of Adjusted EBITDA, putting us north of $40 million. Despite the macro headwinds we are extremely proud of what our team's accomplished in fiscal year 2023. Moving to fiscal year 2024, our guidance communicated earlier this year is revenue in the range of $460-$470 million and an Adjusted EBITDA of $27-$30 million, which is a significant growth over the prior year. In FY24 and beyond our financial strategy is really focused on three main pillars. Number one, it's predictable revenue growth by focusing on bringing in high-quality orders that convert to revenue within 30 months, resulting in a high single-digit unit volume growth, which will further contribute to our service revenue growth. Secondly, margin expansion to unleash an adjusted EBITDA CAGR of 20%-25% over the next three years, resulting in a doubling of adjusted EBITDA as a percentage of revenue over that time horizon. Lastly, strengthening the balance sheet by improving our cash position through working capital optimization and exploring avenues to improve our capital structure and reduce our overall debt. As stated earlier, one of our biggest priorities going into fiscal year 2024 and beyond is delivering predictable revenue growth. This will come in the form of unit volume growth anticipated to have a 6%-8% CAGR in the coming years, which will be fueled by our new innovations and our penetration into the value segment. This increase in installed base will help grow our service business over the coming years and we anticipate our recurring revenue from service to go up from 42% today to the high 40s% as a percentage of total revenue. Additionally, our enhanced customer-centric service solutions will really help drive our service revenue. Overall, we anticipate a 4%-6% revenue CAGR over the next several years with balanced contribution from all of our regions as we penetrate into the value segment. You know, delivering margin expansion is another key priority over the next several years and a lot of this effort has already been activated in fiscal year 2023 and we will continue to work on it in fiscal year 2024. Our margin expansion strategy, as Suzanne has mentioned, is really focused on four main pillars. First, pricing increase. We've armed our commercial teams with enhanced tools and have aligned their incentives to optimize price and are starting to see early signs of more profitable orders contributing to our backlog. On the service side, we are looking at all of our contracts and are adjusting pricing due to inflation and also to drive the right profitability. This, coupled with customer-centric offerings, will help drive service top line and margin growth. Additionally, we are focused on reducing our cost to serve by driving efforts to reduce parts consumption with better quality and through driving efficiency with our field service engineers. In terms of operational excellence, we have a big focus on cost reduction by working with our suppliers and engineering teams to drive cost out. Lastly, we have a strong focus on driving cost discipline to ensure that every dollar we spend has the right ROI. This has been a cultural change that we feel is starting to yield the right results. All of our margin expansion strategies will help us to deliver high single-digit-10% Adjusted EBITDA as a percentage of revenue over the course of the next three years, which is a 20 to 25% CAGR and a doubling of Adjusted EBITDA as a percentage of revenue. We anticipate having continued headwinds from foreign exchange and product mix as we penetrate into the value segment and expand to new par and expand to new markets, but we see that really being offset by volume growth in our margin expansion plans noted earlier. Finally, we're focused on strengthening our balance sheet by optimizing our working capital, by increasing inventory turns, and reducing our DSOs. We recognize that cash is king and are maniacally focused on growing our cash reserves while paying down debt and generating free cash flow. You know, pulling all this together and coupling our financial strategy with a high-performing culture, a strong operating framework, and strategic capital allocation, I believe that we can create some significant value for our customers, shareholders, and employees. With that, Suzanne, I'll hand back to you. Thank you. It's sort of a really exciting time within Accuray, and there's just really good momentum that we're building on. You know, from a product standpoint we have the best product portfolio that we've had in the company's history. It's broader and at the same time we are advancing our portfolio in the markets that we played in before. But we're doubling our TAM. We're also driving patient access in those emerging markets. So again you'll see investment that we are doing from a commercial standpoint in those areas that we think have high potential. And again taking a look at service, this is an area of opportunity that will ultimately, as we grow our installed base, drop down to our EBITDA. So our ability to participate in a greater part of the overall market and grow our installed base is going to help us from that recurring revenue standpoint. And then you can hear the focus on making our company margin improvement, as well as a strong EBITDA player and doubling our EBITDA over the next three years. So exciting times. I'm gonna hand it back to Young to have any additional questions. But thank you. All right, Suzanne. Thank you. All right. That was an excellent overview. Really appreciate it, guys. I guess to start off, you know, a little bit, we have a question from the audience. Go ahead if you have a question. Okay. I mean. Yeah. Yeah. But why don't I start and then, I thought you can do the next one. But, I guess just to start, you know, given we have a little bit more of an international audience, wanted to hear, I guess about geographic mix a little bit more. You know, what's your mix of business in Europe, America, APAC, and maybe you can talk about growth profiles for those markets? Yep. Sounds good. Well, we are a global company and actually 70% of our business is outside of the US and our European business is actually our strongest region. It's actually an EIMEA business so it includes India in that. So within our European business, I would say depending on the subregion there's higher growth, higher potential markets. India is obviously one of those. Western Europe is more mature. However, you know, we do very well in Europe and we have some very strong key opinion leaders. You know, if you've been following us, we at the previous ASTRO, the Royal Marsden, presented data on prostate cancer and it was the PACE-B trials. This really is five-year follow-up data of radiation therapy at the five fractions, so five treatment sessions versus the 20 treatment sessions. It's really groundbreaking data, that shows there's no difference in overall outcome, at least in the short term, but better quality of life, in the long term. The Royal Marsden is one of our sites. They have four of our systems, two CyberKnives. They just bought two RadXact systems. So we could not have better reference sites, in Europe for the technology showing that it really makes a difference, especially as we're advancing standard of care. We have an office, just outside of Geneva and we have a big commercial team, that's based in Europe. But then outside of Europe, you know, obviously Asia-Pacific, China, Japan, very important markets to us. In Japan we're the number two market share player. That's what we wanna get in all of our regions, ultimately is be the number two player in the marketplace, and we think we have that opportunity, especially given the competitive landscape right now. All right. Great. I guess why don't we go to you for your first question. Maybe can we talk to the kind of the 24% volume growth versus the 12% revenue growth? And given geographic expansions, value areas, some margin, and a price headwind, why is that the right strategy? Yes. Right. Great, great question. And you're absolutely right. The unit growth has gone higher than the overall revenue growth, which shows that we have a product mix, you know, challenge that we've gotta manage. So part of our strategy is again advancing innovations on the premium side of our business, getting additional pricing for those innovations within that segment to offset anything that is at a lower price, but you know, not necessarily lower margin on the value segment products. On value segment from a margin perspective, and I'll let Ali speak a little bit more, we are working to get the COGS, you know, down and working very closely with our China JV partner also on local sourcing of individual components. But we're also looking for operating efficiency, operating efficiencies, to make sure that that decision is not margin dilutive. Ultimately more Installed Base is a good strategy for us 'cause ultimately that means more service margin that is higher margin in the future, and that will drop down to EBITDA. Yeah. It's a great question. I think, the way I might, you know, if you peel the onion back on sort of how we're actually generating revenue and how we're growing it, we're actually growing product revenue in line or maybe just shortly lower than our overall revenue, which just means that our installed base continues to grow and then a year later that's gonna contribute to our service revenue, right? And so that's really what's going to help us continue to grow our top line. I think to Suzanne's point, as we penetrate into the value segment, eyes wide open. We know that it's going to have, a little bit of a drag on our product margins, but it's gonna be accretive to our overall EBITDA and that's really where we're focused on, just making sure that we have, accretion in our EBITDA. Follow up as well? Sure. Go for it. Just on innovation. So we've guided radiotherapy. There's been some innovation in imaging over the last few years. Recently there was a biology-guided product that's going out to the markets. Is that kind of innovation meaningful in terms of being able to treat patients that you weren't able to treat before or is that really just the competitiveness? I think it's a great question. Certainly we're all looking at radiopharmaceuticals and the ability to be even more targeted and theranostics at the highest level. The system I think that you're talking about, which is radiopharmacy in addition to a linear accelerator, you know, I think we'll see whether that combination is feasible within the radiation therapy department. You know, I think that it is not; it is an investment in radiopharmacy. It is making sure that the nuclear medicine is also involved in the decisions. And so I think you really have to pick and choose those patients where it's really going to make a big difference. And so, you know, I think it's TBD. All right. Cool. Thanks, Sam. Why don't we go to Danny? You laid out a 24 to 27% EBITDA margin aspiration. Your record's been 26% now. I'm just checking with the 27% you've said low teens was. Yeah. At our latest Investor Day that we did at ASTRO, this is the strategy that we laid out, which is that's our vision over the next three years, to be able to get to about 10% Adjusted EBITDA. I think this is sort of the latest outlook that we're providing right now and then, you know, as time goes by we'll sort of see what 2027 has to offer. You're talking about $27 million. You're talking about halfway to 27. Halfway to 27. Halfway to 27. I'm curious what changed in the last six months that you're not necessarily as committed? Yeah. It's not that we're not willing to commit to it. I mean, I think it's more just, you know, it's, it's a three-year horizon. We feel that three years is a pretty, you know, substantial outlook and, you know, I think it's probably the most responsible outlook knowing what we know today. So that's the latest thinking that we have and that, you know, we think that we have a massive opportunity both for our service business from a margin expansion standpoint. We really think that's gonna get us to, you know, close to 10% of adjusted EBITDA by 2026 and then, you know, of course we, we continue to do long-range planning and, yeah, we'll see where that takes us. Yeah. You know, and I think the other thing that we're watching closely is, first of all, inflation and also FX. You know, FX, especially in our Japanese market, continues to worsen, you know, and we're hoping that back half of the year that we're actually gonna see some improvement there. But those two areas I think also are things that we're taking into account. Suzanne, on the China linac opportunity with JV. Can you maybe just put some light on additional things that we're not. Sure. Not caught on to this for a while. You know, how many systems? Yeah. Being developed potentially off the graphs and, you know, what your. Yeah. So the 15th five-year plan, 14th five-year plan, was announced and so we have a very good idea of what, what the amount over the five-year that the government is committing to. And they have talked of anywhere from 1,600-2,000 systems over the next five years. And so within the Type B segment, that is the largest part of the market. That is a significant number of systems that will be placed, within the market. We believe the Tomo C, which is our jointly developed product, will do very well, in this market. You know, what we have baked into the financials we believe is pretty conservative in terms of, you know, how we see market share, in the first couple of years. But it is the only system that has a CT. So there will be some differentiated reimbursement associated with that and we think the China team's gonna do great with that particular product. They also did give licenses for the Type A market. Type A market is where we are dominant. That is much lower but there'll be about 80 systems over the next 5 years. But that's where the CyberKnife we think will do very well and we've had upwards of 75% market share. All right. Thank you so much. I think we're out of time but if anyone has follow-up questions please feel free to reach out. Thank you so much, Suzanne, Ali. Thank you.