Good afternoon, everyone. My name is Robbie Marcus. I'm with Jefferies. Very happy to introduce our next company session, Bioventus. Gonna bring up CEO Ken Reali for a presentation, then we'll do some Q&A. Ken? Well, thank you, Robbie. It's great being here, look forward to presenting today Bioventus. Bioventus is a growth story, a growth med tech company specializing in orthopedics. Last year alone, we impacted 600,000 patients with our medical devices, relieving pain, restoring function, healing bones. That talks about some of the devices and how we move forward and help a lot of patients each and every year, which we're very proud of. This is the forward-looking statements, which you can also read on our website under Investor Relations. Just an overview of Bioventus. First of all, starting with our LTM through Q3, we are a $517 million business with a $16 billion total addressable market. This is broken up into three distinct verticals: pain treatments, restorative therapies, and surgical solutions. What's important to understand about Bioventus, and really a key strength of our company, is our ability to drive innovative products into the market. In essence, our ability to commercialize products is our key strength, and that's evident in the metric that you're looking at right in front of you in the top middle. 40% of our revenue comes from products launched since 2018. The company has a very robust sales force, a very robust market access team that drives our ability to gain payer coverage and reimbursement and educate surgeons to utilize our devices. What's exciting about this as well is our breakthrough innovation coming, including CartiHeal, where we just started our initial cases in December in the United States. BoneScalpel Access, which we just launched fully, coupled with OSTEOAMP Flowable, offer a complementary two devices and minimally invasive spinal fusion, the fastest-growing area in spine. SonaStar Elite, which we just received 510 approval for, used primarily in tumor ablations, using our ultrasonic technology. Then a product in development, TalisMann, which is our peripheral nerve stimulation device, our next generation device, which we expect to submit for 510(k) approval and launch next year. The company's enjoyed significant growth, 11% CAGR over the past five years through 2021, and we have a diverse portfolio. I would say this about our portfolio and nearly all of our products, we're either the market leader or we're the growth leader, or we're the technology leader in every product that we sell. Our sustainable mid-70% gross margins is significant and allows us to make key investments in our business. We are a compelling investment opportunity, despite some near-term headwinds that we've had in our business, in the medium and long term, Bioventus is resilient and has a platform that we can continue to build and grow from. That starts with the fact that we are a category leader in differentiated technology in markets that are growing with significant tailwinds. We have demonstrated a propensity for M&A and our ability to integrate and drive synergies, I'll highlight some examples of that in a moment. We have proven market access team. In this day and age with medical devices, market access, your ability to gain payer coverage is absolutely critical, and we've shown a strong ability to do that. This is a somewhat busy slide, but I wanna spend a little time on this slide, starting with the top, and talk about the tailwinds in our business. Like a lot of companies in orthopedics, we benefit from the aging population, but very specific areas for Bioventus. First of all, 50 million Americans that live in chronic pain today with the opioid dependency really growing, and this certainly fits with part of our strategy in peripheral nerve stimulation. Osteoarthritis, which is a large part of our portfolio addresses over 78 million people affected by osteoarthritis by 2040, and then 50% of Americans, an increase from over 65 by 2040. The population's aging. This provides significant tailwinds for our consistent growth as a business. Now going to our verticals, starting with pain treatments, we have we're the number two player in hyaluronic acid treatment with DUROLANE, our market-leading single injection product, GELSYN, our three-injection product, and SUPARTZ FX, our five-injection product. We're the only company today that offers a complement of three HA products. StimRouter is our current peripheral nerve stimulator that's on the market today. CartiHeal, our recent acquisition, which we just started launching in the United States. In restorative therapies, we have our market-leading ultrasonic stimulator, EXOGEN, our advanced rehabilitation products, BITS, L300 Go, and Vector. We did just receive, in the fourth quarter, MDR approval, CE mark approval for the L300 Go, which we're very excited about. Our wound business led by TheraSkin, which is a market-leading product, skin replacement product, treating diabetic foot ulcers as well as burn patients. In Surgical Solutions, we are not a hardware company, and we have no desire to be a spinal hardware company. We offer complementary products that really cross the spectrum, and we're able to work with every surgeon. In our bone graft substitutes, our market-leading OSTEOAMP has been a growth leader over the past several years. Coupled with our neXus platform offering with ultrasonics, the ability to remove bone and soft tissue in decompression procedures. What's important to understand is our bone graft substitutes and our ultrasonics are used in the same procedure, and that's a fusion, spinal fusion and decompression, one of the most common procedures done. I'll turn your attention to the bottom of the slide, and what's important here is part of our strategy is going deeper with our customers, particularly when you think about sports medicine as we add on CartiHeal and use our HA sales reps to drive CartiHeal penetration in the years to come, leveraging their significant relationships in sports medicine and total joint reconstruction. I'll point to Surgical Solutions, where we continue to go deeper with those customers, both in spine and neurosurgery. In Restorative Therapies is largely focused in foot and ankle, trauma, and hand. One of the things we've been quite busy over the past several years doing acquisitions, and this is something we're quite proud of. We've increased our total addressable market 4 times through the acquisition of Bioness, Misonix, and CartiHeal. It gives our total addressable market to $16 billion when it was just about four and a half billion dollars back six years ago in 2016. Pain treatments has really benefited from this area as CartiHeal and our peripheral nerve stimulation device fits into that, and obviously, Surgical solutions with the addition of the ultrasonics platform to our bone graft substitutes. Our priorities for 2023 are very clear. Number one, it's enhance our liquidity to meet our CartiHeal milestones. Number two is complete the integration of Misonix. Number three is to deliver on our sales growth initiatives. First of all, on the liquidity with the CartiHeal payments, we announced in December, early December, a restructuring in our business. We had very specific parameters on this restructuring. We did not wanna impact our growth profile and ability to grow as a company. We didn't wanna induce any undue compliance risk either. We're able to go across the business and find significant savings of $9 million-$10 million that will be annualized every year. We are also in the process of divesting non-core assets, and this is a critical component to us continuing to move forward to make the CartiHeal payments, which are upcoming this year, and also working on amending our existing credit agreement. The integration of Misonix is well underway, and we're over a year into this. The final step for us is the movement, the technology transfer from Farmingdale, New York to Memphis, Tennessee. This will complete the acquisition, the integration, and we expect to realize $20 million of cost synergies by the end of 2023, as stated. On the sales side, we look for the full launch of CartiHeal globally. As mentioned, we started cases domestically, and we'll be launching this globally in parts of Europe as well as parts of Asia as we move forward. We look to accelerate our ultrasonics growth with the launch of SonaStar Elite and tumor ablation and the BoneScalpel Access launch, which once again gets us into a fast-growing area, the fastest-growing area in spine in minimally invasive spine fusion. We also expect to submit by the end of the year our 510(k) for the TalisMann, our peripheral nerve stimulation device. Enhancing liquidity. Let me go a step deeper on this because this is critical for us. First of all, the restructure. We announced that in December. We anticipate $9 million-$10 million of annual savings. This went into full effect here earlier this year. Again, the parameters on this were not to impact our ability to hit our growth targets or certainly on the compliance side, and we feel we've accomplished that. We prioritize the CartiHeal investments, and we have further investments we're making there from a development perspective, including follow-up of the IDE clinical study patients and some additional studies that we're doing to shore up the reimbursement coding. We are managing the ASP transition in the HA business. We do expect headwinds in our HA business over the next several quarters as we work to transition from wholesale acquisition cost to average selling price. We are very confident in our ability to continue to be a market leader in HA. We are the number two player today. We have aspirations of being that market leader in the coming 18 months as we do continue to grab market share in hyaluronic acid despite this change. On the divestiture side, we're focused on non-core assets. This was a process that we started in Q3 of last year, and those proceeds will be used to fund the milestone payments and partially repay our term loan. Let me take a step back and talk a little bit further on CartiHeal, what it is and why we're so excited about CartiHeal. First of all, CartiHeal is made out of aragonite. This is a special sea coral, but it's a coral that's designed what they call red coral or coral that absorbs blood. It allows it to cooperate into bone and soft tissue. This is the essence of, and the criticality of using this type of coral, because it's a very specific kind, and that's part of the proprietary nature of CartiHeal. CartiHeal is off the shelf, and this is what's critically important. Many surgeons that treat degenerative conditions in the knee do an MRI, and the diagnostic on an MRI sometimes can be inconclusive, and they go in and they scope the knee. When they scope the knee, that offers them a more firm diagnosis of what the patient's problem is. Oftentimes, they find an osteochondral defect. Maybe it's bigger or it exists, and they didn't even realize it existed. That's where CartiHeal can really make a difference when you talk to surgeons, is it's off the shelf. Intraoperatively, they can grab CartiHeal and utilize it to treat osteochondral defects. These are defects both with and without osteoarthritis. That's the indication that makes it so powerful. The other aspect to CartiHeal, you know, and I've been in around orthopedics for 31 years, and I've rarely seen this, is the superiority data. Most products in orthopedics are non-inferior, and they show non-inferiority to current technology. CartiHeal has shown in a very large patient group of microfracture and debridement to be superior, and not just superior by a small margin, by about 20%. This is unusual for those that have followed orthopedics, and this presents a significant opportunity. This is real clinical data in a controlled trial. The patients are now out three years follow-up, and that sustainability on the superiority has sustained. The market for CartiHeal is pretty straightforward. There are 650,000 microfracture and debridement procedures done in the U.S. every year. This is a $2.6 billion addressable market by doing that math. This is an aging population, so this market continues to expand. Now we view the typical CartiHeal patient as someone between 40s and early 60s. We also view this as an opportunity, very importantly, to delay a total knee procedure. Many patients that face an osteochondral defect do not have a lot of options today. If you can delay a total knee procedure, you save the healthcare system money, certainly you save the patient quite a bit. No surgeon wants to do a total knee procedure on someone in their 40s, 50s, or even early 60s because you set them up for a subsequent revision procedure back when they're in their 70s or early 80s. We're focused as well on gaining reimbursement, both coding and coverage. These are two very distinct things with CartiHeal. The coding process, we already have a Category III code. We feel, based on our research, that the code will be crosswalked to the current allograft code to treat osteochondral defects. We see that happening, and as that happens and expands, we see insurance companies developing coverage decisions to cover CartiHeal. As a lot of payers have told us, with the superiority data and the economics around CartiHeal and the ability to delay a total knee procedure and the superiority over microfracture and debridement, we will cover this. The other aspect to this that will take a little longer is gaining coding specific to CartiHeal. As mentioned today, we have a Category III code. It's going to require us to get a few more publications of new clinical data. We expect a code somewhere around the 2026 timeframe. We do see coverage as starting to unlock the full potential of CartiHeal as we move forward. Now Bioventus has been very busy, not only going public 22 months ago, but doing acquisitions to really build out the company as a growth story, particularly around areas like sports medicine and surgical spine. Started with the Bioness acquisition, which we acquired in March of 2021. We completed the integration in about a year ago and turned a business that was unprofitable to accretive to our own EBITDA within that time period in 2022. With Misonix, we acquired last year, a little over a year ago, in October of 2021. We complete the integration at the end of this year and expect to realize $20 million of synergies. The final step, as mentioned, is the move, the technology transfer to our Memphis facility. CartiHeal we acquired just in July of last year. Initial launch phase is now underway, and we expect a full commercial launch as we end 2023. We are focused on operational synergies across our business. Certainly, as we integrate these organizations with legacy Bioventus, we do expect and have seen more synergies that we can gain. That's a key focus for the management team as we continue to improve our EBITDA margin. This slide shows the focus and success Bioventus has had in launching new products. Once again, over 40% of our revenue today comes from products launched since 2018, and actually it even grew further in Q3, approaching 50%. This is a tribute to our sales team, our market access team, our ability to leverage our relationships across our business, particularly areas like sports medicine and spine. We have over 700 sales reps. Those are both direct reps and sales agents, and a terrific market access team that helps us drive payer coverage. And contracting to get us in the door, whether it's a hunting license we need to get into a hospital with an IDN or it's payer coverage that we gain with our HA business on contracted business. These have all been key catalysts to our growth and market penetration. We have more to come, certainly in pain treatments with CartiHeal and TalisMann next year. In restorative therapies, we continue to gain traction with TheraSkin, our leading skin replacement product, as we gain more coverage with an RCT that was published a year ago. The L300 Go as we launch this into orthopedics this year, it's been heavily focused in neuro rehab, and this is a gait restoration product that can have a significant difference for orthopedic patients, particularly those with foot drop. In surgical solutions, we've got a great combo in minimally invasive spine surgery with the BoneScalpel Access and OSTEOAMP Flowable, and we'll be launching SonaStar Elite this year as well into the neuro market for tumor ablation. We feel Bioventus is a very compelling investment opportunity. We have some near-term headwinds that we're very transparent about addressing and very aggressively addressing, but we're a category leader across all of our markets and growing markets with strong tailwinds. We have a diversified portfolio focused in key growth areas in orthopedics, particularly around sports medicine and spine, and the non-hardware spine, I would add. We've expanded our total addressable market opportunity by 4 times as we've built this business. Most importantly, we're focused on a plan to delever, and we have multiple strategic pathways to do so. I thank you for your time, and certainly happy to take your questions. Thank you for your interest in Bioventus. You can sit there. You talked about there are some short-term headwinds you've been open about. I wanna start there and then move to the long term. Yep. If we do start with the short term, there's been some disruption in the HA market. They switched how they measure pricing, and it's led to a market decline, not just with you, but also across your competitors. Maybe spend a minute there, exactly what's happening? Yeah. How much of an impact it's having at Bioventus, and when it should resolve. Great question, Robbie, certainly, this has been a big factor for us. HA today is 40% of our revenue. We sell three products, just to remind everybody. DUROLANE, our single-injection product that was launched in 2018. GELSYN, our three-injection product launched in 2016. SUPARTZ, which we've had for about 20 years, going back to days when we were part of Smith & Nephew. The wholesale acquisition cost to average selling price has impacted each of those three products differently. Let me break it down. First of all, with DUROLANE, we have seen sustained double-digit volume growth, and that has counteracted any impact on reduction of the transfer price from Wholesale Acquisition to average selling price. We expect we can continue to gain volume growth with DUROLANE as we go through this year because DUROLANE is clinically and technically differentiated. It's the highest molecular weight HA product on the market today. It's the longest residence time in the knee, and it's a single injection. Single injection, the market is slowly shifting to single injection. GELSYN is the most exposed, and that's where we've seen the biggest impact. It's a three-injection product in a much more price-sensitive environment. GELSYN, honestly, doesn't have the distinguishing features that DUROLANE does. We've taken a little bit of hit on GELSYN. We do see GELSYN stabilizing as we head into the back half of this year, but we know the next few quarters with GELSYN, we're gonna have headwinds as we move forward. SUPARTZ, on the other hand, we were already reporting average selling price on SUPARTZ. It has very little impact on SUPARTZ. When we look at the overall HA market, fundamentally, we're strong believers in this market. I'll say that, you know, this market, because of the aging population, continues to grow about 3%-5% per year. Bioventus is the number two player. We continue to gain market share even in this difficult environment. We don't see anything on the horizon. As much as we look at great products coming, other injectables, there's been a lot of failed studies in osteoarthritis, as we all know. Hyaluronic acid offers a treatment for patients that doesn't exist anywhere else today. We view this category as a strong one for us for the future, and certainly view hyaluronic acid as something that will continue to grow and we'll be a big player in. We do expect some headwinds in the next few quarters. By that time, when we reach the fourth quarter or so, we expect things to level off. Ken, you do have a one, three, five injection. How do you think about your overall market share within the HA market? How much more room is there for you to go? Yeah. Great question. You know, we're the number two player today. J&J is the number one player. If you break it down by product, once again, we think with DUROLANE, which was just launched four years ago, we have significant more play there. We're only about 20% of the market in DUROLANE in single injection. If we use SUPARTZ as our baseline, and SUPARTZ we've been selling for 20 years, you know, that has about 40% of the market today. We do view our ability to gain roughly 40% of the market in DUROLANE as an opportunity. That would double our current revenue with DUROLANE or volume as you think about it. GELSYN, we also think we're roughly 20% in GELSYN in the three- injection. We do think as things settle down with GELSYN in the quarters to come, we can continue to gain market share there as well. SUPARTZ FX obviously is pretty stable. Five -injection is slowly declining. Why do we think we win beyond the products themselves? We do have the largest sales force focus in HA. Our resilience out there with our sales team, coupled with our market access strategy, contracted payers such as with UnitedHealth Group and Cigna, give us a distinct advantage and ability to penetrate markets and add new accounts, and that's worked quite well for us. Also in the HA market, there was an issue a couple months ago where there was a rebate that you weren't quite expecting or it was a larger rebate than you were expecting. Any update on how that's progressing? Yeah. How long that will also take to resolve back to normal? Yeah, that was disappointing for us, this was one specific payer where we did see a specific spike just with this payer in our contracted business in Q2. You have to remember that we get these rebate invoices about two quarters lag time. When we ship out our HA syringes, we have no insight into where they're going. We don't know that they're going to a United patient or a Cigna or Blue Cross Blue Shield or Aetna. We don't get that information till quarters later, two quarters or even later sometimes, depending on the lag of the rebate. We've dug into this with this particular payer. They actually gave us NPI data, we could go back and look physician by physician. We were able to isolate it and get comfortable with how we're accruing for rebates going forward. We do feel that going forward, we can be accurate. A couple other points on this. Number one, we're also engaged in a third party going forward to give us better analytics in this area. This was something Bioventus was doing internally, and the internal team has done a terrific job. As we've looked at this externally, there's some better analytics, which I think will help us. Number two, though, the rebate liability has gone down. With the ASP change on July 1st of last year, we renegotiated all of our rebates for our contracted business. The liability is now down 65% from what it was. Even if there is a rebate error going forward, it'll be roughly 65% lower, less impactful for the business. Clearly, we don't want it to happen again, and clearly, our contracted business was higher than we anticipated, but the liability has also been reduced as we go forward. I just add, I think, you know, we feel good about where we're accrued. We feel good about where we're currently accrued, you know, for the business. I think, you know, that's one, getting that behind us and making sure that we, you know, are accurately doing that and getting better visibility into the invoices and working with the partner. Still have the same, you know, different than that, still have the same headwinds that Ken talked about in his first with. That's gonna put a lot of pressure on revenue growth, a lot of pressure on EBITDA, you know, going into 2023. Also on the slide, you talked about divesting non-core assets to help pay the CartiHeal payment coming up. What would you categorize as something that's non-core? Yeah. For us, non-core is areas of the business that don't focus on where we're trying to go deeper with our customers. Clearly, I would highlight sports medicine and surgical spine as areas of focus for us. There's other businesses that we picked up in our acquisitions that are less core, and that's what we're focused on. I'm not gonna get into specifics today, but that's what I would define as non-core for the purposes of this conversation. Since the IPO, you've done a number of acquisitions. How does Bioventus balance internal development, so the R of the R&D versus external acquisition, and how are you budgeting for that internally? Yeah. Well, today, you know, we've always had a pretty robust, I think, development pathway at Bioventus for a company our size, I would add. We have a lot of PMA products. We have a lot of institutional knowledge to evolve and develop those products. Certainly, areas like ultrasonics, we continue to develop. The big effort today is focused in two areas on R&D I'd highlight. One is CartiHeal, where a lot of R&D dollars are going into that. The other is TalisMann, our peripheral nerve stimulation device, which we expect to submit for 510(k) clearance later this year. We try to balance this very carefully. Obviously, we've been heavy on M&A in the recent couple of years. We don't see that continuing, as we focus in and hone in on growing what we have, 'cause we see a lot of growth levers in the business today. Certainly, as we move forward, continuing R&D projects that we think will drive accretive revenue, might not be revolutionary development, but I would call evolutionary product development as we move forward. You talked about CartiHeal having a Category III code, hopefully moving to category one in the 2026 timeframe. How should we think about the ability for Bioventus to ramp that product between launch and permanent coding? Is it a very gradual and then a steep adoption curve, or can you do better than that before the permanent code? Well, I would say, you know, early cases have gone well, Robbie. With the clinical data we have, the ability to gain coverage decisions is gonna be the key. The code can be crosswalked to the existing code that exists using allograft to treat osteochondral defects. The medical directors we've spoken to, about 12, all indicate that that's what they would do. The key after that is to gain coverage decisions. You gain coverage decisions by getting volume on a per payer basis, and that's what we're focused on in the near term. First 100 cases we expect to be done by around September 1st of this year. At that point in time, we'll look to expand our launch further in the fourth quarter of this year and really look to try to ramp more quickly if we can. Just wanna pause and see if there are any questions in the room. You do have the CartiHeal payments coming up this year. Just wanna ask, do you need the divestiture proceeds of some of these non-core assets to be able to pay that? If not, what are some other options you have to be able to pay it? Well, the divestitures are absolutely critical, I would say, and that's certainly plan A that we're proceeding on. There's other plans, plan B and C, D that we're developing, certainly. Those aren't things that we're discussing publicly today. Our goal is to make sure these divestitures work that are non-core and execute on that. As you are committed to a lot of debt repayment, how are you thinking about balancing the need to preserve cash for those payments versus internal development, and keeping the sales force happy? Yeah. Well, obviously, yes, keeping our sales team happy is critical. We feel our operating budget for 2023 is very realistic. That allows us to make these payments and make the interest payments, obviously with plan A and the divestitures, you know. We have a good cash flow in our business historically, and we expect that to continue, and certainly be able to fund our business and the key programs we have to drive our growth. You haven't reported fourth quarter results yet, so we'll see this in a month or so. If we're looking at interest expense specifically, there is some rate sensitivity in there. How are you thinking about maybe the jump-off rate from 22 into 23 and your ability to manage that throughout next year? Yeah, I mean, on the, you know, CartiHeal payments, we have the 8%, you know, interest rate. Then, you know, really based on the term loan, there's not a lot, you know, of significant exposure to that from a year-to-year perspective. Okay. Currency has gotten better, since the last update we've had for you. Can you remind us how much it impacts your top line or percentage of sales, and then also how that flows through down to the bottom line? Yeah, roughly revenue-wise, it's roughly, I mean, overall, it's an immaterial amount to the P&L with the exposure we have. The international market is roughly, you know, a million dollars of FX, you know, exposure that we've, you know, seen in the Q3 and Q4 timeframes. It's about 10% of our revenue. We do see that as an opportunity, particularly as we launch products like CartiHeal internationally for further expansion of that going forward. Ken, you did touch on historically your business has had good free cash flow generation. With the payment reduction in the HA market and the payer review, how should we be thinking about the potential for cash flow generation in the short term? Certainly, EBITDA and revenue is impacted in our HA business. In terms of margins and cash flow, our margins with DUROLANE and SUPARTZ FX in particular are protected, based on the contracts we have. Even with pricing fluctuations, the 80% gross margin we enjoy in HA is protected in those areas. GELSYN, we've got a little work to do with the supplier of GELSYN, because the floor on that particular price needs to be renegotiated. We've been successful doing that in the past, and that's one of our objectives early this year. It's hard for us from the outside to kind of go back and look at the acquisitions you've done and measure you on the integration targets. Yeah. Because we don't have all the inside information. Yeah. There have been a number of acquisitions. How would you grade your acquisitions and your ability to meet your synergy targets, since you do have the answer? I'll give ourselves a B or a B plus. I think Bioness was a big success, as I highlighted, turning that from a company losing money to profitability in less than a year and completing that integration. I think Misonix, we're still underway. I would give us an incomplete on that. This year is a critical one as we complete the technology transfer to Memphis. We are on target there to get our $20 million in synergies. If we hit that and the technology transfer goes well, I'd give ourselves high marks for that. CartiHeal, obviously a very different dynamic there. Less more integration focused, more launch focused, 'cause that's income with revenue. A little bit different situation. Obviously, a lot is at stake on CartiHeal and the success there. Yeah. Maybe spend a minute on what you're hearing from physicians, the need for this type of product. You talked a little bit in the slides, but clearly, you think it's gonna be a big success for you. Yeah. What's driving that belief? You know what drives the belief for me, and I've seen a lot of technologies in my day, is the clinical data. Data doesn't lie, and superiority data, in particular, is rare in orthopedics. You just don't see it, and the patient need here is significant. Even if CartiHeal can delay a total knee procedure in someone 45 or 50 years old for four to five years, that's a victory. It's a victory for the healthcare system, certainly a victory for that patient. The fact that there are 650,000 microfracture debridement procedures done every year in the United States offers a significant opportunity. Those are the factors that really impel me to think about CartiHeal as really a game changer. Clinical data speaks volumes. At the end of the day, as I said, it's rare in orthopedics to see superiority data. We've got it here. This was a breakthrough product designated already by FDA. We're pretty excited about it for those factors. Maybe I'll check any other questions in the room. That's probably a good place to leave it on CartiHeal and that. I wanna thank you. Thank you, Robbie. Thanks everyone for listening. Yep. Thank you very much.