All right. Good morning. Thanks so much for joining us. My name is Matt O'Brien. I cover med tech here at Piper Sandler. Very excited to have the Integer management team here with us. Up on stage with me is Joe, who is the CEO of the company, and then I think Diron and Andrew and Kristen are all around here in the room. So thanks again, Joe, so much for coming. Really do appreciate it. Thanks for having us. Of course. So let's maybe start, you know, bigger picture. Just talk about the general health of the outsourcing industry. Is the sector really poised for continued strong growth, or is there any kind of slowdown we should be expecting as we kind of have come out of this massive COVID ramping period? Sure. So maybe to your point about the industry growth in 2023, based on the markets that we serve, so we come up with our weighted average market growth rate. We saw well above kind of historical industry growth in 2023. We would peg the markets we serve as growing 4%-6% organically. And in 2023, we saw probably 8%-9% growth. We study our customer sales by their end markets to understand their growth rates, because the way we measure ourselves is whether we're winning in those markets that we serve. And the way we know whether we're winning or not is if we're growing faster than the markets or not. As we entered 2024, based upon the demand we were seeing from customers, we were expecting kind of that 4%-6%, more historical, longer-term growth rates. And that's what we were seeing throughout the year. We kind of expect the same thing as we head into 2025. We haven't given any guidance, but just based on what we're hearing and seeing from demand, we would expect kind of a 4%-6% organic growth in the overall industry. Where does that share taking come from that you guys keep delivering? Is it from smaller mom-and-pop shops, or where are you getting that share from where you can continue to outpace the market? Sure. Well, it all starts with getting designed into our customers' most innovative, most exciting programs and products. And this was really the strategy we started in 2017, early 2018, where prior to that, we were more focused on taking existing business from competitors that was already in production. We shifted the strategy in 2018 to be primarily getting designed into our customers' most important programs. And we really focused on getting them in the faster growing markets where there's the most innovation. And why is there the most innovation? That's because that's where the patients are currently underserved or untreated. And those four targeted growth markets for us that we've been focusing on since 2018: structural heart, electrophysiology, neurovascular, neuromodulation. So it's building that development pipeline, which we know takes multiple years to go through that development cycle. To your question about, is it bigger customers, smaller customers, our focus has been on where there's innovation and then participating in that innovation and helping our customers get those products to market. We feel we've got a vertical integration strategy and capabilities that helps our customers simplify their supply chains. And if we help them with their strategy and help them win in the market, then we get to participate in that. So we're kind of agnostic to whether it's big or small. It's really about where there's innovation and how can we help our customers be successful. Got it. Can you talk a little bit about the EP opportunity, which comes up all the time, I'm sure? I don't need specifics. But are you making components for everything that's involved in an EP case, be it mapping, be it diagnostic catheter, be it the actual ablation catheter itself? Are you participating in all different segments? So the quick answer is yes. That's one of the things that I think differentiates Integer in that we've historically participated in multiple steps of the electrophysiology procedure. We've historically had a strong vertical integration capability. We've continued to expand on that, add capacity as well. So we have capability to participate in every step, whether it's access with an introducer or a guidewire or a steerable sheath, the transseptal crossing. We have components and capability for the diagnostic catheter as well as the ablation catheter itself. So as electrophysiology procedures grow, we get to participate in multiple steps of the procedure and help our customers serve the market and accelerate the development of new products and capabilities. Pulsed field ablation specifically gives us the opportunity to have more content on the ablation catheter step of the procedure, which helps us, contributes to our viewing pulsed field ablation and electrophysiology holistically as a tailwind for us. I commented on our last earnings call that we've been growing the last four quarters, which is how we measure our business, to take out the noise of individual quarters. We've been growing one and a half times the industry growth rate in electrophysiology, and we expect that to continue and even accelerate moving forward, given our vertical integration capability and the continued growth in PFA. Got it. Okay. And then on the PFA side specifically, this is a category that when you're making stuff for your customers, you're making it well before it's used on a patient, right? So if the category is starting to convert, you'll see it before then, maybe two to three quarters beforehand. And then is there a point where it starts to tap out just because they're getting to 60%-70% penetration in terms of PFA on the case side? Sure. So maybe I'll start with maybe a broader statement that's not electrophysiology specific. Most of what we do for customers, we ship product to their manufacturing plants. And then they incorporate that into a device, and then they put that in their finished goods distribution channel, and then it goes into a hospital and goes into a procedure. So when we measure how long it takes from the time we ship a product to a customer, which is when we recognize sales, to when that's used in a procedure, it ranges kind of from about four to nine months. The four months would be when we're shipping a finished device or something that's not necessarily going into a production facility. Maybe it's going straight into their distribution channels. It takes them four months because they're carrying two to three times. They're turning inventory two to three times a year. You've seen the data, four to six months. If we ship a finished device directly into the distribution channel, four-ish months before it gets into a procedure. But if they have to put it into their manufacturing plant, incorporate it into a finished device, then put it into the distribution channel, that's when you get more to the six to eight to nine months. We have this data because whenever a product comes back to us for any evaluation, we know when we built it, we know when we shipped it, and we know when they put it in the procedure because we get that information. That's how we know the 4 - 9 months. To your question specifically on electrophysiology or PFA, it's all based upon the customer cycle times and how they're running their manufacturing facility. Our customers are really good, smart business people. And when they run their manufacturing plants, they work to be optimal efficiency. And so they're not having their facility fluctuate meaningfully up and down based upon their end market demands. They're level loading their plant over some period of time. And they're allowing their existing finished goods inventory to be that buffer to allow them to run their plant sufficiently, which then gives us a little bit better predictability as well. And they don't adjust their production schedules meaningfully every month. And so we get really good visibility to how they plan to run their facility based on their communication to us so we can serve them really well. Got it. Okay. So maybe bouncing around a little bit here, Joe. This is a difficult question to answer, but a lot of discussion right now about tariffs, especially in Mexico, big numbers being thrown around. You guys manufacture in Mexico. So how impactful could some of these global tariffs be on your business? Sure. So it is hard to know. We don't know exactly what's going to be implemented, if anything. And maybe it's negotiating tactic. Maybe it comes to fruition. But the way we look at it, we look at our manufacturing footprint, which is, call it roughly half the U.S. We've got meaningful operations in Ireland. I don't think that's the target of the tariffs. We've got operations in the Dominican Republic, Uruguay, Malaysia. So I don't think those are really the target-focused areas. When you look at our sourcing, we source very little in Asia, particularly China, which has been a focal point. Now, maybe there's tier two, three, four suppliers that have some sourcing there, but we do have some protections in our contractual agreements when there's meaningful sudden cost spikes to work with customers on sharing and absorbing some of that. Mexico specifically, we have three operations, three manufacturing facilities in Mexico. They're all maquiladoras. So the very nature of them is material comes in without any duties. They go out as long as they're exported out of the country without any duties, which is almost every bit of what we ship out of those facilities goes outside of Mexico to then into a customer's manufacturing facility to be incorporated into a device. And so the only portion of the maquiladora structure that's subject to standard duties or tariffs is the value add in Mexico, which is really the labor value add, which is by nature of wage rates in Mexico, a very small percentage of the BOM. That's not to say that the tariffs couldn't do something different than the maquiladora structure, but there's a significant amount of business that's set up under those maquiladora structures. Assuming that's how it plays out, then there's a very small percentage of our bill of material from those facilities that would be subject to any tariffs. Okay. And if those products, though, went anywhere else around the world versus back to the U.S., they would be excluded from the tariff? Correct, well, I mean, tariffs specifically, the new tariffs, the structure of the maquiladora is if it goes into the maquiladora and leaves, goes into Mexico and leaves Mexico, it's not subject to any of the standard duties. It would only be the value added portion. Got it. Okay. All right. That's helpful. So let's see. Per your filings, about 50% of sales comes from Abbott, Boston, and Medtronic. And so I actually looked at this last night. The inventory days for Abbott have gone from 97 - 116, Boston from 130 - 147, and Medtronic from 124 - 148, just to confuse you with a bunch of numbers. So those inventory levels are elevated on a days basis. Why are we not at risk with those three working down inventory levels as we go into 2025, as we're trying to improve profitability? And Boston specifically has been very clear that they're trying to improve profitability. So why is that not going to be a headwind for you guys? Sure. Well, I'll start with we feel like we have the best information that's available in the marketplace. And what is that? It's our customers. Their manufacturing plants tell us they place specific orders on us, which is our order book. And then they tell us every month on a rolling 12-month basis what they're expecting to manufacture. And so whatever our customers are planning to build, which factors in their expectation of what their sales are going to be, whatever they're doing with their inventory levels, that's all built into what they're guiding us to for what they need us to do to serve them. And so every time we give guidance to our investors, we incorporate that knowledge of what our customers are sharing with us. We do that every earnings. We track the demand from customers on a weekly sales and ops call. We build our budgets based on that. We update our internal forecast based on that. So every time I'm talking to investors, we're using that insight we get from customers, which I think is the best available information in the market, is what our customers are planning to how they're running their facilities, which then means what they need from us. And so we build that into our guidance. We'll update 2025 when we normally give guidance, which is in February. Okay. And that group used to be 80% of sales. Now they're down to 50%. Where do you think that metric goes over time, just given the growth of some of your other customers? Sure, so I can speak specifically, so in 2017, they were a little over 50%, which is when I stepped into the role, and now they're about 45%, and I can tell you in 2017, 2018, 2019, we didn't have as strong of a development pipeline, not only with the big customers, but the small customers and with the strategic shift getting designed into our customers' most important products in the markets where there's the most innovation. We've been very successful at doing that across all of our customer base, and you can imagine we said to ourselves, 45, 50% of our business, if we're not winning with the biggest players in the market, then we're probably not going to be able to outgrow the market, and so that has been a priority of ours to ensure that we're winning with the biggest players in the market. And we feel like we've been successful at partnering and serving our biggest customers, our smallest customers, and everywhere in between. We think we've got a pretty balanced pipeline of development programs there. So we're happy with the amount of business that we have with the industry. We want to keep growing that. And I'd love to be a higher share of all of our customers' business. Got it. Okay, so another area, Joe, that you talked about historically is structural heart, and you've done really well there. One of your vendors just released some data, and it's good for the LAAC part of the market, and there's more data coming there. That category most likely will go 20% + for a while, which I think you're helping them with what they're doing there along with another provider, but you've got those guys, then you've also got tricuspids, and you've got mitrals that are all coming along as well. Is the structural heart part of your business an area that could be well above the corporate average for several years to come? Yeah. So I think I shared on the third quarter, second quarter earnings call that we've been growing well above the structural heart and market growth. Now, we weren't really a meaningful participant in TAVR if you go back to 2015 to 2017, 2018. Our prioritization with our new strategy is more on tricuspid and mitral delivery systems. And we feel we've made meaningful progress there. We've also got access devices that we think have also enabled us to grow in structural heart as well. So we would absolutely expect structural heart to be a contributor to our above-average growth looking forward and expect to continue outgrowing the structural heart end market. Granted, it's a smaller piece of our business. If you look at all of our end markets we serve, structural heart is one of the smaller ones, but it's faster growing because of our focus on getting designed into our customers' new programs over the last 5 - 6 years. Okay. Of those four areas you mentioned before, are any of them disproportionately better from a margin perspective than the others? No. The margins, I would say, are close enough to the company average. Obviously, with new products that have more innovation, there's oftentimes better margins early on those. And then over time, when you get to scale, you share some of those synergies with your customers. But getting to scale means you're getting manufacturing synergies, and you're sharing some of those synergies. So even though you might be sharing some with your customers, you're still working to improve the margins by becoming more and more efficient with volumes. Got it. Okay. And then one of your customers, Medtronic, they've stated that they're working to consolidate vendors. How does that benefit Integer again because you're specked in? Is it something where it takes time to take over some of that business, or are there some parts of the business that you get quickly and that you really benefit from? Sure. So Medtronic's been particularly open and, I think, vocal about their desire to. We use the phrase. I'm sorry, simplify their supply chain. They want fewer suppliers. They want to partner with suppliers that can do more for them that they have significant trust in, that they feel like they can partner with. But all of our customers are doing that. Medtronic's just been particularly vocal in sharing some of the metrics on the number of suppliers and the amount of consolidation that they're driving for. But all of our customers want a simpler supply chain. I mean, one thing the pandemic taught us all is supply chain resiliency is paramount. And I think all of our customers continue to focus on who are the partners that can deliver for them. That means deliver the level of quality they need, deliver in full, on time, and within spec. So all variables matter. But what really differentiates Integer is our capability to help them design and develop and accelerate bringing products to the marketplace. So I feel like the supplier consolidation plays to our strengths. We've been a trusted supplier with most of our customers for multiple decades, many of them since the beginning of the industry in many different ways. The consolidation of the industry gives us the opportunity to execute our tuck-in acquisition strategy. Many of the acquisition targets that we look at, they come from our customers giving us ideas as to who might be a good fit or who they'd like to see become part of us. We look for that vertical integration fit and where we can either fill capability gaps within our portfolio or compound existing capabilities. But it's really all geared towards and focused on how do we help our customers get their products to market faster? How do we help them execute their strategy? And if we're helping them win, then we get the opportunity to participate in that. Got it. Okay. So you started talking a little bit, Joe, about the deals that you've been doing or maybe looking at. Talk a little bit about some of the recent deals, how they're trending versus planned, and maybe some of the capabilities that they bring. Sure. We've done in the last three years $400 million-$500 million worth of acquisitions, whether it was Oscor, which brought steerable sheaths and lead manufacturing capability, and InNeuroCo, which was focused in the neurovascular market where we got significant finished device design and development capability, which helped us, is going to help us fulfill on our strong pipeline in the neurovascular marketplace. Pulse Technologies, which compounds existing metals processing capabilities for existing strong capability, gives us additional vertical integration and supply chain resiliency and business continuity. When we look at acquisitions, we're looking for either closing an existing capability gap, which we've done, I think, a really good job of checking off all the gaps that we identified back in 2018 when we started this strategy, compounding existing capabilities so that we've either got supply chain resiliency, more capacity, or further differentiation within an area that's already a strength that we're already known for and have a strong pipeline. And we're looking for companies that are either, they're also focused on the four targeted growth markets. Obviously, we want primarily medical or all medical is desirable, but we're looking for differentiation. We're not looking for me-too. We're looking for differentiated capability for either us or compounding capability. We want to be able to get a faster growing acquisition or an acquisition where combined with our capabilities, we think we can accelerate the top line growth. And we want margins to either be accretive or have a very clear path from operational synergies to becoming accretive. The acquisitions we've done really, when we really started this in late 2021, today they all have been. We've been able to expand the margins through operational synergies. We're exceeding the deal models in all cases. In some cases, we're exceeding the deal models meaningfully because we've been able to get operational synergies faster. Commercial synergies take longer just because of the cycle times of getting designed into a customer's product. So we generally don't plan on a lot of commercial synergies in the first three or four years just because of the cycle times. And so it starts with operational synergies. But we've been really excited about customer reaction to the acquisitions that we've done and the opportunities that it's created for us commercially. Got it. Okay, and speaking of which, the cash flow is great, debt levels are low versus where you want to be at. Just talk about the M&A environment right now and just how active you think you're going to be over the next maybe year or two. Sure. So I mean, I'll start with we regulate the acquisitions we do to ensure that our debt leverage is 2.5 - 3.5. We're very committed to the debt leverage because we found with most investors that's a comfortable range. We ended the third quarter at three times, 3.0x debt leverage. By the end of the year, we set on our third quarter earnings call, we expect to be 2.6, 2.7x levered at the end of the year. So you think about that. If, okay, you can go to 3.5, then you've got 0.8, 0.9x EBITDA in terms of available capacity. So think about that as $300 million-$350 million of available capacity. Plus, you acquire some EBITDA with that money, so it gives you a little bit more. So I feel like we've got good firepower in order to continue our acquisition strategy. That doesn't mean that we're itching to do a deal. We remain very disciplined in our acquisition strategy. The team is continuously curating opportunities. We like to get to know our acquisition opportunities really well from a culture perspective, understand their business, work with them, talk with them over a period of time so that when they're ready and when the opportunity is right for them and when we have the capacity that we can do a combination that we think is mutually beneficial. We think we've been really successful at bringing companies under the Integer umbrella and creating growth opportunities. Our goal is always to grow the business. It's rarely a cost-out strategy that we do an acquisition on. It's about how do we grow the business. That's why back to the earlier comment about where can we add vertical integration capability or redundancy that helps our customers get products to market faster. So it's really about looking at where's the technology and how does it fit within the portfolio. Got it. Okay. And we've got about 30 seconds left. Really quickly, profitability-wise, you're 2x now growth on EBITDA or EBIT, excuse me, versus revenue. Congrats on that. Should we expect that kind of performance for the next couple of years, or are we going to get a kind of a little bit of a reversion to the mean just given how well you've done this year? Sure. Well, we'll give guidance like we normally do on the fourth quarter earnings call, but our strategy remains to outgrow the markets we're serving by at least 200 basis points organically, continue to do tuck-in strategies, hopefully with a target of adding 2 to 400 basis points of top line and growing operating profit twice as fast as sales. The last two years, we've grown sales 16%. This year, midpoint's 10, 10 and a half. Profit last year grew 26%. This year, 20% at midpoint. We expect to be able to continue to outgrow our markets while expanding margins. The strategic financial objectives are clear, and we're focused on executing to that. Great. Excellent. We are all out of time, so I'll cap it there. Joe, thanks so much for all the feedback today. Appreciate it. Thank you, Matt. Thanks, Joe. Appreciate it. All right. We're going to get started here. Welcome to the 2024 Piper Sandler Healthcare Conference. My name is Adam Maeder. I'm one of the med tech analysts here at Piper. Very pleased to have the management team from Tactile Medical. With With us, we have Sheri Dodd, President and CEO, and Elaine Birkenmeier, CFO. Thanks so much for joining us. Absolutely. Thank you. Maybe a good place to start is with you, Sherry. You've been in the CEO role at Tactile for, I think, six or seven months now. I'll ask the question this way. What surprised you about the company and the opportunity, either on the positive or negative side of things? And how do you envision putting your fingerprints on the business going forward? So five months, but who's counting? Okay. But I had the privilege of being on the board for three years. So it's not a company that's brand new to me. I think, and despite what you know from the board, it feels different, obviously, when you come in on the CEO side. But what has been really consistent for.