Business Strategy and Outlook
Masimo has been a leading provider in pulse oximetry since developing signal extraction oximetry in the late 1990s, a technology that offered better accuracy and reliability. The firm’s business strategy depends on maintaining product advantages in core pulse oximetry, expanding its installed base of monitors, and developing innovative technologies to grow its footprint in the hospital setting, such as remote monitoring and hospital automation.
Further revenue and market share growth for Masimo will primarily come from one of two sources: winning business from Nellcor customers seeking a technology upgrade and expanding the use of oximetry beyond the critical-care environment with greater penetration in the general ward. In critical care, where pulse oximetry is often necessary for good patient outcomes, Masimo has a saturated position. However, on the general floor, Masimo is continuing to make the case that pulse oximetry can improve patient care and reduce hospital costs.
Apart from its core pulse oximetry business, Masimo has also prioritized the expansion of its hospital automation program, which involves integrating central monitoring with bedside vital-sign aggregation systems. This program is being established as a software-as-a-service business, with a per-bed cost for hospitals of $1,000 to $5,000, depending on services offered. We like the potential here, and we think Masimo is poised to significantly expand revenue from the program, despite having less than 100 hospitals currently under contract.
Masimo’s Opioid SafetyNet is another pipeline product that could have a material impact on the business over the coming decade. This product, a modified version of the company’s remote monitoring Patient SafetyNet system, is designed to monitor for Opioid overdose risk and alert emergency contacts if needed. Masimo was selected as one of eight companies to receive expedited development and regulatory approval support from the U.S. Food and Drug Administration to help with the ongoing opioid crisis, and Masimo expects to receive product approval in 2021. We see potential for Masimo to rapidly scale up this business.
Financial Strength
Masimo has excellent financial strength. The company operates without leverage and has consistently been able to generate strong free cash flow. In December 2018, Masimo established a credit facility for $150 million, with an option to increase borrowing to $555 million based on meeting certain lending conditions. Considering the strong free cash flow of the business, which we estimate will exceed $200 million in 2021, it’s clear Masimo has significant financial flexibility. While we don’t anticipate large-scale litigations like the ones Masimo fought against Nellcor and Phillips, the firm’s strong financial position would be advantageous in a lawsuit or settlement requiring significant legal fees or settlement funds. Given the many lawsuits in the pulse oximetry space over the past two decades, another major court action within the next 10 years is certainly possible, but we don’t think Masimo faces any major litigation risk.We expect Masimo to pursue several smaller acquisitions, and while the firm can make a larger acquisition if one is found that makes sense, we don’t expect material acquisition activity in the near term. Over the 2014-2015 time period, Masimo borrowed over $150 million, primarily using the funds to repurchase shares. This debt was fully paid down by year-end 2016. If Masimo draws from its credit facility at some point to acquire a business, we would likely expect quick repayment based on management’s accelerated debt paydown last time the firm used leverage
Bulls Say’s
- The potential in Masimo’s product pipeline is underappreciated. An estimated $10 billion opportunity for products in development would provide diversification to a strong pulse oximetry business,
- As Masimo continues to take share, the firm’s superior oximeters could become a de facto necessity for clinicians. Masimo could leverage this position to push pricing, generating a tailwind for revenue.
- Masimo’s strong balance sheet and cash flow generation give the company resources to maintain high levels of investment and to explore accretive acquisition opportunities
Company Profile
Masimo is an Irvine, California-based medical device business that focuses on non-invasive patient monitoring. It began by developing superior signal processing algorithms to measure blood oxygenation levels through pulse oximetry and has expanded this expertise into a wide range of measurements and applications. The company generates revenue globally, with the United States the largest market (67% of 2020 sales), followed by Europe, the Middle East, and Africa (21%), Asia and Australia (9%), and North and South America excluding the U.S. (3%).
(Source: MorningStar)
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