dentalcorp Holdings Ltd.

Good morning and welcome to Dental Corp's fourth quarter and Cisco 2024 results conference call. Please note that all lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you would like to redo a question, please press star followed by the number one again. At this time, I would like to turn the call over to Mr. Nate Chaplia, President and Chief Financial Officer of Dental Corp. Sir, please go ahead.

Thank you, operator, and good morning, everyone. Welcome to the Dental Corp fourth quarter and fiscal 2024 results conference call. I'm joined here by Graham Rosenberg, our Chief Executive Officer. Before we start, we would like to remind you that all amounts discussed on this call are denominated in Canadian dollars unless otherwise indicated. Please note that the statements made during this call may include forward-looking statements and information and future-oriented financial information regarding Dental Corp and its business and disclosure regarding possible events, conditions, or results that are based on information currently available to management, which indicate management's expectation of future growth, results of operations, business performance, business prospects, and opportunities. Such statements are made as of the date hereof, and Dental Corp. assumes no obligation to update or revise them to reflect events, disclosures, or circumstances, except as required by applicable securities law. Such statements involve significant risks and uncertainties and are not a guarantee of future performance or results. A number of these risks and uncertainties could cause results to differ materially from results discussed today. Given these risks and uncertainties, one should not place undue reliance on these statements and information. Please refer to the forward-looking statements and information and future-oriented financial information section of our public filings. Without limitations, our MD&A, our earnings press release, is issued today for additional information. For those of you who have dialed into the call, the company has prepared a series of slides to complement our prepared remarks. These slides are available on the investor relations section of our website and the events and presentation section. I will now turn the call over to our Chief Executive Officer, Graham Rosenberg, for opening remarks. Graham?

Thanks, Nate, and good morning, everyone. We're pleased to be with you today to review Dental Call's recent developments, as well as our financial and operating results for the three and 12 months ended December 31, 2024. For today's call, I'm going to share a number of those developments with you, and I will then hand the call over to Nate, who will discuss our financial results in detail after which I will provide forward-looking remarks about how our business is trending. As highlighted on slide three, DentalCorp operates in a $22 billion highly fragmented market that is only 7% consolidated. The industry is a highly recurring essential cash pay healthcare service that is resilient through economic cycles and insulated from disintermediation by technologies. When combined with our proven and repeatable M&A engine, we have delivered strong growth across all key metrics. In addition, we have multi-year Canadian dollar denominated supply contracts with our key suppliers, resulting in minimal direct tariff or foreign exchange exposure. Our confidence in the business is supported by our fourth quarter and four-year results, which met or exceeded our expectations and provide a constructive outlook for the coming year. As you can see on slide four, our teams continue to deliver the highest standards of care to more than 2.3 million active patients, 91% of which are recurring, and visited our practices approximately 5.5 million times last year. We closed fiscal 2024 with approximately $1.6 billion of last 12 months pro forma revenue and approximately $300 million of pro forma adjusted EBITDA. In the 12 months ending December 31, 2024, adjusted free cash flow came in strong at $152 million. On the next slide, you will see that we continue to convert a high percentage of our EBITDA into free cash flow in any given period, and we expect this conversion to increase as we continue to delever and realize network-wide operating leverage. Our business operates with robust and expanding margins, low capex requirements, and capped interest rate exposure on 100% of our existing debt outstanding. And our last 12 months free cash flow conversion increased to 63%, expressed as a percentage of GAAP EBITDA in the quarter, up from 59% in Q4 2023. On slide 6, as expected, we reduced our leverage by 0.6 times from the same period last year to 3.8 times. Q4 marks the fourth consecutive quarter of deleveraging, and we continue to work towards our medium-term target band of 3 to 3.5 times. Turning to the next slide, you can see a comparison of valuation and free cash flow yields versus our peers. At the end of the quarter, we were trading at a level that implied a 5.8 times discount to our peer group on an enterprise value to LTM EBITDA basis and a 9.4% free cash flow yield compared to our total peer group of 3%. On slide eight, you'll see that I'm pleased to report that our business delivered revenue of $397.5 million in the fourth quarter of 2024, up 9.7% over the same period in 2023, and adjusted EBITDA of $73.9 million, up 12.3% over the same period last year. Our adjusted EBITDA margin came in at 18.6%, an improvement of 40 basis points over Q4 2023. and this quarter's adjusted EBITDA margin is the highest in the past nine quarters, dating back to Q3 of 2022. Same practice revenue growth was 2.7% for the quarter, and we delivered free cash flow per share of 20 cents for the quarter, representing an increase of close to 16%. The outcome of our operating efficiencies was a strong adjusted free cash flow for the quarter of $39 million, up approximately 16% of Q4 2023, enabling us to fund the entirety of our acquisition program with free cash flow for the seventh consecutive quarter. With respect to M&A, we acquired 12 practices in the fourth quarter for a total consideration of $75 million. These practices are expected to generate $10.3 million in pro forma adjusted EBITDA after rent, resulting in four-year required pro forma adjusted EBITDA after rent of $21.4 million, exceeding our expectations. We remain the best positioned and well-capitalized partner for independent dentists and will continue to be disciplined about the practices we acquire. I will now pass the call over to Nate, who will walk us through the details of our financial results, and I will share some closing remarks before we open the call for questions. Nate?

Thank you, Graham. In early December 2024, the Canadian government communicated that patients between the ages of 18 to 64 will become eligible to receive care under the CDCP in early 2025, which caused some patients to defer appointments. The start date has still not yet been determined, and so far in Q1, we have seen the beginning of the return of these patients due to the uncertainty with the program. Overall, we continue to see the CDCP as a favorable development for both the Canadian public and dental professionals alike, and expect it to be modestly positive for Dental Corp. Our quarterly results, which met or exceeded expectations in most respects, demonstrate the strength and predictability of our business. Turning to the next slide, you'll see that revenue for the three-month period ended December 31, 2024, as Graham mentioned, was $398 million compared to $362 million for the corresponding period last year, representing an increase of approximately 10%. The increase is attributable to our continued acquisitive and organic growth. As you can see, we reported fourth quarter adjusted EBITDA of approximately $74 million compared to $66 million in the same quarter last year and reported fourth quarter adjusted EBITDA margins of 18.6%, representing a 40 basis point increase year over year. As we continue to realize operating leverage following the significant investments in corporate infrastructure through 2022 and 2023. Looking forward, we continue to be confident about our ability to grow the business through acquisitions and organically. On the next slide, you can see that our net leverage and liquidity as of December 31, 2024 on a net basis was approximately three point times levered, which shows a deleveraging of 0.6 times compared to the same period in 2023. Fourth quarter and full year adjusted free cash flow were 39 and 152 million respectively, further supporting our strong balance sheet. We ended the fourth quarter 2024 with liquidity of $433 million, comprised of $80 million in cash and $353 million in undrawn debt capacity under our senior credit facilities. This quarter marks the sixth consecutive quarter over quarter increase in our interest coverage, as defined by our last 12 months pro forma adjusted EBITDA after rent divided by net interest expense, which currently sits at 3.6 times up from 3.5 times in Q3 2024. Overall, our fourth quarter 2024 performance demonstrates the strength and resilience of our business model. We delivered positive organic growth while successfully expanding margins through operational efficiencies. We continue to strengthen our financial position by deleveraging the balance sheet, completed accretive acquisitions, and realized operating leverage as we continue to expand margins. I will now pass the call over to Graham, who will share some closing remarks before we open up the call for questions. Graham.

Thanks, Nate. We remain highly confident about our future opportunities. As we look ahead to 2025, we expect same practice revenue growth of 3 to 5%. On M&A, we expect to complete acquisitions amounting to $25 million plus of pro forma adjusted EBITDA after rent. These will combine for revenue increases of 10 to 11% over fiscal 2024. and we expect to achieve 20 basis points of adjusted EBITDA margin expansion to 18.7% and 15% pre-tax adjusted free cash flow per share growth, all while continuing to deliver the balance sheet. I would note that as of today's disclosure, we have completed or signed LOIs on acquisitions representing over 60% of our $25 million plus target. For Q1, we anticipate revenues to increase by 8% to 9% over Q1 of 2024, while delivering 3% to 5% same-practice revenue growth. We expect adjusted EBITDA margins to increase by 20 basis points over the first quarter of 2024 and anticipate completing acquisitions representing pro forma adjusted EBITDA after rent of $8 million plus. Finally, We are pleased to announce that the Board of Directors has declared a quarterly dividend of two and a half cents per subordinate voting share and multiple voting share, payable on April 22, 2025, to shareholders of record at the close of business on April 4, 2025. This dividend reflects our commitment to maximizing shareholder value while maintaining our disciplined approach to capital allocation, including adherence to our medium-term leverage target of three to three and a half times. This also provides a return of capital to our network of more than 10,000 dentists and dental professionals throughout the country. We'd like to thank you all for joining our call today. This concludes the formal part of our presentation, and we would like to now open the call to questions. Operator?

Thank you. Ladies and gentlemen, we will now begin the question and answer session. I would like to remind everyone to limit yourselves from one question, one follow-up. Should you have a question, please press star, followed by the number one and touch-tone phone, and you will hear a prompt that your hand has been raised. Should you wish to withdraw, please press star one again. If you're using a speakerphone, please leave the handset before pressing any keys. Our first question comes from the line of Brian Tancalet from Jefferies. Sir, please go ahead.

Hey, good morning, and congrats on the quarter. Maybe, Graham, as we think about the dividend, Obviously very positive here, but just thinking about how you're viewing going forward, you alluded to capital structure and capital deployment. So just curious how we should be thinking, how you're thinking about leveraged targets and balancing that with M&A, and now you've got a dividend in the mix as well. So if you can just share with us how you're thinking through all that.

Okay. Thanks for the questions. As it relates to the dividend, we have more than sufficient pre-cash flow to support a two and a half cent dividend. And the dividend this year will be approximately $15 million of cash out the door during fiscal 2025. We have more than sufficient capital available to support our M&A program, all while delevering. The delevering impact in all scenarios that we've run is less than 0.05 times from a leverage perspective, and so we remain well on track to achieving our three to three and a half times target. Nate, do you want to add anything to that?

Yeah, I think if we look at that $15 million, albeit as a quarter dividend, will be two and a half cents, and for the year will be $20 million, but the cash outlet, as Graham mentioned, would be $15 million. So if we look at that while keeping our M&A pacing consistent at the $25 million we expect to complete this year, all things being equal, it's really a 0.05 impact on our overall leverage. So it doesn't impact our ability to continue to drive organic growth, our ability to continue to execute on our increased pacing of acquisitions, all while continuing to delever to below that three and a half time mark.

Awesome. Very helpful. And then maybe my follow-up, a couple of quick hits here. So as I think about margins, you said you hit kind of like your The highest margin we've seen in seven or so quarters. Just curious where you think that could go. And then the other follow-up is just on Budea Health, anything you can share with us in terms of how that partnership's going.

Thank you. Absolutely. As far as margins go, we're very pleased with the results that we're seeing and primarily the continued leverage that we're seeing on our built out corporate infrastructure, as well as the increased margins that we're seeing at the practice level from the efficiencies we're able to drive from our negotiated agreements, as well as overall operating playbooks. As we see it today, our margins exceeded our expectations in 2024, and we expect that to continue in the 20 basis points plus range of margin expansion as we enter 2025 and continue through the year. brian sorry i didn't i didn't hear the uh the last part of your question the partnership is the data or video health or video yeah absolutely uh the partnership with video has been going uh really nicely uh the product has been received uh incredibly well uh by our partners uh across our network of practices uh as we stand here today we've implemented it in across uh, roughly 100, uh, practices, uh, and really that's from a standing start at the beginning of Q1, uh, to today's date. Uh, our expectation as we continue through to the balance of the year is to have it across 350 plus of our, our practices across the network. Uh, and then as we enter 2026, wrapping up the balance, uh, there on, uh, but the, the reception has been phenomenal. The clinicians enjoy working with it. It's improving their efficiency. It's allowing for them to ensure that their diagnosis is being supported and they have a tool to continue their development. And from a patient perspective, any time that a patient is able to sit in a chair and have that third-party validation and a visual to help them understand the treatment that they're going to undertake, that's always an improvement. overall in the relationship that they have with their dentist and their ability to accept that treatment. Awesome. Congrats again. Thanks, guys. Thanks, Brian.

Thank you. Our next question comes from the line of Daryl Young from Stifle. Please go ahead.

Hey, good morning, everyone. Just one quick one for me. I noticed you added a lot of great detail in the new investor presentation, and I'm just looking at some of the data around practice growth over the last 12 months, visits, active patients. And I'm just wondering, was there any decrease in the average price or a mixed shift in the year that would have potentially offset some of the growth in visits and growth in active patients?

I think overall I think that the year last year just given some of the turbulence that was caused by the rollout in CDCP really disrupted normal patient behavior. There was deferrals of overall visits and there was also deferral of the acceptance of larger treatments with the expectation that they were going to become eligible for cdcp so yes 2024 absolutely had disruption as it related to the uninsured population given the programs rollout or announcement in December 23 really only began to go in large scale in July of 24 and then ultimately as we saw at the end of December in the middle of December with the Minister of Health coming out and not really providing great detail around the launch date in 25 for the remaining cohorts of the working population 18 to 64 but saying that it's going to be launched in earnest And what that really does is that lack of conviction around start date creates confusion and absolutely does cause some disruption, again, both in patient visits as well as acceptance of overall cases, especially the ones that are of higher value given their desire to participate and have the plan support that investment.

That's very tolerant. And just a quick follow-up to that then. As we go forward and the CDCP impacts normalize, would the historical 0.5 to 1% price algorithm in the same practice revenue growth still stand?

Yes, I think if we just split apart the 4% plus range and what we're expecting for the year is that 3% to 5%, which really with the midpoint of 4% with upside from there. So if we take the 4% roughly, call it 2.5% of that. give inflation as a reminder. uh the the provincial associations uh work to set the fee got on an annual basis with reference to the prior year's inflation so assuming things stay consistent with historical rates at two and a half that's expectation this year on a go-forward basis with the remaining 150 basis points split evenly uh between increase in volume and that increase in volume uh is split by frequency of patient visit from our existing patients and newly acquired patients from our acquisitions as well as our ability to attract the gross new patient into our practices given the scale of our network and ability to communicate to them in a very efficient manner. With the other 75 basis points of the remaining growth coming from increased modalities of service that we're able to bring into the practices, be it again orthodontic services with our partnership with Align, implants with our partnership with Invista and continued operating efficiencies and training with our dentist. So the 4% plus is something that we absolutely have conviction around and expect to continue through this year.

Great, thanks and congrats on the good update, guys. Thanks, Scott.

Our next question comes from the line of Scott Fletcher from CIBC. Sarah, please go ahead.

Hi, good morning. I wanted to ask a question on the Q1 guide versus the full year. With Q1, you're sort of lapping the weaker same-practice revenue growth in the prior year, given the CBCP rollout, and you're still sort of looking at 3.5% in the quarter as well as the full year. Maybe sort of help us bridge the gap there between both sort of the same, the flat growth across the full year, but then Q1 just being lower than the full year on a total basis. Any color there would be helpful.

Yeah, absolutely. I think as we sit here today, just given the announcement that took place in the middle of December, there's still the uncertainty around the CDCP program. What we are seeing is the behavior of our insured patient base. There's no disruption. They're continuing to come back accepting of service in the normal course. But what we are seeing specifically is the uninsured population base that have historically visited our practices, we are seeing a slowdown on that front. uh and the correlation uh with the beginning of that uh coming with the announcement in december uh albeit there is now a increase uh in their return back into our practices through q1 we're not seeing that same level uh that we would otherwise expect in in a normal uh in a normal period uh so i can there hasn't really been any clarifying communication since that announcement by the minister of health in the middle of december uh we expect hopefully with the pending election and the results thereof, there will become a little bit more clarity. And one of the worst things that can happen is lack of clarity because people don't have the ability to make a decision. They don't have the ability to plan. So without the date, it kind of freezes people's behaviors, both in booking appointments and accepting of service. But despite all of that, the quarter that we expect to report in Q1 of 25, is a strong one. We're seeing great results despite the fact that we're still in the middle of a little bit of this period as a result of CDCP.

Okay, that's great. And then just a second one for me. On the broader M&A environment, I'm just curious on whether there has been any, you know, changes that you're seeing, whether that's appetite to sell from the practices or competitive pressure. Is there any sort of difference that you're seeing so far this year?

Yeah, absolutely. And as Graham mentioned, we're sitting here with 60% plus of our expected acquisitions of $25 million for fiscal 25 either signed or closed really as of today's date. Our continued position as the acquirer of choice in my 10 plus years here at Dental Corp has never been more significant than it is today. I see our ability to convert the offering that we have. as part of our whole thesis and going public and being able to provide a liquid currency for acquisitions. Our continued investments and the delivery of our services that we've seen in the build-out of our corporate infrastructure supports our partners and 10,000 team members in being able to do what they do. So that continued delivery, that building of trust and that track record has really allowed us to accelerate our growth and continue to maintain pace as a leader. One item as well as around the dividend as we discussed the benefits, really this was done for the continued improvement of our acquisitive model. And as we look at our 10,000 plus people, we have thousands of shareholders and all of our partner dentists and vendor dentists. our equity holders in Dental Corp as well. And this continues to increase the overall value and attractiveness of our offer, as well as continuing to align all of our people shareholders as well in the continued business. So the rollout of the dividend will just continue to accelerate that position that we do have. And from a competitive perspective, there really hasn't been any change. We continue to speak about the strength of our balance sheet at 3.8 times levered We have the strongest balance sheet in the industry, and we'll continue to make use of that to drive our growth in 25 and beyond.

Excellent. Thank you for the call.

Appreciate it.

Thank you. Our next question comes from the line of Evan Lutz from Bank of America. Sir, please go ahead.

Good morning and thanks for taking the questions. One for either Graham or Nate. Really strong incremental gross margins in 4Q. When you think about the 20 bps or more of margin expansion next year, how should we think about the breakout between direct cost leverage and operating cost leverage? You mentioned corporate infrastructure and margins at the practice level improving. Can you talk about just the relative strength that's embedded in that 2025 guidance?

Yeah, absolutely. Great question. Really, as you put it, there's two main drivers. One is practice level margin expansion and then the leverage on our corporate infrastructure. One of the benefits of a dental practice is roughly 75 to 80% of all costs are variable. So as we continue to drive forward and grow both top line and bottom line at the practices, margin is relatively stable, albeit there is a marginal increase in contribution. So if we break down call it that 20 basis points of growth, I'd say roughly five basis points will come from practice level margin expansion with the remainder coming on the leverage of our corporate infrastructure. And as we think about that from an overall top-line growth perspective, expecting high single-digit growth while our corporate infrastructure will grow annually at roughly inflation in that 2% to 3% range. We have the ability to accelerate our margin expansion, and that really is a factor of the pace of our acquisition. So as we continue to increase our pace of acquisition this year, 25 million, and in future years that continues to grow, that pace of margin expansion will continue to grow incrementally and in line with that pacing.

That's really helpful. And then for my follow-up, trying to get a sense of the seasonality of M&A in 2025 that's embedded in the guide here. You mentioned 60%. uh, LOIs out, um, you know, on your goal for the year. How should we think about the, uh, the cadence of the contribution from M&A in 2025, maybe versus 2024 or, or just on an absolute basis. Thanks guys. Yeah, absolutely.

So I think if we think about M&A and it's as predictable as our M&A engine is, there's always some differentiation year to year. But again, we're very pleased with our performance to date. We expect that 60% of our 25 million target will be closed by the end of Q2 and 40% will be completed in the back half of the year.

Great, thank you.

Our next question comes from the line of David Kwan from TD Cowan.

Hey, guys. Obviously, it's a strong end to the year from an M&A standpoint and a good start to this year as well. How much of this faster pace that we've seen is got you guys, I guess, maybe intentionally going out there trying to be more active, trying to close deals versus maybe more dentists just hitting a point where they're more ready to sell their practices?

Yeah, I think it's a great question, David. If we look to our historical pacing of acquisitions, right, if we go back to 2019, it was $40 million plus. Even in 2020 during COVID, we closed $25 million of acquisitions coming out in 21, 40 plus, 22, 54, and then really only in the last two years. How we brought it down to just north of 20 to really provide that balanced approach to growth with the overall macro backdrop and driving our leverage down to below four times as we sit here today. It's never been for a lack of opportunity. It's never been for a lack of our position as a leader in the market, and that's really underpinned by the consistency of our business development team's efforts, the consistency of the number of conversations which we do report on on a quarterly basis that has remained flat and, frankly, increasing over the last number of years, as well as our ability to continue to convert. We have the relationships, we have the balance sheet, we have the teams. So really it's a function of our desire to continue to uh maintain and or increase our ability to uh to grow we believe that on an on any given period we can uh close 35 million plus of acquisitions those opportunities are before us uh but we're committed to continuing to drive both that organic growth the acquisitive growth while getting down to our band of leverage in that three to three and a half times range so just it's great to just add to that you know as we model things out over the next two to three years

We do expect to return to that $30 million plus level. I'd say potentially as soon as next year, depending on how things play out this year. So the pipe and the pace of closing is well within our control. We see no reason why we can't get back to that 30 to 35 at our discretion, if you will. And should next year, we should see the number close to the 30 or just north of 30.

No, thanks for the color, guys. And just a follow-up question. Given that you've had a great start to the year, are you guys thinking maybe a little bit more selective in terms of the acquisitions you're going to pursue, you know, in the coming quarters here? And should we expect valuations to remain in kind of the normal range of seven to seven half times, or might you be able to get a little bit better valuations?

Great question, David, and we've always really been selective with our partners in our acquisitions, and we expect to continue our disciplined approach to growth as it relates to valuations. Very pleased with what the team was able to accomplish in 2024. great year of acquisitions great partners really a tremendous value and as we look here in 2025 our expectations and how we've internally modeled 2025 and beyond really is that that consistent valuation of seven and a half times on a pre synergy basis and just as a reminder we're able to on a on a 12-month look back from acquisition purely as a result of of our efficiencies on our purchasing power, able to bring that valuation down by 10 to 15% to the mid sixes. So still highly accretive valuations for us from an acquisitive perspective, even where we're trading today. And we expect those valuations to continue in that range through 2025. Right. Thanks.

Our next question comes from Stephen from BMO Capital Markets. Please go ahead.

Thank you. Good morning guys. Just wanted to ask about Q4 with respect to the CDCP headwinds. I guess that you sort of disclosed or talked about at the end of beginning in mid December. Is there a way to quantify kind of how that may have held back your same practice revenue growth in the Q4?

What? What I would say is it's very difficult because it's from a from a household income perspective. We don't have that data, so it's very difficult for us to overlay that onto the patient. But what I can say is prior to the announcement we were we were on on trend to get into that 4% plus. So that was that was likely the impact in the quarter.

OK, that's that's helpful. Thanks Nate. And then just turning to, you know, just thinking about leverage here, I know you talked a lot about kind of the balancing now between leverage reduction and M&A and then now the dividend. Do you still kind of intend or expect to continue to delever at that rate of, you know, call it like 0.25 to 0.5 times on an annual basis?

Absolutely. And again, if we look at the dividend cash outflow, in 2025, it's $15 million on what will be a free cash flow growth. We ended 2024 with $151 million and we expect on a pre-tax basis our free cash flow to grow in that 15% plus range in 2025. So ample support from our continued free cash flow generation to drive the funding for acquisitions as well as our uh available debt capacity under our credit facilities all while driving deleveraging as you put it in that 0.25 to 0.5 times uh through to the balance of 2025. yeah okay that's great thanks guys appreciate it our next question comes from the line of Zachary Ebershed from National Bank financial good morning everyone congrats on the quarter

Just wanted to follow up on the CDCP disruption. You did mention that you're starting to see rebookings from the December announcement, and then the impact's roughly 130 basis points plus, given that you're on track for 4%. Should we expect the same level of choppiness once we get the actual date announcement? And if you could remind us how the catch-up rebookings timeline usually plays out after that.

Great question, Zach. I think if just to level set around the disruption that we saw through 2024 and then we can talk about what we're seeing in 2025. One of the significant issues in 2024 is even though the program was announced, the program didn't launch until july and dentists were not signed up to really accept the program until call middle to end of july so what you saw is patients wanting to come to the practice but ultimately the practices and the individual clinicians weren't supporting the program as we sit here today we have 92 plus of the clinicians in our network that do support the program so once the patients do become eligible and do receive their cards, they will have no issue in getting seen by a clinician in the network, which will limit that level of disruption or that level of lead time prior to the patient coming in. What we are seeing and what we saw from last quarter is, again, there is that confusion as to when they will be accepted, and there is a period of time now where They thought maybe it's been two weeks, three weeks, four weeks where they were willing to wait, but ultimately given the efforts from our clinical teams in reaching out and educating them on the really risks and issues of continued deferral for their overall oral care, we do get a significant portion back, albeit there is a small portion that does continue to wait and will be disrupted until they do receive that that final uh final date uh where they will become eligible and be able to accept service under under the program so very difficult to tell you uh what will be in the future what i can tell you is we're very confident uh in that three to five percent range uh specifically in that midpoint uh where uh will continue to drive that growth in q1 and very confident in that three to five range again uh at that midpoint plus uh for the balance of 2025.

Great color. Thanks. I'll turn it over.

I think our next question comes from the line of Tanya Armstrong from Canaccord Genvidi. Please go ahead.

Hi. Good morning, guys. Most of my questions have been asked, so just a couple more from me. On taxes, I think you've previously indicated that you expect to start paying cash taxes in 2025. I noticed the free cash flow growth number that you provided in your guidance was a pre-tax number. Do you still expect to start paying cash taxes toward the end of the year?

Thanks for the question. And unfortunately, we do. It'll be somewhere in the neighborhood of $20 million, again, depending on how things shake out through the year. But that's a number that today we believe is an estimate of approximately the cash tax.

Perfect. That's very helpful. And then secondly, on your insourcing initiative, correct me if I'm wrong, but I think the number of dental practices that have completed the ortho acceleration program is pretty much like unchanged. So it's kind of flattening out. Do you think you've reached critical mass, I guess, of that initiative? Or are there still new practices to come? Is there a reason that's been kind of paused?

That's absolutely there. There's still practices to come. We've been working with Align over the last six to nine months on updating the program, just because Align has improved some of their technologies. There's been change in systems, and we wanted to update the clinical education program around it to elevate it to that 2.0. So the slowdown in the rollout has absolutely been intentional, and you'll see that pick up in 2025.

Excellent. Thanks for that call, Ernie.

Our last question comes from the line of Gary Ho from J. Darjan. Please go ahead.

Hey, good morning, guys. First question is maybe just going back to Vidya Health Partnership, so interesting venture. Any stats you can share, maybe in practices where this has been implemented, have you seen the number of treatments increase or improve in efficiency and accuracy? Just generally, how do you measure success of this well over time? Thanks for the question, Gary.

And yes, we absolutely have. Still very early days. We ran a pilot last year with a small group of practices. And without sharing the statistics, because we want to prove those out as we continue to roll it out at scale. But the benefits of the program we saw on one, the clinician's efficiency. So overall time and chair. and ability to clinically diagnose at a more rapid pace using the tool to validate their initial findings. We've seen an increase in overall case acceptance of treatment by patients just given again the trust that it builds with that third party validation. And three, what we've seen is the increase in the total comprehensiveness of services that are now being provided, which is likely as a result of the more robust nature of diagnosis that the system is able to pick up. with the ability of the dentist to continue to validate and have those conversations with the patient to ensure that their overall oral care is being optimized. So all those things proved out in the pilot in the first 100 that we've rolled out now, still very early days, but seeing signs of those same results continuing, and we believe that it will be fully scaled and those benefits will accrue to the network over time.

Great color. Thanks for that. And then my next question, you've done a great deal with the leveraging over the past few years. So at 3.8 times, you're not too far from your medium term band of three to three and a half times. So once you hit that, should we expect a pivot in the strategy, whether that's increasing the pace of M&A? Graham just mentioned maybe 30 million plus as early as next year or anything else we should know or more of a status quo?

Yeah, absolutely. I think our desire, and as you know, we're being the acquirer of choice, having the built-out infrastructure to support a business that is significantly larger than ours, our desire is to continue to be the leader in dentistry in Canada. You can expect, as Graham mentioned, our acquisitive pacing to increase year over year. We expect that reinvestment going into our acquisitions as the primary source and primary use of capital in 25, 26 and beyond. Outside of that, there's no significant shift in strategy that we expect today, but do expect to continue that significant pace of growth.

Okay, great. Those are my two. Thanks very much.

Thank you. That concludes our conference call for today. Thank you for joining. You may now disconnect.