- **Bitcoin holdings surge**: $586 million in Bitcoin (up 195% YoY), with 31% 2025 yield and 105,000 BTC target by 2027.
- **Healthcare cash flow engine**: $24 million 2024 cash generation to fund Bitcoin purchases via $100 million convertible debt.
- **Strategic leverage advantage**: 1.7x P/E ratio vs. S&P 500's 25x, with plans to explore preferred equity and debt to amplify Bitcoin exposure.
- **Institutional demand opportunity**: 97% of $95T institutional capital cannot buy Bitcoin directly, creating demand for Bitcoin treasury proxies like Semler.
- **mNAV strategy clarity**: 'Slow money' leverage at 1x mNAV positions Semler to outperform Bitcoin if its appreciation exceeds debt costs, with potential premium expansion.

**【Management Opening Remarks】**
- Joe Burnett welcomed participants and outlined the agenda, emphasizing the company's dual-engine strategy of Bitcoin accumulation and healthcare business growth.
- CEO Douglas Murphy-Chutorian paid tribute to co-founder Herbert Semler, highlighting his legacy in medical innovation and patient care.

**【CEO & Executive Chairman Commentary】**
- Eric H. Semler highlighted the company's Bitcoin holdings growth to $586 million, with a 31% Bitcoin yield in 2025 and a target of 105,000 Bitcoin by 2027.
- Emphasized the health care business' potential to generate $24 million in 2024 cash flow, supporting Bitcoin purchases through intelligent leverage.
- Announced strategic hires (Natalie Brunell, Joe Burnett) and the formation of subsidiary CardioVanta to expand into heart failure and arrhythmia markets.
- Criticized the stock's undervaluation, with a 1.7x P/E ratio vs. S&P 500's 25x, and outlined plans to explore preferred equity and convertible debt to amplify Bitcoin exposure.

**【CFO Financial Commentary】**
- Q2 2025 revenue: $8.2 million (down YoY due to CMS rate impacts on PAD device usage).
- Operating expenses: $10.3 million, including $1.9 million in stock-based compensation and $0.5 million in DOJ legal expenses.
- Net income: $66.9 million ($5.04 per diluted share), driven by $83.8 million Bitcoin unrealized gain.
- Bitcoin holdings: 5,021 BTC ($586.2 million) as of July 31, with Q2 purchases of 1,444 BTC at $103,581/BTC.
- ATM equity issuance: $156.6 million in Q2, $47.8 million post-quarter, with $300 million remaining under $500 million program.

**【Bitcoin Strategy & Q&A Highlights】**
- Joe Burnett explained Bitcoin's monetary properties (absolute scarcity, 1% annual supply growth) and the $95 trillion institutional capital opportunity for Bitcoin proxies.
- Addressed investor concerns: 
  - **Supply glut**: Differentiated between 'fast money' (premium-driven) and 'slow money' (intelligently leveraged) strategies, emphasizing Semler's focus on sustainable leverage.
  - **Announcement frequency**: Plans to increase acquisition announcements as capital access expands, but no weekly updates.
  - **mNAV multiple**: Highlighted the 'slow money' strategy (1x mNAV leverage) as the foundation for long-term value, with potential premium expansion if Bitcoin outperforms debt costs.
- Launched a merchandise store to strengthen brand engagement with Bitcoin enthusiasts.


Semler Scientific, Inc. (SMLR) Q2 2025 Earnings Call Transcript

- **Bitcoin Treasury Growth**: 3,808 Bitcoin ($400M) with 22.2% YTD yield, $500M ATM for aggressive purchases.
- **Healthcare Cash Flow**: Q1 revenue down 44% but prioritizing Bitcoin funding via cost management.
- **Strategic Focus**: Bitcoin yield of 152.8% since adoption vs. 64% stock appreciation vs. S&P 500's 9%.
- **Operational Leverage**: Highest leverage ratio among public Bitcoin companies for upside exposure.


**【CEO Opening Remarks】**
- Healthcare business focused on cardiovascular growth opportunities with existing enterprise customers.
- Prioritizing cash generation from healthcare to fund Bitcoin purchases.

**【Eric Semler - Bitcoin Strategy Update】**
- Holds 3,808 Bitcoin (~$400M) as of Q1 2025, 9th largest corporate holder in the U.S.
- 2025 YTD Bitcoin yield: 22.2% ($52M realized gain, 510 Bitcoin acquired).
- New $500M ATM program allows aggressive Bitcoin accumulation.
- Achieved 152.8% Bitcoin yield since adoption in May 2024 ($139M realized gain).

**【COO Jennifer Herrington - Healthcare Business】**
- Q1 2025 revenue down 44% YoY due to CMS payment changes.
- Focusing on diversifying customer base and launching FDA-cleared cardiovascular products.
- Pursuing new 510(k) clearance for heart failure diagnostic tool.
- Managing healthcare business to generate cash for Bitcoin purchases.

**【CFO Renae Cormier - Financial Highlights】**
- Q1 2025 GAAP net loss: $64.7M (includes $41.8M Bitcoin fair value loss).
- Completed $100M convertible note offering, using proceeds to buy Bitcoin.
- $500M ATM program issued ~$61M through May 12, 2025.
- Post-Q1 Bitcoin purchases: 616 Bitcoin ($59.6M), total holdings now worth $400M.

**【Q&A Key Takeaways】**
- Plans to use $500M ATM and other financing to aggressively buy Bitcoin.
- Healthcare business expects gradual revenue stabilization through product diversification.
- Bitcoin strategy prioritized over traditional financial metrics.


Semler Scientific (SMLR)-13 May 25-2025 Q1 Earnings call transcript

- **Bitcoin Dominance**: 3,192 coins ($300M) with 152% yield; 10th largest corporate holder.
- **Convertible Notes Success**: $100M raised at 4.25% interest, 75% conversion premium.
- **Healthcare Revenue Decline**: $12.4M (-18% YoY) but 40% op income growth via cost cuts.
- **Government Support**: SAB 121 repeal enabling bank custody seen as Bitcoin bullish.

**【CEO Opening Remarks】**
- The company generated $24M in cash from healthcare operations in 2024, with proceeds from ATM offerings used to acquire Bitcoin.
- Bitcoin holdings now total 3,192 coins valued at $300M, representing a 152% yield since adoption in May 2024.
- Market cap has grown 200% since implementing Bitcoin treasury strategy.

**【Chairman Bitcoin Strategy Update】**
- Completed $100M convertible notes offering with 75% conversion premium, maturing in 2030.
- Total Bitcoin investment to date: $280M, with 894 additional coins purchased post-Q4.
- Ranked 10th largest corporate Bitcoin holder globally.

**【COO Medical Business Update】**
- QuantaFlo product line extension 510(k) application submitted for 2025 approval.
- Testing new cardiovascular products with existing customer base.
- Q4 2024 healthcare revenue $12.4M (-18% YoY) due to CMS rate changes.

**【CFO Financial Highlights】**
- Q4 2024 net income $29.2M ($3.64 EPS), driven by $28.8M Bitcoin valuation gain.
- Operating expenses down 29% YoY to $8.9M, improving gross margin.
- ASU 2023-08 adoption requires marking Bitcoin to market, creating income volatility.

**【Q&A Key Takeaways】**
- Convertible notes chosen for lower dilution vs. equity; $100M offering oversubscribed.
- 2025 healthcare revenue expected to decline 5-10% due to CMS rate impact.
- Regulatory clarity on Bitcoin custody (SAB 121 repeal) viewed as bullish for corporate adoption.

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