Contradictions Unveiled: Medicaid Impact and Rhode Island Growth in American Shared Hospital Services' Q2 2025 Call

Impact of Medicaid reimbursement changes, expansion in Rhode Island and facility synergies, staffing and operational capacity in Rhode Island centers, marketing efforts in Rhode Island are the key contradictions discussed in American Shared Hospital Services' latest 2025Q2 earnings call



Revenue Growth and Operational Strategy:
- American Shared Hospital Services reported second quarter 2025 revenue of $7.1 million, a 16% increase from the previous quarter and a slight increase compared to Q2 2024.
- This growth was driven by the expansion of the Direct Patient Services segment, including the acquisition of radiation therapy centers in Rhode Island and the opening of a new treatment center in Puebla, Mexico.

Gamma Knife and Proton Beam Radiation Therapy:
- Gamma Knife revenue increased 25% quarter-over-quarter to $2.6 million in Q2 2025, while proton beam therapy revenue grew 17% to $1.9 million.
- The growth in Gamma Knife revenue is attributed to increased utilization of Gamma Knife systems by health system customers, while the decline in proton beam therapy revenue is due to normal cyclical fluctuations.

International Business Expansion:
- The company's international business segment represents a large growth opportunity, with treatments expanding in countries like Peru and Ecuador, and new centers in Guadalajara and Puebla, Mexico.
- This growth is supported by the establishment of the fourth international center in Guadalajara, Mexico, which will be the only S3 Gamma Knife center in a country of 130 million people.

Financial Performance and Outlook:
- Q2 2025 adjusted EBITDA was $1.7 million, compared to $949,000 in Q1 2025 and $2 million in Q2 2024.
- Despite a decline in gross margin and operating income due to lower Gamma Knife volumes and increased operational expenses, the company remains confident in its long-term growth strategy and has a strong balance sheet.