Semler Scientific Q2 2025 Earnings Report

Semler Scientific EPS Results

• Actual EPS: $5.04
• Consensus EPS: -$0.27
• Beat/Miss: Beat by +$5.31
• One Year Ago EPS: N/A

Semler Scientific Revenue Results

• Actual Revenue: $8.22 million
• Expected Revenue: $8.10 million
• Beat/Miss: Beat by +$116.00 thousand
• YoY Revenue Growth: N/A

Semler Scientific Announcement Details

• Quarter: Q2 2025
• Date: 8/4/2025
• Time: After Market Closes
• Conference Call Date: Monday, August 4, 2025
• Conference Call Time: 4:30PM ET

Semler Scientific (NASDAQ:SMLR), Inc. provides technology solutions to enhance the clinical effectiveness and efficiency of healthcare providers in the United States. The company's products include QuantaFlo, a four-minute in-office blood flow test that enables healthcare providers to use blood flow measurements as part of their examinations of a patient's vascular condition. It also offers Insulin Insights, a software program that is used by a healthcare provider to optimize outpatient insulin dosing. The company's products serve cardiologists, internists, nephrologists, endocrinologists, podiatrists, family practitioners, healthcare insurance plans, integrated delivery networks, independent physician groups, and companies contracting with the healthcare industry, such as risk assessment groups and retailers. It offers its products through sales representatives and distributors. The company was incorporated in 2007 and is headquartered in Santa Clara, California.

Semler Scientific Q2 2025 Earnings Call Transcript

Key Takeaways

• Positive Sentiment: The company reported Q2 GAAP net income of $66.9 million (or $5.40 per diluted share) driven by an $83.8 million unrealized Bitcoin gain, implying a 1.7× forward P/E versus the S&P 500 average.
• Positive Sentiment: Similar Scientific purchased $195 million of Bitcoin in Q2, growing holdings to $586 million (5,021 BTC) with a 300% BTC yield since May 2024 and a target of 10,000 BTC by year-end 2025 and 105,000 BTC by year-end 2027.
• Negative Sentiment: Healthcare revenue declined to $8.2 million in Q2, resulting in a $1.2 million operating loss due to CMS reimbursement cuts that reduced device usage.
• Positive Sentiment: The newly formed CardioVanta subsidiary will develop SaaS-based heart failure and arrhythmia monitoring products in multibillion-dollar markets, with plans to raise outside capital to unlock long-term value.
• Neutral Sentiment: Management is seeking shareholder approval for proxy proposals to expand financing flexibility—including preferred equity—and plans to use leverage and ATM offerings for further Bitcoin acquisitions.

Presentation

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Good afternoon, and welcome to the Similar Scientific second quarter twenty twenty five financial results conference call. After today's prepared remarks, as time permits, management will take questions submitted prior to this call via email. Please note this event is being recorded. Before we begin, we want to remind you that certain comments made during this call may constitute forward looking statements and are made pursuant to and within the meaning of the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 as amended.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

These include expressed or implied statements regarding the expectations for our Bitcoin treasury strategy, plans to acquire additional Bitcoin, opportunity for upsize in the price of Bitcoin, expansion of the health care business, and the development and marketing of additional products, including the receipt and time timing of an additional five ten k clearance for heart failure and for our wholly owned subsidiary, Cardiovanta, and our proposed settlement with the US Department of Justice. Such forward looking statements are subject to both known and unknown risk and uncertainties that could cause actual results to differ materially from such statements. Those risks and uncertainties are described in the press release of our SEC filings. The forward looking statements made today are as of the date of this call, and the company does not undertake any obligation to update the forward looking statements. If you do not have a copy of today's release, you may obtain one by visiting the Investor Relations page of the website, similarscientific.com.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Now I would like to introduce doctor Doug Murphy Chutorian, CEO of Similar Scientific.

[Douglas Murphy-Chutorian, CEO & Board Member at Semler Scientific]

Good afternoon, every everybody. I want to thank you too for joining second conference at twenty twenty five results call. I also want to take a moment to pause and pay tribute to our late cofounder, Herbert J. Semler, who passed away in July at the age of 90 year 96 years. Doctor.

[Douglas Murphy-Chutorian, CEO & Board Member at Semler Scientific]

Semler was a pioneering physician, visionary leader, and a creative genius in medical devices. His teaching continues to take shape who we are and what we do. His passion for innovation and commitment to help with patient care laid the foundation for our mission and remain that at the heart of what we do today. Join us join us in honoring a remarkable life that will be to do improving health and and vaccine medicine. His legacy of caring lives on.

[Douglas Murphy-Chutorian, CEO & Board Member at Semler Scientific]

And now I'll hand the call over to Eric Sumner, our executive chairman. Eric?

[Eric Semler, Executive Chairman at Semler Scientific]

Thank you, Doug. We are super excited about the excellent progress we are making in our Bitcoin operations and we are confident in the potential of our healthcare business. We believe that renewed strength in our healthcare business will generate meaningful cash flow in the coming years enabling us to acquire Bitcoin in a highly accretive way. This dual engine strategy differentiates us among Bitcoin treasury companies. During the quarter and through July 31, we purchased approximately a $195,000,000 of Bitcoin and now hold a total of approximately 586,000,000.

[Eric Semler, Executive Chairman at Semler Scientific]

In addition, during the second quarter, we took bold steps to strengthen our Bitcoin team, adding highly acclaimed Bitcoin journalists and educator Natalie Brunell to our board. Since joining in May, Natalie has made a significant contribution to advancing our Bitcoin mission. We are thrilled to have her insights and support. In June, we further strengthened our team by hiring Joe Burnett as director of Bitcoin strategy. Joe is a recognized leader in Bitcoin treasury management and having his expertise in house is a game changer for us.

[Eric Semler, Executive Chairman at Semler Scientific]

His full time focus on building and executing Semler's Bitcoin roadmap is already making a measurable impact. Later on, Joe will discuss our Bitcoin philosophy and strategy in more detail. In addition, in June, I went from being a chair from being chairman of the company to executive chairman to deepen my role in operations of the company. No. I am.

[Eric Semler, Executive Chairman at Semler Scientific]

Hey, man. We are extremely proud of the progress we are making as a Bitcoin treasury company and thrilled about the opportunities ahead. Since becoming the second US public company to adopt Bitcoin the Bitcoin standard in May 2024, we have made accretive Bitcoin purchases every quarter. The growth and profitability of our Bitcoin operations as reported today are truly remarkable. For the 2025, we reported GAAP net income of $66,900,000 or $5.4 per fully diluted share.

[Eric Semler, Executive Chairman at Semler Scientific]

On an annualized basis, this would imply a price to earnings multiple of only 1.7 times, significantly lower than the S and P 500 average of 25 times forward PE estimates. Our board of directors, as significant shareholders ourselves, believes the current valuation of Semler Scientific stock is disconnected from the company's underlying performance and and its intrinsic value. It is clear to us that our stock is absurdly undervalued. We are committed to unlocking value for all Semler stockholders and are actively exploring accretive opportunities to do so. As I noted earlier, I strongly believe that Semler Scientific offers investors a differentiated business model among Bitcoin treasury companies.

[Eric Semler, Executive Chairman at Semler Scientific]

Our top priority is to provide stockholders with amplified exposure to Bitcoin using intelligent leverage. With nearly $600,000,000 of Bitcoin holdings and only a 100,000,000 of convertible debt that doesn't mature until August 2030, we believe we have ample room to take on more leverage to amplify stockholder returns, and we are actively exploring a wide range of financing options. Not only are we the sixth largest Bitcoin treasury company in The U. S, but we also operate a healthcare business with 80 plus employees that has the potential to generate free cash flow that will enable us to purchase Bitcoin in a very accretive way. In 2024, we we achieved record cash generation of $24,000,000 in our healthcare business.

[Eric Semler, Executive Chairman at Semler Scientific]

While our business has faced headwinds this year, we believe we are on the cusp of launching several new products in markets that are much larger than our current PAD market. These new businesses will be housed in a subsidiary called CardioVanta. We may seek capital in cardio for CardioVanta from outside investors to validate its long term value and fund its relatively modest capital needs. We strongly believe that our health care business has substantial optionality and that its outsized potential upside is not reflected in our market valuation. We are extremely pleased with the value we have created by our consistent accretive accumulation of Bitcoin.

[Eric Semler, Executive Chairman at Semler Scientific]

Since adopting the Bitcoin standard just over a year ago, we've strategically and assertively acquired 5,021 Bitcoin, now valued at approximately $586,000,000 with a cost basis of 476,000,000 resulting in an unreal unrealized gain of a $110,000,000. So far in 2025, we have acquired 2,723 Bitcoin and generated a BTC yield of 31%. This resulted in BTC gain of $7.19 Bitcoin and a BTC dollar gain of $84,000,000 as of July 31. Since adopting the Bitcoin standard in May 2024, we have achieved a 300% positive Bitcoin yield. This has resulted in BTC gain of $17.47 Bitcoin and a BTC dollar gain of $195,000,000 through 07/31/2025.

[Eric Semler, Executive Chairman at Semler Scientific]

We remain confident in our long term goals for accumulating Bitcoin. We are targeting 10,000 Bitcoin by year end twenty twenty five, 42,000 by year end 2026, and 105,000 by year end 2027. We are exploring a wide range of options to meet our Bitcoin targets. Historically, to buy Bitcoin, we've used operating cash flow from our health care business, monetized a portion of one of our healthcare investments and issued convertible bonds and accretively issued common stock through our ATM offerings. In our recent proxy filing, we included two proposals, proposals three and four on the agenda for our upcoming annual meeting on September 5.

[Eric Semler, Executive Chairman at Semler Scientific]

These proposals are vital to our strategic direction as they provide the financial flexibility to raise capital efficiently and to pursue our long term Bitcoin acquisition strategy. This includes enabling access to a broader range of capital instruments such as preferred equity. We strongly encourage stockholders to vote for all proposals outlined in the proxy statement. Our Bitcoin strategy has significantly expanded our investor base. We now have more than 30 up from approximately 11,000 in 2023.

[Eric Semler, Executive Chairman at Semler Scientific]

We're honored by your support and enjoyed meeting many of you at b t BTC twenty twenty five in Vegas and BTC Prague in June. In closing, thank you for joining us today. Your continued support means a great deal for us. Now I'll turn the call over to Joe, our director of Bitcoin strategy.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Thank you, Eric. I'm going to discuss Bitcoin, our Bitcoin strategy, and how Similar Scientific is positioned to amplify Bitcoin's future returns. But first, it's important to understand the fundamentals of Bitcoin and why it has historically delivered such a remarkable compound annual growth rate and outperformed traditional asset classes. Bitcoin is the first form of money with these monetary properties, absolute scarcity, portability, durability, divisibility, and fungibility. In contrast, the US dollar has experienced consistent inflation.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Over the past fifty years, the supply of US dollars measured by m two money supply has grown at an average annual rate of roughly 8%. My thesis has always been money is being debased. As a result, nearly all smart investors are relentlessly buying a diversified portfolio of financial assets, often regardless of valuation, because they know that holding cash over any meaningful period of time is a losing proposition. This creates a perpetual bid under asset classes like real estate, stocks, bonds, and gold, Not necessarily because they're undervalued, but because people feel uncomfortable holding dollars. In this way, a monetary premium has been embedded into these asset classes.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

They're bid up beyond what their fundamentals might otherwise justify simply because investors are looking for somewhere to store wealth. The Bitcoin thesis flips that dynamic. Instead of the US dollar growing at 8% per year, Bitcoin supply is growing at less than 1% annually today, and over time, that number will trend towards zero. So to summarize my thesis in five simple points, one, the money is broken. Two, people save in real estate, stocks, and fixed income.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Three, Bitcoin is good money. Four, the monetary premium from other assets is getting siphoned into Bitcoin. And five, we believe there's a possibility that Bitcoin could ultimately become a $300,000,000,000,000 asset. Now on top of the bullish case for Bitcoin, here's the key institutional reality. Many institutions can't buy Bitcoin directly.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Approximately 97% of institutional capital, a $95,000,000,000,000 market, is restricted by mandate to owning only equities and credit. In other words, they can't own Bitcoin, the commodity, or Bitcoin ETFs. They, in essence, are forced to own Bitcoin proxies like Bitcoin treasury stocks should they want exposure to Bitcoin as an asset class. This represents a huge opportunity for Similar Scientific. Our shares are already owned by several of the most highly regarded institutional investors and funds.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

In addition, brokerage houses and sell side research firms are launching coverage of our company. In July, Cantor Fitzgerald, Benchmark Equity Research, and Maxim Group all initiated research on Similar Scientific with buy ratings. Now, of course, Bitcoin holders can buy and self custody Bitcoin themselves. That's a great strategy. Every Bitcoin holder should own some spot Bitcoin directly, But BTC Equity, public companies like Similar Scientific, are uncommon.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Through our status as a public Bitcoin treasury company, we can amplify Bitcoin exposure through intelligent leverage that public companies can access. Specifically, we can issue low interest, long duration debt, like our outstanding convertible note, to acquire additional Bitcoin. And importantly, we're supported by a valuable health care business that has enabled us to allocate operating profits into more Bitcoin. So the logic is straightforward. If you expect Bitcoin to outperform fixed income over the long run, and we do, it's rational to borrow in dollars at low interest in long duration to accumulate more Bitcoin.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

And the results are already showing up. On the Bitcoin treasury's leaderboard, Similar Scientific is currently ranked fifteenth globally among public companies holding Bitcoin on their balance sheet. But if you narrow the list to only companies truly operating on a Bitcoin standard, that is companies that actively measure progress with the BTC yield KPI, we believe similar rates six in The US. In short, we are already one of the largest public Bitcoin treasuries in the world, and we plan to continue climbing. Our long term target is to reach a 105,000 by year end 2027.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Lastly, I'd like to share that we are launching the Similar Scientific merch store where you'll be able to purchase hats, shirts, jackets, and more. As of today, the store is officially live at similarscientific.com/store. Now I will turn the call over to Renee Cormier, our chief financial officer.

[Renae Cormier, CFO at Semler Scientific]

Thank you, Joe, and thank you everyone for joining us today for our call. I'll cover our second quarter financial results, Bitcoin and capital markets activity, as well as more details on our plans for our health care business. Total revenues in q two twenty twenty five were $8,200,000, which was down compared to the 2024 due to the continued phase in of the 2024 CMS rate announcement that impacted reimbursement for positive PAD patients and which is resulting in decreased usage of our device at some of our customers. Operating expenses for q two twenty twenty five, which includes cost of revenues, were $10,300,000 and loss from operations was $1,200,000 Operating expenses in q two twenty twenty five included $1,900,000 in noncash stock based compensation expense and 500,000.0 of legal expenses related to the DOJ settlement agreement in principle pertaining to a civil investigative demand. The DOJ settlement process is progressing smoothly and on track.

[Renae Cormier, CFO at Semler Scientific]

Further details are laid out in our press release and the appendix to our second quarter presentation. We recorded a net unrealized gain of 83,800,000.0 from the change in fair value of our Bitcoin holdings during the second quarter, calculated using a $170,176 price per Bitcoin. Accounting standards require Bitcoin assets to be measured at fair value with gains and losses from the changes in fair value to be recognized in net income in each reporting period. While this may introduce volatility into our reported net income, it does not impact our cash flow from operations. For the second quarter twenty twenty five, our net income was $66,900,000 or $5.71 per basic share and $5.4 per fully diluted share.

[Renae Cormier, CFO at Semler Scientific]

Cash, cash equivalents, and restricted cash at 06/30/2025 was $13,600,000. Onto our Bitcoin highlights. We acquired 1,444 Bitcoin in q two at a total cost of a 149,600,000.0 or a $103,581 dollars per Bitcoin. At 06/30/2025, we held 4,636 Bitcoin valued at $496,900,000. Subsequent to quarter end, we acquired 385 Bitcoin at a total cost of $45,800,000 or a $119,000.09 $0 per Bitcoin.

[Renae Cormier, CFO at Semler Scientific]

As of 07/31/2025, we held 5,021 Bitcoin with total market value of $586,200,000 based on the 4PM eastern time price per Bitcoin as reported on Coinbase of a 116,758. Capital markets activity in q two twenty twenty five revolved around equity issuances under our ATM offering. In q two, we issued approximately 4,100,000.0 shares for net proceeds of $156,600,000 Subsequent to quarter end and through 07/31/2025, we issued approximately 1,100,000.0 shares for net proceeds of $47,800,000 As of 07/31/2025, we have a little over $300,000,000 remaining in our $500,000,000 ATM. Year to date through 07/31/2025, we generated a 31.3% Bitcoin yield. This translated into a Bitcoin dollar gain of 84,000,000 As you know, we maintain a bit Bitcoin dashboard at ir.semblerscientific.com where investors are able to go to find our Bitcoin related statistics in one location.

[Renae Cormier, CFO at Semler Scientific]

We encourage investors to check back often as it will track additional Bitcoin purchases as we announce them and provide a real time snapshot of our market and Bitcoin metrics. In June, we announced the formation of a wholly owned subsidiary, CardioVanta, to unlock the value of our future health care business opportunities focused on early detection of heart failure and cardiac arrhythmia. It will be as structured as a high margin software as a service or SaaS business model. It will seek capital from outside investors to validate its long term value and fund its relatively modest initial capital needs. The markets for early detection of heart failure and cardiac arrhythmia monitoring are estimated to be in the multibillion dollar range and are projected to grow substantially due to rising cardiovascular disease, technology advancements such as artificial intelligence and the aging population, and increasing adoption of wearable and remote monitoring solutions.

[Renae Cormier, CFO at Semler Scientific]

According to the Centers for Disease Control and Prevention, heart failure affects more than six million Americans and costs The US health care system more than 30,000,000,000 annually. While CardioVanta will focus on cardiac technology and care systems, Semler Scientific will continue marketing its QuantiFlo device and software for early detection of peripheral artery disease. Now I'll turn it back over to Joe to begin the q and a.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Great. Thank you, Renee. Our first question is, are you concerned about a potential supply glut of public companies pursuing similar Bitcoin treasury strategies? No. We're not concerned.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

As I mentioned earlier on the call, we believe Bitcoin is on track to become a multi $100,000,000,000,000 market by absorbing monetary glut premium from traditional asset classes like real estate, equities, and fixed income. Given that outlook, companies operating as Bitcoin treasuries with intelligent leverage, effectively long Bitcoin and short the dollar, are simply position positioning themselves to outperform if this thesis proves correct. Rather than viewing them as competition, we see them as peers accelerating Bitcoin adoption and helping monetize the asset globally. In fact, we believe this trend will benefit all early movers. The more credible companies that adopt Bitcoin as a treasury reserve asset, the faster the monetization process accelerates and the more valuable our own Bitcoin becomes.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Our second question, do you plan to make more regular Bitcoin acquisition announcements? We do not currently plan to make weekly announcements like some other Bitcoin treasury companies. However, we do expect that our Bitcoin acquisition announcements may increase in both regularity and size over time. That said, we may also strategically choose to announce acquisitions with a less frequent cadence. Just because we have not announced an acquisition does not mean we are actively accumulating Bitcoin during the quarter.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

As we explore additional ways to issue securities and acquire more Bitcoin, the pace of our announcements could naturally accelerate. Our focus remains on executing our strategy in a disciplined, accretive, and stockholder aligned way. Last, our final third question. How does management think about the MNAV multiple at which similar trades at relative to its peers? I think there's been confusion about Bitcoin treasury companies because there are actually two different games to play.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

The first is the fast money game. This occurs when a Bitcoin treasury company trades at a substantial premium to its Bitcoin net asset value or MNAV. At this level, the company can tap its common equity ATM, issue additional shares, and immediately use the capital to acquire more Bitcoin. This instantly generates a positive BTC yield, increasing Bitcoin holdings per share. That process can repeat rapidly compounding returns provided the premium to MNAV doesn't collapse.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

The inherent risk, of course, is the potential compression of this premium. The second strategy is the more sustainable slow money game. This strategy is available to all Bitcoin treasury companies of a certain size, and it even works at one x MNAV. In this scenario, the company intelligently leverages its balance sheet using fixed income liabilities to enhance its exposure to Bitcoin. If Bitcoin appreciates significantly and the MNAV ratio stays stable at one x, the leverage amplifies returns.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Essentially, as long as Bitcoin's appreciation outpaces the interest cost of the liabilities, the Bitcoin treasury company should logically outperform Bitcoin itself. In my in my opinion, the presence of this lower slower sustainable strategy actually underpins and fuels the faster premium driven game. The attractiveness of the intelligently leveraged position sets the foundation. Whenever market sentiment for leveraged Bitcoin exposure strengthens even slightly above one x MNAV, the premium driven fast money strategy becomes viable again, allowing for rapid value creation. In short, the slow money game is likely where pre why premiums develop in the first place, offering the best way to amplify the future returns of Bitcoin.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

Similar's balance sheet currently uses intelligent leverage. This enables the potential for Similar to amplify the future returns of Bitcoin, and it enables the potential for future MNAV expansion. The only thing better than Bitcoin is more Bitcoin, and the premiums on Bitcoin treasury companies may exist because the market loves more Bitcoin. Thank you everyone for your questions. As we wrap up this conference call, we wanna emphasize our ongoing commitment to continued execution of our Bitcoin treasury strategy and and our healthcare business.

[Joe Burnett, Director of Bitcoin Strategy at Semler Scientific]

We appreciate your participation in today's discussion and thank you for your ongoing support. Operator, you can conclude the call.

[Operator]

Thank you. The conference call has now concluded. Thank you for attending today's presentation. You may now disconnect.

Participants

Executives

• Joe Burnett, Director of Bitcoin Strategy
• Renae Cormier, CFO

Analysts

• Douglas Murphy-Chutorian, CEO & Board Member at Semler Scientific
• Eric Semler, Executive Chairman at Semler Scientific