American Shared Hospital Services signals robust international expansion and new Rhode Island centers as direct patient services revenue climbs 12%

Earnings Call Insights: American Shared Hospital Services (AMS) Q2 2025

MANAGEMENT VIEW

* Executive Chairman Raymond C. Stachowiak reported "volumes have continued to improve and second quarter 2025 revenue increased 16% sequentially from last quarter," attributing growth to expansion in the Direct Patient Services segment and international business development. He emphasized the company's shift from equipment leasing to a patient-centric model and highlighted that "for the past 4 consecutive years, we've shown significant revenue growth, which has almost doubled since 2021."
* CEO Gary Delanois noted a "double-digit sequential revenue growth, which increased 16% from last quarter," mentioning the ongoing benefits from the Rhode Island acquisition and the opening of the Puebla, Mexico radiation therapy center. He stated, "Our Q2 2025 adjusted EBITDA came in at $1.7 million compared to $949,000 in Q1 2025."
* Delanois added, "We have recruited and secured through our professional services agreement with Brown University Health, 3 outstanding radiation oncologists. And as of today, I am pleased to announce they are seeing new patient consultations at our 3 centers." He also discussed ongoing development of two new centers in Rhode Island, including the state's first proton beam therapy facility.
* CFO Frech Raymond Scott reported, "For the second quarter ended June 30, 2025, total revenue increased 16% to $7.1 million, compared to $6.1 million for Q1 of 2025 and was up slightly compared to Q2 2024. Revenue from our Direct Patient Services segment was $3.5 million for Q2 2025 compared to $3.1 million in Q2 2024, marking an increase of 12%."

OUTLOOK

* Management continues to expect increased treatment growth in Ecuador and strong volume from the upgraded center in Peru, with new centers in Guadalajara and Puebla anticipated to contribute to future revenue. Delanois stated, "We continue to expect to start treating patients and generating revenue towards the end of this year" in Guadalajara, Mexico. The company also looks ahead to further expansion in Rhode Island, including a new radiation therapy center in Bristol and the first proton beam center in the state.

FINANCIAL RESULTS

* CFO Scott detailed that revenue from Equipment Leasing decreased to $3.6 million from $3.9 million in Q2 2024. Gamma Knife revenue reached $2.6 million for Q2 2025, up 25% from Q1 2025, with 264 procedures performed—a 27% increase sequentially, but down 22% year-over-year due to contract expirations. Proton beam radiation therapy revenue increased 17% from Q1 2025 to $1.9 million but decreased 20% from Q2 2024. Linear Accelerator revenue was $2.5 million in Q2 2025, up 7% from Q1 and 34% from Q2 2024.
* Gross margin for Q2 2025 rose 73% sequentially to $1.6 million but fell 34% from Q2 2024, reflecting increased operating expenses and staffing costs. Operating loss was ($544,000) in Q2 2025, improving from a ($1.3 million) loss in Q1 2025. Net loss attributable to AMS was ($280,000) or ($0.04) per diluted share, compared to ($625,000) or ($0.10) per share in Q1 2025. Adjusted EBITDA was $1.7 million for Q2 2025, up from $949,000 in Q1 2025.
* Cash and cash equivalents stood at $11.3 million as of June 30, 2025, unchanged from year-end 2024. Shareholders' equity was $24.5 million or $3.78 per outstanding share.

Q&A

* Marla Marin, Zacks Small-Cap Research: "So as you move more and more towards the direct patient segment, you're seeing strong growth... Are there any preopening activities that you can engage in to try to make sure that you hit the ground running in those locations once they open?" Gary Delanois: "One of the key items that we were able to accomplish... was the addition of 3 full-time radiation oncologist... they will obviously also be covering the new centers, obviously, the more imminent center is the Bristol location, which is a radiation therapy center, the longer-term project would be the proton center."
* Marin: "So that will benefit the 2 centers presumably once they open." Delanois: "Yes, there's definitely economies of scale with us expanding within the greater Rhode Island marketplace."

SENTIMENT ANALYSIS

* Analyst sentiment was constructive and focused on operational execution, staffing, and growth in direct patient care, with a neutral to slightly positive tone.
* Management maintained a consistently confident and optimistic tone in both prepared remarks and Q&A, emphasizing growth, operational readiness, and the impact of strategic hires. Delanois stated, "We are well on our way, and I remain confident that we will see steady growth in treatment volumes."
* Compared to the previous quarter, management's tone shifted from cautiously optimistic to more assertive regarding growth execution and operational milestones, while analysts' tone remained inquisitive but slightly more focused on execution details.

QUARTER-OVER-QUARTER COMPARISON

* Guidance language continues to stress long-term growth, but the Q2 call featured more concrete operational milestones, such as the onboarding of radiation oncologists and timelines for new center openings.
* Strategic focus further shifted toward direct patient services and international expansion, with increased detail regarding new market entries and staffing achievements.
* Key metrics showed a sequential rise in revenue, adjusted EBITDA, and procedure volumes, but year-over-year comparisons still reflect the impact of contract expirations and investment in growth initiatives.
* Management's confidence is more pronounced this quarter, repeatedly referencing operational progress and future growth drivers.
* Analysts' focus moved from regulatory and reimbursement risks in Q1 to operational execution and scalability in Q2.

RISKS AND CONCERNS

* Contract expirations in the Equipment Leasing segment led to lower Gamma Knife and proton therapy volumes compared to the prior year.
* Increased operational and staffing costs compressed gross margins year-over-year, despite sequential improvements.
* Management recognized potential for quarterly fluctuations, with Delanois noting, "there will be some fluctuations from time to time... our focus and track record of long-term revenue growth and profitability... gives me great confidence."
* The company continues to monitor and pursue tuck-in acquisitions to support future growth and address potential gaps.

FINAL TAKEAWAY

American Shared Hospital Services management underscored the company's ongoing transformation toward a patient-centric service model, highlighting robust sequential growth in revenue and adjusted EBITDA, strengthened by successful staffing and new center launches in Rhode Island and Mexico. Operational momentum is building, with leadership expressing strong confidence in continued volume growth, international expansion, and the ability to drive both top- and bottom-line improvements as new strategic projects come online.

Read the full Earnings Call Transcript [https://seekingalpha.com/symbol/ams/earnings/transcripts]

MORE ON AMERICAN SHARED HOSPITAL

* American Shared Hospital Services (AMS) Q2 2025 Earnings Call Transcript [https://seekingalpha.com/article/4813252-american-shared-hospital-services-ams-q2-2025-earnings-call-transcript]
* American Shared Hospital Services (AMS) Q1 2025 Earnings Call Transcript [https://seekingalpha.com/article/4787283-american-shared-hospital-services-ams-q1-2025-earnings-call-transcript]
* AMS outlines international expansion and targets new Rhode Island center as revenue grows 17% [https://seekingalpha.com/news/4449085-ams-outlines-international-expansion-and-targets-new-rhode-island-center-as-revenue-grows-17]
* Seeking Alpha’s Quant Rating on American Shared Hospital [https://seekingalpha.com/symbol/AMS/ratings/quant-ratings]
* Historical earnings data for American Shared Hospital [https://seekingalpha.com/symbol/AMS/earnings]