Lumexa Imaging (LMRI) 44th Annual J.P. Morgan Healthcare Conference summary

Industry Overview and Growth Drivers

• The U.S. diagnostic imaging market is valued at $140B with a 4% CAGR, while outpatient imaging is $33B and growing at 7% CAGR, driven by aging demographics, chronic conditions, and new treatment paradigms.

• Advanced imaging (MRI, CT, PET) is the main revenue driver, accounting for 63% of revenue and growing twice as fast as routine imaging, with payments per procedure ~3.3x higher.

• The industry is highly fragmented, with the top 10 operators comprising only ~20% of IDTF locations and the two largest players holding less than 10% market share, offering significant consolidation opportunities.

• Outpatient centers offer a 60% lower cost than hospital outpatient departments, with 99%+ in-network coverage and a strong commercial payer mix.

• AI and technology are expected to further improve efficiency, margins, and patient outcomes.

Business Model and Operations

• Operates 188 outpatient imaging centers in 13 states, focusing on advanced modalities and high-growth metropolitan areas, with 86 in joint ventures with major health systems.

• Growth achieved through de novo openings (44 to date, 9 in the past year), 20 acquisitions since 2018, and joint ventures, targeting 8-10 new centers annually.

• Centers average $5.3M in revenue and 6,500 sq ft, with $4M CapEx per de novo, breaking even in about a year and reaching maturity in 24 months.

• Patient and provider satisfaction are core metrics, with a 97% patient satisfaction rate, 91 NPS, and 88% referring physician satisfaction.

• Centralized scheduling, revenue cycle, and sales teams support scalable operations, high referral rates, and seamless patient journeys.

Financial Performance and Strategy

• Achieved $1,003M consolidated GAAP revenue and $220M adjusted EBITDA (22% margin) for the LTM ending September 30, 2025, with ~8% YTD consolidated revenue growth.

• System-wide and consolidated revenue metrics are used due to the joint venture model; strong high single-digit EBITDA growth and 6-7% revenue growth in recent years.

• Leverage reduced from 5.5x to 3.5x post-IPO, supporting further expansion while maintaining financial discipline.

• M&A is a tertiary growth lever, with attractive acquisition multiples (6–9x EBITDA) and proven integration success.

• Diversified payer base: 63% commercial, 19% Medicare, 3% Medicaid, 600 payer contracts, and 99%+ in-network reimbursement.