GE HealthCare Technologies Q1 2024 Earnings Call Transcript

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Provided by Quartr
April 30, 2024

Key Takeaways

  • GE Healthcare reported Q1 results with flat organic revenue, a book-to-bill of 1.03x, a healthy $18.7 billion backlog, 14.7% adjusted EBIT margin (+50 bps y/y), $0.90 adjusted EPS (+6%), and $274 million free cash flow.
  • The company reaffirmed its full-year 2024 guidance, anticipating modest sequential sales and margin improvement in Q2 and a stronger second half driven by procedure tailwinds, backlog conversion, and new product launches.
  • Margin expansion continued as gross margin rose 120 bps in Q1 via pricing and productivity initiatives, and GE Healthcare has exited ~330 TSAs so far with most remaining agreements expected to conclude by year-end.
  • Commercial execution advanced through strategic collaborations and new technologies, including a 10-year alliance with OSF Healthcare, an extended Hartford HealthCare contract, an Elekta MEMS software partnership, the first global install of ALIA IGS Pulse, and multiple AI-enabled ultrasound innovations.
  • China revenue fell low double-digits in Q1 due to anti-corruption measures and tough stimulus comparisons; management is watching a proposed multi-year cash grant stimulus that could support equipment orders once details are clear.
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Earnings Conference Call
GE HealthCare Technologies Q1 2024
00:00 / 00:00

There are 11 speakers on the call.

Operator

Please note that today's conference may be recorded.

Operator

I will now turn the conference over to your speaker host, Carolynne Borders, Chief Investor Relations Officer. Please go ahead.

Speaker 1

Thanks, operator. Good morning, and welcome to GE Healthcare's Q1 2024 earnings call. I'm joined by our President and CEO, Peter Arduini and our Vice President and CFO, Jay Saccharo. Our conference call remarks will include both GAAP and non GAAP financial results. Reconciliations between GAAP and non GAAP measures can be found in today's press release and in the presentation slides available on our website.

Speaker 1

During this call, we'll make forward looking statements about our performance. These statements are based on how we see things today. As described in our SEC filings, actual results may differ materially due to risks and uncertainties. And with that, I'll hand the call over to Peter.

Speaker 2

Thanks, Carolyn, and thanks to all those joining us today. We've made good progress against our key priorities for 2024. In the Q1, we delivered margin expansion while continuing to invest in innovation to help solve the evolving needs of customers and patients. Healthy backlog, orders growth and positive book to bill position us for accelerated growth for the rest of the year. Today, we reaffirmed our 2024 guidance, which Jay will discuss in greater detail.

Speaker 2

Now I'd like to highlight some milestones that illustrate our commercial execution. We're making steady progress with large multi year multi modality deals across equipment and service resulting in incremental share gains. In the U. S, we secured a 10 year strategic alliance with OSF Healthcare to deliver technology, digital solutions and equipment management services to help clinicians improve care delivery and patient outcomes. We also extended our relationship with Hartford HealthCare to run through 2,030.

Speaker 2

As a trusted partner, we'll continue to work together to optimize their imaging fleet and provide specialized support from our GE Healthcare service technicians. Our Care Pathway strategy is progressing well, enabling commercial growth opportunities and introducing us to adjacent markets with attractive growth potential. For example, last week, we announced the expansion of our collaboration with Elekta to enhance their radiation therapy planning offerings using MEMS software, which we acquired in April. In Spain, we announced the 1st global install of our ALIA IGS Pulse system, which is our market leading cath lab design that we expect will be a growth vehicle in this important interventional cardiology market. As we look to 2024, we see a growing funnel of opportunities for products like our IGS portfolio.

Speaker 2

Our strategic initiatives and trusted partnerships are taking hold and position us well for a future where healthcare is more connected, efficient and patient centric. Looking ahead, our outlook reflects a strong global procedure environment, particularly in the United States and customers continue to be optimistic about capital investment and market normalization. These tailwinds combined with our focus on execution give us confidence in our ability to deliver on our commitments for 2024 and our medium term goals. Now I'll pass it on to Jay, who will take us through the details of our Q1 performance. Jay?

Speaker 3

Thanks, Pete. Let's start with our financial performance on Slide 4. For the Q1 of 2024, revenues of $4,600,000,000 were approximately flat organically year over year. Recall, this quarter's results follow the strong double digit growth we delivered in the Q1 of 2023, which benefited from easing supply chain conditions and strong China stimulus sales. Organic orders increased 1% year over year, primarily driven by strength in the U.

Speaker 3

S. With orders dollars continuing to outpace sales, we generated a solid total company book to bill of 1.03x versus 1.01x last year. We also exited the Q1 with a healthy backlog of $18,700,000,000 Adjusted EBIT margin was 14.7 percent, up 50 basis points year over year with improvements in both gross profit margin and SG and A. 1st quarter adjusted EPS was $0.90 up 6% year over year driven by improved margins and lower interest expense and we generated $274,000,000 in free cash flow from improved working capital. On Slide 5, let's take a closer look at total company revenue performance for the Q1.

Speaker 3

Organic revenue growth was approximately flat versus the 12% that we generated in the same period last year. On a reported basis, service grew 2% and product revenue declined 3%. Product performance was impacted by the difficult year over year comparison. Longer term, we see good growth opportunities in both product and service, including greater service revenue from a larger installed base. China revenue declined low double digits given the stimulus that benefited the Q1 of 2023 as well as anti corruption impact in the quarter.

Speaker 3

EMEA sales were up slightly and sales in the U. S. And rest of world were flat with prior year results. Turning to Slide 6 and the progress we made in the Q1 on margin initiatives. Adjusted gross margin expanded 120 basis points as we benefited from commercial wins and productivity initiatives.

Speaker 3

We also delivered positive price in the quarter. Productivity is an ongoing focus for our teams and our lean practices continue to drive improvements. Our teams are expanding daily management and standard work to new areas while delivering on current commitments. All of our segments delivered mid single digit or greater variable cost productivity and made significant platforming improvements. We've been making strategic investments in advanced manufacturing technologies such as 3 d printing and additive across our segments to enhance product capabilities and quality and improve variable cost productivity.

Speaker 3

To date in the U. S, we have more 3 d printing related patents than any other imaging company with 51. These investments drive lower cost and higher durability. For example, in MR, we're applying these methodologies across the entire portfolio, saving us more than $1,000,000 a year and improving performance and reliability. On SG and A, we continue to make progress with roughly 330 TSAs exited since spin and we're well positioned to exit the vast majority of the remaining agreements this year.

Speaker 3

This will allow us to further optimize our cost structure in the future. We delivered solid progress in gross margin and adjusted EBIT margin expansion, while continuing to fund strategic priorities for future growth. Now, I'll turn to our segments. Let's start with Imaging on Slide 7, where we had approximately flat organic revenue growth. This was against a difficult comparison to the prior year when sales were up 12%.

Speaker 3

Segment EBIT margin was up 2 10 basis points year over year. We made progress on enhancing gross margin through productivity, price and service contract capture rate, while investing in R and D. Margin expansion in this business remains critical priority for us and we're on track to the plans we communicated at our Investor Day. Customer demand for our imaging products remains healthy as new therapies drive the need for precision imaging guidance. We're excited about the impact our new product introductions are expected to have on both future revenue and margin.

Speaker 3

Turning to ultrasound on Slide 8, organic revenue was down 4 percent year over year following double digit growth in the prior year. Segment EBIT margin decreased 200 basis points year over year, driven primarily by inflation and lower volume. During the quarter, the team's strong focus on productivity through standardization and commonality across platforms along with ongoing pricing strategies help to partially offset these challenges. Looking ahead, our funnel is solid and we expect growth to accelerate as well as productivity initiatives to drive margin improvements in the second half of the year. Most notably, we also recently launched several exciting new ultrasound innovations that will benefit both top and bottom line performance.

Speaker 3

Moving to Patient Care Solutions on Slide 9. Organic revenue was down 4% year over year driven primarily by in quarter fulfillment delays and prior year COVID related ventilator volume in China, which drove double digit growth last year. Backlog remains healthy, which positions us well for growth. Segment EBIT margin decreased 310 basis points year over year due to inflation and timing of shipments. We implemented programs to drive productivity and price that we expect will improve our margin in future quarters.

Speaker 3

Moving to Pharmaceutical Diagnostics on Slide 10, we had another strong quarter generating 8% year over year organic growth driven by price and continued volume growth. In the quarter, we saw encouraging progress with the first signs of sales upticks for imizumel in the U. S. And other countries. With additional Alzheimer's therapy approvals, we expect more substantial increases in the second half of twenty twenty four.

Speaker 3

Segment EBIT margin of nearly 30 percent improved 190 basis points year over year, mostly driven by price, productivity actions and volume, While we continue to invest in our robust R and D pipeline, we're also encouraged by the continued strength of global procedures, which drives the need for our imaging agents. We're executing on significant capacity investments to strengthen the security of supply for our customers and to deliver on our patients' needs. Planned expansion at our Lindesnes facility in Norway is expected to be completed during the Q2. At the same time, our lean methodology is foundational to delivering for our customers as we continue to increase patient dose capacity across our supply chain. Turning to Slide 11, I'll walk through our cash flow performance.

Speaker 3

In the Q1, we delivered free cash flow of $274,000,000 Our working capital improved year over year and reflected improved inventory turns and lower accounts receivable. Many of our lean efforts and priorities associated with inventory management and the collection processes help drive our progress here. Our strong cash generation capabilities provides us with the financial flexibility to support future growth, leaving room for organic and opportunistic M and A to accelerate innovation. As previously disclosed, we strengthened our balance sheet by paying down $150,000,000 of debt in the quarter. Now let's turn to our outlook on Slide 12.

Speaker 3

In short, we are reaffirming our full year 2024 guidance. We expect a modest sequential improvement in 2nd quarter organic sales growth and adjusted EBIT margin. As discussed in our Q4 call, we expect stronger revenue growth and adjusted EBIT margin in the second half of the year. There are a few catalysts that will support growth through the rest of the year. This includes a number of new product launches that will accelerate growth in ultrasound.

Speaker 3

In addition, we expect to see growth in imaging supported by healthy backlog and a large order funnel. We expect continued growth in our PDX business as procedure trends remain strong. And in PCS, we have healthy backlog and expect the fulfillment challenges in the Q1 to resolve by mid year. With that, I'll turn the

Speaker 2

call back over to Pete. Thanks, Jay. Turning to our precision innovation strategy on Slide 13.

Speaker 4

We're excited

Speaker 2

about recent product introductions across our segments to address customer challenges and improve patient outcomes. The industry continues to be challenged with higher rates of clinical burnout fueled by increased demand for imaging and caring for an aging population. Our customers need solutions that increase flexibility in staffing, scheduling and operations. Digitally enabled remote scanning and connected patient monitoring are ways we can help address these issues. In the U.

Speaker 2

S, GE Healthcare is the exclusive distributor of a vendor agnostic system that allows clinical experts to provide remote MR, CT and PETCT scanning support and image review. And by enabling virtual clinical experts to provide real time guidance to technologists on-site, we're helping to address staffing shortages and streamlining operational workflows. Our Portrait mobile and monitoring solutions platform recently introduced the Portrait Vital Signs Monitor in the U. S. And Europe.

Speaker 2

This new solution integrates with the EHR, allowing clinicians to customize early patient warning scores like low oxygen rates and declining blood pressure to identify patient deterioration sooner. We're also focused on advancing cancer research and creating AI to address some of the biggest challenges in cancer care. For example, immunotherapy has revolutionized the way we think about cancer treatment. However, patient outcomes vary with some response rates ranging from 15% to 30% in solid tumors and 45% to 60% in melanoma. Because of this variation, a considerable amount of research is focused on determining treatment response.

Speaker 2

AI can potentially make a difference. In our pharmaceutical diagnostics business, we created AI research models in collaboration with Vanderbilt University Medical Center that demonstrated a 70% to 80% accuracy in predicting cancer patients' response to certain immunotherapies. What's unique about the approach is that we created these AI models using routinely collected data available in the EHR giving them the potential for broad deployment and adoption methodology that was recently published in a peer reviewed scientific journal. These AA models have the potential to help clinicians to match patients to the most effective treatment sooner, while avoiding unnecessary side effects and costs and could be integrated into our digital suite of tools in the future. We're bolstering our leading portfolio in ultrasound with 6 new products, introductions that include significant upgrades, platforming solutions and new artificial intelligent applications for radiology, urology and cardiology.

Speaker 2

This is a direct correlation to our increased investments in R and D dollars. We've supported clinicians for more than 30 years with our premium general imaging platform, Logic, and we're excited to share that we've made significant enhancements. These include the launch of 3 upgraded premium systems and a new mid tier solution, the Logic Totus, all with AI and vScan Air wireless handheld probe integration. Our new urology based software feature, Prostate Volume Assist, is now available on several BK active imaging systems. Between MIM Software's prostate fusion solutions and the power of AI, we're strengthening our prostate focused ultrasound solutions and improving the cancer journey for providers and patients.

Speaker 2

Earlier this month, we launched the Vscan Air SL with Caption AI Cardiac Guidance at the American College of Cardiology Conference. By integrating AI into our handheld system, we're enabling clinicians to acquire up to 10 standard cardiac use with guidance, creating even more access and use cases for ultrasound point of care. For example, with AI in the palm of their hand, a primary care physician with less ultrasound experience may uncover heart disease sooner or cardiologists can easily and automatically calculate a left ventricular ejection fraction, potentially diagnosing heart failure earlier. We expect these advancements in ultrasound to drive price and cost efficiencies over time and continue to realize more productivity while accelerating growth. We also continue to build our reputation as a trusted partner in ultrasound with several collaborations to address growing patient needs globally.

Speaker 2

For example, 2 leading public health agencies in China recently chose GE Healthcare to develop innovative technologies, patient management models and clinical trading programs to improve outcomes for patients with liver disease. In summary, on Slide 14, I'd like to thank our team for their focus and execution in the Q1. I'm encouraged by the progress on the product pipeline and market outlook. This situates us well for an improving growth profile as we move through the year. I look forward to sharing more about our progress and future innovation plans at upcoming conferences.

Speaker 2

I'd like to introduce that we will host our Investor Day on November 21 in New York City, where we will provide more in-depth views on technology and innovation. With that, we'd like to open up the call for questions.

Speaker 1

Thank you, Peter. Operator, can you please open the line?

Operator

Certainly.

Speaker 4

First question

Operator

coming from the line of Suraj Kalia with Oppenheimer. Your line is open.

Speaker 2

Good morning, Suraj.

Speaker 4

Good morning. Good morning, everyone. Peter, can you hear me all right?

Speaker 2

Yes, clear.

Speaker 4

My apologies for the background noise. So Peter, the obvious question, U. S. Year over year was flattish. I get your point on China in terms of ventilators and tough comps.

Speaker 4

Can you set the stage for us in terms of the U. S. Portion of the business, the flattish performance in the quarter and how you see it progressing through the year?

Speaker 2

Yes. So look, I would just kind of start out to say from that standpoint is just remember we talked about the compare was our toughest one of the year. So obviously it gets better throughout the year. We talked about that in our guidance. But really Q1 was impacted by, fundamentally just was 2 items.

Speaker 2

And Jay touched this on the prepared remarks. One was some fulfillment delays in PCS. I think we've got those well in hand to have them resolved by mid year. I think that's the first part of this. And there were specific items, less about technology and more about actually delivery of the components.

Speaker 2

And then the China piece. And again, we know that anti corruption presents a challenging environment and we expect the data to play out through mid year. I mean those are really the 2 items. If I look at the U. S.

Speaker 2

Specifically, we actually are seeing a more positive backdrop relative to orders funnel, relative to growth potential and really across all of our businesses. And I'd just say ultrasound, I talked a lot just on the call here about new products. 2023 market was somewhat down for the whole market in ultrasound. We see that actually turning around in 2024. And so the timing of our new product introductions is very good, as well as in imaging.

Speaker 2

So I'm rather confident on how we're going to see the capital landscape and the market evolve within the United States. But relative to the quarter, it was those 2 specific items that dampened our top line.

Speaker 4

Got it. And Peter, my follow-up, specifically within imaging, how should we think about backlog, I. E, business that is already in the hand flowing through in the next three quarters versus new orders coming in versus NPI and price increase. Just kind of give us how you all are thinking about within imaging as the year progresses, which are the levers to be pulled? And how should we think about the cadence of imaging growth as the year progresses?

Speaker 4

Thank you for taking my question.

Speaker 2

Yes, great. Thanks. Let me comment and Jay, you can jump in as well on this. So we've got a very solid backlog for our imaging business. I think we feel quite good about the diversity of it, the mix of it, and it actually being growing with price in the backlog and then new platforming capabilities that are coming in like our IGS system, our new cath lab, which will come in and actually bring better margins.

Speaker 2

So it's positioned well from that standpoint. We think the profile is going to be more second half just as we've communicated there hasn't been a lot. We're going to clearly see a pickup in the second quarter, but the majority of it is more profiled out towards Q3 and Q4. And again, that really hasn't changed from what we've laid out our initial guidance on. I would say from a broader order standpoint, we expect that we will see an uptick in broader imaging orders both in Q2, Q3 and Q4, most likely having a larger step up in the second half.

Speaker 2

And some of that's tied to the China stimulus discussion that we had from an order standpoint. But even the U. S. Profile, when you take a look at the products that we've got laid out, some of the big deals that we have visibility into the pipeline, they're probably going to nest more so in that second half of the year.

Speaker 4

Thank you.

Speaker 5

Thank you.

Operator

Thank you. And our next question coming from the line of Edward Lee Day with Redburn Atlantic. Your line is open.

Speaker 6

Hi, Les. Thank you very much. So my first question just to follow-up actually on the China stimulus plans, the new Chinese stimulus that is being discussed. We've seen headline details from the authorities there, but not much more. Could you speak to what you see the benefits of these might be for your address markets through the remainder of the year?

Speaker 6

And your peer yesterday was talking about some evidence of hospital submitting new orders as a result of the potential new stimulus. I don't know if you could speak to that first, please.

Speaker 2

Yes, Ed. So look, the data is unveiling as we speak. So I think we don't have perfect information on it. But I think if you look at since our guidance, what is new is obviously not anti corruption that's out there and it's going to continue, we believe, to be tough through mid year. And as we said before, we believe that that's going to continue to begin to improve in the second half.

Speaker 2

What is new is this stimulus. And from our understanding of it, the prior stimulus was more about low interest rates or relief relative to loans where this will actually be specific cash grants, which then would reach a larger instance group of institutions that aren't just looking for loans, but are looking for supplemental dollars to buy equipment. So we think that obviously opens this up to a larger population. The second piece to that then as well is that its ability to be multi year. And so we'll see how that ultimately plays out.

Speaker 2

But those are the two characteristics. Relative to the rollout of it, I would say what we did see at the end of the Q1 is actually a little bit of tapping of the brakes of some orders in China relative to stimulus coming in. You say, well, why would that be? Customers taking a look at to say, I really want to understand the rules of it. So when I submit an order, I make sure I get the full benefit of the stimulus.

Speaker 2

So we believe that there's going to be clarity to the stimulus rules, so to speak, at some point here in Q2. And post those rules, then we would expect an uptake in orders. And then how that plays out if the orders come sooner, there's more possibility for sales within the year. If the orders come later, businesses like ultrasound that you can do, flow shipments most likely would benefit sooner, whereas installed products would probably be a little bit later. But net net, this is all positive and kind of how we see the landscape as we speak right now.

Speaker 6

Thank you. That's very helpful. And just a quick follow-up actually on your radiopharmaceutical business. If you can give us any color when we should expect FDA approval for pyridaz? And also any other updates that we should be thinking about or looking forward the remainder of the year?

Speaker 6

Thank you.

Speaker 2

Yes. Look, I mean, flopirdaz that you referenced is an agent that's in our PDX business that will be used for cardiac imaging and PETCT. We think it's going to be a really breakthrough approach to be able to do cardiac perfusion imaging in PETCT. And a lot of it, as you know, is tied to logistics, the half life and the ability ship a product there as opposed to have to generate it in 1000000 seconds on-site. Files have been submitted to the FDA and we'll provide updates here on the milestones.

Speaker 2

I think from what I hear from the team, we have everything in. We're not assuming anything within our 2024 guidance. I mean this will be more of a 2025, 26, 27 event as those ramp up. But all things good and we'll be waiting to hear back from the agency if there's any questions or follow ups that they have for us. Thanks for your questions.

Speaker 6

Yes, great. Thanks.

Operator

Thank you. And our next question coming from the line of Selju Hosanna with HSBC. Your line is open.

Speaker 7

Hi, Selju Hosanna from HSBC here. Thanks for taking my questions. I hope you can hear me all right. Yes. Great.

Speaker 7

My first one is on your confidence on the full year 'twenty four outlook. Given the lower book to bill, are you more on the lower end? Or do you are you equally confident on both ends of your guidance? And the second one is on your pricing versus volume comments. I've seen that the positive pricing comment.

Speaker 7

Has this been reflected uniformly across the segments as well as across the regions? Some color there would be really helpful.

Speaker 2

So maybe I'll start, then Jay, you can talk a little bit more about some of the book to bill and the cadence. But look, as I walked through just a minute ago the impact for Q1, including the difficult comp. We expect that to alleviate through the year, which again gives us strong confidence in our ability to hit our guidance. And again, 4 things, the comps get better quarter over quarter, a funnel growing on orders and sales, we have good visibility into including our service funnel. So how does service grow?

Speaker 2

When you won share in a previous year, you have 1 year of warranty. When it comes off of warranty, it becomes part of a contract. We're starting to see the benefit of that service growth now in 2024. 3, the new products against across the whole product line, but particularly in ultrasound and select areas in imaging, the new products and then in improving China. So that's really the 4 items that kind of gives us confidence.

Speaker 2

Jay, maybe over to you talk a little bit how we think about book to bill and price.

Speaker 3

Sure. From a book to bill standpoint, you have to recall that we include in our book to bill calculation both service and PDX coming in at 1 to 1. So if we were to adjust those two items out, the actual book to bill is much higher. So we feel good about the overall book to bill that we have for the quarter. The other thing I would say is the backlog sits at near record levels.

Speaker 3

We're sitting at roughly $19,000,000,000 of backlog. We feel very good about the orders that we have in the backlog. It's a robust pipeline of future sales that we have in place. So overall, that's great. And then as we think about pricing, the pricing environment continues to be solid.

Speaker 3

We highlighted at the beginning of the year, we expect 1% to 2% in pricing impact to sales and we're trending very much in line with those expectations. So we had a good quarter from a pricing standpoint. From a volume standpoint, I think Pete highlighted some temporary issues that we've been navigating, which we expect to resolve. The other thing to remember is the comps get a lot easier as we move through the rest of the year. So I think all of those elements come into play as we were able to firmly reiterate guidance from a sales and an EPS standpoint.

Speaker 7

That's very helpful. Thank you.

Operator

Thank you. One moment for our next question. And our next question coming from the line of Craig Bishop with Bank of America Securities. Your line is open.

Speaker 8

Good morning, guys. Thanks for taking the questions. Wanted to start on order growth. And you guys have seen low single digit order growth over the last three quarters. And I understand that there are a couple of reasons for that.

Speaker 8

But wanted to see if you guys could maybe give a little bit of more color on how that order growth translates into revenue growth in subsequent quarters and your confidence that that order growth will really accelerate over 24 and then be able to drive kind of the mid single digit revenue growth target that you guys have put out there?

Speaker 2

Yes, Craig, thanks for the question. It's a great question. Look, the reality of it is, is that over the last year plus, year and a half, we've actually had a positive book to bill ratio again. And we give that ratio with everything in so that you can see not just the capital piece, but you kind of get a feel for the total composite of it. I think as long as that is a positive scenario and the backlog is almost about $1,000,000,000 higher than where it was pre COVID, we've got a lot of gas in the tank to deliver on mid single digit revenue growth.

Speaker 2

So that's just kind of how the profile of this works. And I think you guys understand with some of the capital that can be lumpy. So shipments tend to be a little bit smoother, but you can pick up significant a couple of large IDN deals in a given quarter and your orders can spike up in that quarter and they can be lower in the following quarter. But that's kind of how we see it from that standpoint. The interesting part here is that over the last, I'd say, 12 months, 18 months, the markets that we've played in and we track these with 3rd party data, have been probably in the neighborhood of only up a point or they've been down a couple of points relative to different markets in the world.

Speaker 2

Our outlook when we see what the rest of this year is and going into 2025 definitely brings a more positive view, which we would expect to see orders pick up relative to those markets. So that's one aspect of it. The other side is, is when you start winning share and I mentioned this on a previous comment and you start growing your installed base, the opportunity for the service revenue to play a bigger contributing component in revenue is there. So you saw this quarter, we actually had positive growth within our service component. We would expect that growth rate to continue to advance, grow faster than it did in the Q1 this year, which means in the second half, we have more service contributing to the growth.

Speaker 2

That service is already in the backlog and so we have visibility into it. So it's a host of those things and then obviously the typical thing, 6 new product launches in ultrasound. We just refreshed the cardiac platform. We just refreshed the Voluson Women's Health care platform, handheld. First Cath Lab that I would say that we've had in quite some time that is very competitive.

Speaker 2

It's robotic platform with new tube, SCT platform, which is doing well, new wider bore MR, our new 3T. All of those then turn around into faster growth and a faster growing market, but also winning some share. So that's those are the pieces that give us confidence. But again, I think when you look at our backlog compared to what we need to deliver on mid single digit growth, we've got plenty of gas in the tank on that just over the next couple of years. But we would expect to see our orders growth pick up.

Speaker 2

And my expectation here is the second half, we're going to start seeing that pick up in that mid single digit range. And again, not every quarter will be consistent, but how that will play out over multiple quarters will be in that range.

Speaker 8

Great. Thanks for that, Pete. And if I could follow-up on the hospital CapEx sentiment, you mentioned that it's still pretty good. So are you here I know you guys or you survey your customers often. So are you hearing any concern given that the interest rate environment looks like we're not going to see many more cuts?

Speaker 8

And then just on top of that, maybe just talk about how the pricing, your ability to get that price that Jay mentioned in one of the previous calls, how does that get impacted in if there's some concern or hesitation on capital spending by hospitals?

Speaker 2

Yes. Let me start and then Jay, you can kind of fill in some of the gaps on this. I think again, if you compare it to over a year ago, you're taking a look at an environment where hospitals were primarily in the red heavily tied to labor cost. We're seeing that moderate and most of our customers particularly our big important IDNs back in the black. So I think that's a quarter late.

Speaker 2

Relative to rates, it's obviously out there. It's a topic. We haven't really seen it come up or in a major discussion that's limiting how things are playing out. I still think the underlying play here is that demand for procedures is just still on continuing to grow. So if you think about some of our peer group of the device companies that are showing very high growth rates in their implants, we're showing that same kind of growth in our PDX business because we see that day to day.

Speaker 2

The effect of that on equipment isn't in that same quarter. The effect on the equipment is usually 3 to 4 quarters out. Why is that? Because you're using current equipment and then you start having capacity constraints and you need to buy upgrades or new equipment. And so that's what also gives us confidence that we're going to see that pick up in later quarters.

Speaker 2

But at this point in time, backlogs to get a MR scan or a PET still are much longer than they were pre COVID. And that brings high value procedures within to an institution. And again, that's what gives us confidence we're to continue to see investments that take place, particularly in the United States. Jay, I don't think that's the price.

Speaker 3

That's exactly right. I think when we do a survey each quarter, Pete's comments are very reflective of what we heard from our customers, continued procedure volume demand, staffing shortages, ease, good economics for the hospitals. Interest rates really have played a less prominent role in some of those discussions and survey results. So we feel quite good about that. From a pricing standpoint, as I said, we've talked about we're talking about low single digit, 1%, 2% price increases.

Speaker 3

And what we're finding is that's not the difference between buying and not buying. It's not really the decisions aren't that sensitive. And so as we continue to emphasize this focus on pricing discipline across the organization, we've been able to see that driving a positive impact for the company.

Speaker 5

Thanks guys.

Operator

Thank you. And our next question coming from the line of Larry Biegelsen with Wells Fargo. Your line is open.

Speaker 4

Good morning. Thanks for taking the question. A follow-up on China. So sales were down about 11% in Q1 in China. What are the expectations for the rest of the year?

Speaker 4

Does the new stimulus represent potential upside to the prior guidance? And I had one follow-up.

Speaker 3

Yes. I think it will depend upon when the details of the stimulus package are laid out. Because as Pete said earlier, we did see some hesitancy amongst customers as they wait clarity on the stimulus rules before submitting orders. And that makes complete sense to me. We've seen that continue in the Q2 of the year.

Speaker 3

And so from our standpoint, the stimulus package, Larry, we view that as a good long term catalyst for the market. Exactly when that shapes up with respect to 2024 is something that we're watching. To the extent that we get clarity sooner, then it certainly could be a positive catalyst versus guidance previous. To the extent that we're still waiting and there's still hesitancy amongst customers with respect to orders, it could be sort of a negative in the short term. But again, I think from our standpoint, we're very pleased to learn about this and long term, it's a very positive development for the overall market.

Speaker 3

D.

Speaker 2

Moriarty:] Yes. I mean Larry, the only thing I would add is from our guide, not a lot has changed. The first half we guided would be negative. The second half will be positive. I think in the second half, the stim is going to have an effect of probably having a bigger step up in Q4 than Q3 just because of the delivery time to ship equipment.

Speaker 2

If it gets more clarified within Q2, then you could actually have a little bit sooner. But I think those are the dynamics. I think the good part is even if it's later that then benefits a Q1 20 25 or a Q2 20 25. But we're expecting that there's going to be clarity here before we get into the half and we'll see how that plays out. So fundamentally, our guidance doesn't change, but stimulus could have a benefit to it.

Speaker 2

But at this point in time, we need to see more of the cards be unveiled.

Speaker 4

That's helpful. Pete, you've been very active on the business development front, mostly very small deals. Is that what we should expect going forward? And maybe just refresh us on areas of interest and if you think robotics is would fit within GE Healthcare? Thank you.

Speaker 2

Yes. Look, Larry, I would just say on your last point on robotics, it's not a from a surgical standpoint, it's not a top priority focus for us. I think from a broader standpoint of robotics and AI, and I mentioned our Alia IGS, it's actually a robot that actually comes into position on how it's used. It's one of the only that's actually used within the cath lab from that standpoint. But tuck in deals of the right size that have a strategic fit into a core business that enable us to connect different parts of our portfolio to bring more differentiated capability.

Speaker 2

That's what we're looking at, both in partnership and in acquisition. So I think that's what you should stay focused on that. That is our primary target. And as we've always said, if a larger deal came up, that actually was a really good fit for us, we would obviously take a look at it. But our 85%, 90% target range is the type of deals like the MIM deal that we did that are just really good fits into 1, our priorities, right, growing our care pathway within oncology, linking our products to make them more differentiated on how they actually work together.

Speaker 2

And we just have a very good funnel of opportunities like those.

Speaker 3

Thanks a lot. Thanks, Larry.

Operator

Thank you. And our next question coming from the line of Ryan Zimmerman with BTIG. Your line is open.

Speaker 5

Hey, thanks for taking my questions. A lot has been asked. I want to ask 2 separate questions. 1, leukemic numbers were off to, I think, a strong start for Biogen, at least that's what it seemed like. And so just curious how the conversation around Alzheimer's has changed at all or the trajectory that you're expecting, I think, for the uptake and kind of patient adoption?

Speaker 5

And then I have a second one on margin.

Speaker 2

Yes, Ryan. So you heard Jay's comments probably on the call relative to we saw some slight upticks here for Gizumel. I would just again remind everyone what we said is our expectation was that we'll start seeing some uptick more in the second half of the year. I think that's pretty much in line with what we're expecting. I think since we gave guidance, there's been discussions that the Lilly drug might be a little bit delayed coming out.

Speaker 2

But when combination of all of those from a diagnostic standpoint, which is what our role is, we expect to see some of that picking up in the second half of the year. Now relative to any type of major material moves, this is not a 24 play as far as we see it right now. I think we think that again in the 25%, 26%, 27% range based on the adoption of both molecules, that's when you're going to see an uptick. There is reimbursement now for the agent in the outpatient center. That's still being worked through in inpatient.

Speaker 2

And I think as that gets more cleared up, that's also going to drive more need for the product. But we were encouraged to see on a ratio standpoint, the numbers are up significantly from an actual dose standpoint. But we would view that as positive and on track to what we'd already communicated of what the ramp should look like during the year.

Speaker 5

Okay. And then Jay, we spent a little go ahead, sorry.

Speaker 2

No, I was going to say go ahead and ask your next question, Brian.

Speaker 5

Thanks, Peter. Just Jay, on gross margins for a bit here. You got some segments kind of down, you got some segments up in terms of EBIT margin. Pricing, I think we all understand those dynamics, but there are still I think a lot of TSAs left. And just help us understand kind of the trajectory of gross margin as you see it today and kind of what you're tackling to get that higher outside of maybe price pickup?

Speaker 3

Yes. Overall, I think we were very pleased with the 1st quarter margin performance. And gross margin in particular, we expanded 120 basis points, really driven by pricing and productivity. Now there's an element that has not yet featured in our numbers, which is related to some of the new products that Pete referenced in his discussion. We'll see benefits from some of the new imaging and some of the new ultrasound products that will also support gross margin expansion.

Speaker 3

But in the Q1, it was really about pricing. I discussed that and productivity. In my prepared remarks, I talked a little bit about some of the lean initiatives and what we call the variable cost productivity initiatives that we have in place. And it's safe to say we're off to a great start from a productivity standpoint. We delivered, I think, mid single digits in each of our businesses more than offsetting inflation and allowing us to drive this gross margin going forward.

Speaker 3

And so as we look at things on a full year basis, we will continue to see solid margin, gross margin performance supporting the EBIT expansion that we've laid out 50 basis points to 80 basis points of EBIT expansion. But really nice to see in the face of flat sales, the 50 basis points of expansion that we saw in the Q1. Now you referenced another comment, which relates to TSAs and we're making good progress there. A lot of great support from GE, but also a lot of good work on our team's side. We've eliminated we've removed roughly 330.

Speaker 3

We're on a path to completing virtually all of the TSAs by year end. And what will happen as a result of this, I would say it predominantly impacts SG and A over time. It will allow us to optimize our structure, optimize our IT systems for the needs of our organizations, but really a gating factor to get at all of that is coming off the TSA. So we've seen a little bit of benefit in terms of SG and A and G and A savings this year. We'll expect to see more next year as we stand on our own 2 feet as an independent company.

Speaker 3

So overall, that's really the story on margin. Pete, anything to add?

Speaker 2

Yes, Ryan, I would just say again, just to remind everyone, I mean, our focus on the increased R and D dollars is obviously new products. But a really important part of it is kind of doing this gross margin triple, which is getting price out of a new product, increased volume because of differentiated features and reducing the actual cost of that product because of platforming. And so when you do that, obviously, if you can get the growth in the lift because of people want it differentiated, you get more price at a lower cost. We have this focus as we mentioned that any new product comes out at a higher gross margin. And again, that's something we drive across the whole portfolio.

Speaker 5

Thank you.

Operator

Thank you. And our next question coming from the line of Gramndall with UBS. Your line is open.

Speaker 9

Good morning, guys. Thanks for taking my questions. Thanks, Graham. Can I just ask one again, it's on China, but just to get context for things as we go through the year? So firstly, just on revenues.

Speaker 9

The comps do get a I mean, just the comps get a bit easier on the revenue side. But am I correct in saying you did grow revenues in H2? And are you assuming a sort of catch up now in the numbers? I think you flagged earlier in the year that H2 would grow enough to offset the sort of H1 weakness. And then just one question on order intake.

Speaker 9

I know you've gone to sort of great lengths to explain how the growth sort of algorithm should work through the year on order intake. But what sort of number are we looking for? Because it seems like mid single digit growth when you combine what's happened over the last sort of 12, 18 months. It wouldn't make me super bullish that you can do high single digit growth in revenue terms next year. But is there something we've missed in terms of how you can translate, say, 5% to 6% growth for the next three quarters into better revenue growth for 2025?

Speaker 9

Thank you.

Speaker 3

Sure. Maybe first on the China comp and the contours of the year. As you recall last year, we saw roughly 20% organic growth in the first half of the year. So when we gave guidance originally, we said first half negative, second half positive. And one of the things that we're watching very carefully is the timeline around this new stimulus package.

Speaker 3

As I said earlier, I think this is long term very positive for the market, but how much of this impact we see in 2024 really relates to sharing more guidance from the government and then also customers acting on it. So we're very bullish, but what that means is, certainly there's going to be some positive impact relative to our previous expectations in the Q4 related to stimulus. But what happens in the Q3 and how much of that demand is pent up paid off in the Q3 versus delayed to the Q4? How much of the 4th quarter stimulus impacts Q1 and Q2 of 2025? To Pete's comments earlier, that's really a question that we're watching very carefully.

Speaker 3

And so we're optimistic about this, but I think it's as we think about the 3rd Q4, Q3 will be a much very flattish in that sort of a range with 4th quarter seeing some of that pent up demand paid off. But again, a lot of this depends on when all of this comes together from a customer demand standpoint. As it relates to the order one, maybe Pete, you want to address that?

Speaker 2

Yes. I think, Graham, I mean, it's a little bit of more of the same. I mean, the first part is, again, the markets that we participate in around the world over the last 18 months coming out of COVID have either been roughly flat or slightly down. We see that trend over the next 2 years. Again, a lot of it tied to this lagging indication that the more actually procedures are growing, more patients are coming into the systems, you need more things that we make.

Speaker 2

So that's a really important one. And again, I think across all of our markets this year, we'll actually see an uptick over the 2023 window. The new NPIs is a big deal. And so again, that adds some pricing growth. It also adds to some share gains with it.

Speaker 2

And then services, so we have been gaining some share in the last of years. Our prior $78,000,000 we haven't probably gained as much. When you do that, you start growing your service base and service becomes a bigger contributor within your overall capabilities. And then the last part is these care pathway areas that we've been nurturing start to bring more growth in the next year or so. Again, from how Alzheimer's we talked about, cardiovascular care pathways and how products work together, but even a product like Flipuridez.

Speaker 2

Those are some of the things that we take a look at that will continue to kind of drive focus on mid single digit growth in orders that will then translate that into revenue. And then based on timing, you may be slightly higher or lower in a given quarter, but that's the formula that we're executing on.

Speaker 9

Great. A cheeky quick follow-up on China just because it did this sort of stimulus package or idea that you sort of mentioned, I know Phillips and Siemens have referenced something similar. Presuming that relates to this medical equipment renewal because it doesn't on the surface look particularly ambitious in terms of the 6% CAGR on spend. But is this something you've seen in the past where these things can expand and become bigger? Is that what gives you some cautious optimism around that?

Speaker 2

Well, there's a couple of different views out there. There's a larger stimulus number that's in the 1,000,000,000,000 of yen that's touching multi industry. And that is money that actually is kind of stipend dollars, if you will, that will go to particular areas within healthcare and other industries. So what that direct distribution looks like, it's a big number. That's more of what we're actually referencing.

Speaker 2

And so again, if you compare it to the previous stimulus, which was interest free loans, this is portrayed and laid out to actually be dollars that will be granted to actually buy equipment. And again, so we believe that will have a larger appeal because by definition many customers weren't even going for loans. So this opens up the field for that. And it also is being expressed at this point to be not a 90 day or 120 day window, but to be a multi year approach. So again, more to come and see what the details are on it.

Speaker 2

But from when we gave guidance to start the year, this is net net positive really any way you look at it from a China outlook. And we'll see what it means for this year. But clearly, if implemented the way it's described, it will have a bigger impact as well going into next year.

Speaker 9

Thank you, everybody. Appreciate the extra question. Thanks, guys.

Speaker 2

Thank you.

Operator

Thank you. And our next question coming from the line of Matt Taylor with Jefferies. Your line is open.

Speaker 10

Hi, thank you for taking the question. Good morning. I was hoping you could comment on 2 things. One is that you identified the catalyst in ultrasound and the resolution of some of the fulfillment issues to resolve as catalysts for growth inflection through the year in those segments. Could you help us understand how much inflection that could drive as you work through the launches and resolve the challenges?

Speaker 2

So Matt, maybe just take I'll take a hit on the ultrasound piece. I think you're referring to the PCS shipments on that. Jay, you can touch on that. Look, I think with ultrasound, again, I think the first part is that when we look at our market dynamics, they are definitely continuing to prove and improve and as one of the top 2 largest players worldwide that has a positive impact. From a standpoint of the compares, I mean, if you take a look at our expectation is that we will continue to ramp our revenue growth throughout the year from Q2 on.

Speaker 2

And then also from an order standpoint, it's a highly correlated business. I mean, just to give you an idea, a vast majority of this business is sell and install. China, this tends to be a larger portion of our business. And so some of the effect that we felt here in the Q1 was directly correlated to the challenges in China. And I think even China's stem will help ultrasound.

Speaker 2

But ex China around the world, U. S, Europe, we're bullish on how we'll see the pickup within China excuse me, in ultrasound and particularly because of the new product introductions that we've laid out. Jay, what about that?

Speaker 3

Yes. And just at the highest level, Matt, I do think we have easing comps throughout the year and I think that's supportive of the accelerated growth profile at a GE Healthcare level. With respect to PCS, we'll see accelerating growth as we move forward here with the second half of the year more similar to growth rates that we saw last year. And as we resolve some of the bottlenecks in the second quarter, we'll see some level of improved growth. But then again, more of those benefits will accrue to the second half of the year.

Speaker 10

Great. And can I ask a follow-up on phasing? You talked about some sequential improvement in organic growth and margin in the second quarter and that would be modest improvement. If I think about what modest means, maybe going to slightly positive organic and I don't know 20 to 40 basis points on margin. If I flow that through, consensus EPS looks like it needs to come down a little bit.

Speaker 10

Is that kind of thinking or math wrong or can you help us at all with the Q2?

Speaker 3

From a second quarter standpoint, we're looking at low single digits on the sales and continued we'll see a reasonable expansion versus the prior year. So that will actually the Q1 is the lowest quarter of the year. So we'll see a little bit more sequential margin expansion, more similar to year over year improvements versus last year similar to what we saw in the Q1. So I don't have the we don't talk about consensus. We don't get into that.

Speaker 3

But I think those are the dimensions that are in play in the Q2. Okay.

Speaker 4

All right.

Speaker 10

Thanks, Jay. Thanks, Pete.

Speaker 2

Thanks.

Operator

Thank you. And that concludes the question and answer session. Speakers, please proceed with any closing remarks.

Speaker 2

Thank you, operator. Thanks everyone for joining us today. Hopefully, we addressed your questions. We've got all the right pieces in place here to deliver on our annual guidance that we've laid out. And we look forward to connecting with each of you in some upcoming calls or conferences in the next few months.

Speaker 2

Thank you very much.

Operator

Ladies and gentlemen, that does conclude our conference for today. Thank you for your participation. You may now disconnect.

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