In an earnings call covering its 2024 full-year results, executives from Ekso Bionics (Nasdaq: EKSO) described the company’s plans to get its Ekso Indego Personal exoskeleton into the hands of more patients.
“Revenue of $17.9 million was down from $18.3 million for the same period in 2023,” Ekso Bionics CFO Jerome Wong said, in describing full-year 2024 revenue during a March 3 investors’ call.
But Wong noted very different circumstances in 2023 versus 2024.
“I think it’s fair to pause here for a moment to address the marginal year-over-year decline,” Wong said. “It essentially came down to a difficult 2023 comparable, driven by two main factors. First, we were on a procurement cycle with several of the large independent delivery networks in 2023, but not in 2024.
“Second, 2023 was the first full year of having the Indego Personal product line, which we acquired from Parker Hannifin in late 2022. As part of that acquisition, we inherited an approximately $2 million pipeline that Parker Hannifin had with the VA [Veterans Affairs], but weren’t able to fulfill due to the impact of COVID. We delivered most of those devices in 2023, and were rebuilding that pipeline through 2024.”
Medicare coverage changes the exoskeleton landscape
Ekso Bionics CEO Scott Davis then provided further details on what turned out to be a seminal year for the company. Ekso reported 2024 fourth-quarter revenue of $5.1. million.
“While we’re pleased to achieve record revenue in the 2024 fourth quarter, in many respects, our primary focus throughout those three months was focused on the future, particularly for Ekso Indego Personal,” Davis said, referring to the lower-extremity exoskeleton.
“As many of you know, CMS [Centers for Medicare & Medicaid Services] established pricing determination for the device in Q2 2024. Our main focus previous to this event was on post-acute care rehab hospitals and selling capital equipment within the legacy enterprise health market, with some focus on Veterans [Affairs] for at-home devices. So establishing an effective market access function to operate within the CMS reimbursement environment was new to Ekso Bionics.”
Following that policy change, “We immediately set out to establish a go-to-market strategy aimed at notifying as many early physician and provider adopters as possible of the new CMS benefit category redetermination and the fee schedule listing,” Davis added. “This regulatory change has created a significant opportunity to help Medicare enrollees living with a spinal cord injury by removing what has historically been the primary barrier to accessing our exoskeleton.
“Additionally, we began working closely with our extensive network of neurorehabilitation partners across the country, focused on education efforts on appropriate patient selection and process for patients prescribed an Ekso Indego Personal for the home and community settings. That good work was necessary, but only part of what is required to drive the compelling growth opportunity that we continue to see ahead for the Ekso Indego Personal starting in 2025.”
PRIA Healthcare is supporting claims submission process
Before Medicare coverage was approved, Davis said, Ekso was largely focused on building awareness of its exoskeletons and educating stakeholders. Now, Ekso is pivoting to focus on driving provision of the Indego Personal to individual owners and users.
Davis said the company has partnered with PRIA Healthcare, a Torrington, Connecticut-based company that describes itself as working “to accelerate the adoption of health-care innovation by advocating for consistent and reliable reimbursement” of new medical devices and procedures. Davis said Ekso has a “backlog” of more than 25 Medicare beneficiaries that the company believes qualify for and would benefit from the Indego Personal system. In addition, Ekso is working to identify more consumers who could qualify.
“Moving forward with PRIA’s help throughout the submission process, we anticipate submitting those claims to CMS over the next six to nine months,” Davis said. “While we obviously cannot guarantee those claims will be submitted in that timeframe or ultimately be paid, we are confident that PRIA has the ability to provide us with strategic guidance and leverage its expertise to help Ekso navigate the complexities of coding, coverage and payment, ensuring that Ekso Indego Personal reaches the individuals that need this potentially life-changing, mobility-enhancing technology.”
Distribution partnerships in the making
And Ekso recently signed an agreement within the complex seating and mobility space, as well.
“In another move designed to broaden access to EKSO Indego Personal, a few weeks ago we named National Seating & Mobility [NSM] as the company’s exclusive distributor of the personal device within the Complex Rehabilitation Technology or CRT industry in the United States,” Davis noted. “This marks our first entrance into the large and growing CRT space. With [NSM’s} network of over 180 locations and more than 2,400 team members who support more than 250,000 mobility solutions each year, we believe NSM is ideally suited to expand the distribution of Indego personal through this new strategic partnership.”
Davis said Ekso, headquartered in San Rafael, California, is also ramping up pilot programs and partnerships with durable medical equipment suppliers who have focused on traditional orthotics and prosthetics.
The CEO said most of Ekso’s 2025 revenue will still come from its enterprise side, but the company is expecting increased contributions from its Personal health products line, starting from this year. Thanks to Medicare coverage, the Ekso Indego Personal is well positioned, but “will continue to take time to scale and produce results,” Davis said.