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  "documentTitle": "iRhythm Technologies, Inc. (IRTC)",
  "authorId": "54_Spruce_Point_Capital",
  "authorName": "Spruce Point Capital Management",
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  "presentationDate": "2025-08-18 00:00:00",
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  "pageNumber": 78,
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  "density": "dense",
  "nDataPoints": 60,
  "notes": "The slide uses red highlighting in the table to draw attention to unfavorable trends in 2023 and 2024.",
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      "kind": "callout",
      "text": "iRhythm acknowledges in its risk factors that some patients fail to return their device, which prevents the Company from being able to produce and bill for the final report. Since iRhythm has already recognized some portion of revenue for Zio AT services, we believe some recognized revenue is never actually received.",
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      "kind": "callout",
      "text": "We believe the aggregate impact of all these trends and changes has resulted in a worsening of revenue quality.",
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      "text": "revenue quality",
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      "kind": "paragraph",
      "text": "We believe multiple signs indicate that iRhythm's reported revenue quality has substantially declined over the past two years. First, the percent of revenue derived from non-contracted payors has increased. Second, iRhythm estimates the amount of revenue it will collect from contracted parties, with the difference between gross and net revenue represented by a contractual allowance. That contractual adjustment as a percent of “contracted” revenue has increased markedly since 2021. Third, iRhythm's DSOs remain elevated. Fourth, iRhythm's provision for credit losses shrank to 17% of gross accounts receivable despite write-offs as a percent of gross accounts receivable reaching a six-year high in 2024. Finally, iRhythm is recognizing more revenue earlier as Zio AT revenue is recognized under two performance obligations, during the patient wear period and the delivery of the final report. We believe the aggregate impact of all these trends and changes has resulted in a worsening of revenue quality.",
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      "kind": "source-note",
      "text": "Source: iRhythm SEC filings",
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      "text": "iRhythm Revenue Quality Metrics 2019 to 2024",
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      "text": "We Believe iRhythm Revenue Quality Is Declining",
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      "name": "Cost Of Inaction",
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      "evidence": "The document discusses potential risks and consequences of inaction.",
      "position": 1,
      "objective": "To highlight the risks of not addressing concerns about iRhythm's business practices",
      "structure": "The Status Quo -> The Hidden Costs Accumulating -> The Future State of Inaction -> The Tipping Point",
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