Heartflow IPO next week on etrade. I did some homework

Here’s an analysis of HeartFlow, Inc. (NASDAQ: HTFL) and whether its upcoming IPO may be worth considering:

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Business Overview

• HeartFlow is a California-based medical technology company that offers non invasive, AI-powered diagnostic software for coronary artery disease (CAD).

• Its flagship service, HeartFlow FFRCT Analysis, creates personalized 3D models from CT scans to quantify blood flow, identify blockages, and characterize plaque Yahoo Finance+15IPO Scoop+15MDDI Online+15.

• As of March 31, 2025, over 400,000 patients had been assessed using HeartFlow's platform, including 132,000 in 2024 alone Fierce Biotech+6IPO Scoop+6Renaissance Capital+6.

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Financial Snapshot

• Revenue: ~$136M in the twelve months ending March 2025, up ~44% year-over-year QQ Insights+5IPO Scoop+5LinkedIn+5.

• Q1 2025 revenue: $37.2M (+39% YoY) wallstreetobserver.com+3LinkedIn+3MedTech Dive+3.

• Losses: Net loss reached $32.3M in Q1 2025 (vs. $20.9M Q1 2024); full-year net loss ~$96M in 2024 and ~$95.7M in 2023 Fierce Biotech.

• Cash position: ~$109–110M in cash, and estimated two-year runway; IPO proceeds will pay down $50–55M in debt MedTech Dive+1LinkedIn+1.

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Growth Prospects & Market Catalysts

• Recent policy changes boosted reimbursements: Medicare expanded coverage for plaque analysis and doubled CT angiography billing rates effective Jan 2026, plus a new AMA CPT code for AI-enabled analysis StockAnalysis+5Cardiovascular Business+5medwire.ai+5.

• Addressable U.S. market is estimated at ~$5B, with global growth of ~8.2% CAGR through 2030 LinkedIn.

• Product pipeline includes Roadmap Analysis, Plaque Analysis, and FFRCT; a new PCI Planner is slated for 2026 StockAnalysis+11IPO Scoop+11LinkedIn+11.

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Risks & Headwinds

• High customer concentration and revenue dependence on HeartFlow FFRCT (accounted for 99% of revenue) increase vulnerability medwire.ai+15MedTech Dive+15Seeking Alpha+15.

• Product reliability issues: Past software defects caused usage interruptions and FDA reports MedTech Dive.

• Competition intensifying: Imaging giants like Siemens, Philips, Canon may develop rival solutions and bundle software with their scanners MedTech Dive.

• Negative Rule of 40 score (~8%), indicating growth is high but profitability remains distant LinkedIn+1PitchBook+1.

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IPO Terms & Valuation

• Shares offered: 12.5 million; priced at $15–$17/share, targeting ~$200–212.5M in proceeds MarketWatch+2IPO Scoop+2Bioworld+2.

• Post-IPO market cap at the $16 midpoint would be around $1.27B with ~79.5M outstanding shares MarketWatch+1IPO Scoop+1.

• Managed by top underwriters J.P. Morgan, Morgan Stanley, Piper Sandler Renaissance Capital+4IPO Scoop+4Reuters+4.

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Verdict: Is It Worth It?

Strengths

• Rapid revenue growth and proven clinical utility of its AI driven diagnostic platform.

• Favorable regulatory and reimbursement environment accelerating adoption.

• Strong market opportunity with limited direct public competitors early in the AI?cardiac diagnostics space.

Risks

• Continued operating losses and unclear path to profitability.

• Reliance on a single primary product (FFRCT) and a few key customers.

• Competitive threat from major imaging hardware vendors.

Investment Considerations

• HeartFlow is appealing if you're bullish on the AI in medicine trend, believe in expanding value-based reimbursements, and accept early-stage risk in hope of long-term return.

• If you’re more risk-averse, prefer companies with profitability or robust diversification, you may want to wait and observe execution post?IPO.

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Quick Recap Table

Factor	Summary
Revenue Growth	~44% YoY, ~$136M trailing
Profitability	Operating/net losses; ~8% Rule of 40
Cash/Debt	~$110M cash; IPO to repay ~$50–55M debt
Market Opportunity	U.S. CAD diagnostics ~$5B; global growth 8.2% CAGR
Regulatory Tailwinds	Increased Medicare reimbursement & new CPT code