LifeMD Reports First Quarter 2024 Results; Raises Full Year Revenue Guidance

Rhea-AI Summary

LifeMD reported a strong first quarter of 2024 with a 33% revenue increase year-over-year to $44.1 million. Telehealth revenue grew by 53% compared to the previous year. The company raised full-year revenue guidance to at least $205 million, showing growth in all business segments. Weight management subscribers surpassed 50,000, with cash-adjusted EBITDA at $4.8 million, a 108% increase. The company generated $5.2 million in cash flow and had a $2.0 million net increase in cash during the quarter.

Positive

• First quarter revenue increased by 33% year-over-year to $44.1 million.

• Raising full-year revenue guidance to at least $205 million, up from previous guidance of $200 million.

• Growth in all business segments, with weight management subscribers growing to over 50,000.

• Cash-adjusted EBITDA was $4.8 million, a 108% increase versus the year-ago period.

• Generated $5.2 million of cash flow from operations and had a $2.0 million net increase in cash during the first quarter.

Negative

• GAAP net loss was $7.5 million or $0.19 per share, compared to a loss of $4.8 million or $0.15 per share in the year-ago period.

• Adjusted EBITDA decreased to $0.5 million from $2.0 million in the year-ago period.

• Adjusted diluted EPS decreased to $0.01 from $0.06 in the year-ago period.

Insights

Financial Analyst

LifeMD's Q1 2024 financial results exhibit a robust 33% year-over-year growth, signaling a strong market position in the telehealth industry. The company's strategic focus on expanding its subscription base, reflected in the 53% increase in telehealth revenue and reaching over 50,000 weight management subscribers, has certainly paid off. The growth trajectory is also underlined by the operational efficiency with a noteworthy 108% increase in cash-adjusted EBITDA. However, despite these positive indicators, the GAAP net loss widened to $7.5 million and adjusted EBITDA decreased to $0.5 million compared to $2.0 million in the year-ago period. Investors should consider the scalability of LifeMD's business model and the potential impact of new initiatives like the Medifast collaboration and commercial insurance acceptance. The upward revision of full-year revenue guidance to at least $205 million shows management confidence, but it's also essential to observe how the company will manage its bottom line moving forward.

Healthcare Industry Analyst

From a healthcare perspective, the impressive subscriber growth in LifeMD's weight management program is a testament to the increasing demand for virtual healthcare services. Their partnership with Withings to incorporate metabolic data into patient care is a forward-thinking approach that could set a new industry standard for telehealth providers. However, it's important for investors to track patient retention rates and the cost-effectiveness of acquiring new subscribers. The reported 80% retention after 90 days is a strong signal of customer satisfaction and program efficacy. Additionally, investors should consider the strategic moves LifeMD is making, such as enhancing their pharmacy and medical benefits infrastructure and navigating the complexities of insurance approvals, which have a direct relevance to the scalability of their services in a competitive market.

Market Research Analyst

LifeMD's market strategy appears to be well-aligned with the broader telehealth market trends. Their focus on GLP-1 weight management programs capitalizes on a growing segment within healthcare, catering to the heightened awareness around obesity as a chronic condition. The 66% sequential growth in weight management revenue is a clear indicator of success in this niche. However, the relatively modest 3% increase in WorkSimpli revenue and the decline in WorkSimpli subscribers could suggest a need for further innovation or marketing efforts in that segment. The projected revenue for Q2 2024, between $48 million and $50 million and the full-year revenue upgrade are positive indicators, but monitoring the evolution of their different business segments is key for a holistic understanding of LifeMD's market positioning.

• First quarter revenue increased 33% year-over-year to $44.1 million with telehealth revenue growing 53% versus the year-ago period.
  
• Raising full-year revenue guidance to at least $205 million, up from prior guidance of at least $200 million.
• Growth in all business segments, with weight management subscribers growing to 42,000 as of March 31, 2024. As of today, weight management subscribers exceed 50,000.
• Including the increase in deferred revenue from prepaid weight management subscriptions, cash-adjusted EBITDA was $4.8 million, a 108% increase versus the comparable measure in the year-ago period. Excluding this increase, adjusted EBITDA for the first quarter was $0.5 million.
• Generated $5.2 million of cash flow from operations and a $2.0 million net increase in cash during the first quarter.
  

Conference call begins at 4:30 p.m. Eastern time today

NEW YORK, May 08, 2024 (GLOBE NEWSWIRE) -- LifeMD, Inc. (Nasdaq: LFMD), a leading provider of virtual primary care services, today reported financial results for the three months ended March 31, 2024.   

Management Commentary

“During the first quarter of 2024, LifeMD continued to demonstrate the scalability of our virtual care platform and the alignment of a solid long-term strategy with a current market need. Our focus is on making high quality healthcare accessible for all and we are proud of the impact we are having in this area. We continue to accelerate growth in new patient sign-ups and active subscribers in our GLP-1 weight management business, which alone added over 20,000 net new patients and ended the quarter with over 42,000 subscribers. As of today, we have over 50,000 weight management subscribers on our platform. Moreover, retention for our weight management program remained strong with over 80% of patients starting GLP-1 treatment remaining a patient after 90 days. We also made significant progress on our pharmacy and medical benefits infrastructure and are now seeing prior authorization approval rates between 40-50% for branded GLP-1 treatments. Perhaps most important, our unit economics remain very strong as we continue to achieve a Day 1 return on ad spend of approximately 1.0x with retention that continues to exceed our expectations. I am also particularly proud of our recent announcement to partner with Withings, making us the first telehealth provider to leverage critical metabolic data to drive improved patient outcomes and improved management of chronic conditions and co-morbidities,” said Justin Schreiber, Chairman and CEO of LifeMD.

“Our lifestyle healthcare businesses, led by RexMD^®, continued to produce consistent double-digit growth with robust contribution margins that exceeded 30%,” he added. “We continued to make progress on several key fronts that will provide new, long-term growth levers for LifeMD including our Medifast collaboration, acceptance of commercial insurance which we will launch on a limited basis in the second quarter and the launches of two new product categories under RexMD in the second quarter. The strength of our existing businesses coupled with these new initiatives position LifeMD for accelerated growth and profitability in the back half of 2024 and beyond.”

“We continued our strong financial performance during the first quarter with outstanding topline growth led by a 53% increase in telehealth revenue and over $5 million of cash flow from operations. For the fourth consecutive quarter we achieved positive cash flow from operations and generated positive net cash flow. Adjusting for the large increase in deferred revenue related to the continued over-performance in our GLP-1 weight management program, we generated strong cash-adjusted EBITDA and cash flow continued to outperform expectations. Given the strength of our combined telehealth businesses, we are raising our full-year 2024 revenue guidance to at least $205 million, up from prior guidance of at least $200 million,” added Marc Benathen, Chief Financial Officer of LifeMD.

First Quarter Financial Highlights

• Revenue increased 33% year-over-year to $44.1 million.
• Telehealth revenue increased 53% versus the year-ago period. WorkSimpli revenue increased 3% versus the year-ago period.
• Telehealth active subscribers increased 31% over the year-ago period to approximately 235,000 at quarter-end.
• WorkSimpli subscribers grew by 8,000 sequentially over the prior quarter as performance in this business rebounded in the back half of the quarter.
• Weight management revenue grew 66% sequentially versus the fourth quarter of 2023.
• Gross margin expanded to a record 90%, up from 87% in the year-ago period.
• GAAP net loss was $7.5 million or $0.19 per share, compared with GAAP net loss of $4.8 million or $0.15 per share in the year-ago period.
• Adjusted EBITDA was $0.5 million compared with $2.0 million in the year-ago period (see definition below of this non-GAAP financial measure and reconciliation to GAAP).
• Including the $4.3 million increase in deferred revenue during the quarter related to weight management growth, cash-adjusted EBITDA was $4.8 million, up 108% versus the comparable measure in the year-ago period (see definition below of this non-GAAP financial measure and reconciliation to GAAP).
• Adjusted diluted EPS was $0.01 compared with $0.06 in the year-ago period (see definition below of this non-GAAP financial measure and reconciliation to GAAP).
• Generated $5.2 million of cash flow from operations and positive net cash flow. LifeMD exited the quarter with $35.1 million of cash, an increase of $2.0 million on a net cash flow basis versus the prior quarter driven by continued strong cash flow from operations.
  

First Quarter Key Performance Metrics
($ in 000s)		Three Months Ended March 31,					Y-o-Y
Key Performance Metrics		2024			2023		% Growth
Revenue
Telehealth	$	30,841		$	20,203		53%
WorkSimpli	$	13,303		$	12,924		3%
Total Revenue	$	44,144		$	33,126		33%
Subscription Revenue as % of Total		97%			94%		3%
Active Subscribers
Telehealth Active Subscribers		235,452			179,933		31%
WorkSimpli Active Subscribers		166,352			173,333		-4%
Total Active Subscribers		401,804			353,266		14%

Financial Guidance

For the second quarter of 2024, the Company expects:

• Revenue to be between $48 million and $50 million.
• Adjusted EBITDA to be between $2 million and $3 million.
• Cash-adjusted EBITDA (adjusted EBITDA including the increase in Deferred Revenue from multi-month, prepaid subscriptions primarily from our weight management program) to be between $6 million and $7 million.
  

For the full year 2024, the Company expects:

• Revenue to be at least $205 million, raised from previous guidance of at least $200 million.
• Reaffirming adjusted EBITDA guidance to be between $18 million and $22 million.

Conference Call

LifeMD’s management will host a conference call today at 4:30 p.m. Eastern time to discuss the Company’s financial results and outlook, and answer questions. Details for the call are as follows:

Toll-free dial-in number:	1-888-886-7786
International dial-in number:	1-416-764-8658
Conference ID:	51137398

A live and archived webcast will be available in the Investors section of the Company’s website at ir.lifemd.com.

About LifeMD

LifeMD is a leading provider of virtual primary care. LifeMD offers telemedicine, laboratory and pharmacy services, and specialized treatment across more than 200 conditions including primary care, men’s and women's health, weight management and hormone therapy. The Company leverages a vertically-integrated, proprietary digital care platform, a 50-state affiliated medical group and a U.S.-based patient care center to increase access to high-quality and affordable care. For more information, please visit LifeMD.com.

Cautionary Note Regarding Forward Looking Statements

This news release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended; Section 21E of the Securities Exchange Act of 1934, as amended; and the safe harbor provision of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements contained in this news release may be identified by the use of words such as: “believe,” “expect,” “anticipate,” “project,” “should,” “plan,” “will,” “may,” “intend,” “estimate,” predict,” “continue,” and “potential,” or, in each case, their negative or other variations or comparable terminology referencing future periods. Examples of forward-looking statements include, but are not limited to, statements regarding our financial outlook and guidance, short and long-term business performance and operations, future revenues and earnings, regulatory developments, legal events or outcomes, ability to comply with complex and evolving regulations, market conditions and trends, new or expanded products and offerings, growth strategies, underlying assumptions, and the effects of any of the foregoing on our future results of operations or financial condition.

Forward-looking statements are not historical facts and are not assurances of future performance. Rather, these statements are based on our current expectations, beliefs, and assumptions regarding future plans and strategies, projections, anticipated and unanticipated events and trends, the economy, and other future conditions, including the impact of any of the aforementioned on our future business. As forward-looking statements relate to the future, they are subject to inherent risk, uncertainties, and changes in circumstances and assumptions that are difficult to predict, including some of which are out of our control. Consequently, our actual results, performance, and financial condition may differ materially from those indicated in the forward-looking statements. These risks and uncertainties include, but are not limited to, “Risk Factors” identified in our filings with the Securities and Exchange Commission, including, but not limited to, our most recently filed Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, and any amendments thereto. Even if our actual results, performance, or financial condition are consistent with forward-looking statements contained in such filings, they may not be indicative of our actual results, performance, or financial condition in subsequent periods.

Any forward-looking statement made in the news release is based on information currently available to us as of the date on which this release is made. We undertake no obligation to update or revise any forward-looking statement, whether as a result of new information, future events, or otherwise, except as may be required under applicable law or regulation.

Investor Contact
LifeMD, Inc.
Marc Benathen, CFO
marc@lifemd.com

Media Contact
press@lifemd.com

LIFEMD, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
	March 31, 2024				December 31, 2023
	(Unaudited)
ASSETS
Current Assets
Cash	$	35,110,929			$	33,146,725
Accounts receivable, net		5,336,491				5,277,250
Product deposit		288,938				485,850
Inventory, net		2,373,640				2,759,932
Other current assets		1,298,737				934,510
Total Current Assets		44,408,735				42,604,267
Non-current Assets
Equipment, net		585,980				476,303
Right of use assets		1,674,014				594,897
Capitalized software, net		12,023,248				11,795,979
Intangible assets, net		2,763,297				3,009,263
Total Non-current Assets		17,046,539				15,876,442
Total Assets	$	61,455,274			$	58,480,709
LIABILITIES, MEZZANINE EQUITY AND STOCKHOLDERS' EQUITY (DEFICIT)
Current Liabilities
Accounts payable	$	12,395,032			$	11,084,855
Accrued expenses		14,555,480				13,937,494
Notes payable, net		115,907				327,597
Current operating lease liabilities		447,559				603,180
Current portion of long-term debt		3,958,333				-
Deferred revenue		13,202,757				8,828,598
Total Current Liabilities		44,675,068				34,781,724
Long-term Liabilities
Long-term debt, net		14,069,838				17,927,727
Noncurrent operating lease liabilities		1,311,452				73,849
Contingent consideration		100,000				131,250
Total Liabilities		60,156,358				52,914,550
Commitments and Contingencies
Mezzanine Equity
Preferred Stock, $0.0001 par value; 5,000,000 shares authorized Series B Convertible Preferred Stock, $0.0001 par value; 5,000 shares authorized, zero shares issued and outstanding, liquidation value, $0 per share as of March 31, 2024 and December 31, 2023		-				-
Stockholders’ Equity (Deficit)
Series A Preferred Stock, $0.0001 par value; 1,610,000 shares authorized, 1,400,000 shares issued and outstanding, liquidation value approximately $25.55 per share as of March 31, 2024 and December 31, 2023		140				140
Common Stock, $0.01 par value; 100,000,000 shares authorized, 40,731,676 and 38,358,641 shares issued, 40,628,636 and 38,255,601 outstanding as of March 31, 2024 and December 31, 2023, respectively		407,317				383,586
Additional paid-in capital		220,721,095				217,550,583
Accumulated deficit		(221,810,154	)			(214,265,236	)
Treasury stock, 103,040 shares, at cost, as of March 31, 2024 and December 31, 2023		(163,701	)			(163,701	)
Total LifeMD, Inc. Stockholders’ (Deficit) Equity		(845,303	)			3,505,372
Non-controlling interest		2,144,219				2,060,787
Total Stockholders’ Equity		1,298,916				5,566,159
Total Liabilities, Mezzanine Equity and Stockholders’ Equity (Deficit)	$	61,455,274			$	58,480,709

LIFEMD, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
	Three Months Ended March 31,
	2024				2023
Revenues
Telehealth revenue, net	$	30,841,402			$	20,202,803
WorkSimpli revenue, net		13,302,862				12,923,532
Total revenues, net		44,144,264				33,126,335
Cost of revenues
Cost of telehealth revenue		4,194,595				3,920,182
Cost of WorkSimpli revenue		405,582				294,787
Total cost of revenues		4,600,177				4,214,969
Gross profit		39,544,087				28,911,366
Expenses
Selling and marketing expenses		24,173,880				16,717,645
General and administrative expenses		15,305,732				10,602,763
Other operating expenses		2,300,447				1,704,765
Development costs		2,087,232				1,183,599
Customer service expenses		1,848,041				1,555,404
Total expenses		45,715,332				31,764,176
Operating loss		(6,171,245	)			(2,852,810	)
Other expenses
Interest expense, net		(477,678	)			(264,465	)
Loss on debt extinguishment		-				(325,198	)
Net loss		(6,648,923	)			(3,442,473	)
Net income attributable to noncontrolling interests		119,432				565,983
Net loss attributable to LifeMD, Inc.		(6,768,355	)			(4,008,456	)
Preferred stock dividends		(776,563	)			(776,563	)
Net loss attributable to LifeMD, Inc. common stockholders	$	(7,544,918	)		$	(4,785,019	)
Basic loss per share attributable to LifeMD, Inc. common stockholders	$	(0.19	)		$	(0.15	)
Diluted loss per share attributable to LifeMD, Inc. common stockholders	$	(0.19	)		$	(0.15	)
Weighted average number of common shares outstanding:
Basic		39,242,237				31,680,776
Diluted		39,242,237				31,680,776

LIFEMD, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
	Three Months Ended March 31,
	2024				2023
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss	$	(6,648,923	)		$	(3,442,473	)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Amortization of debt discount		100,444				38,461
Amortization of capitalized software		1,787,404				1,088,645
Amortization of intangibles		245,966				233,560
Accretion of consideration payable		13,644				65,478
Depreciation of fixed assets		65,915				47,651
Loss (gain) on debt extinguishment		-				325,198
Operating lease payments		206,809				184,333
Stock compensation expense		2,544,430				2,663,514
Changes in Assets and Liabilities
Accounts receivable		(59,241)				(102,249	)
Product deposit		196,912				(119,014	)
Inventory		386,292				320,781
Other current assets		(364,227	)			(387,041	)
Operating lease liabilities		(203,944	)			(193,546	)
Deferred revenue		4,374,159				348,039
Accounts payable		1,310,177				(3,203,759	)
Accrued expenses		1,246,342				97,803
Other operating activity		-				(579,319	)
Net cash provided by (used in) operating activities		5,202,159				(2,613,938	)
CASH FLOWS FROM INVESTING ACTIVITIES
Cash paid for capitalized software costs		(2,014,673	)			(1,777,983	)
Purchase of equipment		(175,592	)			(33,656	)
Net cash used in investing activities		(2,190,265	)			(1,811,639	)
CASH FLOWS FROM FINANCING ACTIVITIES
Proceeds from long-term debt, net		-				14,473,002
Proceeds from notes payable		-				2,000,000
Cash proceeds from exercise of options		7,813				-
Preferred stock dividends		(776,563	)			(776,563	)
Net payments for membership interest of WorkSimpli		-				(306,514	)
Contingent consideration payment for ResumeBuild		(31,250	)			(62,500	)
Distributions to non-controlling interest		(36,000	)			(36,000	)
Repayment of notes payable, net of prepayment penalty		(211,690	)			(3,299,959	)
Net cash (used in) provided by financing activities		(1,047,690	)			11,991,466
Net increase in cash		1,964,204				7,565,889
Cash at beginning of period		33,146,725				3,958,957
Cash at end of period	$	35,110,929			$	11,524,846
Cash paid for interest
Cash paid during the period for interest	$	644,919			$	273,000
Non-cash investing and financing activities:
Cashless exercise of options	$	641			$	-
Cashless exercise of warrants	$	12,685			$	-
Stock issued for noncontingent consideration payments	$	642,000			$	642,000
Warrants issued for debt instruments	$	-			$	873,100
Right of use asset	$	1,285,926			$	93,115
Right of use lease liability	$	1,285,926			$	93,115

About the Use of Non-GAAP Financial Measures:
To supplement our financial information presented in accordance with GAAP, we use adjusted EBITDA and adjusted EPS as non-GAAP financial measures to clarify and enhance an understanding of past performance. We believe that the presentation of these financial measures enhances an investor’s understanding of our financial performance. We further believe that these financial measures are useful financial metrics to assess our operating performance from period-to-period by excluding certain items that we believe are not representative of our core business. We use certain financial measures for business planning purposes and in measuring our performance relative to that of our competitors.

Adjusted EBITDA is defined as income (loss) attributable to common shareholders before interest, taxes, depreciation, amortization, accretion, financing transaction expense, non-controlling interests, foreign currency translation, inventory valuation, sales return reserves, litigation costs, loss on debt extinguishment, dividends, insurance acceptance and Sarbanes-Oxley readiness, acquisition costs, severance expenses and stock-based compensation expense. We have provided below a reconciliation of adjusted EBITDA to net loss attributable to common shareholders, its most directly comparable GAAP financial measure.

Cash-adjusted EBITDA is defined as adjusted EBITDA before the change in the Company's deferred revenue balance from the most recent fiscal year-end. We have provided below a reconciliation of Cash adjusted EBITDA to adjusted EBITDA.

Adjusted EPS is defined as the diluted net loss attributable to LifeMD, Inc common shareholders before interest, taxes, depreciation, amortization, accretion, financing transaction expense, non-controlling interests, foreign currency translation, inventory valuation, sales return reserves, litigation costs, loss on debt extinguishment, dividends, insurance acceptance and Sarbanes-Oxley readiness, acquisition costs, severance expenses and stock-based compensation expense. We have provided below a reconciliation of adjusted EPS to Diluted loss per share attributable to LifeMD, Inc common shareholders, its most directly comparable GAAP financial measure.

We believe the above financial measures are commonly used by investors to evaluate our performance and that of our competitors. However, our use of the terms adjusted EBITDA and adjusted EPS may vary from that of others in our industry. Adjusted EBITDA and adjusted EPS should not be considered as an alternative to net loss before taxes, net loss per share, operating loss or any other performance measures derived in accordance with GAAP as measures of performance.

Reconciliation of GAAP Net Loss to Adjusted EBITDA to Cash-Adjusted EBITDA
(in whole numbers, unaudited)
	Three Months Ended March 31,
	2024				2023
Net loss attributable to common shareholders	$	(7,544,918	)		$	(4,785,019	)
Interest expense (excluding amortization of debt discount)	377,234				113,812
Depreciation, amortization and accretion expense	2,112,929				1,435,334
Amortization of debt discount	100,444				38,461
Loss on debt extinguishment	-				325,198
Financing transactions expense	172,229				144,451
Litigation costs	182,547				72,800
Inventory and reserve adjustments	302,629				99,639
Severance costs	160,495				-
Acquisitions expenses	-				25,126
Insurance acceptance readiness	706,341				-
Sarbanes Oxley readiness	159,908				-
Accrued interest on Series B Convertible Preferred Stock	-				112,192
Foreign exchange (gain) loss	(26,248		)		355,622
Taxes	-				-
Dividends	1,079,380				812,563
Stock-based compensation expense	2,544,430				2,663,514
Net income attributable to noncontrolling interests	119,432				565,983
Adjusted EBITDA	$	446,832			$	1,979,676
Change in Deferred Revenue	4,374,159				348,039
Cash-Adjusted EBITDA	$	4,820,991			$	2,327,715

 

Reconciliation of GAAP Diluted Loss per Share Attributable to Common Shareholders to Adjusted EPS
(unaudited)
	Three Months Ended March 31,
	2024				2023
Diluted loss per share attributable to LifeMD, Inc. common shareholders	$	(0.19	)		$	(0.15	)
Adjustments to Reconcile GAAP Diluted Loss Per Share to Adjusted EPS
Interest expense (excluding amortization of debt discount)	0.01				-
Depreciation, amortization and accretion expense	0.05				0.05
Amortization of debt discount	-				-
Loss on debt extinguishment	-				0.01
Financing transactions expense	0.01				-
Litigation costs	0.01				-
Inventory and reserve adjustments	0.01				-
Severance costs	-				-
Acquisitions expenses	-				-
Insurance acceptance readiness	0.02				-
Sarbanes Oxley readiness	-				-
Accrued interest on Series B Convertible Preferred Stock	-				-
Foreign exchange (gain) loss	-				0.02
Taxes	-				-
Dividends	0.03				0.03
Stock-based compensation expense	0.06				0.08
Net income attributable to noncontrolling interests	-				0.02
Adjusted EPS	$	0.01			$	0.06

FAQ

What was LifeMD's first quarter revenue in 2024?

LifeMD's first quarter revenue in 2024 was $44.1 million, a 33% increase year-over-year.

How much did telehealth revenue grow in the first quarter of 2024?

Telehealth revenue grew by 53% in the first quarter of 2024 compared to the year-ago period.

What is LifeMD's full-year revenue guidance for 2024?

LifeMD raised its full-year revenue guidance to at least $205 million for 2024.

How many weight management subscribers does LifeMD have as of March 31, 2024?

As of March 31, 2024, LifeMD has over 50,000 weight management subscribers.

What was the cash-adjusted EBITDA for LifeMD in the first quarter of 2024?

LifeMD's cash-adjusted EBITDA was $4.8 million in the first quarter of 2024, a 108% increase versus the year-ago period.