Semler Scientific, Inc. (SMLR): Business Model Canvas [Dec-2025 Updated]

You're digging into Semler Scientific, Inc. and seeing a company that's defintely taken a sharp turn this year, moving far beyond just medical devices. Honestly, their business model right now is a fascinating, dual-powered machine: one side is the core healthcare play-the QuantaFlo diagnostic-which still boasts gross profit margins near 91%-but the other, much louder engine is their aggressive Bitcoin treasury strategy, funded by raising over $203.8 million in net proceeds through Q3 2025 via At-the-Market (ATM) equity offerings. To understand the real risk and reward profile here, especially with $586.2 million in Bitcoin holdings as of July 31, 2025, you need to see how these two very different worlds connect across their entire operation, so let's break down the full Business Model Canvas below.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Key Partnerships

You're looking at the critical external relationships that fuel Semler Scientific, Inc.'s dual strategy of medical diagnostics and corporate Bitcoin treasury management as of late 2025. These aren't just vendors; they are capital conduits and strategic exit partners. Here's the breakdown of the key players supporting their operations and the recent Strive, Inc. merger.

Capital Markets Facilitators: Investment Banks for ATM Offerings

Semler Scientific, Inc. relies heavily on its relationship with major financial institutions to execute its At-the-Market (ATM) equity offerings, which fund Bitcoin acquisitions and operations. This partnership structure is key to their capital-raising efforts.

On April 15, 2025, Semler Scientific, Inc. entered into a new Controlled Equity OfferingSM Sales Agreement, which replaced an initial agreement with Cantor Fitzgerald & Co. The new arrangement involves a consortium of firms to sell up to $500.0 million of common stock over time.

The primary partners named in these agreements include Barclays Capital Inc. and Cantor Fitzgerald & Co., alongside Canaccord Genuity LLC, Needham & Company, LLC, Craig-Hallum Capital Group LLC, and Lake Street Capital Markets, LLC.

Here's a look at the capital raised through these ATM programs:

• Initial Sales Agreement proceeds (prior to April 22, 2025): approximately $126.0 million from selling about 2.4 million shares.
• Net proceeds as of May 22, 2025, from the new agreement: approximately $114.8 million from issuing and selling 3,003,488 shares.
• Net proceeds from April 25, 2025, to April 29, 2025: approximately $19.5M from selling 559,000 shares.
• Net proceeds through May 12, 2025, under the new agreement: approximately $61.5 million from issuing and selling 1,796,797 shares.
• Total net proceeds as of early June 2025: approximately $136.2 million from selling over 3.5 million shares.

Bitcoin Treasury Funding: Coinbase Credit Inc.

To fund its operations, including a settlement with the U.S. Department of Justice, Semler Scientific, Inc. established a financing partnership with Coinbase Credit Inc., utilizing its Bitcoin holdings as collateral. This is a direct, non-traditional debt facility.

Semler Scientific, Inc. entered a Master Loan Agreement on April 15, 2025, allowing it to borrow cash or digital assets secured by Bitcoin.

On September 25, 2025, Semler Scientific borrowed $20 million in cash.

The terms of this specific loan include:

If the value of the Bitcoin collateral falls below the minimum margin requirements, Semler Scientific, Inc. could be required to post additional collateral or repay the loan.

Strategic Exit and Consolidation: Strive, Inc.

The most significant partnership as of late 2025 is the pending acquisition by Strive, Inc., which will combine the two companies' Bitcoin treasuries and medical assets. This is structured as an all-stock transaction, meaning no cash is exchanged for the equity of Semler Scientific, Inc.

The definitive agreement was signed on September 22, 2025.

The transaction valuation metrics are stark:

To prepare for the merger, Strive, Inc. purchased 5,816 Bitcoin for $675 million (at an average price of $116,047 per Bitcoin) concurrent with signing.

The combined Bitcoin treasury will be substantial:

• Semler Scientific, Inc. Bitcoin holdings at announcement: 5,021 BTC.
• Strive Bitcoin holdings before purchase: 5,886 BTC.
• Combined post-merger Bitcoin holdings: Over 10,900 BTC.

Product Component Suppliers

Semler Scientific, Inc. maintains relationships with various suppliers for the components necessary to manufacture and support its medical devices, specifically the QuantaFlo device and the newer CardioVanta product line.

The company has continued to invest in the medical division, including forming CardioVanta in 2025.

Finance: draft 13-week cash view by Friday.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Key Activities

You're looking at the core actions Semler Scientific, Inc. is taking to execute its dual strategy, balancing its medical technology with its aggressive digital asset accumulation. Here's the breakdown of those key activities, grounded in the latest figures available through late 2025.

Strategic acquisition and management of Bitcoin treasury assets, targeting 10,000 BTC by year-end 2025.

Semler Scientific, Inc. is actively managing a significant portion of its balance sheet as a Bitcoin treasury. The stated objective for the end of 2025 was to reach 10,000 BTC. The company has been acquiring these assets using proceeds from equity financings and operating cash flow.

Here's a look at the reported Bitcoin holdings progression leading up to the end of Q3 2025:

The position as of September 30, 2025, represented 5,048 Bitcoins, valued at $575.8 million based on the Coinbase exchange price at that quarter's end. The total cost basis for these holdings was approximately $478.94 million, with an average cost of $94,877 per BTC, according to one report. The company also reported cash, restricted cash, and cash equivalents of about $10.3 million as of September 30, 2025. This strategy is a core activity. It's a defintely bold move for a healthcare firm.

Sales and licensing of the QuantaFlo device for Peripheral Arterial Disease (PAD) diagnosis.

The core medical activity involves the QuantaFlo device, which measures early signs of PAD. Reimbursement from payors like Medicare is a significant factor for provider adoption. The company is experiencing headwinds here due to changes in the Centers for Medicare and Medicaid Services (CMS) reimbursement landscape.

Key revenue indicators related to QuantaFlo activity:

• Q1 2025 Revenue: $8.8 million.
• Q2 2025 Revenue: $8.2 million.
• Q3 2025 Expected Revenue Range: $6.9 million to $7.5 million.
• A customer accounting for 44.9% of Q2 2025 revenue notified the company of a substantial reduction in device use starting October 1, 2025.
• Anticipated Q4 2025 revenues are projected to be at least 50% lower than the Q3 2025 expected figures.
• Trailing Twelve Months (TTM) Revenue as of a recent report: $36.95 Million USD.

Research and development for new cardiovascular products via the CardioVanta subsidiary.

Semler Scientific, Inc. formed CardioVanta, Inc. as a wholly-owned subsidiary to house future healthcare initiatives. This subsidiary focuses on the early detection of heart failure and cardiac arrhythmia monitoring. CardioVanta is structured as a high-margin, software-as-a-service (SAAS) business model. The plan involves seeking capital from outside investors to validate its long-term value and fund its initial capital needs, which were described as relatively modest. The markets for these areas are estimated in the multibillion-dollar range.

Capital raising through ATM offerings, generating approximately $203.8 million net proceeds through Q3 2025.

The company actively uses its at-the-market (ATM) offering program to raise capital, often to fund its Bitcoin purchases. The proceeds from these equity issuances are a critical component of the overall funding strategy.

ATM Program Proceeds Snapshot:

• Net proceeds under the initial Sales Agreement through April 22, 2025: approximately $126.0 million.
• Net proceeds under the new Sales Agreement through July 31, 2025: approximately $194.3 million.
• Total net proceeds from the ATM program through September 30, 2025: approximately $203.8 million, derived from the sale of 5,207,036 shares of common stock.

Finance: review the Q4 2025 cash flow projection incorporating the DOJ settlement payment of approximately $30.1 million by end of October.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Key Resources

You're looking at the core assets that power Semler Scientific, Inc.'s current strategy, which is heavily dual-focused on medical technology and its treasury strategy. Honestly, the resources here are a mix of traditional IP and a very modern, aggressive balance sheet play.

Bitcoin Treasury Assets

The most significant, and certainly the most volatile, key resource is the digital asset holdings. Semler Scientific, Inc. has made a clear commitment to Bitcoin as its primary treasury reserve asset, using proceeds from capital markets activity to fund this accumulation. As of July 31, 2025, the company held 5,021 Bitcoin with a reported market value of $586.2 million. This is a massive shift from its historical medical device focus. To put this in perspective against the cost, as of July 2, 2025, the firm had spent approximately $430 million (inclusive of fees) to acquire 4,636 Bitcoin at an average cost of $92,753 per coin. The company has an ambitious goal of reaching 10,000 Bitcoin by the end of 2025. That's a resource that requires constant monitoring.

Here's a quick look at the scale of the treasury resource as of the end of the third quarter:

Intellectual Property and Human Capital

The foundation remains the patented medical technology. The QuantaFlo device technology is critical, as it is used for arterial blood flow measurement, specifically for diagnosing Peripheral Arterial Disease (PAD). The core patent for this technology is set to expire on December 11, 2027. The device received its initial FDA 510(k) clearance on March 5, 2015, based on its use of photoplethysmography. Still, the healthcare revenue stream is under pressure; Q3 2025 revenue was only $7.491 million, and management warned Q4 2025 revenue could be at least 60% lower than Q3 due to external factors and customer attrition.

The intellectual capital has also been strategically augmented to support the treasury strategy. This includes the appointment of Joe Burnett as Director of Bitcoin Strategy in June 2025. Furthermore, the company established a wholly owned subsidiary, CardioVanta, in June 2025, to focus development efforts on early detection of heart failure and cardiac arhythmia, separating that development team from the core corporate structure.

Key elements of the intellectual and human capital include:

• QuantaFlo FDA Clearance Date: March 5, 2015.
• Patent Expiration Date: December 11, 2027.
• Director of Bitcoin Strategy: Appointed in June 2025.
• CardioVanta Team: Dedicated to heart failure detection.
• Q3 2025 Healthcare Revenue: $7.491 million.

Access to Capital Markets

To fund the aggressive Bitcoin accumulation, access to capital markets is a necessary resource. Semler Scientific, Inc. has an active at-the-market (ATM) equity financing program. In April 2025, the company entered a $500 million stock sale agreement. By July 31, 2025, the company had issued and sold approximately 5,207,036 shares of common stock for net proceeds of about $203.8 million under this program. This access is crucial for maintaining the treasury strategy while the core business faces headwinds. The ability to raise capital via debt and equity is a direct enabler of the current asset allocation policy.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Value Propositions

For Healthcare Customers, the primary value proposition centers on the flagship QuantaFlo® device and software, which is patented and cleared by the U.S. Food and Drug Administration (FDA) to provide rapid point-of-care testing to measure arterial blood flow in the extremities, directly aiding in the diagnosis of peripheral arterial disease (PAD). This is a non-invasive assessment delivered directly at the point of care.

For Investors, Semler Scientific, Inc. offers a unique proposition as a publicly traded vehicle structured around a dual-powered treasury model. This model amplifies exposure to Bitcoin, which the company has adopted as its primary treasury reserve asset. As of September 30, 2025, Semler Scientific held 5,048 Bitcoins, with a reported market value of $575.8 million based on the Coinbase exchange price at the quarter's end. The company had an explicit target to reach 10,000 Bitcoin by year-end 2025. The performance of this strategy is tracked via metrics like the BTC Yield, which was reported as 0.9% in the third quarter of 2025 and 30.6% year-to-date through November 10, 2025.

The core healthcare business maintains high gross profit margins, reported at nearly 91%, with preliminary Q3 2025 data showing a margin of 90.84%. This high margin on the established product contrasts with recent revenue headwinds, as Q2 2025 revenue was $8.2 million, and Q3 2025 expected revenue was projected between $6.9 million and $7.5 million.

Semler Scientific, Inc. is expanding its value proposition through its wholly-owned subsidiary, CardioVanta, Inc., which focuses on new solutions for heart failure and cardiac arrhythmia monitoring. This move targets markets estimated in the multibillion-dollar range. To put the scale of the problem in context, heart failure affects more than six million Americans and costs the U.S. healthcare system over $30 billion annually. CardioVanta is structured to operate as a high-margin, software-as-a-service (SAAS) business model.

Here's a quick look at the dual-engine platform metrics as of late 2025:

The value proposition for the healthcare segment is further detailed by the specific applications:

• Rapid, non-invasive testing for Peripheral Arterial Disease (PAD) diagnosis via QuantaFlo.
• Development of products for early detection of heart failure.
• Development of systems for cardiac arrhythmia monitoring through CardioVanta.
• Pursuit of new 510(k) clearance for expanded labeling, though not expected until mid- to late 2026 at the earliest.

The investor value proposition is underpinned by the company's capital structure and treasury strategy, which includes:

• Strategic accumulation of Bitcoin using cash flow and financing proceeds.
• Total proceeds from the ATM offering through July 31, 2025, reached approximately $194.3 million.
• The company reported a pre-tax income of $80.6 million for Q2 2025, significantly boosted by Bitcoin gains.
• The intention to seek outside capital for CardioVanta to fund its relatively modest initial capital needs.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Customer Relationships

You're looking at how Semler Scientific, Inc. manages its connections with its various customer groups-the health plans using QuantaFlo and the investors following the dual-pronged strategy. It's definitely a mix of direct medical sales and high-level financial communication.

Direct, high-touch relationships with large enterprise customers (health plans) for QuantaFlo licensing.

The relationship with healthcare providers and payers centers on the QuantaFlo device, which aids in diagnosing Peripheral Artery Disease (PAD). Semler Scientific primarily uses a license model, which means you don't need a large capital equipment sale upfront. Approximately two-thirds of your customers operate on the fixed-fee software licensing model, while just under one-third use the variable-fee model based on usage. The fixed-fee portion is what you can view as annual recurring revenue (ARR), which historically showed consistent growth of 10% year-over-year, suggesting high customer retention, though recent pressures are evident.

The customer concentration risk is notable. For the first quarter ended March 31, 2025, Semler Scientific's two largest customers, including their affiliates, comprised 42% and 32% of that quarter's revenues, respectively. However, the relationship is under strain due to regulatory shifts. The Centers for Medicare & Medicaid Services (CMS) changes mean that for 2025, Medicare only covers 33% of PAD expenses for patients without complications, down from 67% in 2024. This regulatory environment directly impacts customer usage; management warned that Q4 2025 revenue would be at least 60% lower than Q3 2025 because a customer representing more than 10% of revenue ceased QuantaFlo usage in Q2-Q3. The QuantaFlo patent itself is set to expire in December 2027.

Investor relations focused on communicating the Bitcoin treasury strategy and key performance indicators (KPIs).

Investor engagement is heavily weighted toward the Bitcoin treasury strategy, which you adopted as your primary reserve asset in May 2024. The roadmap communicated to investors is aggressive: 10,000 Bitcoin by the end of 2025, 42,000 by the end of 2026, and 105,000 by the end of 2027. To support this, you have been actively accessing capital markets. For instance, in Q2 2025, equity issuances under the ATM offering raised $156.6 million. The stockholder count grew from 11,078 in September 2023 to 32,164 by July 2025, showing expanding interest in this narrative.

The financial performance shared with investors highlights the dual nature of the business, where GAAP net income is often driven by non-operational Bitcoin revaluation. For Q3 2025, net income was $16.9M, entirely driven by other income from Bitcoin fair value changes of $28.5M. You are positioning yourself as a 'dual-pronged powerhouse in the Bitcoin and medical technology sectors'.

Dedicated Bitcoin dashboard for public transparency on holdings and yield.

Transparency on the Bitcoin holdings is a key part of the investor relationship, utilizing a dedicated dashboard to disclose material nonpublic information. Key performance indicators (KPIs) tracked publicly include the absolute Bitcoin holdings and the BTC Yield. As of July 31, 2025, the reported holdings were 5,021 Bitcoin, with a fair value of $586.2 million against a total cost basis of $475.8 million. The BTC Yield year-to-date through July 31, 2025, was reported at 31.3%. Another reported KPI is the 'BTC Gain,' which reached 719 year-to-date through July 31, 2025.

Here's a quick look at the Bitcoin treasury status as of mid-2025:

• Bitcoin Holdings (as of July 31, 2025): 5,021 BTC
• Fair Value (as of July 31, 2025): $586.2 million
• Total Cost Basis: $475.8 million
• BTC Yield (YTD through July 31, 2025): 31.3%
• Target Holdings for Year-End 2025: 10,000 BTC

Seeking outside investment for the CardioVanta subsidiary to validate its long-term value.

Semler Scientific, Inc. created CardioVanta, Inc. as a wholly-owned subsidiary on June 24, 2025, to house future healthcare business activities focused on early detection of heart failure and cardiac arrhythmia monitoring. This entity is structured with a high-margin, software-as-a-service (SAAS) business model. The core customer relationship strategy here is to attract external capital. CardioVanta will seek funding from outside investors specifically to validate its long-term value and cover its 'relatively modest initial capital needs'. The target market for these new initiatives is substantial, estimated in the multibillion-dollar range. This move is intended to allow Semler Scientific to continue its core focus on marketing the QuantaFlo device while establishing CardioVanta as a separate value driver.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Channels

Direct sales force and licensing agreements for the QuantaFlo medical device are the primary channels for the healthcare segment, which reported Q3 2025 healthcare revenue of $7.491M. This revenue stream is under pressure, as Q3 2025 revenue was down 45% year-over-year, and the company anticipates Q4 2025 revenues will be at least 60% lower than Q3 2025 expected revenue. The direct sales model emphasizes physician office laboratories (POLs) and outpatient settings for the QuantaFlo test, which is a four-minute in-office blood flow test. The company also launched CardioVanta™, a wholly owned subsidiary, to drive future healthcare initiatives. The company's revenue has declined 30.39% over the last twelve months as of October 2025, with analysts forecasting a further 41% decrease for the full year 2025.

Public equity markets, specifically NASDAQ: SMLR, serve as a critical channel for capital raising. As of the latest close on November 28, 2025, Semler Scientific, Inc. traded at $20.68 with a market capitalization of $313.51 million and a volume of 261,325 shares. The 52-week range for the stock has been $81.5551/$17.41. The company actively uses an at-the-market (ATM) program for capital access.

Bitcoin exchanges and over-the-counter (OTC) desks are utilized as the primary channel for strategic asset acquisition, supporting the company's treasury strategy. As of September 30, 2025, Semler Scientific held 5,048 BTC, with an estimated fair value of $575.8 million. The total cost basis for the holdings was approximately $478.94M, resulting in an average cost of $94,877 per BTC. The company is targeting 10,000 Bitcoin by year-end 2025.

• BTC Holdings (as of September 30, 2025): 5,048 BTC
• BTC Fair Value (as of September 30, 2025): $575.8 million
• Total Cost Basis: $478.94M
• BTC Acquired (Aug 1 - Sep 30, 2025): 27 Bitcoins
• Cash and equivalents (as of September 30, 2025): Approx. $10.3 million

Investor Relations website and press releases serve as the disclosure channel for financial and strategic updates. The company's website is www.semlerscientific.com. The Quarterly Report on Form 10-Q for the period ended September 30, 2025, was filed on or about November 12, 2025. Due to a pending transaction with Strive, Inc., Semler Scientific did not host a conference call or provide an accompanying earnings presentation for its Q3 2025 results. News regarding insider activity, such as the CEO filing to sell up to $30M shares on November 18, 2025, is also disseminated through this channel.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Customer Segments

You're looking at the customer base for Semler Scientific, Inc. (SMLR) as of late 2025, which clearly splits between its core healthcare services and its aggressive digital asset treasury strategy. The healthcare side targets large health plans and physician groups, specifically those deeply involved in Medicare Advantage risk adjustment programs. This segment relies on Semler Scientific's technology to assess patient risk profiles, which directly impacts reimbursement economics for these entities.

The second major segment is institutional and retail investors. These customers are seeking corporate exposure to Bitcoin as a treasury asset, viewing Semler Scientific as a publicly traded vehicle for that exposure. The company's commitment to this strategy is clear; as of July 31, 2025, Semler Scientific held 5,021 Bitcoins. Management has maintained an ambitious accumulation target of 10,000 Bitcoin by the end of 2025.

A new, developing segment is healthcare providers interested in advanced cardiac monitoring, driven by the subsidiary CardioVanta. This wholly owned subsidiary is focused on the early detection of heart failure and cardiac arrhythmia. The company is actively pursuing a new 510(k) clearance for a product extension aimed at aiding heart failure diagnosis, with hopes of obtaining that clearance sometime in 2025. This effort is intended to generate cash flow to support the primary Bitcoin strategy.

To be fair, the healthcare revenue stream remains highly concentrated, which is a near-term risk you need to watch. For the first quarter ended March 31, 2025, total revenues were $8.8 million. The reliance on a few key accounts is significant, as evidenced by the Q1 2025 figures.

This concentration means that any disruption with one of those top two accounts-which include affiliates-has an outsized impact on the top line. For instance, Q1 2025 revenue was down 44% year-over-year to $8.8 million, partly attributed to CMS rate changes impacting customer risk-adjustment economics. The company is actively trying to diversify its customer base and introduce additional FDA-cleared products to mitigate this reliance.

• Medicare Advantage risk adjustment clients are the core users of the primary diagnostic service.
• Institutional and retail investors are drawn by the corporate Bitcoin treasury strategy.
• CardioVanta targets providers needing heart failure and arrhythmia monitoring solutions.
• Customer concentration risk remains high, with the top two customers accounting for 74% of Q1 2025 revenue.

Finance: review the Q3 2025 customer retention rates against the top two Q1 2025 customers by end of next week.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Cost Structure

You're looking at the major drains on Semler Scientific, Inc.'s (SMLR) finances, which are heavily skewed by their dual strategy of healthcare operations and Bitcoin treasury accumulation. The cost structure reflects significant, non-recurring legal settlements alongside the direct costs of running the medical device business and funding the digital asset strategy.

The direct cost associated with delivering the QuantaFlo device and service saw a reduction early in the year. For the first quarter ended March 31, 2025, the Cost of revenues was reported at $0.9 million, which was a 25% decrease year-over-year.

A major component impacting operating expenses relates to legal matters. Semler Scientific reached an agreement in principle in April 2025 to settle claims with the U.S. Department of Justice (DOJ) for a total settlement amount of $29.75 million, excluding potential relators' counsel fees. This was reflected in Q1 2025 operating expenses as a contingent liability of $29.8 million. Legal expenses specifically related to this proposed settlement in Q2 2025 were $0.5 million.

The aggressive Bitcoin treasury strategy introduces substantial, non-operating costs related to asset acquisition. During the second quarter ended June 30, 2025, Semler Scientific purchased 1,444 Bitcoins for an aggregate cost of $149.6 million, including fees and expenses. This purchase price equates to an average cost of $103,581 per Bitcoin for that quarter.

General and administrative (G&A) costs include significant non-cash expenses. For the second quarter of 2025, non-cash stock-based compensation expense was $1.9 million. To give you a clearer picture of the cost base across the first half of 2025, here's a look at some key expense line items:

Overall operating expenses, which bundle the cost of revenues, were $39.9 million for Q1 2025, a substantial jump from $8.9 million in Q1 2024. In contrast, total operating expenses for Q2 2025 were much lower at $10.3 million.

You should note the structure of the DOJ settlement payment itself, which is a cash outflow commitment. The $29.75 million settlement amount is subject to interest at 4.25% per annum starting from April 28, 2025. Furthermore, of that total, $5.2 million plus 17.5% of the interest is designated for the relators.

The company is funding these costs and its Bitcoin strategy through various means, which impacts the overall financial structure, even if not strictly a recurring operating cost:

• Proceeds from At-The-Market (ATM) Equity Issuance in Q2 2025: $156.6 million in net proceeds.
• Proceeds from Convertible Senior Notes issued in January 2025: $100.0 million aggregate principal amount.
• Total aggregate purchase amount for Bitcoin holdings as of July 31, 2025: $475.8 million.

Finance: draft 13-week cash view by Friday.

Semler Scientific, Inc. (SMLR) - Canvas Business Model: Revenue Streams

You're looking at how Semler Scientific, Inc. (SMLR) is bringing in money right now, and honestly, it's a tale of two engines, one sputtering and the other roaring. The core medical device revenue stream is definitely under pressure.

Licensing and Service Revenue from QuantaFlo

The traditional revenue from the QuantaFlo system is showing significant headwinds. For the second quarter of 2025, the total revenues reported by Semler Scientific were $8.2 million. This figure represented a 43% decrease year-over-year, which is a clear signal of the decline you mentioned. The pressure is coming from the phase-in of the 2024 Centers for Medicare and Medicaid Services rate announcement impacting reimbursement for P A (Peripheral Artery) patients, leading to decreased device usage at some customer sites. Looking ahead, the company expects Q3 2025 revenues to be between $6.9 million and $7.5 million. Furthermore, management disclosed that a customer representing more than 10% of revenue in both Q2 and Q3 2025 has stopped using the QuantaFlo devices. The outlook for the immediate future is even more challenging, with the anticipation that fourth quarter 2025 revenues will be at least 60% lower compared to the third quarter 2025 expected revenue.

Here are the key data points showing the pressure on this stream:

• Q2 2025 Revenue: $8.2 million.
• Year-over-year Q2 2025 decline: 43%.
• Expected Q3 2025 Revenue range: $6.9 million to $7.5 million.
• Anticipated Q4 2025 revenue drop versus Q3 2025: At least 60%.

Unrealized and Realized Gains from Bitcoin Holdings

This is the engine currently driving the reported net income. Semler Scientific, Inc. has adopted Bitcoin as its primary treasury reserve asset, and the changes in its fair value are recognized in net income, which introduces volatility. For the second quarter ended June 30, 2025, the company recorded a net unrealized gain of $83.8 million from the change in fair value of its Bitcoin holdings, calculated using a price of $170,176 per Bitcoin for that period. This gain pushed the Q2 2025 pre-tax income to $80.6 million, resulting in a net income of $66.9 million. Year-to-date through July 31, 2025, the Bitcoin strategy generated more than $110.4 million in unrealized gains. More recently, for the third quarter ended September 30, 2025, the company reported an unrealized gain of approximately $30.0 million from the change in fair value of its Bitcoin holdings since June 30, 2025. As of July 31, 2025, Semler Scientific held 5,021 Bitcoins with a fair value of $586.2 million.

Net Proceeds from At-the-Market (ATM) Equity Offerings

The company actively uses its At-the-Market (ATM) equity offering program to generate cash proceeds, which are then used to fund the treasury strategy, specifically for acquiring more Bitcoin. This is a crucial funding mechanism supporting the asset accumulation strategy. The activity has been substantial in 2025.

You can see the scale of the capital raised through the ATM program below:

As of July 31, 2025, the company reported having a little over $300,000,000 remaining available under its $500,000,000 ATM program. Between August 1 and September 30, 2025, the company acquired 27 Bitcoins for $3.1 million using proceeds from this ATM program.

Potential Future Revenue from CardioVanta SaaS Model

Semler Scientific, Inc. launched CardioVanta, a wholly owned subsidiary, to focus on future healthcare initiatives centered on the early detection of heart failure and cardiac arrhythmia. This is positioned as the future growth driver for the healthcare segment. The intended revenue model for this new focus is a software-as-a-service (SaaS) model. While specific revenue figures for CardioVanta are not yet reported as of late 2025, its successful deployment and adoption under a recurring SaaS structure would represent a new, potentially more stable revenue stream to complement the existing, but currently declining, QuantaFlo licensing revenue. Finance: draft 13-week cash view by Friday.