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Inspire Medical Systems
(NYSE:INSP)
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Rating:71Outperform
Price Target:
$58.00
▲(17.91% Upside)
Action:Upgraded
Date:08/04/26
INSP scores well on financial performance, led by strong profitability, solid cash generation, and an exceptionally low-debt balance sheet. The score is held back primarily by earnings-call-driven near-term uncertainty from coding/reimbursement disruption (expected YoY revenue declines and profitability pressure) and by a mixed technical picture (improving short-term trend but still below the 200-day moving average). Valuation is a supportive factor given the ~11 P/E.
Positive Factors
Low leverage and strong balance sheet
An exceptionally low debt-to-equity ratio and an expanded equity base give Inspire durable financial flexibility. With ample liquidity the company can fund Project Horizon, clinical and commercial investments, and absorb reimbursement shocks without taking on covenant-driven leverage or distress financing.
Negative Factors
Coding and reimbursement disruption
Material and ongoing coding/WISeR disruptions directly reduce procedure volumes and revenue visibility. Because payer coding rules and WISeR program scope can take months to settle, this is a sustained structural headwind that pressures top-line growth and operating leverage across the planning horizon.
Read all positive and negative factors
Positive Factors
Negative Factors
Low leverage and strong balance sheet
An exceptionally low debt-to-equity ratio and an expanded equity base give Inspire durable financial flexibility. With ample liquidity the company can fund Project Horizon, clinical and commercial investments, and absorb reimbursement shocks without taking on covenant-driven leverage or distress financing.
Read all positive factors
Inspire Medical Systems Key Performance Indicators (KPIs)
Any
Revenue by Geography
Shows how much revenue comes from the U.S. versus international markets. For Inspire Medical Systems, a U.S.-heavy mix points to strong domestic clinical adoption and reimbursement, while rising international sales signal successful approvals and new growth lanes. Large geographic concentration increases exposure to U.S. policy or payer changes; broadening global sales can smooth growth and reduce single-market risk.
Shows how much revenue comes from the U.S. versus international markets. For Inspire Medical Systems, a U.S.-heavy mix points to strong domestic clinical adoption and reimbursement, while rising international sales signal successful approvals and new growth lanes. Large geographic concentration increases exposure to U.S. policy or payer changes; broadening global sales can smooth growth and reduce single-market risk.
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The Fly
The FlyInspire Medical Systems (INSP) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$1.45B
Dividend YieldN/A
Average Volume (3M)998.72K
Price to Earnings (P/E)11.1
Beta (1Y)0.61
Revenue Growth8.94%
EPS Growth102.92%
CountryUS
Employees1,333
SectorHealthcare
Sector Strength45
IndustryMedical - Devices
Share Statistics
EPS (TTM)4.66
Shares Outstanding28,813,152
10 Day Avg. Volume718,491
30 Day Avg. Volume998,719
Financial Highlights & Ratios
PEG Ratio0.11
Price to Book (P/B)3.47
Price to Sales (P/S)2.97
P/FCF Ratio34.52
Enterprise Value/Market Cap<0.01
Enterprise Value/Revenue<0.01
Enterprise Value/Gross Profit<0.01
Enterprise Value/Ebitda<0.01
Forecast
1Y Price Target
$60.15Price Target Upside22.29% Upside
Rating ConsensusHold
Number of Analyst Covering14
EPS Forecast (FY)0.91
Revenue Forecast (FY)$843.39M
Inspire Medical Systems Business Overview & Revenue Model
Company Description
Inspire Medical Systems, Inc. operates as a medical technology enterprise, concentrating on the development and commercialization of advanced, minimally intrusive therapies for patients diagnosed with obstructive sleep apnea (OSA) across both dome...
How the Company Makes Money
Inspire Medical Systems primarily makes money by selling its Inspire therapy system for obstructive sleep apnea. Revenue is generated mainly from U.S. and international sales of the implantable neurostimulation device and its associated components...
Inspire Medical Systems Earnings Call Summary
Earnings Call Date:Aug 03, 2026
(Q2-2026)
| % Change Since: |
Next Earnings Date:Nov 09, 2026
Earnings Call Sentiment Neutral
The call presented a balanced picture: meaningful near-term headwinds from coding and reimbursement disruption depressed top-line growth (Q2 revenue down 7.6% and a full-year disruption impact estimated at $120M–$130M), drove elevated tax and restructuring items, and widened near-term guidance. Offsetting these challenges, management delivered profitability and positive operating cash flow ahead of expectations, possesses a strong cash position ($415M, no debt), announced Project Horizon to create $30M of reinvestment capacity, and highlighted strong clinical evidence and favorable proposed CMS facility reimbursement changes (+12% hospital, +15% ASC for 2027). Given the comparable weight of material negatives (revenue/headwinds, restructuring, reimbursement uncertainty) and material positives (cashflow, balance sheet, clinical momentum and planned reinvestment), the overall tone is balanced with a path to recovery but meaningful near-term uncertainty.Positive Updates
Revenue and Sales Execution (Contextual)
Second quarter revenue was $200.6 million (down 7.6% year-over-year) but management reported results ahead of internal expectations driven by sales execution and improved gross profit mix toward Inspire V.
Negative Updates
Near-Term Revenue Pressure from Coding and Reimbursement Disruption
Management estimates coding, reimbursement and WISeR-related disruption adversely impacted Q2 by approximately $40 million and now estimates a full-year adverse impact in the range of $120 million to $130 million.
Read all updates
Q2-2026 Updates
Positive
Negative
Revenue and Sales Execution (Contextual)
Second quarter revenue was $200.6 million (down 7.6% year-over-year) but management reported results ahead of internal expectations driven by sales execution and improved gross profit mix toward Inspire V.
Read all positive updates
Company Guidance
Management updated 2026 guidance, raising full‑year revenue to $835–$875 million while estimating a total adverse impact from coding/reimbursement and WISeR of $120–$130 million for the year (about $40 million in Q2); they expect Q3 revenue to be down 8–10% year‑over‑year with roughly breakeven adjusted operating income. For the year they target adjusted operating margin of 4–6%, GAAP diluted EPS of a loss of $0.42 to earnings of $0.17, adjusted diluted EPS of $1.05–$1.45, an effective tax rate of 95–100% (adjusted tax rate 30–35%), weighted average diluted shares of ~29.4 million, and capital expenditures of $35–$40 million. They expect to take Project Horizon pretax restructuring charges of $20–$25 million (≈90% in Q3), including $16–$20 million of noncash impairments, to create about $30 million of annualized growth investment capacity. Q2 actuals cited on the call included revenue of $200.6 million (−7.6% YoY), operating cash flow of $23.2 million (YTD $36.1M), cash & investments of $415 million, Q2 diluted EPS $0.01 (adjusted $0.14) and adjusted EBITDA margin of 19.4%.Inspire Medical Systems Financial Statement Overview
Summary
Income Statement
78
Positive
Balance Sheet
90
Very Positive
Cash Flow
76
Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 898.74M | 911.98M | 802.80M | 624.80M | 407.86M | 233.39M |
| Gross Profit | 774.11M | 778.76M | 679.82M | 528.22M | 341.74M | 200.12M |
| EBITDA | 83.09M | 79.79M | 65.03M | -17.06M | -40.73M | -38.62M |
| Net Income | 135.04M | 145.42M | 53.51M | -21.15M | -44.88M | -42.04M |
Balance Sheet | ||||||
| Total Assets | 925.99M | 918.49M | 808.38M | 676.81M | 564.88M | 295.08M |
| Cash, Cash Equivalents and Short-Term Investments | 320.68M | 308.27M | 445.55M | 460.38M | 451.41M | 214.47M |
| Total Debt | 29.09M | 32.16M | 31.79M | 24.85M | 16.41M | 34.09M |
| Total Liabilities | 100.41M | 126.16M | 118.69M | 104.30M | 68.87M | 66.04M |
| Stockholders Equity | 825.58M | 781.16M | 689.70M | 572.51M | 496.01M | 229.05M |
Cash Flow | ||||||
| Free Cash Flow | 117.09M | 78.48M | 91.12M | 1.02M | 2.47M | -24.79M |
| Operating Cash Flow | 157.07M | 116.98M | 130.25M | 24.65M | 11.57M | -20.12M |
| Investing Cash Flow | -31.26M | 21.45M | -113.12M | -294.82M | -19.60M | 29.14M |
| Financing Cash Flow | -104.96M | -183.45M | -52.39M | 13.95M | 235.08M | 14.95M |
Inspire Medical Systems Risk Analysis
Inspire Medical Systems disclosed 60 risk factors in its most recent earnings report. Inspire Medical Systems reported the most risks in the "Legal & Regulatory" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Inspire Medical Systems Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
81 Outperform | $30.60B | 20.33 | 24.41% | 1.23% | 10.28% | 16.40% | |
72 Outperform | $182.90B | 33.99 | 10.52% | 2.41% | 8.06% | -61.33% | |
71 Outperform | $1.45B | 11.08 | 17.62% | ― | 8.94% | 102.92% | |
69 Neutral | $4.40B | 40.68 | 15.41% | ― | 12.40% | ― | |
68 Neutral | $109.30B | 22.77 | 9.85% | 3.43% | 8.43% | 3.17% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
46 Neutral | $439.47M | -19.78 | -120.74% | ― | 18.06% | 21.86% |
* Healthcare Sector Average
INSP
Inspire Medical Systems
58.89
-18.16
-23.57%
ABT
Abbott Laboratories
107.96
-21.12
-16.36%
MDT
Medtronic
85.92
-2.45
-2.77%
RMD
Resmed
223.24
-54.21
-19.54%
LIVN
LivaNova
75.78
27.26
56.18%
NPCE
NeuroPace
13.90
4.98
55.83%
Inspire Medical Systems Corporate Events
Business Operations and StrategyFinancial Disclosures
Inspire Medical Systems Raises Outlook, Launches Project Horizon
Positive
Aug 3, 2026
Inspire Medical Systems reported that in the quarter ended June 30, 2026, revenue declined 7.6% year on year to $200.6 million, mainly due to U.S. weakness from coding and reimbursement changes, though international sales grew. Despite the top-lin...
Executive/Board Changes
Inspire Medical Systems Adds Michael Carrel to Board
Positive
Jul 24, 2026
On July 20, 2026, Inspire Medical Systems appointed Michael H. Carrel to its Board of Directors as a Class III director, with his term running until the 2027 annual meeting of stockholders. He was simultaneously named to the Organization and Compe...
Business Operations and StrategyExecutive/Board Changes
Inspire Medical Systems Announces Planned Board Leadership Transition
Neutral
Jul 22, 2026
On July 16, 2026, long-serving director Casey M. Tansey notified Inspire Medical Systems of his decision to retire from the Board and related committees, effective July 30, 2026, and not stand for re-election at the 2027 annual shareholders’...
Business Operations and StrategyRegulatory Filings and Compliance
Inspire Medical Hosts June Investor Meetings and Presentation
Neutral
Jun 26, 2026
In June 2026, Inspire Medical Systems plans to meet with investors and analysts, using a prepared set of presentation materials to support its discussions. The company has made these materials available through its investor relations website, unde...
Business Operations and StrategyExecutive/Board ChangesRegulatory Filings and ComplianceShareholder Meetings
Inspire Medical Shareholders Approve Board Declassification and Governance Changes
Positive
May 5, 2026
At its April 30, 2026 annual meeting, Inspire Medical Systems’ stockholders approved a key amendment to the company’s certificate of incorporation to phase out its classified board structure, moving to annual elections for all director...
Business Operations and StrategyFinancial Disclosures
Inspire Medical Cuts 2026 Outlook Amid Reimbursement Headwinds
Negative
May 4, 2026
Inspire Medical Systems reported first‑quarter 2026 results on May 4, 2026, showing revenue up 1.6% year over year to $204.6 million and gross margin improving to 86.5%, driven by a higher mix of its Inspire V system. The company posted a ne...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.