A strategic roadmap to evolve Altus from a startup-OEM into a diversified, multi-segment orthopedic platform poised to deliver superior investor returns. This robust plan capitalizes on Altus’s current $17M inventory and established product portfolio, while systematically enhancing commercial infrastructure and pursuing targeted product expansions to drive sustainable growth and unlock high-value exit opportunities
Hire a VP of Sales and 2-3 Regional Sales Directors who can leverage their extensive industry relationships in high-volume markets to achieve immediate revenue growth.
Strategic Contractual Access
Hire a leader to manage contracts and strategic accounts, focusing on expanding contractual access to key Group Purchasing Organizations (GPOs), national and regional health systems, and academic institutions.
Year 1: Monetizing $17M Inventory
Altus currently holds $17M in inventory, much of which risks remaining unsold due to an underdeveloped sales strategy.
My working assumption is that $15M of this inventory, after a $2M write-off, can generate approximately $60M in revenue over the next five years. This projection is contingent upon building a highly capable sales organization.
1
Quick Wins Strategy
Expand our customer base by leveraging existing relationships to acquire new surgeons with high lifetime value and low contractual barriers at their hospitals or ASCs. Additionally, engage with larger stocking distributors who are already vendors of record at their accounts, enabling immediate stocking purchases from Altus.
2
Inventory Optimization
Perform a detailed audit to categorize SKUs by demand and margin. Prioritize high-volume, high-margin products immediately, For slower-moving SKUs, we’ll craft a 12-month plan leveraging flexible distribution channels, strategic stocking, and adaptive pricing to transform these products into profitable contributors.
Year 1: Pricing & Surgeon Relationships
Price Optimization
Revisit contracts with current hospital customers, implementing modest price increases where justified. Launch an ASC-focused price model balancing affordability for outpatient settings with profitable margins.
Surgeon Engagement
Engage Key Opinion Leaders at leading academic spine centers to champion our Monaco screws and Indy Standalone ALIF, unlocking the potential of these high-quality, readily available products.
Year 1 Success Indicators
Revenue uplift of $3-5M from new surgeon relationships. Significant inventory utilization from the $17M stock. EBITDA expansion to $7-10M range through higher volume and optimized pricing.
Year 1: Financial Snapshot
$4.25M
Incremental New Business
Assumes 15% penetration of Top 15 "high-confidence" surgeon targets
$19.5M
Total Revnue
Assumes new salesforce prevents any churn in existing user base and modest 10% growth of existing customers
$6.8M
EBITDA
Includes Headcount Additions in Sales, Marketing, and Commercial Ops
Year 3: Distribution Channel Expansion
ASC Dominance
Secure contracts with regional and national Ambulatory Surgery Center networks, including PE-backed MSOs. Develop bundled solution offerings that reduce procedural costs while maintaining strong margins.
GPO Partnerships
Finalize or expand Group Purchasing Organization contracts to cover a broader hospital base. Position Altus as a "value-driven partner" with consistent quality and robust support infrastructure.
Channel Diversification
Build a multi-pronged distribution strategy across hospitals, ASCs, and large stocking distributors to maximize market penetration and create revenue stability.
Year 3: Explore International Growth & Product Extensions (Not included in current projections)
1
Australia Market Growth
Strengthen distribution agreements in Australia to boost the annual run rate by a modest double-digit percentage, elevating it from the initial forecast of $1M to $2M, and laying the groundwork for wider global expansion in very specific markets.
2
International Expansion
Investigate further regions, particularly Japan, which boasts an expanding spine market with consistent and predictable growth factors, to apply the same "cost-effective, high-quality" positioning and distribution approach. Distributors in Japan have already expressed enthusiasm for several Altus products.
3
Portfolio Expansion
Introduce small bone & extremities devices. Explore novel material science, AR navigation, robotic technologies via licensing or co-selling.
Year 3: Operational Efficiency & Success Metrics
1
Supply Chain Optimization
Formalize supply agreement with Acero, transitioning to a cost-plus or fixed-price model ensuring stable margins and predictable manufacturing outcomes.
2
Inventory Management
Implement real-time tracking systems to avoid overproduction. Prioritize SKUs aligned with highest surgeon demand and margin profile to maximize capital efficiency.
3
Year 3 Success Indicators
Revenue target of $25M-$27M+ annually from expanded channels. EBITDA margin of mid-30%, aided by volume scaling and improved pricing. 25-35% revenue from new products or markets.
Assumes sales infrastructure prevents customer churn and supports modest growth (10%) of existing customers
$9.2M
EBITDA
We can further improve free cash flow years 1-3 by selling through existing inventory
Year 5: Diversified Portfolio
1
1
Full-Line Spine
Leadership in fusion devices, deformity solutions, and MIS technologies
2
2
Trauma & Extremities
Significant share in extremity fixation, plates, pins, and small bone fracture
3
3
Innovative Therapies
Robotic navigation, biologics, or novel surface materials (partnerships/license)
By Year 5, Altus aims to evolve from a spine-focused company into a comprehensive orthopedic device platform by integrating upper and lower extremity fixation. This strategic expansion diversifies revenue streams while leveraging our established manufacturing, regulatory, and distribution networks to accelerate market adoption.
Focusing on high-growth areas like small bone and extremities, we can access new revenue opportunities, enhance valuations, and mitigate potential spine reimbursement challenges. Our proven expertise and robust infrastructure uniquely position Altus to execute this strategy with minimal risk, creating a diversified orthopedic platform that investors will value highly.
Revenue benefits from the market penetration efforts completed in Year 3 (e.g., ASC, Hospital, GPO segments), as well as potential new growth targets onboarded between Years 3 and 5
$36.4M
Total Revenue
Reflects a combination of sustained growth from the existing customer base (building on the 10% growth mentioned in Year 3) and the added revenue from new business segments integrated by Year 5
$12.7M
EBITDA
Improved its profitability through efficiencies gained from scale, optimized operations, and better cost control, moving beyond the inventory sell-through strategy noted in Year 3. New invetory ramp could offset efficiencies from scale
Year 5: Strategic M&A and Exit Options
1
2
3
4
1
IPO or Strategic Acquisition
Premium valuation exit
2
$36.5M+ Revenue with 30-35% EBITDA Margins
Financial performance driving valuation
3
Multi-Segment Portfolio and Global Presence
Diverse product lines across multiple markets
4
Strategic M&A to Accelerate Growth
Targeted acquisitions enhancing platform value
Year 5 positions Altus for substantial value creation through multiple potential exit avenues. The company will be structured for either IPO readiness or strategic acquisition by larger medtech companies seeking a ready-made spine and small bone platform, with 4-5x multiple expansion potential from the original ~$30M valuation.
Strategic Enablers for Value Creation
Inventory Turnover & Cash Flow
Immediate utilization of $17M inventory for near-term revenue while managing stock to maximize cash flow and avoid future overproduction.
Surgeon Relationships as Growth Engine
Nurture key surgeon relationships through top-tier clinical support and leadership roles on advisory boards to drive product adoption and loyalty.
ASC Focus & Price Sensitivity
Maintain cost competitiveness for outpatient procedures while emphasizing the "one-stop-shop" proposition for ASC administrators.
Strategic Leadership Transition
Evolution from founder-led to commercially-driven model under David Flickinger with robust governance structures guiding Phase 2 expansion.
Leadership Approach
1
Ruthless Accountability
Set clear standards and ensure every individual is held accountable. No excuses, only outcomes.
2
Operational Excellence
Drive Altus toward relentless execution by streamlining processes and eliminating waste.
3
Innovation Through Discipline
Foster calculated risk-taking, always grounded in discipline and regulatory standards.
Leadership Approach
My leadership philosophy is forged from the discipline, accountability, and excellence I internalized as an infantry officer in the Marine Corps and refined in high-stakes private sector roles. In the military, every decision carried weight—often life-or-death consequences—and I bring that same gravity to business leadership. At Altus, where our medical devices directly affect patient outcomes and shareholder value, this mindset is not just relevant; it’s essential. My approach rests on three pillars:
Ruthless Accountability: I lead by setting clear, non-negotiable standards and ensuring every individual—from the C-suite to the production floor—is held accountable for delivering results. In the Marine Corps, accountability was the backbone of mission success; in the medical devices industry, it’s the foundation of trust with patients and stakeholders. At Altus, I’ll establish rigorous key performance indicators (KPIs) tied to strategic objectives, ensuring transparency in performance and swift correction of shortfalls. This means no excuses, only outcomes—because lives and livelihoods depend on it.
Operational Excellence: Excellence isn’t an aspiration; it’s a baseline. My experience in competitive environments has taught me that precision and efficiency separate winners from also-rans. I’ll drive Altus toward relentless execution by streamlining processes, eliminating waste, and embedding a culture of continuous improvement. Whether it’s accelerating product development cycles or optimizing supply chain logistics, I’ll ensure every action aligns with our mission to deliver life-changing devices with speed and quality.
Innovation Through Discipline: Innovation isn’t about unchecked creativity—it’s about solving problems with structure and purpose. In the military, I led teams to adapt under pressure, devising solutions within tight constraints. At Altus, I’ll foster an environment where calculated risk-taking is encouraged, but always grounded in discipline. This means empowering teams to push technological boundaries while maintaining the rigor needed to meet regulatory standards and market demands. By blending creativity with accountability, we’ll keep Altus at the forefront of the medical devices industry.
I’ll integrate with the existing team by modeling these principles daily, earning trust through consistency and results.