American Shared Hospital Services (NYSE: AMS)

American Shared Hospital Services provides turnkey technology solutions for stereotactic radiosurgery and advanced radiation therapy equipment and services. The company focuses on delivering radiation therapy through medical equipment leasing and direct patient services to healthcare providers and patients. Its main drivers of revenue are the number of sites, procedure volume and reimbursement rates.

The company generates revenue primarily by leasing radiosurgery and radiation therapy equipment under fee per use or revenue sharing arrangements and by operating its own treatment centers that provide services directly to patients. Under fee per use contracts the company receives a set amount per procedure while under revenue sharing agreements it receives a percentage of the reimbursement collected by the facility. The company also earns income from the sale of equipment and related services such as planning, installation and marketing support.

The company operates through the following segments.

• Medical equipment leasing segment: This segment provides radiosurgery and radiation therapy equipment to hospitals and clinics through fee per use or revenue sharing contracts, sharing revenue and operating costs with the customer.

• Direct patient services segment: This segment owns and operates treatment facilities that deliver radiosurgery and radiation therapy directly to patients, including sites in Rhode Island, Peru, Ecuador, Mexico and other locations.

American Shared Hospital Services is a recognized provider of stereotactic radiosurgery and radiation therapy services, competing with conventional neurosurgery, standard LINAC based radiation therapy and other radiosurgery platforms. Key competitors in the radiosurgery space include manufacturers of alternative devices and companies offering proton therapy such as Mevion, IBA Particle Therapy, Hitachi, Sumitomo Heavy Industries, ProTom International and Mitsubishi Electric. The company differentiates itself through its turnkey service approach, its long history of equipment financing and its ability to place Gamma Knife and proton therapy units in a variety of clinical settings while sharing costs with healthcare partners.

The company serves a diverse base of customers that includes hospitals, cancer treatment centers and standalone radiation therapy facilities. Specific lessee names include Southwest Texas Methodist Hospital in San Antonio Texas, Central Mississippi Medical Center in Jackson Mississippi, OSF Saint Francis Medical Center in Peoria Illinois, Albuquerque Regional Medical Center in Albuquerque New Mexico, Northern Westchester Hospital in Mount Kisco New York, PeaceHealth Sacred Heart Medical Center at RiverBend in Eugene Oregon, Orlando Health Cancer Institute in Orlando Florida and Methodist Hospital in Merrillville Indiana. In addition the company owns and operates direct patient service centers in Woonsocket Warwick and Providence Rhode Island, Lima Peru, Guayaquil Ecuador and Puebla Mexico.