Below The Knee | Market Signal

The CAMP Reset Is Repricing the Category at Once

Smith+Nephew reported Q2 2026 earnings this week with an outcome that should frame how you think about skin substitutes for the rest of the year. Underlying revenue growth came in at 1.6 percent, below expectations. Full-year guidance got cut to roughly 4 percent underlying growth, down from prior guidance that was tracking north of 5. The culprit isn't hard to find. Advanced Wound Bioactives revenue declined materially on the back of the January 2026 CMS reimbursement rule changes, affecting both volumes and pricing in non-surgical settings.

The company's working around it. PICO single-use NPWT and RENASYS traditional NPWT performed strongly in Emerging Markets. H1 profit grew and margins expanded despite near-term skin substitute headwinds. SNN's not in crisis. But the company is posting guidance cuts in real time on a category that's been the growth engine of advanced wound care for the better part of a decade. That's a data point worth holding onto.

Solventum announced the same week that it's separating its Health Information Systems business, signaling a strategic refocus on core medical technology and wound care segments. The spinoff would let Solventum concentrate resources on advanced wound care and medical solutions, including NPWT and skin substitute products inherited from 3M's Health Care spin-out. Call that the strategic response to the same policy reset SNN is reporting against.

Here's what's actually happening. CAMP reimbursement compression is repricing the entire category at once. Companies that spent the last two years growing skin substitutes into their margin engine are now facing a binary choice: hold the revenue and accept lower price realization, or move capital and focus upstream to where margins can still breathe. SNN's answer is to cut guidance and lean on PICO and Emerging Markets strength. Solventum's answer is structural reorganization. Neither is the outcome you'd forecast a year ago when CAMP looked like an open money spigot. That's the reset in the real market, not the policy papers.

Here's the week.

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September 10–11 | The Ritz-Carlton, New Orleans, LA Hosted by Kernexus Med Comms

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Regulatory | Nevada Doctor Charged in Medicare Fraud Scheme Involving Wound Care

A Nevada physician was charged in a Medicare fraud case related to wound care billing. Fraudulent billing schemes in wound care typically involve upcoding, unnecessary procedures, or false claims for advanced wound products, particularly skin substitutes. The enforcement action reflects ongoing CMS and DOJ scrutiny of wound care billing practices, especially around high-cost CAMP products.

The BTK read: This lands in the same month CMS is taking heat in Congress for over-permissive reimbursement in skin substitutes. A complementary enforcement signal. Watch for more clinical documentation and billing audits across CAMP categories over the next two quarters.

Market | Medipyxis Launches Real-Time Medicare Part A/B Eligibility Check for Mobile Wound Care

Medipyxis launched a real-time Medicare Part A/B eligibility verification tool designed for mobile wound care teams, enabling point-of-care billing accuracy before treatment is rendered. The tool addresses a critical reimbursement pain point: facility-based versus non-facility billing distinctions that commonly affect mobile wound care providers. For the market, this reduces claim denials and compliance risk, particularly relevant given CMS scrutiny of skin substitute billing in mobile and SNF settings.

The BTK read: Infrastructure plays that solve billing fragmentation tend to get easier adoption and faster scale than new clinical technologies in mature wound care settings. This one's worth tracking for user adoption and whether it becomes table-stakes for mobile operators competing on reimbursement efficiency.

Market | Solventum Plans to Separate Health Information Systems Business

Solventum announced its intent to separate its Health Information Systems business, signaling a strategic refocus on core medical technology and wound care segments. The spinoff would allow Solventum to concentrate resources on its advanced wound care and medical solutions portfolio, which includes NPWT and skin substitute products inherited from 3M's Health Care spin-out. This restructuring is significant for the wound care market as it may sharpen Solventum's competitive positioning and potentially open the door to future M&A activity.

The BTK read: This is covered in depth in the Opening Shot above. The key signal is that one of the category's major players is doing structural reorganization to realign away from information services drag and refocus on product lines getting repriced by policy right now. Worth watching for whether the separation accelerates any asset sales or partnerships in the NPWT and skin substitute portfolios post-close.

Market | Smith+Nephew Q2 2026 Results Show CMS Reimbursement Impact on Skin Substitutes

Smith+Nephew reported H1 2026 results with Advanced Wound Bioactives revenue declining due to the January 2026 CMS reimbursement rule changes for skin substitutes, affecting volumes and pricing in non-surgical settings. Q2 underlying revenue growth of 1.6 percent came in below expectations. Full-year guidance was cut to approximately 4 percent underlying growth. PICO single-use NPWT and RENASYS traditional NPWT performed strongly in Emerging Markets. The company reported strong H1 profit growth and margin expansion despite near-term skin substitute challenges.

The BTK read: This is also in the Opening Shot, and it bears repeating here because it's the clearest real-market evidence of CAMP reimbursement compression hitting top-line growth at a major public company. SNN isn't struggling on execution. It's struggling on category reimbursement reset. That's a strategic fact, not a company fact.

Market | BioStem Technologies Announces Nasdaq Uplisting, Trading Commences August 7

BioStem Technologies announced that Nasdaq completed its review of the company's listing application and approved its common stock for listing on The Nasdaq Capital Market, effective August 7, 2026, under ticker symbol BSEM. The company operates in perinatal tissue allograft regenerative medicine with a portfolio including Neox, Clarix, VENDAJE, and American Amnion product lines, leveraging proprietary BioRetain, CryoTek, and SteriTek processing technologies. The uplisting expands access to capital, improves market visibility and liquidity for shareholders, and strengthens the company's ability to attract talent.

The BTK read: BioStem's Nasdaq approval signals capital market appetite for smaller-cap regenerative medicine players even in the context of CAMP reimbursement repricing. The +21.30% fund move this week reflects the uplisting enthusiasm. Worth monitoring: whether perinatal allograft positioning (adjacent to but distinct from traditional CAMP) insulates BioStem from the same pricing pressure hitting SNN and Solventum. Also flag the timing — BioStem filing Form 10 in July, uplisting approved in early August. That's efficient capital market access when major players are cutting guidance. Suggests investor confidence in the subcategory's durability.

Market | Penumbra Q2 2026 Revenue Up 14.9% to $390M, But EPS Misses

Penumbra reported Q2 2026 revenue of $390.0 million, up 14.9 percent year over year, with thrombectomy revenue growing 12.5 percent and embolization/access revenue up 20.0 percent. However, EPS of $0.88 missed analyst estimates of $1.16, driven by higher operating expenses. Company withheld full-year guidance due to the pending Boston Scientific acquisition valued at $374 per share, totaling approximately $14.5 billion.

The BTK read: Top-line growth is real. Bottom-line miss is a function of acquisition uncertainty and elevated operating costs during the pending deal period. The embolization/access line doing 20 percent growth is the piece worth isolating. That segment tends to pull in capital from competitors watching the trajectory.

Market | LeMaitre Vascular Q2 2026 Earnings Miss, Cuts FY Guidance

LeMaitre Vascular reported Q2 2026 EPS of $0.74, missing consensus of $0.81, with revenue of $70.38 million versus $71.47 million expected. The company lowered full-year 2026 EPS guidance to $2.84–$2.94 from prior guidance of $2.93–$3.08, signaling softer vascular device demand despite 9.6 percent year-over-year revenue growth. Guidance reduction indicates market headwinds for peripheral vascular disease treatment.

The BTK read: LMAT's a useful contrast to Penumbra's top-line strength. Same category, same macro, opposite trajectories. The guidance cut suggests the company is managing through softer procedure volume or pricing pressure in PVD space, worth tracking against elective procedure utilization data over the next two quarters.

Market | InfuSystem Reports Strong Q2 2026 Results, Reaffirms Full-Year Outlook

InfuSystem reported second-quarter 2026 revenue of $36.9 million, up 2.6 percent year over year, with net income of $3.2 million. Patient Services grew 15 percent, driving the beat, while Device Solutions remained soft. The company reaffirmed its full-year 2026 guidance despite continued headwinds in Device Solutions, signaling confidence in the Patient Services diversification strategy.

The BTK read: InfuSystem's the rare name in the space where NPWT/services diversification is working. Patient Services +15 percent is real, and the company's holding guidance despite Device headwinds. That's execution in a reset market. Worth tracking against other services-adjacent names to see if the infrastructure-plus-recurring-revenue model holds up through H2.

Market | ConvaTec H1 2026 Reports 5% Growth with H2 Acceleration Expected

ConvaTec reported 5 percent growth in H1 2026 with expectations for acceleration in the second half. The company is a major player in advanced wound care and ostomy products, making their earnings results relevant to the wound care medtech market. If confirmed, steady growth signals continued demand resilience in the advanced wound dressings and NPWT segments.

The BTK read: ConvaTec's H1 anchor is solid, and H2 acceleration guidance is worth holding until October earnings. The company's diversification across ostomy, continence, and infusion gives it structural buffer against category-specific policy headwinds. Watch for what they say about pricing and mix on the next call.

Market | Stryker Q2 2026 Beats EPS but Misses Revenue, Narrows Full-Year Guidance

Stryker reported Q2 2026 adjusted EPS of $3.69, beating the $3.52 estimate, on revenue of $6.59 billion, missing the $6.65 billion expectation. The company posted 9.0 percent organic growth recovery from prior cyberattack impacts. MedSurg and Neurotechnology grew 9.2 percent, Orthopaedics 8.6 percent. Company narrowed 2026 guidance to 8.3–9.3 percent organic growth and $14.95–15.10 adjusted EPS, citing better visibility into H2 execution.

The BTK read: SYK's the bellwether for medtech M&A and consolidation appetite. A beat-and-narrow on guidance after a cyberattack-disrupted prior year reads as the company gaining confidence in planning but not in visibility. Worth watching for whether they telegraph any acquisition appetite or deployment of cash on the next call.

Market | Smith+Nephew Q2 2026 Results: Lower Growth, Down Guidance

Smith+Nephew reported Q2 2026 underlying revenue growth of 1.6 percent, below expectations, and cut full-year revenue growth guidance to approximately 4 percent underlying. Weakness in U.S. Orthopaedics (knees) and Advanced Wound Bioactives (SANTYL) offset strong Sports Medicine growth. Acquisition of Integrity Orthopaedics (Tendon Seam rotator cuff system) provides upside but adds near-term headwinds.

The BTK read: This is the CAMP story and the guidance cut story covered in depth in the Skin Substitutes section above. The Integrity acquisition is the strategic offset. SNN's betting that Tendon Seam traction plus NPWT geography strength can compensate for CAMP compression, and the stock's reaction will tell you whether the market is buying that trade.

Market | Novo Nordisk Raises 2026 Guidance on GLP-1 Momentum

Novo Nordisk raised its full-year 2026 outlook for adjusted sales and operating profit growth on August 4, driven by continued rapid adoption of Wegovy pill in the U.S., with 5 million-plus prescriptions, and strong GLP-1 momentum. Q2 adjusted sales grew 7 percent and adjusted operating profit increased 11 percent at constant exchange rates, reflecting favorable rebate adjustments and geographic volume growth.

The BTK read: GLP-1 adoption curves are worth monitoring tangentially for wound care comorbidity shifts. If obesity and diabetes therapeutics are moving the needle on preventive care and weight-loss-driven complication reduction, that's a macro headwind for wound care utilization in the medium term, though the effect is years out. Track it alongside diabetic foot ulcer incidence data in your pipeline diligence.

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BTK Wound Care Fund (5D): +0.005% | S&P 500: +2.94% | Dow Jones: +2.67% | NASDAQ: +3.84%

Top 5, five days:

Bottom 5, five days:

The BTK read: INFU's +29.87 percent is the Patient Services story landing hard into the fund. BSEM's +21.30 percent appears to be a standalone bounce. LMAT's −20.23 percent is the guidance cut story from above, a vascular device repricing on softer PVD demand. SNN's −5.93 percent is the CAMP guidance cut we've been discussing all week, tracking within the broader category reset. SOLV's −2.90 percent is interesting: it's up on spinoff announcement momentum but the market's pricing execution risk and focusing on the wound care upside. Watch next quarter to see if the spinoff separates the signals more clearly.

Educational model portfolio. Not a real fund. Not investment advice. Performance is model-calculated and unaudited.

Already behind us this week: Smith+Nephew, InfuSystem, ConvaTec, Penumbra, Stryker, and LeMaitre Vascular all reported Q2, all covered in full above.

Next week: AVITA Medical (RCEL) reports after market close on August 6.

August 6–9 | Nashville, TN — APMA Annual Scientific Meeting — Gaylord Opryland

September 10–11 | New Orleans, LA — IPAWS & Tissue Repair Summit (Kernexus) — The Ritz-Carlton (BTK Official Market Intelligence Partner)

September 14–16 | Louisville, KY — NAWCO HEAL Conference 2026

September 17–20 | Bengaluru, India — DFSICON 2026 (Diabetic Foot Society of India Conference, in collaboration with ALPS)

September 23–27 | Kuala Lumpur, Malaysia — WUWHS 2026

October 15–18 | Las Vegas, NV — SAWC Fall 2026 — Caesars Palace

October 22–24 | Anaheim, CA — DFCon 2026 — JW Marriott

November 6 | Virtual — WoundCon Fall 2026

Early December (dates TBD) | San Antonio, TX — DFUpdate 2026 (ALPS)

December 9–12 | Phoenix, AZ — Desert Foot, Multi-Disciplinary Limb Salvage & Wound Care Conference

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See you next week,

-Scott