BofA Downgrades Inspire Medical to Underperform Amid Coding Concerns
Written by Emily J. Thompson, Senior Investment Analyst
Updated: May 22 2026
0mins
Source: seekingalpha
- Rating Downgrade: Bank of America downgraded Inspire Medical Systems (INSP) from Neutral to Underperform, primarily due to the absence of a clear coding pathway for reimbursement of its Inspire V implant for sleep apnea, leading to decreased market confidence.
- Revenue Forecast Reduction: Analyst Travis Steed noted that Inspire has already cut its 2026 revenue guidance, projecting growth for 2027; however, the lack of an official code has led to lowered revenue and EPS estimates for 2027 and 2028, reflecting a pessimistic outlook on the company's future.
- Price Target Cut: BofA slashed Inspire's stock price target from $53 to $39, indicating concerns over the company's future profitability, especially given the significant risks associated with the absence of a stable coding pathway.
- Market Reaction: Following BofA's downgrade, Inspire's stock fell in premarket trading, reflecting investor concerns about the company's outlook, particularly with the potential delay in obtaining official coding until 2028 or later.
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Analyst Views on INSP
Wall Street analysts forecast INSP stock price to rise
19 Analyst Rating
13 Buy
6 Hold
0 Sell
Moderate Buy
Current: 43.070
Low
91.00
Averages
145.31
High
180.00
Current: 43.070
Low
91.00
Averages
145.31
High
180.00
About INSP
Inspire Medical Systems, Inc. is a medical technology company. The Company focuses on the development and commercialization of advanced, minimally invasive solutions for patients with obstructive sleep apnea (OSA). Its proprietary Inspire therapy is neurostimulation technology that provides safe and effective treatment for moderate to severe obstructive sleep apnea. The Company's closed-loop solution continuously monitors a patient’s breathing and delivers mild hypoglossal nerve stimulation to maintain an open airway. The Company sells its Inspire system to hospitals and ambulatory surgery centers (ASCs) in the United States (U.S.) and in select countries in Europe and Japan through a direct sales organization and sells its Inspire system in Singapore and Hong Kong through distributors. Its direct sales force engages in sales efforts and promotional activities focused on ear, nose and throat (ENT) physicians and sleep centers.
About the author
Emily J. Thompson
Emily J. Thompson, a Chartered Financial Analyst (CFA) with 12 years in investment research, graduated with honors from the Wharton School. Specializing in industrial and technology stocks, she provides in-depth analysis for Intellectia’s earnings and market brief reports.
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BofA Downgrades Inspire Medical to Underperform Amid Coding Concerns
- Rating Downgrade: Bank of America downgraded Inspire Medical Systems (INSP) from Neutral to Underperform, primarily due to the absence of a clear coding pathway for reimbursement of its Inspire V implant for sleep apnea, leading to decreased market confidence.
- Revenue Forecast Reduction: Analyst Travis Steed noted that Inspire has already cut its 2026 revenue guidance, projecting growth for 2027; however, the lack of an official code has led to lowered revenue and EPS estimates for 2027 and 2028, reflecting a pessimistic outlook on the company's future.
- Price Target Cut: BofA slashed Inspire's stock price target from $53 to $39, indicating concerns over the company's future profitability, especially given the significant risks associated with the absence of a stable coding pathway.
- Market Reaction: Following BofA's downgrade, Inspire's stock fell in premarket trading, reflecting investor concerns about the company's outlook, particularly with the potential delay in obtaining official coding until 2028 or later.
See More
Inspire Medical Systems Q1 2026 Results and Guidance Revision
- Sales Performance Overview: Inspire Medical Systems reported Q1 2026 sales of $204.58 million, despite a net loss of $11.29 million, indicating pressure on the company's market competitiveness and profitability challenges.
- Guidance Revision: The company revised its full-year 2026 revenue guidance down to $825 million to $875 million, with diluted EPS adjusted to $0.07 to $0.62, reflecting negative impacts from reimbursement and coding issues that may dampen investor confidence.
- Shareholder Approval Plans: Inspire filed a $118.82 million shelf registration for 2.6 million common shares tied to its employee stock ownership plan and secured shareholder approval to expand its incentive award plan, highlighting ongoing investments in governance reforms and employee alignment.
- Long-Term Investment Outlook: Despite short-term reimbursement pressures, Inspire projects $1.1 billion in revenue and $97.5 million in earnings by 2029, requiring an 8% annual growth rate, indicating confidence in long-term market potential while cautioning against pessimistic market expectations.
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- Market Recovery: The S&P 500 rose by 0.37% and the Nasdaq 100 by 0.42%, with the Dow Jones Industrial Average hitting an all-time high, reflecting optimism about a potential US-Iran peace deal that could boost investor confidence.
- Consumer Sentiment Decline: The University of Michigan's consumer sentiment index was revised down to a record low of 44.8, below the expected 48.2, indicating growing concerns among consumers about the economic outlook, which may impact future spending.
- Rising Inflation Expectations: The 1-year inflation expectations for May were revised upward to 4.8%, exceeding the expected 4.6%, potentially prompting the Federal Reserve to consider interest rate hikes in upcoming meetings, which could pressure the stock market.
- Tech Stocks Lead Gains: Workday's stock surged over 5% after reporting Q1 adjusted EPS of $2.66, surpassing expectations, highlighting strong performance in the software sector and potentially attracting more investor interest in tech stocks.
See More
US Stocks Rise, Nasdaq Hits Weekly High
- Strong Market Performance: The S&P 500 rose by 0.50% and the Nasdaq 100 by 0.73%, with the Dow Jones Industrial Average hitting an all-time high, reflecting optimism about a potential US-Iran peace deal that could boost investor confidence.
- Decline in Consumer Confidence: The University of Michigan's consumer sentiment index was revised down to 44.8, a record low, below the expected 48.2, indicating growing consumer concerns about the economic outlook, which may negatively impact future spending.
- Rising Inflation Expectations: The 1-year inflation expectations for May were revised up to 4.8%, a 9-month high, exceeding the expected 4.6%, which could prompt the Fed to consider interest rate hikes at the upcoming meeting, affecting market liquidity.
- Chip Stocks Lead Gains: Qualcomm's stock surged over 12%, leading the Nasdaq 100, demonstrating ongoing market enthusiasm for semiconductor and AI infrastructure, which may yield higher returns for related companies.
See More
US Stocks Rise as Market Optimism Grows
- Strong Market Performance: The S&P 500 rose by 0.54%, the Nasdaq 100 increased by 0.53%, and the Dow Jones Industrial Average reached an all-time high, reflecting market optimism regarding a potential peace deal between the US and Iran, which could boost investor confidence.
- Software Stocks Lead Gains: Workday's stock surged over 8% after reporting Q1 adjusted EPS of $2.66, exceeding the consensus of $2.51, and forecasting Q2 subscription revenue of $2.46 billion, further enhancing confidence in the software sector.
- Oil Price Volatility Affects Markets: Crude oil prices dipped slightly as Qatar coordinated with the US to send a negotiating team to Tehran, raising concerns about future supply; the IEA warned that global oil inventories will remain tight, potentially impacting overall economic growth.
- International Markets Rebound: The Euro Stoxx 50 climbed 1.23%, China's Shanghai Composite rose 0.87%, and Japan's Nikkei increased by 2.68%, indicating a global market optimism that may provide support for the US market.
See More
BofA Downgrades Inspire Medical to Underperform Amid Coding Concerns
- Rating Downgrade: Bank of America downgraded Inspire Medical Systems (INSP) from Neutral to Underperform, primarily due to the absence of a clear coding pathway for reimbursement of its Inspire V implant for sleep apnea, leading to decreased market confidence.
- Revenue Forecast Reduction: Analyst Travis Steed noted that Inspire has already cut its 2026 revenue guidance, projecting growth for 2027; however, the lack of an official code has led to lowered revenue and EPS estimates for 2027 and 2028, reflecting a pessimistic outlook on the company's future.
- Price Target Cut: BofA slashed Inspire's stock price target from $53 to $39, indicating concerns over the company's future profitability, especially given the significant risks associated with the absence of a stable coding pathway.
- Market Reaction: Following BofA's downgrade, Inspire's stock fell in premarket trading, reflecting investor concerns about the company's outlook, particularly with the potential delay in obtaining official coding until 2028 or later.
See More
Inspire Medical Systems Q1 2026 Results and Guidance Revision
- Sales Performance Overview: Inspire Medical Systems reported Q1 2026 sales of $204.58 million, despite a net loss of $11.29 million, indicating pressure on the company's market competitiveness and profitability challenges.
- Guidance Revision: The company revised its full-year 2026 revenue guidance down to $825 million to $875 million, with diluted EPS adjusted to $0.07 to $0.62, reflecting negative impacts from reimbursement and coding issues that may dampen investor confidence.
- Shareholder Approval Plans: Inspire filed a $118.82 million shelf registration for 2.6 million common shares tied to its employee stock ownership plan and secured shareholder approval to expand its incentive award plan, highlighting ongoing investments in governance reforms and employee alignment.
- Long-Term Investment Outlook: Despite short-term reimbursement pressures, Inspire projects $1.1 billion in revenue and $97.5 million in earnings by 2029, requiring an 8% annual growth rate, indicating confidence in long-term market potential while cautioning against pessimistic market expectations.
See More
U.S. Stocks Close Higher, Led by Tech Gains
- Tech Stock Surge: Intel's stock soared over 12% after Apple held exploratory talks with Intel and Samsung Electronics for U.S. processor production, indicating strong market confidence in tech stocks and driving gains across chipmakers.
- Oil Price Decline: WTI crude oil prices fell more than 3% as the ceasefire in the Middle East eased geopolitical risks, providing support for the stock market and reflecting market demand for stability amid fluctuating oil prices.
- New Home Sales Growth: U.S. March new home sales rose 7.4% month-over-month to 682,000, surpassing expectations of 652,000, indicating a robust recovery in the housing market that could bolster economic confidence.
- Positive Earnings Outlook: As of Tuesday, 83% of the 354 S&P 500 companies that reported Q1 earnings exceeded estimates, with projected earnings growth of 12% year-over-year, demonstrating sustained corporate profitability that may further drive stock market gains.
See More
