Inspire Medical Systems Inc. (INSP) — RQD Stock Rating Cockpit

Per the Roarable RQD rating, INSP scores 66 out of 100, a C+ grade with the verdict "Roarable Hold — Upper Neutral / Watch for Breakout." The five pillars are:

• Fundamental Cash Engine: 8 / 20. Per the RQD rating, this pillar reflects ROIC of 6% and an FCF yield of 3.81%. This is the weakest pillar and the main reason the overall score sits in the neutral band. The FCF yield indicates the cash generated relative to market value is modest.
• Whale 13F Flow: 11 / 20. Per the RQD rating, institutional accumulation and options positioning are rated in the middle of the range. The source data does not provide the underlying 13F holdings detail (see Analyst View & Smart Money Ownership).
• Insider Conviction: 16 / 20. Per the RQD rating, SEC Form 4 and Congressional PTR cluster flow scores in the upper half. The underlying trade records are not included in the source data.
• Macro Regime Fit: 13 / 20. Per the RQD rating, beta is 1.0 and sector sensitivity is moderate. Per the market data, beta of 1.0 implies the stock is expected to move in line with the broader market.
• Forensic Balance Sheet: 18 / 20. Per the RQD rating, Altman Z is 11.4, Piotroski F is 7 of 9, and Debt/Equity is 0.5. This is the strongest pillar.

For a prospective investor, the pattern is a balance sheet and insider signal that screen well against a cash-generation profile that screens weakly. Upside drivers implied by the data are the strong forensic balance sheet and the upper-half insider and flow readings. The valuation tradeoff is that trailing P/E of 14.2 sits alongside EV/EBITDA of 23.3 and a 6% ROIC, so earnings multiples and enterprise-level multiples tell different stories. The rating itself describes a hold-with-watch posture rather than a directional call.

Inspire Medical Systems Inc. is a NYSE-listed issuer in the Health Care sector, Medical/Dental Instruments industry. Per the company profile, it operates as a publicly traded medical instruments company. Not available in source data: product descriptions, customer segments, and revenue model specifics beyond sector and industry classification.

Per the SEC financials, revenue grew from $624.8M in FY 2023 to $912.0M in FY 2025, and operating income moved from a loss of $-40.3M to $51.0M over the same span. Per the market data, gross margin is 85.4%, operating margin 5.6%, and net margin 15.9%; the gap between operating and net margin is not explained in the source data. Per the RQD rating, ROIC is 6% and the Forensic Balance Sheet pillar cites Altman Z of 11.4 and Piotroski F of 7 of 9, with Debt/Equity at 0.5. Reported FCF declined from $91.1M in FY 2024 to $78.5M in FY 2025, and cash declined from $150.2M to $104.8M over the same period.

Per the recent news feed, the headlines cover the following themes:

• A report on Category I CPT codes for Inspire V, labeled as market wire with a YELLOW light.
• A GuruFocus report citing a GF Score of 64 alongside a 3.8% share price move, labeled CATALYST with a GREEN light.
• An Investing.com report referencing a fair value gain of roughly 70%, labeled CATALYST with a GREEN light.
• A TradingView report on a 47.8% three-month gain, labeled CATALYST with a GREEN light.
• A Yahoo Finance Q2 earnings review, labeled market wire with a YELLOW light.
• A Moomoo options chain listing, labeled market wire with a YELLOW light.

Risk watch items: the feed contains no bearish headlines, and the YELLOW-flagged items are market-wire coverage without a stated directional signal. The Butterfly Supply-Chain Graph reports no proprietary signals and no links.

Per the Butterfly Supply-Chain Graph, the supply chain is recorded as NONE, with no butterfly links and no proprietary signals. Not available in source data: upstream suppliers, downstream customers, and sector correlation figures. Investors seeking second-order ripple analysis would need supplier and customer disclosures not present in this dataset.

• What drove the gap between FY 2025 net income of $145.4M and operating income of $51.0M, and how much of it is non-recurring?
• Why did FCF and cash both decline in FY 2025 despite revenue growth, and what is the cash burn trajectory?
• What are the debt balance and EPS figures for the reported periods, which the source lists as N/A?
• Which insider, 13F, and Congressional transactions underlie the RQD flow pillar scores?
• What is the company's product and reimbursement exposure behind the Category I CPT code news?