The recent wave of companies adding bitcoin to their balance sheets has not yielded universally positive results. Semler Scientific (SMLR), a medical technology firm that pivoted into bitcoin treasury strategy, has seen its stock fall over nearly 50% in 2025 to nearly the level it was at a bit more than one year ago when it first began to accumulate BTC.

The company’s premium to its net asset value (NAV), often referred to as multiple-to-NAV (mNAV), has dropped below 1x. On a basic share count basis, its market cap sits at approximately $420 million compared to bitcoin holdings valued around $491 million (4,449 BTC), putting its NAV ratio at just 0.859x, according to Strategy-Tracker.

The mNAV being below 1.0 is crucial as Semler's main mechanism for accumulating bitcoin is to raise capital via share sales. However, for the share sale strategy to be accretive to shareholders, the stock must trade at a premium to the value of the company’s bitcoin holdings. With the share price at or below NAV, issuing new shares would dilute existing shareholders without adding proportional value, effectively halting the company’s ability to pursue further bitcoin accumulation under the current strategy.

Bitcoin bull Tom Lee, Head of Research at Fundstrat, however, views Semler Scientific as an opportunity in his firm's "Granny shot" research portfolio. Granny shot refers to an unconventional way of shooting free throws in basketball and Fundstrat's Granny Shot (GRNY) portfolio is meant to emphasize the firm's unusual approach to research.

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