First Quarter 2024 Earnings Call This presentation contains "forward-looking statements" made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements generally relate to future events and relationships, plans, future growth and future performance, including, but not limited to, the Company's ability to complete or integrate acquisitions as planned and to realize ...

[PART I — FINANCIAL INFORMATION](index=4&type=section&id=Part%20I.%20Financial%20Information) This section details unaudited consolidated financial statements, management's analysis, market risks, and internal controls [Item 1. Financial Statements](index=4&type=section&id=Item%201.%20Financial%20Statements) This section presents R1 RCM Inc.'s unaudited consolidated financial statements for Q1 2024 and 2023, with notes [Consolidated Balance Sheets](index=5&type=section&id=Consolidated%20Balance%20Sheets) This section presents the company's financial position, detailing assets, liabilities, and equity at specific dates | Metric | March 31, 2024 (in millions) | December 31, 2023 (in millions) | Change (in millions) | % Change | | :-------------------------------- | :----------------------------- | :------------------------------ | :------------------- | :------- | | Total assets | $5,795.2 | $4,960.2 | $835.0 | 16.8% | | Total liabilities | $2,971.6 | $2,208.8 | $762.8 | 34.5% | | Total stockholders' equity | $2,823.6 | $2,751.4 | $72.2 | 2.6% | - Total assets increased by **$835.0 million**, primarily driven by increases in intangible assets (**$315.8 million**) and goodwill (**$420.0 million**), largely due to the **Acclara acquisition**[11](index=11&type=chunk)[36](index=36&type=chunk) - Total liabilities increased by **$762.8 million**, mainly due to a significant increase in long-term debt by **$619.1 million**, reflecting financing for the **Acclara acquisition**[11](index=11&type=chunk)[60](index=60&type=chunk)[61](index=61&type=chunk) [Consolidated Statements of Operations and Comprehensive Income (Loss) (Unaudited)](index=6&type=section&id=Consolidated%20Statements%20of%20Operations%20and%20Comprehensive%20Income%20(Loss)%20(Unaudited)) This section presents the company's unaudited financial performance, detailing revenue, expenses, and net income/loss | Metric | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | Change (in millions) | % Change | | :------------------------------------------ | :---------------------------------------------- | :---------------------------------------------- | :------------------- | :------- | | Net services revenue | $603.9 | $545.6 | $58.3 | 10.7% | | Total operating expenses | $595.9 | $511.9 | $84.0 | 16.4% | | Income from operations | $8.0 | $33.7 | $(25.7) | (76.3)% | | Net interest expense | $41.3 | $30.7 | $10.6 | 34.5% | | Net income (loss) | $(35.1) | $1.6 | $(36.7) | n.m. | | Basic net income (loss) per common share | $(0.08) | $— | $(0.08) | n.m. | | Diluted net income (loss) per common share | $(0.08) | $— | $(0.08) | n.m. | - Net services revenue increased by **$58.3 million (10.7%)** year-over-year, primarily driven by the **Acclara acquisition**[13](index=13&type=chunk)[32](index=32&type=chunk) - The company reported a net loss of **$35.1 million** for Q1 2024, a significant decline from a net income of **$1.6 million** in Q1 2023, largely due to increased operating expenses and net interest expense[13](index=13&type=chunk) [Consolidated Statements of Stockholders' Equity (Unaudited)](index=7&type=section&id=Consolidated%20Statements%20of%20Stockholders'%20Equity%20(Unaudited)) This section details changes in stockholders' equity, including common stock, paid-in capital, and deficit | Metric | Balance at December 31, 2023 (in millions) | Balance at March 31, 2024 (in millions) | Change (in millions) | | :------------------------------------ | :--------------------------------------- | :------------------------------------ | :------------------- | | Common Stock (Amount) | $4.5 | $4.5 | $0.0 | | Additional Paid-In Capital | $3,197.4 | $3,306.6 | $109.2 | | Accumulated Deficit | $(136.7) | $(171.8) | $(35.1) | | Accumulated Other Comprehensive Loss | $(5.9) | $(5.2) | $0.7 | | Treasury Stock (Amount) | $(307.9) | $(310.5) | $(2.6) | | Total Stockholders' Equity | $2,751.4 | $2,823.6 | $72.2 | - Total stockholders' equity increased by **$72.2 million**, primarily driven by increases in additional paid-in capital (**$109.2 million**) from share-based compensation, warrant issuance, and refund of inducement dividend, partially offset by a net loss of **$35.1 million**[16](index=16&type=chunk) [Consolidated Statements of Cash Flows (Unaudited)](index=8&type=section&id=Consolidated%20Statements%20of%20Cash%20Flows%20(Unaudited)) This section presents the company's cash flows from operating, investing, and financing activities | Cash Flow Activity | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | Change (in millions) | | :------------------------------------ | :---------------------------------------------- | :---------------------------------------------- | :------------------- | | Net cash provided by operating activities | $46.7 | $54.7 | $(8.0) | | Net cash used in investing activities | $(698.4) | $(25.6) | $(672.8) | | Net cash provided by (used in) financing activities | $656.1 | $(35.4) | $691.5 | | Net increase (decrease) in cash, cash equivalents and restricted cash | $4.4 | $(5.9) | $10.3 | - Cash provided by operating activities decreased by **$8.0 million**, mainly due to larger cash bonus payouts and Acclara acquisition expenses in 2024[149](index=149&type=chunk) - Cash used in investing activities significantly increased by **$672.8 million**, primarily due to the **$661.9 million** cash consideration for the **Acclara acquisition**[151](index=151&type=chunk) - Cash provided by financing activities increased by **$691.5 million**, driven by **$575.0 million** in Incremental Term B Loans and **$80.0 million** in Senior Revolver borrowings to fund the **Acclara acquisition**[153](index=153&type=chunk) [Notes to Consolidated Financial Statements (Unaudited)](index=9&type=section&id=Notes%20to%20Consolidated%20Financial%20Statements%20(Unaudited)) This section provides detailed notes to the unaudited consolidated financial statements, covering business, acquisitions, accounting policies, and financial disclosures [1. Business Description and Basis of Presentation](index=9&type=section&id=1.%20Business%20Description%20and%20Basis%20of%20Presentation) This section outlines the company's business, recent acquisitions, and the basis for financial statement presentation - R1 RCM Inc. is a leading provider of technology-driven solutions that enhance financial performance and patient experience for healthcare systems, hospitals, and physician groups[23](index=23&type=chunk) - On January 17, 2024, the Company completed the acquisition of **Acclara**, the revenue cycle management business of Providence Health & Services, and entered into a 10-year partnership with Providence[24](index=24&type=chunk)[25](index=25&type=chunk) - The Company prospectively adopted ASU 2022-03 (Fair Value Measurement) effective January 1, 2024, which clarifies that contractual sale restrictions on equity securities should not be considered in fair value measurement[29](index=29&type=chunk) [2. Acquisitions](index=10&type=section&id=2.%20Acquisitions) This section details the company's acquisition activities, including the Acclara acquisition and its financial impact - The Company acquired Acclara on January 17, 2024, for a total purchase price of **$786.0 million**, consisting of **$726.2 million** in cash and **$59.8 million** from the issuance of a warrant to Providence[33](index=33&type=chunk) Preliminary Fair Value of Acquired Assets and Assumed Liabilities | Asset/Liability | Preliminary Fair Value (in millions) | | :---------------------------------- | :--------------------------------- | | Cash and cash equivalents | $64.3 | | Accounts receivable | $48.1 | | Intangible assets | $374.0 | | Goodwill | $420.0 | | Deferred income tax liabilities | $(84.6) | | Net assets acquired | $786.0 | - The acquisition resulted in **$420.0 million** in goodwill, primarily attributable to expected synergies, and **$374.0 million** in customer relationships intangible assets with a 12-year useful life[36](index=36&type=chunk) Pro Forma Results | Pro Forma Results (Three Months Ended March 31) | 2024 (in millions) | 2023 (in millions) | | :---------------------------------------------- | :----------------- | :----------------- | | Net services revenue | $615.7 | $621.7 | | Net loss | $(20.3) | $(37.1) | [3. Intangible Assets](index=12&type=section&id=3.%20Intangible%20Assets) This section provides a breakdown of the company's intangible assets, including changes due to acquisitions and amortization expense Intangible Asset Net Book Value | Intangible Asset Class | March 31, 2024 Net Book Value (in millions) | December 31, 2023 Net Book Value (in millions) | | :--------------------- | :------------------------------------------ | :--------------------------------------------- | | Customer relationships | $718.8 | $357.4 | | Technology | $897.2 | $939.3 | | Trade name | $10.5 | $14.0 | | Total intangible assets | $1,626.5 | $1,310.7 | - Total intangible assets, net, increased by **$315.8 million** from December 31, 2023, to March 31, 2024, primarily due to the **Acclara acquisition**, which added **$374.0 million** in customer relationships[42](index=42&type=chunk)[36](index=36&type=chunk) - Intangible asset amortization expense increased to **$58.2 million** for the three months ended March 31, 2024, from **$50.1 million** in the prior year period[43](index=43&type=chunk) [4. Revenue Recognition](index=13&type=section&id=4.%20Revenue%20Recognition) This section details the company's revenue sources and contract balances, highlighting changes in net services revenue Net Services Revenue by Source | Revenue Source | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | | :----------------- | :---------------------------------------------- | :---------------------------------------------- | | Net operating fees | $381.5 | $361.0 | | Incentive fees | $15.6 | $23.6 | | Modular and other fees | $206.8 | $161.0 | | Net services revenue | $603.9 | $545.6 | - Net services revenue increased by **$58.3 million (10.7%)** year-over-year, with modular and other fees showing the largest growth (**$45.8 million**), while incentive fees decreased by **$8.0 million**[47](index=47&type=chunk)[132](index=132&type=chunk) Contract Balances | Contract Balance | March 31, 2024 (in millions) | December 31, 2023 (in millions) | | :--------------------- | :----------------------------- | :------------------------------ | | Total contract assets, net | $137.7 | $132.1 | | Total contract liabilities | $22.7 | $23.6 | [5. Accounts Receivable and Allowance for Credit Losses](index=15&type=section&id=5.%20Accounts%20Receivable%20and%20Allowance%20for%20Credit%20Losses) This section provides details on accounts receivable and the allowance for credit losses, including changes over the period Accounts Receivable Components | Accounts Receivable Component | March 31, 2024 (in millions) | December 31, 2023 (in millions) | | :---------------------------- | :----------------------------- | :------------------------------ | | Billed receivables | $265.9 | $218.5 | | Unbilled receivables | $98.8 | $99.2 | | Allowance for credit losses | $(46.8) | $(48.3) | | Total accounts receivable, net | $317.9 | $269.4 | - Total accounts receivable, net, increased by **$48.5 million** from December 31, 2023, to March 31, 2024, primarily due to an increase in billed receivables[57](index=57&type=chunk) Allowance for Credit Losses Activity | Allowance for Credit Losses | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | | :-------------------------- | :---------------------------------------------- | :---------------------------------------------- | | Beginning balance | $48.3 | $15.2 | | Provision (recoveries) | $(0.5) | $1.1 | | Write-offs | $(1.0) | $(0.2) | | Ending balance | $46.8 | $16.1 | [6. Debt](index=16&type=section&id=6.%20Debt) This section details the company's debt structure, including changes due to financing activities and compliance with covenants Debt Components | Debt Component | March 31, 2024 (in millions) | December 31, 2023 (in millions) | | :----------------------------- | :----------------------------- | :------------------------------ | | Senior Revolver | $80.0 | $— | | Term A Loans | $1,162.5 | $1,162.5 | | Term B Loans | $1,068.8 | $493.8 | | Total debt | $2,280.6 | $1,637.5 | | Total long-term debt | $2,189.6 | $1,570.5 | - Total debt increased by **$643.1 million** to **$2,280.6 million** as of March 31, 2024, primarily due to **$575.0 million** in Incremental Term B Loans and **$80.0 million** in Senior Revolver borrowings to finance the **Acclara acquisition**[60](index=60&type=chunk)[61](index=61&type=chunk) Scheduled Debt Maturities | Scheduled Maturities | Amount (in millions) | | :------------------- | :------------------- | | Remainder of 2024 | $72.8 | | 2025 | $72.8 | | 2026 | $704.1 | | 2027 | $436.1 | | 2028 | $10.8 | | 2029 | $1,014.7 | | Total | $2,311.3 | - The Company was in compliance with all financial and non-financial covenants under the Second A&R Credit Agreement as of March 31, 2024[63](index=63&type=chunk) [7. Derivative Financial Instruments](index=17&type=section&id=7.%20Derivative%20Financial%20Instruments) This section describes the company's use of derivative financial instruments to manage currency and interest rate risks - The Company uses cash flow hedges to manage currency risk (total notional value of **$106.0 million** as of March 31, 2024) and interest rate risk (total notional value of **$500.0 million** as of March 31, 2024)[65](index=65&type=chunk)[67](index=67&type=chunk)[68](index=68&type=chunk)[70](index=70&type=chunk) - As of March 31, 2024, the Company had **$0.3 million** in unrealized gains related to foreign currency hedges and **$11.1 million** in unrealized gains related to interest rate swaps, recorded in accumulated other comprehensive loss[65](index=65&type=chunk)[68](index=68&type=chunk) Fair Value of Derivative Instruments | Derivative Type | March 31, 2024 Fair Value (in millions) | December 31, 2023 Fair Value (in millions) | | :-------------------------- | :-------------------------------------- | :----------------------------------------- | | Foreign currency forward contracts | $0.1 | $0.5 | | Interest rate swaps | $11.1 | $9.6 | [8. Share-Based Compensation](index=19&type=section&id=8.%20Share-Based%20Compensation) This section details the company's share-based compensation expense and related equity grants Share-Based Compensation Expense Allocation | Share-Based Compensation Expense Allocation | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | | :------------------------------------------ | :---------------------------------------------- | :---------------------------------------------- | | Cost of services | $18.8 | $6.9 | | Selling, general and administrative | $13.2 | $5.4 | | Total share-based compensation expense | $32.0 | $12.3 | - Total share-based compensation expense increased by **$19.7 million (160%)** to **$32.0 million** for the three months ended March 31, 2024, compared to **$12.3 million** in the prior year, with significant increases in both cost of services and SG&A[74](index=74&type=chunk)[129](index=129&type=chunk) - RSUs granted during Q1 2024 include **1,983,791 RSUs** issued upon the Acclara Acquisition to replace outstanding unvested options of Acclara[78](index=78&type=chunk) [9. Other Expenses](index=21&type=section&id=9.%20Other%20Expenses) This section provides a breakdown of other expenses, including business acquisition costs, integration costs, and technology transformation Other Expense Categories | Other Expense Category | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | | :----------------------- | :---------------------------------------------- | :---------------------------------------------- | | Business acquisition costs | $15.7 | $0.1 | | Integration costs | $8.7 | $15.8 | | Technology transformation | $6.8 | $3.6 | | Strategic initiatives | $0.8 | $4.4 | | Facility-related charges | $1.3 | $1.2 | | Other | $0.6 | $5.1 | | Total other expenses | $33.9 | $30.2 | - Total other expenses increased by **$3.7 million (12%)** to **$33.9 million**, primarily driven by a significant increase in business acquisition costs (**$15.7 million** in 2024 vs. **$0.1 million** in 2023) related to the **Acclara acquisition**[82](index=82&type=chunk)[135](index=135&type=chunk) - Integration costs decreased from **$15.8 million** in Q1 2023 to **$8.7 million** in Q1 2024, while technology transformation costs increased from **$3.6 million** to **$6.8 million**[82](index=82&type=chunk) [10. Income Taxes](index=22&type=section&id=10.%20Income%20Taxes) This section discusses the company's income tax provision and effective tax rate, including deferred tax assets - The income tax provision increased by **$0.4 million** to **$1.8 million** for the three months ended March 31, 2024[136](index=136&type=chunk) - The effective tax rate was approximately **(5%)** for Q1 2024, lower than the statutory federal tax rate due to tax benefits for pre-tax loss, offset by discrete tax expenses[136](index=136&type=chunk) - The Company had gross deferred tax assets of **$137.9 million** at December 31, 2023, including **$23.7 million** related to net operating loss (NOL) carryforwards, which are expected to be utilized[92](index=92&type=chunk) [11. Earnings (Loss) Per Share](index=22&type=section&id=11.%20Earnings%20(Loss)%20Per%20Share) This section presents the company's basic and diluted earnings (loss) per share calculations Earnings (Loss) Per Share Data | Metric | Three Months Ended March 31, 2024 | Three Months Ended March 31, 2023 | | :------------------------------------------ | :-------------------------------- | :-------------------------------- | | Net income (loss) | $(35.1) million | $1.6 million | | Basic weighted-average common shares | 420,427,136 | 417,346,840 | | Diluted weighted average common shares | 420,427,136 | 452,925,789 | | Net income (loss) per common share (basic) | $(0.08) | $— | | Net income (loss) per common share (diluted) | $(0.08) | $— | - Basic and diluted net loss per common share was **$(0.08)** for the three months ended March 31, 2024, compared to **$—** (basic) and **$—** (diluted) in the prior year[95](index=95&type=chunk) - **19,030,415** common share equivalents (stock options, PBRSUs, RSUs) and warrants to acquire **54.2 million** shares were excluded from the diluted EPS calculation for Q1 2024 due to their anti-dilutive effect[96](index=96&type=chunk) [12. Commitments and Contingencies](index=23&type=section&id=12.%20Commitments%20and%20Contingencies) This section outlines the company's legal commitments and contingencies, including ongoing litigation and settlements - The 'In re R1 RCM Inc. Stockholders Litigation' was settled on January 15, 2024, with TCP-ASC, Ascension, TowerBrook, Cloudmed stockholders, and Company directors contributing to a **$45.5 million** settlement[99](index=99&type=chunk) - The Company received **$16.4 million** from the settlement for derivative claims, recorded as a refund of an inducement dividend to Additional paid-in capital[99](index=99&type=chunk) - The 'Graziosi v R1 RCM Inc.' False Claims Act case, filed in 2013, is ongoing with additional dispositive motions expected through 2024 and a potential trial in 2025; the Company believes it has meritorious defenses[100](index=100&type=chunk) [13. Related Party Transactions](index=24&type=section&id=13.%20Related%20Party%20Transactions) This section describes transactions with related parties, particularly Ascension, a significant customer - Transactions with Ascension and its affiliates are significant, with Ascension being the Company's largest customer[101](index=101&type=chunk)[102](index=102&type=chunk) - New Mountain Capital, L.L.C. became a related party following the Cloudmed acquisition, but there were no material transactions with them subsequent to the acquisition[101](index=101&type=chunk) [14. Segments and Customer Concentrations](index=24&type=section&id=14.%20Segments%20and%20Customer%20Concentrations) This section clarifies the company's operating segment and highlights significant customer concentrations - The Company operates as a single operating segment, providing revenue cycle management services to U.S.-based healthcare providers[103](index=103&type=chunk) Customer Concentration of Net Services Revenue | Customer Name | % of Net Services Revenue (Q1 2024) | % of Net Services Revenue (Q1 2023) | | :------------------ | :---------------------------------- | :---------------------------------- | | Ascension and its affiliates | 36% | 40% | | Intermountain Healthcare | 10% | 11% | - Ascension represented **8%** of accounts receivable as of March 31, 2024, down from **10%** at December 31, 2023, indicating a concentration of credit risk[105](index=105&type=chunk) [15. Supplemental Financial Information](index=24&type=section&id=15.%20Supplemental%20Financial%20Information) This section provides supplemental financial details, including depreciation, amortization, and lease-related cash flows Depreciation and Amortization Expense Allocation | Expense Allocation | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | | :------------------------------------ | :---------------------------------------------- | :---------------------------------------------- | | Cost of services (Depreciation & Amortization) | $19.3 | $15.5 | | Selling, general and administrative (Depreciation & Amortization) | $0.3 | $0.4 | | Total depreciation and amortization | $19.6 | $15.9 | Lease-Related Cash Flows | Lease-Related Cash Flows | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | | :---------------------------------------------------- | :---------------------------------------------- | :---------------------------------------------- | | Operating cash flows for operating leases | $7.3 | $6.2 | | Right-of-use assets obtained in exchange for operating lease obligations | $13.6 | $3.1 | [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=26&type=section&id=Item%202.%20Management's%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management discusses financial condition, operations, non-GAAP measures, and liquidity, focusing on Acclara acquisition and Change Healthcare cyberattack impacts [Overview](index=27&type=section&id=Overview) This section provides an overview of the company's business, strategic developments, and market conditions - R1 RCM Inc. is a leading provider of technology-driven solutions for healthcare systems, hospitals, and physician groups, aiming to improve financial performance and patient experience[112](index=112&type=chunk) - The Board of Directors formed a special committee on March 11, 2024, to evaluate all strategic alternatives in response to Schedule 13D/A filings by New Mountain Capital and TCP-ASC[115](index=115&type=chunk) - The Change Healthcare cyberattack on February 21, 2024, caused significant delays in payments and disruptions, impacting the Company's Q1 2024 revenue by approximately **$9.5 million** due to lower incentive and modular fees[116](index=116&type=chunk) - The Company proactively borrowed **$75.0 million** under the Senior Revolver on April 3, 2024, to mitigate potential working capital impacts from the cyberattack[116](index=116&type=chunk) - The U.S. revenue cycle management market is projected to grow at a compounded annual growth rate of **10.3%** through 2030, driven by increasing complexity in reimbursement, industry consolidation, and labor shortages[118](index=118&type=chunk)[119](index=119&type=chunk) - On January 17, 2024, the Company completed the acquisition of Acclara for **$786.0 million**, funded by cash on hand, Senior Revolver borrowings, and Incremental Term B Loans[123](index=123&type=chunk) [CONSOLIDATED RESULTS OF OPERATIONS](index=29&type=section&id=CONSOLIDATED%20RESULTS%20OF%20OPERATIONS) This section presents a summary of the company's consolidated financial performance for the periods presented | Metric | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | Change (in millions) | % Change | | :------------------------------------------ | :---------------------------------------------- | :---------------------------------------------- | :------------------- | :------- | | Net operating fees | $381.5 | $361.0 | $20.5 | 6% | | Incentive fees | $15.6 | $23.6 | $(8.0) | (34)% | | Modular and other fees | $206.8 | $161.0 | $45.8 | 28% | | Total net services revenue | $603.9 | $545.6 | $58.3 | 11% | | Income from operations | $8.0 | $33.7 | $(25.7) | (76)% | | Net income (loss) | $(35.1) | $1.6 | $(36.7) | n.m. | | Adjusted EBITDA | $152.2 | $142.2 | $10.0 | 7% | [Use of Non-GAAP Financial Measures](index=30&type=section&id=Use%20of%20Non-GAAP%20Financial%20Measures) This section explains the company's use of non-GAAP financial measures, specifically Adjusted EBITDA, and its reconciliation - Adjusted EBITDA is a non-GAAP financial measure used by management for planning, forecasting, and evaluating performance, including executive incentive compensation programs[126](index=126&type=chunk) - Adjusted EBITDA is defined as net income (loss) before net interest income/expense, income tax provision/benefit, depreciation and amortization, share-based compensation, CoyCo 2 share-based compensation, strategic initiatives costs, and other expenses[127](index=127&type=chunk) Reconciliation of Net Income (Loss) to Adjusted EBITDA (non-GAAP) | Reconciliation Item | Three Months Ended March 31, 2024 (in millions) | Three Months Ended March 31, 2023 (in millions) | Change (in millions) | % Change | | :------------------------------------ | :---------------------------------------------- | :---------------------------------------------- | :------------------- | :------- | | Net income (loss) | $(35.1) | $1.6 | $(36.7) | n.m. | | Net interest expense | $41.3 | $30.7 | $10.6 | 35% | | Income tax provision | $1.8 | $1.4 | $0.4 | 29% | | Depreciation and amortization expense | $78.3 | $66.0 | $12.3 | 19% | | Share-based compensation expense | $30.2 | $10.5 | $19.7 | 188% | | CoyCo 2 share-based compensation expense | $1.8 | $1.8 | $0.0 | 0% | | Other expenses | $33.9 | $30.2 | $3.7 | 12% | | Adjusted EBITDA (non-GAAP) | $152.2 | $142.2 | $10.0 | 7% | [Three Months Ended March 31, 2024 Compared to Three Months Ended March 31, 2023](index=32&type=section&id=Three%20Months%20Ended%20March%2031,%202024%20Compared%20to%20Three%20Months%20Ended%20March%2031,%202023) This section provides a detailed comparison of the company's financial performance between Q1 2024 and Q1 2023 - Net services revenue increased by **$58.3 million (11%)** to **$603.9 million**, primarily driven by **$57.1 million** from the **Acclara acquisition**[132](index=132&type=chunk) - Cost of services increased by **$62.9 million (14%)** to **$497.6 million**, with Acclara contributing approximately **$52.9 million**, and increases in share-based compensation and depreciation/amortization[133](index=133&type=chunk) - Selling, general and administrative expenses rose by **$17.4 million (37%)** to **$64.4 million**, mainly due to **$7.1 million** from Acclara and **$7.8 million** in increased share-based compensation[134](index=134&type=chunk) - Other expenses increased by **$3.7 million (12%)** to **$33.9 million**, largely due to higher business acquisition costs related to **Acclara**[135](index=135&type=chunk) - The income tax provision increased by **$0.4 million** to **$1.8 million**, with the effective tax rate at **(5%)** for Q1 2024 due to tax benefits for pre-tax loss[136](index=136&type=chunk) [CRITICAL ACCOUNTING ESTIMATES](index=33&type=section&id=CRITICAL%20ACCOUNTING%20ESTIMATES) This section confirms no material changes to the company's critical accounting estimates from the prior fiscal year - There have been no material changes to the critical accounting estimates disclosed in the Company's 2023 Form 10-K[137](index=137&type=chunk) [NEW ACCOUNTING PRONOUNCEMENTS](index=33&type=section&id=NEW%20ACCOUNTING%20PRONOUNCEMENTS) This section outlines recently adopted and upcoming accounting pronouncements and their potential impact - The Company prospectively adopted ASU 2022-03 (Fair Value Measurement) effective January 1, 2024[29](index=29&type=chunk)[138](index=138&type=chunk) - The Company is currently assessing the impact of ASU 2023-07 (Segment Reporting) and ASU 2023-09 (Income Taxes), effective for fiscal years beginning after December 15, 2023, and December 15, 2024, respectively[30](index=30&type=chunk)[31](index=31&type=chunk) [LIQUIDITY AND CAPITAL RESOURCES](index=33&type=section&id=LIQUIDITY%20AND%20CAPITAL%20RESOURCES) This section discusses the company's liquidity sources, capital resources, and material cash requirements - Primary sources of liquidity include cash flows from operations and borrowings under the Second A&R Credit Agreement[139](index=139&type=chunk) Total Available Liquidity | Liquidity Metric | March 31, 2024 (in millions) | December 31, 2023 (in millions) | | :----------------------- | :----------------------------- | :------------------------------ | | Total available liquidity | $696.8 | $772.4 | - The Company expects cash and cash equivalents, operating cash flows, and Senior Revolver availability to be sufficient for operating activities and cash commitments for the next 12 months and beyond[142](index=142&type=chunk) - Material cash requirements include **$2.3 billion** in outstanding debt (with **$91.0 million** due within 12 months), **$134.6 million** in fixed future lease payments (**$28.7 million** within 12 months), and **$196.2 million** in software purchase and service obligations (**$42.7 million** within 12 months)[144](index=144&type=chunk)[146](index=146&type=chunk)[147](index=147&type=chunk) [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=36&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) This section discusses the Company's exposure to market risks, including interest rate and foreign currency, and mitigation through hedging - As of March 31, 2024, **$500.0 million** of the Company's **$2.3 billion** floating rate debt is hedged to a fixed rate of **3.01%** plus applicable spread, with the remaining **$1.8 billion** subject to variable rates (**7.58%** for Term A Loans/Senior Revolver, **8.33%** for Term B Loans)[159](index=159&type=chunk) - A one percentage point increase or decrease in interest rates would change annual interest expense on the **$1.8 billion** variable rate debt by approximately **$18.1 million**[159](index=159&type=chunk) - The Company is exposed to foreign currency exchange risk, primarily from the Indian rupee and Philippine peso, as **10%** of Q1 2024 expenses were foreign currency denominated. A **10%** change in foreign currency spot rates would reduce earnings by **$6.5 million**[161](index=161&type=chunk) - Foreign currency forward contracts are used as cash flow hedges (notional value **$106.0 million**) and fair value hedges (notional value **$27.0 million**) to manage currency risk[162](index=162&type=chunk)[163](index=163&type=chunk) [Item 4. Controls and Procedures](index=37&type=section&id=Item%204.%20Controls%20and%20Procedures) This section confirms effective disclosure controls and procedures and no material changes to internal control over financial reporting in Q1 2024 - The Chief Executive Officer and Chief Financial Officer concluded that the Company's disclosure controls and procedures were effective as of March 31, 2024[167](index=167&type=chunk) - There have been no changes in internal control over financial reporting during the first quarter of 2024 that have materially affected, or are reasonably likely to materially affect, the Company's internal control over financial reporting[168](index=168&type=chunk) [PART II — OTHER INFORMATION](index=38&type=section&id=Part%20II.%20Other%20Information) This section covers other information, including legal proceedings, risk factors, equity sales, and exhibits [Item 1. Legal Proceedings](index=38&type=section&id=Item%201.%20Legal%20Proceedings) This section refers to Note 12 for legal proceedings, stating no other material litigation or regulatory proceedings are pending or threatened - The Company is not a party to any material litigation or regulatory proceeding, nor is it aware of any pending or threatened litigation that could have a material adverse effect on its business, beyond what is described in Note 12[170](index=170&type=chunk) [Item 1A. Risk Factors](index=38&type=section&id=Item%201A.%20Risk%20Factors) This section highlights key risks, including strategic alternatives review, service disruptions, and Change Healthcare cyberattack impacts - The review of strategic alternatives, initiated on March 11, 2024, poses risks such as stock price fluctuations, management distraction, difficulties in retaining personnel, challenges in customer relationships, and substantial advisory expenses[172](index=172&type=chunk) - Disruptions in global business services centers or third-party data centers due to natural disasters, cyberattacks, or other events could adversely affect the Company's ability to provide services and its financial results[174](index=174&type=chunk)[175](index=175&type=chunk) - The Change Healthcare cyberattack caused significant payment delays and disruptions, leading to lower incentive fee revenue, incremental costs, and a proactive **$75 million** borrowing under the Senior Revolver to manage working capital[176](index=176&type=chunk) [Item 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=40&type=section&id=Item%202.%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) This section confirms no unregistered equity sales and details the Company's share repurchase program, noting no repurchases in Q1 2024 - There were no sales of unregistered equity securities during the first quarter of 2024 that were not previously reported[177](index=177&type=chunk) Share Repurchase Program Activity | Period | Total Number of Shares Purchased | Average Price Paid per Share | Maximum Dollar Value of Shares that May Yet be Purchased Under Publicly Announced Plans or Programs (in millions) | | :--------------------------------------- | :----------------------------- | :--------------------------- | :------------------------------------------------------------------------------------------------------------------ | | January 1, 2024 through January 31, 2024 | — | $— | $453.2 | | February 1, 2024 through February 29, 2024 | — | — | $453.2 | | March 1, 2024 through March 31, 2024 | — | — | $453.2 | - The Board authorized a share repurchase program up to **$500.0 million**, but no shares were repurchased during the three months ended March 31, 2024[178](index=178&type=chunk) [Item 5. Other Information](index=40&type=section&id=Item%205.%20Other%20Information) This section states no directors or officers adopted, modified, or terminated Rule 10b5-1 or non-Rule 10b5-1 trading arrangements in Q1 2024 - No directors or officers adopted, modified, or terminated Rule 10b5-1 or non-Rule 10b5-1 trading arrangements during the quarter ended March 31, 2024[179](index=179&type=chunk) [Item 6. Exhibits](index=41&type=section&id=Item%206.%20Exhibits) This section lists all exhibits filed or incorporated by reference in this Form 10-Q, including key agreements and certifications - Key exhibits include the Amended and Restated Certificate of Incorporation and Bylaws, the Warrant and Director Nomination Agreement related to Providence Health & Services, and Amendment No. 2 to the Second Amended and Restated Credit Agreement[180](index=180&type=chunk) - Certifications from the Chief Executive Officer and Chief Financial Officer pursuant to the Sarbanes-Oxley Act of 2002 are also included[180](index=180&type=chunk) [SIGNATURES](index=42&type=section&id=SIGNATURES) This section contains the official signatures of the Chief Executive Officer and Chief Financial Officer, certifying the report - The report is signed by Lee Rivas, Chief Executive Officer, and Jennifer Williams, Chief Financial Officer and Treasurer, on May 8, 2024[184](index=184&type=chunk)

Exhibit 99.1 R1 RCM Reports First Quarter 2024 Results Murray, Utah - May 8, 2024 - R1 RCM Inc. (NASDAQ: RCM) ("R1" or the "Company"), a leading provider of technology-driven solutions that transform the financial performance and patient experience for health systems, hospitals, and physician groups, today announced results for the three months ended March 31, 2024 and updated full year 2024 outlook. First Quarter 2024 Results: The quarter reflects impacts of the Change Healthcare cyberattack totaling $9.5 ...

Sure. On incentive fees, last quarter, we had some one-time items that increased our incentive fees in the quarter, and so we had reflected that we knew we would have a decrease quarter-over-quarter in incentive fees. Incentive fees landed right in line with our expectations, so there was no surprise there. Those one-time fees were really twofold. One was related to an acceleration of some incentive fees for a contract that ended in Q4, and it accelerated. So, we had extra, if you will, incentive fees in Q3 ...

Part I [Business](index=6&type=section&id=Item%201.%20Business) R1 RCM provides technology-driven revenue cycle management solutions, offering comprehensive and modular services to healthcare providers - R1 RCM provides **technology-driven RCM solutions** to **over 3,700 hospitals**, including **93 of the top 100 health systems**, and **over 30,000 physicians**, covering **over $1 trillion of Net Patient Revenue (NPR)** as of December 31, 2023[17](index=17&type=chunk) - The company's **technology platform**, **R1 Intelligent Automation**, automates **over 200 million tasks annually**, which is equivalent to the capacity of **more than 5,000 full-time employees**[18](index=18&type=chunk) - R1 offers **two primary partnership models**: **comprehensive End-to-End Operating Partnerships** (typically **7-10 year contracts**) and **flexible Modular Solutions** (typically **up to 3-year contracts**) to address specific RCM challenges[20](index=20&type=chunk)[21](index=21&type=chunk)[23](index=23&type=chunk) Revenue Concentration from Ascension | Fiscal Year | Percentage of Total Net Services Revenue from Ascension | | :--- | :--- | | 2023 | 40% | | 2022 | 49% | | 2021 | 61% | - As of December 31, 2023, the company employed **approximately 30,000 people**, with about **12,300 in the U.S.** and **17,600 internationally** (primarily in India and the Philippines)[79](index=79&type=chunk) [Risk Factors](index=24&type=section&id=Item%201A.%20Risk%20Factors) The company faces substantial risks from intense competition, cybersecurity threats, significant revenue concentration, high indebtedness, and complex healthcare regulations - The company operates in a **highly competitive industry**, facing pressure from healthcare systems' internal RCM departments and various external competitors, which could adversely affect operating results and market share[88](index=88&type=chunk) - A **significant risk** is the **concentration of revenue** from healthcare providers affiliated with Ascension, which represented **40% of total net services revenue** in 2023 The early termination of their agreement would **materially harm the business**[114](index=114&type=chunk) - **Cybersecurity threats**, including ransomware attacks, are a **major risk** A breach could lead to **unauthorized access** to **sensitive patient data**, resulting in **contract penalties**, **loss of customers**, and **significant liabilities**[100](index=100&type=chunk)[103](index=103&type=chunk) - The company's business is impacted by **macroeconomic conditions** like **inflation** and **high interest rates**, which could affect customer financial health and increase the company's **allowance for credit losses**[120](index=120&type=chunk)[123](index=123&type=chunk) - As of December 31, 2023, the company had **approximately $1.7 billion in consolidated indebtedness** This increased by **$655.0 million** in January 2024 to finance the **Acclara Acquisition**, which could **decrease business flexibility**[128](index=128&type=chunk) - The healthcare industry is **heavily regulated** Failure to comply with laws like HIPAA, the False Claims Act (FCA), and the Stark Law could result in **significant liability**, **adverse publicity**, and **negative business impact**[132](index=132&type=chunk)[140](index=140&type=chunk) [Unresolved Staff Comments](index=39&type=section&id=Item%201B.%20Unresolved%20Staff%20Comments) The company reports no unresolved staff comments from the SEC - There are **no unresolved staff comments**[152](index=152&type=chunk) [Cybersecurity](index=39&type=section&id=Item%201C.%20Cybersecurity) R1's cybersecurity program, based on the NIST framework, protects sensitive information and is overseen by the Board, with no material threats identified in 2023 - The company's **cybersecurity program** is designed using the **National Institute of Standards Technology (NIST) framework** to protect **Protected Health Information (PHI)**, **Personally Identifiable Information (PII)**, and **payment card information (PCI)**[153](index=153&type=chunk) - The program undergoes **annual independent audits**, including **SOC 2 Type 2**, **HIPAA Security Rule risk assessments**, **PCI-DSS attestations**, and **HITRUST certification**[155](index=155&type=chunk) - **Oversight is provided by the Board's Compliance & Risk Management Committee and the Audit Committee**, with operational management led by the **Chief Information Security Officer**, Cecil Pineda[159](index=159&type=chunk)[160](index=160&type=chunk)[161](index=161&type=chunk) - In 2023, the company did not identify any risks from **cybersecurity threats** that **materially affected** or are reasonably likely to materially affect its business strategy, results of operations, or financial condition[158](index=158&type=chunk) [Properties](index=40&type=section&id=Item%202.%20Properties) R1 RCM leases all its facilities, including its principal executive office in Murray, Utah, with sufficient domestic and international office space - The company **leases all its facilities**, with its **principal executive office** located in Murray, Utah[162](index=162&type=chunk)[163](index=163&type=chunk) - Total leased office space includes **approximately 240,000 sq. ft. in the U.S.** and **640,000 sq. ft. internationally**[163](index=163&type=chunk) [Legal Proceedings](index=40&type=section&id=Item%203.%20Legal%20Proceedings) The company is not a party to any material litigation or regulatory proceeding that would have a material adverse effect on its business - The company reports **no material litigation or regulatory proceedings**, except as described in Note 18 to the consolidated financial statements[165](index=165&type=chunk) [Mine Safety Disclosures](index=41&type=section&id=Item%204.%20Mine%20Safety%20Disclosures) This item is not applicable to the company - **Not applicable**[166](index=166&type=chunk) Part II [Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities](index=42&type=section&id=Item%205.%20Market%20for%20Registrant%27s%20Common%20Equity%2C%20Related%20Stockholder%20Matters%20and%20Issuer%20Purchases%20of%20Equity%20Securities) R1 RCM's common stock trades on NASDAQ, with no dividends paid, and the company has an active share repurchase program, showing volatile stock performance - The company's **common stock is listed on the NASDAQ** under the symbol "RCM"[169](index=169&type=chunk) - **No dividends were paid** on common stock in 2023, 2022, or 2021, and the company intends to **retain future earnings for business growth**[170](index=170&type=chunk) - As of December 31, 2023, **approximately $453.2 million remained available for share repurchases** under the company's **authorized stock repurchase program**[172](index=172&type=chunk) Cumulative Total Return Comparison (2018-2023) | | 12/31/2018 | 12/31/2019 | 12/31/2020 | 12/31/2021 | 12/31/2022 | 12/31/2023 | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | R1 RCM Inc. | $100.00 | $163.27 | $302.14 | $320.63 | $137.74 | $132.96 | | NYSE Composite Index | $100.00 | $122.32 | $127.70 | $150.90 | $133.50 | $148.17 | | NASDAQ Health Care Index | $100.00 | $125.83 | $163.63 | $157.82 | $125.58 | $133.80 | [Management's Discussion and Analysis of Financial Condition and Results of Operations](index=44&type=section&id=Item%207.%20Management%27s%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) The company achieved significant revenue and Adjusted EBITDA growth in 2023, improved net income, and completed the Acclara acquisition, maintaining strong liquidity - On January 17, 2024, the company **completed the acquisition of Acclara** from Providence for **$675.0 million in cash and a warrant** The acquisition was **funded with cash on hand and additional debt**[183](index=183&type=chunk) 2023 vs. 2022 Key Financial Results (in millions) | Metric | 2023 | 2022 | Change (%) | | :--- | :--- | :--- | :--- | | Total net services revenue | $2,254.2 | $1,806.4 | 24.8% | | Income (loss) from operations | $147.9 | $(2.8) | 5,382.1% | | Net income (loss) | $3.3 | $(63.3) | 105.2% | | Adjusted EBITDA (Non-GAAP) | $614.3 | $423.8 | 45.0% | - The **24.8% increase in net services revenue** in 2023 was primarily driven by a **full year of revenue from the Cloudmed acquisition** and **increased revenue from end-to-end customers** onboarded in 2022[208](index=208&type=chunk) - **Selling, general and administrative expenses increased by 27.5%** in 2023, driven by a **$22.9 million increase in bad debt expense** and a **$10.9 million increase in compensation expense**[210](index=210&type=chunk) - As of December 31, 2023, the company had **total liquidity of $772.4 million**, consisting of **cash and cash equivalents** and **remaining availability under its Senior Revolver**[218](index=218&type=chunk) Cash Flow Summary (in millions) | | 2023 | 2022 | 2021 | | :--- | :--- | :--- | :--- | | Net cash provided by (used in) operating activities | $340.1 | $(9.9) | $256.5 | | Net cash used in investing activities | $(102.8) | $(949.5) | $(332.1) | | Net cash (used in) provided by financing activities | $(173.9) | $943.0 | $31.4 | [Quantitative and Qualitative Disclosures About Market Risk](index=57&type=section&id=Item%207A.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) The company is exposed to market risks from interest rate fluctuations on variable-rate debt and foreign currency exchange rates, which it partially mitigates through hedging - The company is **exposed to interest rate risk** on its **variable-rate debt** Of its **$1.7 billion in debt**, **$1.2 billion is subject to variable rates** A **1% change in rates** would alter annual interest expense by about **$11.6 million**[243](index=243&type=chunk) - The company has **hedged $500.0 million of its floating-rate debt** to a **fixed rate of 3.01% plus an applicable spread**[243](index=243&type=chunk) - The company is **exposed to foreign currency risk**, primarily from the **Indian rupee** and **Philippine peso**, as **9% of its expenses in 2023 were denominated in foreign currencies** It uses **derivative contracts to hedge this exposure**[245](index=245&type=chunk)[246](index=246&type=chunk) [Financial Statements and Supplementary Data](index=58&type=section&id=Item%208.%20Financial%20Statements%20and%20Supplementary%20Data) This section indicates that the required financial statements are located starting on page F-1 of the report - The **financial statements required by this Item are located beginning on page F-1 of this report**[250](index=250&type=chunk) [Changes in and Disagreements With Accountants on Accounting and Financial Disclosure](index=58&type=section&id=Item%209.%20Changes%20in%20and%20Disagreements%20With%20Accountants%20on%20Accounting%20and%20Financial%20Disclosure) The company reports no changes in or disagreements with its accountants on accounting and financial disclosure - **None**[251](index=251&type=chunk) [Controls and Procedures](index=58&type=section&id=Item%209A.%20Controls%20and%20Procedures) Management concluded that disclosure controls and internal control over financial reporting were effective as of December 31, 2023, with a previously reported material weakness remediated - **Management, including the CEO and CFO, concluded that the company's disclosure controls and procedures were effective** as of December 31, 2023[254](index=254&type=chunk) - **Management concluded that the company's internal control over financial reporting was effective** as of December 31, 2023, based on the **COSO framework**[255](index=255&type=chunk) - A **previously reported material weakness** in internal control over financial reporting related to business combination accounting was **remediated** as of December 31, 2023[257](index=257&type=chunk) - Ernst & Young LLP, the independent registered public accounting firm, issued an **unqualified opinion** on the company's **internal control over financial reporting** as of December 31, 2023[262](index=262&type=chunk) [Other Information](index=62&type=section&id=Item%209B.%20Other%20Information) During the fourth quarter of 2023, none of the company's directors or officers adopted, modified, or terminated a Rule 10b5-1 or non-Rule 10b5-1 trading arrangement - **No directors or officers adopted, modified, or terminated a Rule 10b5-1 or non-Rule 10b5-1 trading arrangement** during the fourth quarter of 2023[270](index=270&type=chunk) Part III [Directors, Executive Officers and Corporate Governance](index=63&type=section&id=Item%2010.%20Directors%2C%20Executive%20Officers%20and%20Corporate%20Governance) Information regarding directors, executive officers, and corporate governance is incorporated by reference from the company's 2024 Proxy Statement - **Required information is incorporated by reference from the company's 2024 Proxy Statement**[274](index=274&type=chunk)[275](index=275&type=chunk) [Executive Compensation](index=63&type=section&id=Item%2011.%20Executive%20Compensation) Information regarding executive compensation is incorporated by reference from the company's 2024 Proxy Statement - **Required information is incorporated by reference from the company's 2024 Proxy Statement**[276](index=276&type=chunk) [Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters](index=63&type=section&id=Item%2012.%20Security%20Ownership%20of%20Certain%20Beneficial%20Owners%20and%20Management%20and%20Related%20Stockholder%20Matters) This section details the company's equity compensation plans, with information on security ownership incorporated by reference from the 2024 Proxy Statement Equity Compensation Plan Information as of December 31, 2023 | Plan Category | Number of Securities to be Issued Upon Exercise/Vesting (a) | Weighted Average Exercise Price of Outstanding Options (b) | Number of Securities Remaining Available for Future Issuance (c) | | :--- | :--- | :--- | :--- | | Equity compensation plans approved by stockholders | 12,580,339 | $3.41 | 7,456,142 | | Equity compensation plans not approved by stockholders | 5,654,741 | $ — | 519,830 | | **Total** | **18,235,080** | | **7,975,972** | - The company maintains a **Fourth Amended and Restated 2010 Stock Incentive Plan** and a **2022 Inducement Plan** for equity grants[277](index=277&type=chunk)[278](index=278&type=chunk) [Certain Relationships and Related Transactions, and Director Independence](index=64&type=section&id=Item%2013.%20Certain%20Relationships%20and%20Related%20Transactions%2C%20and%20Director%20Independence) Information regarding related party transactions and director independence is incorporated by reference from the company's 2024 Proxy Statement - **Required information is incorporated by reference from the company's 2024 Proxy Statement**[282](index=282&type=chunk) [Principal Accountant Fees and Services](index=64&type=section&id=Item%2014.%20Principal%20Accountant%20Fees%20and%20Services) Information regarding principal accountant fees and services is incorporated by reference from the company's 2024 Proxy Statement - **Required information is incorporated by reference from the company's 2024 Proxy Statement**[283](index=283&type=chunk) Part IV [Exhibit and Financial Statement Schedules](index=65&type=section&id=Item%2015.%20Exhibit%20and%20Financial%20Statement%20Schedules) This section lists the financial statements, financial statement schedules, and exhibits filed as part of the Form 10-K report - This section contains a **list of all documents filed with the report**, including **financial statements and various legal and corporate exhibits**[285](index=285&type=chunk)[286](index=286&type=chunk) [Form 10-K Summary](index=70&type=section&id=Item%2016.%20Form%2010-K%20Summary) The company reports that there is no Form 10-K summary - **None**[292](index=292&type=chunk) Financial Statements and Notes [Consolidated Financial Statements](index=76&type=section&id=Consolidated%20Financial%20Statements) The consolidated financial statements provide a comprehensive overview of the company's financial position, operational results, and cash flows Consolidated Balance Sheet Data (in millions) | | Dec 31, 2023 | Dec 31, 2022 | | :--- | :--- | :--- | | Total current assets | $633.3 | $564.5 | | Total assets | $4,960.2 | $5,121.8 | | Total current liabilities | $346.2 | $349.7 | | Total liabilities | $2,208.8 | $2,419.3 | | Total stockholders' equity | $2,751.4 | $2,702.5 | Consolidated Statement of Operations Data (in millions) | | 2023 | 2022 | 2021 | | :--- | :--- | :--- | :--- | | Net services revenue | $2,254.2 | $1,806.4 | $1,474.6 | | Income (loss) from operations | $147.9 | $(2.8) | $136.2 | | Net income (loss) | $3.3 | $(63.3) | $87.3 | | Diluted EPS | $0.01 | $(0.18) | $(1.90) | [Notes to Consolidated Financial Statements](index=80&type=section&id=Notes%20to%20Consolidated%20Financial%20Statements) The notes provide detailed information on accounting policies, business combinations, debt, customer concentrations, and legal proceedings supporting the financial statements - The company recognizes **revenue from end-to-end operating partnerships** (net operating fees and incentive fees) and **modular solutions** For certain modular services, revenue is estimated as a **contract asset** based on **expected collections by customers**[330](index=330&type=chunk)[331](index=331&type=chunk)[337](index=337&type=chunk) - The **measurement period for the Cloudmed acquisition closed in Q2 2023**, with **final purchase price allocation** resulting in **$2.085 billion of goodwill** and **$1.367 billion of intangible assets**[380](index=380&type=chunk)[381](index=381&type=chunk) Customer Revenue Concentration | Customer Name | 2023 | 2022 | 2021 | | :--- | :--- | :--- | :--- | | Ascension and its affiliates | 40% | 49% | 61% | | Intermountain Healthcare | 11% | 12% | 14% | - As of Dec 31, 2023, **total debt was $1.638 billion**, primarily under **Senior Secured Credit Facilities** In January 2024, the company **borrowed an additional $575.0 million in Term B Loans** and **$80 million from its revolver to fund the Acclara acquisition**[426](index=426&type=chunk)[518](index=518&type=chunk)[519](index=519&type=chunk) - The company is **defending a False Claims Act (FCA) lawsuit** (U.S. ex rel. Graziosi vs. Accretive Health, Inc. et. al.) related to its **Physician Advisory Services (PAS) business** The company believes it has **meritorious defenses**[506](index=506&type=chunk)

11 Forward-Looking Statements These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on by any investor as, a guarantee, assurance, prediction or definitive statement of fact or probability. Actual outcomes and results may differ materially from those contemplated by these forward-looking statements as a result of uncertainties, risks and changes in circumstances, including but not limited to risks and uncertainties related to: ( ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 Form 10-Q (Mark One) ☑ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the quarterly period ended September 30, 2023 OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to Murray Utah (Address of principal executive of ices) (Zip code) 84123 (312) 324-7820 COMMISSION FILE NUMBER: 001-41428 R1 RCM INC. (Exact name of regis ...

Elizabeth Anderson Elizabeth Anderson Sean Dodge is when some of these resources is bringing new business. So, as this new business comes on, likely resources could transition to new wins and new business to support that revenue. So, there is a lot of dynamics there as far as the specific resources, but generally, we are continuing to watch the metrics, and we are going to make sure that performance is in line. But overall, as you have seen in our incentive fees and the progress that we have made quarter-ov ...

Forward-Looking Statements All forward-looking statements included herein are expressly qualified in their entirety by these cautionary statements as of the date hereof and involve many risks and uncertainties that could cause the Company's actual results to differ materially from those expressed or implied in the Company's forward-looking statements. Subsequent events and developments, including actual results or changes in the Company's assumptions, may cause the Company's views to change. The Company ass ...

Selling, general and administrative $62.6 $30.9 $47.0 $ in millions Reconciliation of GAAP Net Income (Loss) to Non-GAAP Adjusted EBITDA Three Months Ended June 30, Three Months Ended March 31, Note1: For details, see Note 8, Other Expenses, to the consolidated financial statements included in the Company's quarterly report on Form 10-Q Technology and Automation August 2, 2023 This presentation includes information that may constitute "forward-looking statements" made pursuant to the safe harbor provisions ...