Financial Data and Key Metrics Changes - In Q4 2024, the company reported revenue of $87.4 million, an increase of 2% year-over-year, and adjusted EBITDA of $17.2 million, which was an increase of 44% compared to the previous year [8][49]. - For the full year 2024, total revenue was $339 million, with adjusted EBITDA of $53 million, exceeding the high end of guidance [10][58]. - Cash flow from operations improved to $32 million from just over $1 million in the previous year, with Q4 cash flow from operations at $10.3 million, a $23 million improvement year-over-year [10][38]. Business Line Data and Key Metrics Changes - Financial Health revenue for Q4 was $54.7 million, up 7.3% year-over-year, representing approximately 63% of total revenue [49]. - Patient Care revenue decreased by 6.3% year-over-year to $32.7 million, primarily due to the impact of revenues from ESG and Centriq in Q4 2023 [50]. - Total bookings for the year were $82 million, reflecting a 2.3% increase compared to the prior year, with Financial Health bookings flat and Patient Care bookings up 6% [54][56]. Market Data and Key Metrics Changes - The company noted that the market for hospitals with 100 to 400 beds grew from 5% to over 20% of financial health opportunities in their pipeline from 2023 to 2024 [16]. - The company is focusing on expanding its presence in this market segment, which is expected to drive future growth [16]. Company Strategy and Development Direction - The company plans to continue improving customer satisfaction and retention, as well as increasing profitability and growth in 2025 [18][32]. - A new leadership appointment in the Financial Health business unit aims to enhance customer satisfaction and pipeline expansion [19][20]. - The company is also focusing on optimizing its operations and capital allocation, with a goal of reducing its net leverage ratio to 2.5 times [40]. Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, despite some uncertainty regarding healthcare funding from the government, which could impact deal timing [13][106]. - The company is committed to maintaining momentum from 2024 into 2025, with expectations of mid-single-digit revenue growth and EBITDA margins in the mid-20s [32][60]. Other Important Information - The company has made significant improvements in cash flow management and working capital, with a focus on accounts receivable and collections [38][47]. - The company has also rationalized its capital expenditures, reducing its capitalized software as a percentage of total revenue [43][44]. Q&A Session Summary Question: Can you speak to the visibility on closing the remaining deals expected to close in Q4 2024? - Management indicated that while some deals slipped, they expect to close them in the first half of 2025, citing external factors affecting customer decisions [64][66]. Question: What are the expectations for sales and marketing initiatives in 2025? - The company plans to increase investments in marketing to enhance brand exposure, particularly among hospitals that do not currently use their technology [68][70]. Question: How does the company view the growth among its two segments for 2025? - Financial Health is expected to be the primary growth driver, while Patient Care is anticipated to see low single-digit growth [85][87]. Question: Can you provide insights on the demand environment and secondary metrics like pipeline and win rate? - Management noted that about 40% of bookings in a quarter are opportunities that opened and closed within that quarter, and the win rate is above 50% when excluding no-decision outcomes [89][95]. Question: How does the company plan to handle the 60 key CBO client renewals in the next 24 months? - Management emphasized a focus on customer satisfaction to ensure high retention rates among these clients, with no outsized clients among them [99][102].

Revenue Performance - Revenue for 2024 was $339.2 million, with Q4 revenue at $87.4 million, representing a slight decrease from $339.4 million in 2023[5]. - Financial Health revenue for 2024 was $216.1 million, accounting for 63.7% of total revenue, compared to $193.9 million in 2023[11]. - Total annual bookings reached $82.1 million, up from $80.2 million in 2023[11]. - TruBridge's total revenue from the Financial Health segment for the twelve months ended December 31, 2024, was $34,559,000, up from $24,800,000 in 2023, reflecting a growth of approximately 39%[26]. - Total bookings for the twelve months ended December 31, 2024, were $82,074,000, up from $80,239,000 in 2023, showing a growth of about 2%[21]. Profitability and Loss - Net loss for 2024 was $23.1 million, with a Q4 net loss of $5.7 million, compared to a net loss of $42.5 million in Q4 2023[6]. - TruBridge reported a net loss of $23,084,000 for the twelve months ended December 31, 2024, an improvement from a net loss of $45,789,000 in 2023, indicating a reduction of 49% year-over-year[19]. - For the three months ended December 31, 2024, the company reported a non-GAAP net income of $715,000, compared to $5,129,000 in the same period of 2023, representing a decrease of approximately 86%[30]. - The non-GAAP EPS for the twelve months ended December 31, 2024, was $0.24, down from $1.79 in 2023, indicating a decline of about 87%[30]. Adjusted EBITDA and Margins - Adjusted EBITDA for 2024 was $53.1 million, with Q4 adjusted EBITDA at $17.2 million, an increase from $12.0 million in Q4 2023[6]. - Adjusted EBITDA for the twelve months ended December 31, 2024, was $53,090,000, compared to $47,576,000 in 2023, marking an increase of approximately 11%[28]. - The company’s adjusted EBITDA margin improved to 15.7% in 2024 from 14.0% in 2023[28]. Operational Efficiency - The company transitioned approximately 30% of its Financial Health Complete Business Office client base offshore, improving operational efficiency[5]. - The leverage ratio improved from 4x at the end of 2023 to approximately 3x at the end of 2024 due to significant debt repayment[5]. Assets and Liabilities - Total current assets decreased to $90,274,000 in 2024 from $111,455,000 in 2023, representing a decline of approximately 19%[17]. - Total liabilities decreased to $225,737,000 in 2024 from $247,804,000 in 2023, reflecting a reduction of about 9%[17]. - The company’s total stockholders' equity decreased to $168,695,000 in 2024 from $186,618,000 in 2023, a decline of approximately 10%[17]. - Cash and cash equivalents increased to $12,324,000 at the end of 2024 from $3,848,000 at the end of 2023, representing a significant increase of 221%[19]. Strategic Initiatives - The company divested American Health Tech, marking its first divestiture in history, as part of its strategic initiatives[5]. - The provision for expected credit losses increased to $3,669,000 in 2024 from $1,920,000 in 2023, indicating a rise of 91%[19]. - The company plans to focus on strategic planning and operational performance evaluation using non-GAAP financial measures to better understand ongoing business trends[33]. - Management emphasizes that non-GAAP financial measures are important indicators of operational strength and should be considered alongside GAAP measures for a comprehensive view of financial performance[39]. Revenue Breakdown - Total Patient Care revenues for the twelve months ended December 31, 2024, were $123,098,000, a decrease of 15.4% from $145,506,000 in 2023[32]. - Recurring revenues from Acute Care for the three months ended December 31, 2024, were $28,193,000, slightly down from $28,640,000 in the same period of 2023[32]. - Non-recurring revenues from Acute Care increased to $4,515,000 for the three months ended December 31, 2024, compared to $2,447,000 in 2023, marking an increase of approximately 84.5%[32]. Other Financial Adjustments - The company incurred a pre-tax adjustment of $2,993,000 for severance and other nonrecurring charges in the three months ended December 31, 2024[30]. - The amortization of acquisition-related intangible assets for the twelve months ended December 31, 2024, was $12,505,000, down from $16,426,000 in 2023, reflecting a decrease of about 23.5%[30]. - The weighted average shares outstanding, diluted, increased to 14,330,000 for the three months ended December 31, 2024, compared to 14,205,000 in the same period of 2023[30].

Company Overview - TruBridge (TBRG) shares increased by 6.4% to $27.16 in the last trading session, with a notable trading volume, and have gained 21.1% over the past four weeks [1][2] - The company is a healthcare information technology firm that is expected to report quarterly earnings of $0.58 per share, reflecting a year-over-year increase of 61.1%, while revenues are projected to be $84.53 million, a decrease of 1.6% from the previous year [3] Recent Developments - TruBridge has entered into cooperation agreements with Pinetree Capital Ltd., L6 Holdings Inc., and Ocho Investments LLC, leading to the appointment of Jerry Canada and Dris Upitis to its Board of Directors effective February 11, 2025 [2] - The company has announced several initiatives aimed at enhancing corporate governance and creating stockholder value [2] Earnings Estimates and Market Position - The consensus EPS estimate for TruBridge has remained unchanged over the last 30 days, indicating stability in earnings expectations [4] - The stock currently holds a Zacks Rank of 3 (Hold), suggesting a neutral outlook in the market [4] - TruBridge operates within the Zacks Medical Info Systems industry, which includes other companies like Fulgent Genetics, Inc. (FLGT), that has seen a decline of 9.9% in the past month [4]

Company Overview - TruBridge, Inc. (TBRG) is currently experiencing significant attention from investors due to high implied volatility in the options market, particularly the March 21, 2025 $7.50 Put option [1] - The company is ranked 3 (Hold) by Zacks in the Medical Info Systems industry, which is in the top 14% of the Zacks Industry Rank [3] Analyst Insights - Over the last 60 days, one analyst has raised earnings estimates for the current quarter, increasing the Zacks Consensus Estimate from 52 cents per share to 58 cents [3] - The current sentiment among analysts indicates a potential for a significant price movement in TruBridge shares, as reflected by the high implied volatility [4] Options Market Dynamics - High implied volatility suggests that options traders are anticipating a major price movement for TruBridge, which could be due to an upcoming event that may trigger a rally or sell-off [2][4] - Seasoned options traders often seek to sell premium on options with high implied volatility, aiming to benefit from the decay of the option's value if the stock does not move as much as expected [4]

Financial Performance - Total revenues for the first nine months of 2024 were $251.8 million, a decrease of 1% from $253.6 million in the same period of 2023[170]. - Net loss for the first nine months of 2024 increased to $17.4 million from $3.3 million in the prior-year period[170]. - Net loss for the third quarter of 2024 was $9.8 million, or $(0.66) per share, compared to a net loss of $3.6 million, or $(0.24) per share, for the third quarter of 2023[191]. - Net loss for the first nine months of 2024 increased by $14.1 million to $17.4 million, or $(1.17) per share, compared to a net loss of $3.3 million, or $(0.23) per share, for the same period in 2023[208]. - Patient Care adjusted EBITDA decreased by $5.3 million, or 31%, compared to the first nine months of 2023, primarily due to declining revenues[217]. Revenue Segments - Financial Health revenues comprised 57% of the company's consolidated revenue for 2023[149]. - Financial Health revenues increased by $18.4 million, or 13%, compared to the first nine months of 2023, primarily due to the acquisition of Viewgol[192]. - Recurring Financial Health revenues were $53.1 million, or 98% of total Financial Health revenues[174]. - Total Patient Care revenues decreased by $6.6 million, or 18%, compared to the third quarter of 2023[178]. - Total Patient Care revenue for the first nine months of 2024 was $90.4 million, down from $110.6 million in the same period of 2023, representing a decrease of $20.2 million, or 18%[212]. - Recurring Patient Care revenues decreased by $18.3 million, or 18%, compared to the first nine months of 2023, primarily due to the sale of AHT in January 2024[196]. - Non-recurring Patient Care revenues decreased by $1.9 million, or 17%, compared to the first nine months of 2023, also driven by the sale of AHT[197]. Cost Management - Total costs of revenue (exclusive of amortization and depreciation) decreased to 51% of revenues during the third quarter of 2024, down from 53% in the third quarter of 2023[180]. - Total costs of revenue decreased by $4.7 million compared to the first nine months of 2023, with costs of revenue as a percentage of total revenues decreasing to 51% from 52%[198]. - General and administrative expenses decreased by $1.6 million, or 8%, compared to the third quarter of 2023[186]. - General and administrative expenses increased by $3.2 million, or 6%, compared to the first nine months of 2023, mainly due to increased stock compensation and expenses from the acquisition of Viewgol[203]. - Margin optimization efforts include organizational realignment and expanded use of offshore resources, with expectations of improved cost efficiencies[165][167]. - The company recognizes the impact of wage inflation on its cost structure and is implementing measures to preserve gross margins[168]. - Financial Health segment's cost structure is heavily dependent on human capital, exposing it to wage inflation risks[167]. Strategic Initiatives - The company plans to enhance its recurring revenue base to stabilize revenues and cash flows, focusing on customer retention and subscription demand[157]. - The company aims to grow through acquisitions of businesses, technologies, or products to meet strategic goals[154]. - The shift towards SaaS arrangements is expected to reduce Patient Care revenues in the short term but increase long-term revenue growth[162]. - SaaS license models accounted for 100% of annual new acute Patient Care installations in 2023, up from 12% in 2018[162]. Cash Flow and Financing - As of September 30, 2024, the company had cash and cash equivalents of $8.6 million and remaining borrowing capacity under the revolving credit facility of $39.6 million[219]. - The company drew $41.0 million from its revolving credit facility for the Viewgol acquisition, leaving $40.6 million available as of October 16, 2023[220]. - Net cash provided by operating activities increased by $8.5 million to $21.8 million for the nine months ended September 30, 2024, compared to $13.3 million for the same period in 2023[221]. - Net cash provided by investing activities increased by $24.1 million to $5.8 million during the nine months ended September 30, 2024, primarily due to the sale of AHT, which resulted in a net cash inflow of $21.4 million[222]. - Financing activities resulted in a net cash use of $22.9 million during the nine months ended September 30, 2024, compared to a net cash use of $0.5 million in the same period of 2023[223]. - As of September 30, 2024, the company had $57.3 million in principal amount outstanding under the term loan facility and $120.4 million under the revolving credit facility, with an average interest rate of 8.40%[225]. - A one hundred basis point change in interest rate on borrowings outstanding as of September 30, 2024, would result in a change in interest expense of approximately $1.8 million annually[241]. - The company was in compliance with the covenants contained in the Amended and Restated Credit Agreement as of September 30, 2024[229]. Backlog and Bookings - The company reported a twelve-month backlog of approximately $8 million in non-recurring system purchases and approximately $320 million in recurring payments as of September 30, 2024[232]. - Total bookings for the third quarter of 2024 increased by $5.973 million, or 38%, compared to the third quarter of 2023, driven by both net-new and cross-sell bookings[235]. - Patient Care bookings increased by $6.5 million, or 31%, during the first nine months of 2024, primarily due to add-on and new business sales[238].

Financial Data and Key Metrics Changes - Bookings in Q3 2024 were $21 million, an increase of 40% year-over-year, marking the fourth consecutive quarter with over $20 million in total bookings [31][41] - Revenue for the quarter was $83.8 million, up just over 1% compared to the previous year, with total year-to-date cash flow from operations reaching $21.8 million, an improvement of $8.5 million from the prior year [32][25] - Adjusted EBITDA for the quarter was $13.8 million, a 42% increase year-over-year, with an adjusted EBITDA margin of 16.5%, up from 11.4% in Q1 and 14.8% in Q2 [38][45] Business Line Data and Key Metrics Changes - Financial Health revenue, including Viewgol, was $54.3 million, representing 65% of total revenue and up approximately 17% year-over-year; excluding Viewgol, organic revenue grew 5.3% [33][34] - Patient Care revenue was $29.6 million, down 18% compared to last year, primarily due to the impact from AHT and Centriq [34] Market Data and Key Metrics Changes - The company reported a decrease in accounts receivable balance by 5% sequentially, with Days Sales Outstanding (DSOs) improving by approximately eight days from Q1 [25] - Total gross margins increased to 49.5%, up 250 basis points year-over-year, with Financial Health gross margins at 46.2%, an increase of 450 basis points [35] Company Strategy and Development Direction - The company is focusing on integrating its Viewgol acquisition and expanding its workforce in India to support customer transitions, aiming to double the number of customers supported by its Indian team by the end of 2025 [10][12] - The management is emphasizing the importance of maintaining customer satisfaction during the transition to offshore services while also aiming for significant margin improvements in 2025 [12][54] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the strength of bookings and pipeline, indicating a positive outlook for the remainder of the year and beyond [22] - The company is navigating challenges in the labor market and billing complexities, particularly with the shift towards Medicare Advantage plans, which is expected to drive demand for their services [49][60] Other Important Information - The company announced changes to its Board of Directors, with Denise Warren stepping down and Amy O'Keefe being elected to the Board, bringing valuable financial and operational expertise [18][19] - The company is rationalizing its real estate footprint, having sold property in Mobile, Alabama for $2.8 million gross [29] Q&A Session Summary Question: Insights on net new clients and macro demand backdrop - Management noted traction in the 100 to 400 bed hospital space and ongoing labor pressures impacting billing complexity, which is driving demand [48][49] Question: Savings from offshoring and future expectations - Management indicated that net savings from offshoring are expected to increase in Q4, with more robust numbers anticipated in 2025 [51][52] Question: Competitive environment and product announcements - Management acknowledged competition but emphasized their focus on incremental improvements and customer support, which differentiates them in the market [60][61] Question: Revenue cycle cross-sales and client transitions - Management highlighted the importance of consistent cash collections and the integration of EHR and RCM services as key factors in successful cross-sales [72][75] Question: Impact of claim denials from MCOs - Management confirmed that increases in claim denials are a challenge but also an opportunity to enhance their technology and processes to improve acceptance rates [86][87]

Company Performance - TruBridge reported a quarterly loss of $0.21 per share, significantly below the Zacks Consensus Estimate of $0.52, marking an earnings surprise of -140.38% [1] - The company posted revenues of $83.83 million for the quarter ended September 2024, exceeding the Zacks Consensus Estimate by 1.86% and showing a year-over-year increase from $82.71 million [2] - Over the last four quarters, TruBridge has surpassed consensus revenue estimates four times, but has only exceeded consensus EPS estimates once [2] Stock Movement and Outlook - TruBridge shares have increased by approximately 16.2% since the beginning of the year, while the S&P 500 has gained 24.3% [3] - The future performance of TruBridge's stock will largely depend on management's commentary during the earnings call and the company's earnings outlook [3][4] - The current consensus EPS estimate for the upcoming quarter is $0.52 on revenues of $85.58 million, and for the current fiscal year, it is $0.86 on revenues of $335.87 million [7] Industry Context - The Medical Info Systems industry, to which TruBridge belongs, is currently ranked in the top 22% of over 250 Zacks industries, indicating a favorable outlook compared to the bottom 50% [8] - Empirical research suggests a strong correlation between near-term stock movements and trends in earnings estimate revisions, which can impact TruBridge's stock performance [5][6]

Financial Performance - Total bookings for Q3 2024 reached $21.0 million, up from $15.0 million in Q3 2023, representing a 40% increase[1] - Total revenue for Q3 2024 was $83.8 million, slightly up from $82.7 million in Q3 2023, indicating a 1.3% growth[1] - Financial Health revenue accounted for $54.3 million, a 16.0% increase from $46.6 million in Q3 2023, representing 64.7% of total revenue[1] - Adjusted EBITDA for Q3 2024 was $13.8 million, compared to $9.7 million in Q3 2023, reflecting a 42.3% increase[1] - TruBridge, Inc. reported a net loss of $17,374,000 for the nine months ended September 30, 2024, compared to a net loss of $3,315,000 for the same period in 2023[12] - For the three months ended September 30, 2024, TruBridge, Inc. reported a net loss of $9,809,000, compared to a net loss of $3,562,000 for the same period in 2023[16] - Non-GAAP net income for the three months ended September 30, 2024, was $(2,963,000), compared to $6,348,000 for the same period in 2023[17] - The company reported a net income margin of (11.7%) for the three months ended September 30, 2024, compared to (4.3%) in the same period of 2023[16] Revenue Projections - For Q4 2024, TruBridge expects total revenue between $83.5 million and $85.5 million[5] - For the full year 2024, total revenue is projected to be between $335 million and $337 million, narrowed from previous guidance of $330 million to $340 million[5] Operational Changes - The company is focused on optimizing operations and realizing margin improvements over time following the Viewgol integration[2] - Executive leadership changes include the retirement of COO David Dye, effective December 31, 2024, with general managers now reporting directly to the CEO[4] Asset and Liability Management - Total current assets decreased to $91,621,000 as of December 31, 2023, down from $111,455,000 at the end of 2022, reflecting a decline of approximately 17.8%[11] - Total liabilities decreased to $228,886,000 as of December 31, 2023, compared to $247,804,000 at the end of 2022, representing a reduction of about 7.6%[11] - The company’s long-term debt decreased to $173,343,000 as of December 31, 2023, down from $195,270,000 at the end of 2022, a decline of about 11.2%[11] - The company’s total stockholders' equity decreased to $172,647,000 as of December 31, 2023, down from $186,618,000 at the end of 2022, a decline of about 7.5%[11] Cash Flow and Operating Activities - Cash and cash equivalents increased to $8,586,000 at the end of the period, up from $1,473,000 at the end of September 30, 2023[12] - TruBridge, Inc. experienced a net cash provided by operating activities of $21,839,000 for the nine months ended September 30, 2024, compared to $13,319,000 for the same period in 2023, reflecting an increase of approximately 64.4%[12] Patient Care and Bookings - The company reported a significant increase in patient care bookings, reaching $8,454,000 for the three months ended September 30, 2024, compared to $5,897,000 for the same period in 2023, a growth of approximately 43.5%[13] - Total recurring revenues from Patient Care for the three months ended September 30, 2024, were $26,584,000, down from $32,662,000 in the same period of 2023[18] - Total Patient Care revenues for the nine months ended September 30, 2024, were $90,389,000, down from $110,594,000 in the same period of 2023[18] Non-GAAP Financial Measures - Management emphasizes the importance of non-GAAP financial measures as indicators of operational strength and performance[23] - Adjusted EBITDA, Non-GAAP net income, and Non-GAAP EPS are used to measure performance objectives under the Company's incentive programs[23] - Non-GAAP financial measures do not provide a measure of cash flow or liquidity, and are not alternatives to GAAP measures[23] - Limitations of non-GAAP measures include not reflecting all amounts associated with results of operations as per GAAP[23] - There is uncertainty regarding future expenses similar to those excluded in non-GAAP calculations[23] - Investors are encouraged to review the "Unaudited Reconciliation of Non-GAAP Financial Measures" for clarity[23]

Revenue Performance - Revenue cycle management (RCM) revenues comprised 57% of the company's consolidated revenue for 2023[130]. - Total revenues for the first six months of 2024 were $168.0 million, a decrease of 2% from $170.9 million in the same period of 2023[147]. - RCM revenues increased by $10.8 million, or 11%, in the first six months of 2024, primarily due to the acquisition of Viewgol, which contributed $9.9 million[166]. - Total EHR revenue for the first six months of 2024 was $60.831 million, down from $74.464 million in the same period of 2023, representing a decrease of $13.633 million, or 18%[183]. - RCM segment revenues increased by $10.755 million, or 11%, to $107.146 million for the first six months of 2024 compared to $96.391 million in 2023[183]. Customer Retention and Growth - The company achieved a retention rate of 92.1% for its Acute Care EHR customers in 2023, with rates consistently in the mid-to-high 90th percentile since 2019[136]. - The shift towards Software as a Service (SaaS) license models increased from 12% of annual new acute care EHR installations in 2018 to 100% in 2023[141]. - The company plans to enhance its recurring revenue base to stabilize revenues and cash flows, focusing on customer retention and subscription demand[137]. - RCM revenues are expected to grow as the company cross-sells services to its existing EHR customer base and expands market share[135]. Financial Performance and Costs - Net loss for the first six months of 2024 was $7.6 million, a decrease of $7.8 million from the prior-year period[147]. - General and administrative expenses decreased by $0.2 million, or 1%, compared to the second quarter of 2023, driven by reductions in non-recurring severance costs[160]. - Total costs of revenue (exclusive of amortization and depreciation) decreased to 51% of revenues during the second quarter of 2024, down from 52% in the same quarter of 2023[155]. - General and administrative expenses increased by $4.8 million, or 14%, compared to the first six months of 2023, driven by stock compensation and the acquisition of Viewgol[175]. - Net loss for the second quarter of 2024 was $5.0 million, compared to a net loss of $2.8 million in the second quarter of 2023[165]. Strategic Initiatives - The transition to a subscription-based recurring revenue model is a key component of the company's long-term growth strategy[127]. - Margin optimization efforts include organizational realignment and expanded use of offshore resources, with expectations of improved cost efficiencies[144]. - The company anticipates additional pressure on margins due to the integration of Viewgol, acquired in October 2023[145]. Market and Regulatory Environment - The healthcare IT sector is projected to continue receiving investment due to its potential to improve efficiency and meet regulatory requirements[139]. - The company faces risks related to significant legislative and regulatory uncertainty in the healthcare industry, which may impact operations[126]. Cash Flow and Debt Management - Net cash provided by operating activities increased by $1.5 million, from $10.2 million for the six months ended June 30, 2023, to $11.7 million for the six months ended June 30, 2024, primarily due to improved working capital management[190]. - As of June 30, 2024, the company had $181.5 million in principal amount of indebtedness outstanding under credit facilities[188]. - The company had cash and cash equivalents of $7.7 million as of June 30, 2024, compared to $3.8 million as of December 31, 2023[188]. - The company made a draw of $41.0 million on the revolving credit facility in connection with the Viewgol acquisition on October 16, 2023[189]. - As of June 30, 2024, the company had $58.1 million in principal amount outstanding under the term loan facility and $123.4 million under the revolving credit facility, with an average interest rate of 8.42%[195]. Bookings and Backlog - RCM bookings increased by $2.1 million, or 8%, in the first six months of 2024 compared to the same period in 2023, driven by strong performance from Viewgol[203]. - EHR bookings increased by $2.5 million, or 34%, during the second quarter of 2024 compared to the second quarter of 2023, with Acute Care EHR bookings increasing by $3.1 million[204]. - As of June 30, 2024, the company had a twelve-month backlog of approximately $10 million in non-recurring system purchases and approximately $318 million in recurring payments under support and maintenance and RCM services[201].

Financial Data and Key Metrics Changes - Total bookings for Q2 2024 reached $23.3 million, marking an 11% increase year-over-year and the third consecutive quarter exceeding $20 million [4][14] - Cash flow from operations was positive at $13.8 million for the quarter, compared to $0.7 million in the same quarter last year [11][17] - Revenue for the quarter was $84.7 million, essentially flat compared to the previous year, impacted by the divestiture of AHT and the sunsetting of Centric [14][15] - Adjusted EBITDA was $12.6 million, a 12% increase year-over-year and a 33% increase sequentially, with an adjusted EBITDA margin of 14.8% [16] Business Line Data and Key Metrics Changes - Revenue Cycle Management (RCM) generated $54.1 million, accounting for approximately 64% of total revenue, with gross margins improving to 44.1% [15] - Electronic Health Records (EHR) bookings were $9.8 million, with over two-thirds coming from existing customers, indicating strong customer satisfaction [14] - The integrated nTrust solution saw a 60% increase in new clients in the first half of 2024 compared to the same period in 2023 [5] Market Data and Key Metrics Changes - The company reported that over 90% of projected 2024 revenue is under contract, indicating strong future revenue visibility [7] - The offshoring initiative has progressed, with 43% of CBO and EVO operations now offshore, up from 25% at the end of Q1 [8] Company Strategy and Development Direction - The company is focused on enhancing its financial quality controls and forecasting processes, aiming for long-term margin expansion despite short-term challenges [10][13] - Continued emphasis on client retention and proactive customer management is a priority, especially during the transition to offshore operations [9] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the continued momentum in bookings and the potential for revenue growth in the second half of the year [4][7] - The competitive landscape is evolving, with increasing acceptance of outsourcing models among hospitals, which is expected to drive demand for the company's services [38] Other Important Information - The company is on track to achieve $5 million in cost savings for the year, with most initiatives already initiated [11] - The company reiterated its full-year revenue guidance of $330 million to $340 million and adjusted EBITDA guidance of $45 million to $50 million [18] Q&A Session Summary Question: Can you talk about margin progression? - Management indicated that while margins are expected to improve, they may be muted in the near term due to the transition to offshore staffing [20][21] Question: How is the financial health of your customer base? - Management noted that the customer base is mixed but has benefited from past COVID relief, allowing for cash accumulation [25] Question: Is there momentum biased towards one segment in the second half? - Management sees growth opportunities in both RCM and EHR segments, with a larger market opportunity in RCM [28][30] Question: How is the legacy base holding up? - Retention rates outside of the Centric customer base are strong, with ongoing investments to keep customers satisfied [45] Question: Are you seeing utilization strength flow through to RCM? - Management observed that hospitals expanding services are seeing increased utilization, which is beneficial for RCM [47]