Core Insights - LBMC Physician Business Solutions (PBS) is expanding into the Memphis market through a partnership with Physician Data Services (PDS) [1][5] - Shade Robinson, founder of PDS, joins PBS as Partner and Memphis Market Leader, bringing extensive experience in revenue cycle management [1][2][3] Company Overview - PDS, founded in 1991, has established a strong reputation in revenue cycle management and credentialing for healthcare providers in the Mid-South [2] - Robinson has led PDS for nearly 35 years, known for operational excellence and strong client relationships [2] Strategic Implications - The partnership enhances LBMC's regional footprint and service capabilities in the Southeast, particularly in Memphis [3][5] - Robinson's role will focus on Memphis market strategy and business development, leveraging her expertise in billing, auditing, and compliance [3][4] Organizational Benefits - Joining LBMC allows PDS to access expanded resources, technologies, and talent, enhancing value for clients [4] - The transaction reinforces LBMC's commitment to supporting healthcare providers with expertise in operational efficiency and compliance [5] LBMC Overview - LBMC is the largest Tennessee-based professional services firm, serving over 11,000 clients across various industries [6] - The firm utilizes advanced business intelligence and AI technologies to drive growth and efficiency for its clients [6]

Financial Data and Key Metrics Changes - Revenue for Q2 2025 reached $271 million, representing a 15% year-over-year growth with an adjusted EBITDA margin of 42% [10][24] - Adjusted EBITDA for Q2 2025 was $113 million, an increase of 20% year-over-year, driven by revenue growth and a shift to higher margin provider solutions [26][30] - The company raised its full-year revenue guidance to a range of $1.03 billion to $1.042 billion, reflecting a 10% year-over-year growth [29] Business Line Data and Key Metrics Changes - Subscription revenue increased to $131 million, up 17% year-over-year, while volume-based revenue reached $138 million, a 14% increase year-over-year [25] - The number of clients generating more than $100,000 in trailing twelve-month revenue increased to 1,268, a 14% year-over-year growth [15] Market Data and Key Metrics Changes - The company noted a strong demand for its AI-powered software platform as providers face margin pressures and workforce shortages [10][12] - Waystar's net revenue retention rate was 115%, benefiting from rapid onboarding of clients affected by a competitor's cyber event [24] Company Strategy and Development Direction - The acquisition of Iodine Software is expected to expand Waystar's total addressable market by over 15% and enhance its product roadmap [6][7] - Waystar aims to lead in the revenue cycle management space by leveraging AI to improve efficiency and reduce administrative burdens for healthcare providers [20][22] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's resilience against potential Medicaid funding cuts, estimating less than a 1% impact on revenue from a hypothetical 15% reduction in Medicaid funding [12][85] - The demand environment remains robust, with providers prioritizing technology that enhances efficiency and cash flow [51][52] Other Important Information - Waystar was recognized as the best overall healthcare payments solution provider by MedTech Breakthrough and named one of the U.S. News Best Companies to Work For [22][23] - The company has established a strong governance structure with the addition of two new independent board members [23] Q&A Session Summary Question: Impact of client migration post-cyber attack on Q2 revenue - Management indicated that the year-over-year benefit from client migration had normalized by Q2, with no significant impact noted [34][36] Question: Recurring nature of volume-based revenue from large clients - Management expects that volume-based revenue from newly onboarded large clients will transition to subscription revenue as contracts mature [45][46] Question: Drivers behind the sequential increase in subscription revenue - The increase in subscription revenue was attributed to strong performance in provider solutions, which comprise a significant portion of total revenue [50][55] Question: Volume growth and digital payment penetration - Management noted that higher utilization in the healthcare system and the adoption of digital payment solutions contributed to volume growth, with a good mix from both patient payment and provider solutions [58][61] Question: Competitive landscape and client demand - Management reported strong win rates against competitors and noted an increase in client demand for AI-driven solutions [106]

Healthcare Industry Challenges - 40% of hospitals operate at a negative margin due to broken revenue cycle processes [1] - Healthcare administration has increased 30-fold in the past three decades, while clinicians have barely doubled, indicating growing complexity [11][12] - 20% of the GDP is attributed to the healthcare system, with a large proportion being the administration of healthcare [9] Revenue Cycle Management (RCM) & AI Opportunity - Revenue cycle management (RCM) refers to the financial process of the patient's journey within the healthcare system [3] - AI has a big opportunity to shift resources from bureaucracy towards clinical care by addressing inefficiencies in RCM [16] - Ensemble Health Partners estimates a large amount of the cost associated with healthcare is related to friction in communication between payers, providers, and patients [14] Ensemble Health Partners' Approach - Ensemble Health Partners is an end-to-end RCM organization with 14,000 employees, providing a unique lens into inefficiencies throughout the entire process [2][3] - Ensemble Health Partners uses its EIQ platform to bring together multiple data formats within a single platform to address the challenges of unstructured data scattered across systems [33][34] - Ensemble Health Partners has seen a 40% reduction in time in the clinical appeal process by using GenAI [30] - Ensemble Health Partners aims to build a smarter, more coordinated system to reduce waste in the overall revenue cycle process [37]

Core Viewpoint - MDaudit is set to acquire Streamline Health Solutions in a cash transaction valued at approximately $37.4 million, which includes debt, aiming to enhance financial performance and billing compliance in healthcare organizations [2][3]. Company Overview - MDaudit is a cloud-based platform focused on continuous risk monitoring, helping healthcare organizations minimize billing risks and maximize revenues [2][12]. - Streamline Health Solutions provides solutions that enable healthcare providers to improve financial performance and address revenue leakage [13]. Merger Details - The acquisition will involve MDaudit purchasing all outstanding shares of Streamline stock for $5.34 per share, representing a premium of 138% over Streamline's closing price on May 28, 2025 [3][7]. - The merger is expected to close in the third quarter of 2025, after which Streamline will become a wholly-owned subsidiary of MDaudit and its stock will no longer be listed on the Nasdaq [8]. Strategic Rationale - The merger aims to combine Streamline's pre-bill integrity solutions with MDaudit's billing compliance and revenue integrity platform, enhancing the ability to unify data silos and improve revenue cycle management [4][5]. - Both companies share a vision of improving financial stability for healthcare organizations, which is increasingly important given the financial pressures faced by health systems [5][6]. Financial Implications - The combined entity will support healthcare organizations with an aggregate Net Patient Revenue exceeding $300 billion, providing enhanced visibility and actionable insights across the revenue cycle [1][4].

Financial Data and Key Metrics Changes - The company completed its 2022 restatement and is on track to become current with its filing obligations [6][8] - For 2023, estimated GAAP revenue is projected to be between $620 million and $625 million, with recurring revenue making up approximately 80% of total revenue [23][24] - Adjusted EBITDA for 2023 is estimated to be between $139 million and $144 million, which is higher than previously estimated [24] - For 2024, GAAP revenue is estimated to be between $583 million and $588 million, with a recurring revenue percentage consistent with prior years [27] - Adjusted EBITDA for 2024 is estimated to be between $85 million and $90 million, below previous guidance [29][30] Business Line Data and Key Metrics Changes - Provider business revenue dipped by 1% year-over-year, while payer and life sciences revenue declined by 10% [27][28] - The company signed significant contracts in its provider business, including a multimillion-dollar deal with a large urology practice and a major wound care organization [13][14] - The payer business saw the onboarding of nearly 400 new sites in 2025, with care gap alerts provided to over 3,500 healthcare practices [14] Market Data and Key Metrics Changes - The company experienced unexpected revenue shortfalls in the payer and life sciences segments, particularly in Q4 of 2024 [26][68] - The life sciences segment saw softness in media revenue and real-world data sales, while the payer segment faced implementation delays [68] Company Strategy and Development Direction - The company aims to remediate material weaknesses and enhance internal controls while executing its growth strategy [15][36] - The focus is on expanding the core provider base and enhancing the value of offerings, including AI-enabled workflows [15][16] - The company is pursuing additional debt financing to ensure liquidity and support future growth [80] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the business model despite revenue shortfalls and emphasized the importance of operational improvements [12][36] - The outlook for 2025 anticipates flat revenue compared to 2024, with expectations of growth from new customers offset by customer attrition [32][58] - Management noted that the remediation efforts and regaining current filing status are expected to occur in 2026 [33][41] Other Important Information - The company incurred significant external audit and legal fees in 2023 and 2024, impacting cash flow [9][30] - The acquisition of Science.io and Koa Health is expected to impact EBITDA margins due to new costs associated with these businesses [101][102] Q&A Session Summary Question: Clarification on remediation efforts and filing status - Management clarified that remediation efforts can continue while regaining currency on filings, with both expected to occur in 2026 [38][40] Question: Net attrition in provider business - Higher net attrition was noted in the core provider business, particularly in revenue cycle management, but not driven by market consolidation [44][46] Question: Revenue visibility for FY 2025 - Management indicated that while revenue is expected to be flat, there are uncertainties due to customer attrition and the need for a rebound from the previous year's shortfall [60][63] Question: Trends in life sciences and pharma segment - Management noted softness in media revenue but observed a pickup in spending in Q1 2025, indicating potential recovery in the life sciences segment [89] Question: Impact of acquisitions on financials - The acquisition of Science.io is not expected to contribute revenue in 2024, but it is seen as a strategic investment in AI capabilities [97][100]

Core Insights - Nextech is showcasing enhancements to its revenue cycle management (RCM) platform at the AAD Annual Meeting, emphasizing its role in reducing denied claims and increasing reimbursement for specialty providers [1][4]. Group 1: Company Overview - Nextech is a leader in healthcare technology and practice management solutions, focusing on specialty providers since 1997 [5]. - The company serves over 16,000 physicians and more than 60,000 office staff across various clinical specialties, including dermatology, med spa, ophthalmology, orthopedics, and plastic surgery [5]. Group 2: RCM Solutions - Nextech's RCM services are designed to address the complexities of managing a practice's revenue cycle, particularly in light of rising claim denials and evolving payer requirements [2]. - The RCM platform is fully integrated within Nextech's specialty-specific system and offers customizable services tailored to individual practice needs, such as collections for unpaid patient responsibilities and patient payment plans [3]. Group 3: Industry Challenges - The increase in insurance claim denials has led to significant challenges for providers, impacting cash flow and creating operational inefficiencies [2]. - Nextech RCM aims to alleviate these challenges by streamlining billing workflows and reducing administrative burdens, allowing providers to focus on patient care [2].

Financial Data and Key Metrics Changes - The company reported adjusted EBITDA of $69 million for Q4 2024, significantly exceeding previous guidance [10] - Consolidated revenue growth was just over 1%, with same unit growth of 8.7%, primarily offset by the impact of portfolio restructuring [18] - Operating cash flow for Q4 was $135 million, compared to $73 million in the prior year, with a reduction in net debt from $515 million to $386 million [21][23] Business Line Data and Key Metrics Changes - The company completed a portfolio restructuring, exiting practices that represented $200 million in annual revenue, which was a drag on earnings [10] - The decline in practice-level expenses reflected the restructuring, with same unit salary expense growth remaining above the historical range of 2% to 3% [20][31] Market Data and Key Metrics Changes - The payer mix was a significant positive factor in 2024, contributing to strong operating results, although it is not expected to change significantly in 2025 [30][61] - The company anticipates flat volume in its 2025 outlook, despite some acceleration in the latter half of 2024 [37][38] Company Strategy and Development Direction - The company aims to prioritize patient-centric care, strengthen hospital relationships, and manage its improved financial position effectively [13][14] - A preliminary expectation for adjusted EBITDA in 2025 is set between $215 million and $235 million, reflecting a cautious outlook due to uncertainties in the healthcare provider space [14][17] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the company's prospects despite acknowledging headwinds in the healthcare sector [17] - The focus for 2025 includes maintaining stability in the revenue cycle management (RCM) process and seeking improvements through automation [29] Other Important Information - The company ended 2024 with cash of $230 million and plans to build cash again in 2025 [23][24] - The impact of the portfolio restructuring is expected to provide an annualized EBITDA benefit of approximately $30 million, with a third realized in 2024 [27][81] Q&A Session Summary Question: Can you provide more details on the 2025 outlook? - Management indicated that they are baking in flat volume growth and stable pricing expectations for 2025, with a focus on maintaining performance under the hybrid RCM model [36][40] Question: Are there opportunities for improved economics in NICU management? - Management confirmed ongoing discussions with hospital partners but did not incorporate any increases into their forecast [44] Question: How much of the strong pricing in Q4 came from improvements in contract admin fees? - Approximately one-third of the pricing component was attributed to hospital admin fees [75] Question: What is the expected EBITDA tailwind from exiting primary and urgent care clinics? - The exit is part of a broader restructuring, with about a third of the expected $30 million EBITDA benefit realized in 2024 and the remainder anticipated in 2025 [81] Question: What are the company's plans for capital allocation and returning cash to shareholders? - The company is focused on maintaining a strong balance sheet and will evaluate the best uses of cash, including potential debt repayment or shareholder returns [88][90]