Financial Data and Key Metrics Changes - Total revenue for Q3 2025 was $76.3 million, flat year-over-year, exceeding guidance [7][15] - Adjusted EBITDA for Q3 2025 was $12 million, up 64% compared to Q3 2024, exceeding guidance of approximately $10.5 million [17] - Adjusted gross margin increased to 53%, up approximately 510 basis points year-over-year [16] Business Line Data and Key Metrics Changes - Technology segment revenue was $52.1 million, representing a 7% year-over-year growth driven by recurring revenue from new and acquired clients [7][15] - Professional services revenue for Q3 2025 was $24.3 million, a 12% decline compared to Q3 2024, primarily due to exiting less profitable contracts [15][16] - Adjusted technology gross margin was 68%, an increase of approximately 330 basis points year-over-year [16] Market Data and Key Metrics Changes - The company anticipates approximately 30 net new platform client additions for 2025, with dollar-based retention expected to be in the low 90% [8][14] - The market remains dynamic, with ongoing financial and workforce pressures impacting client operations [10][14] Company Strategy and Development Direction - The company is focused on solutions with proven ROI, aiming to maintain a strong pipeline while managing costs and making targeted investments [8][14] - Recent leadership appointments aim to support long-term vision and improve performance, reflecting a commitment to building an agile organization [10] - The company plans to balance growth, revenue mix, and free cash flow progression while prioritizing existing capabilities and recently acquired assets [15][21] Management's Comments on Operating Environment and Future Outlook - Management expects revenue performance in 2026 to be a few points lower than in 2025, driven by dollar-based retention pressures and lower net new client counts [14] - The company is optimistic about improving adjusted EBITDA in 2026, reflecting ongoing strategic focus and cost management [14][21] - Management emphasizes the importance of meeting clients where they are, providing flexibility in migration timelines to enhance client experience and retention [12][28] Other Important Information - The company is committed to realizing a strong return on acquisition investments and does not anticipate pursuing additional acquisitions in the near to medium term [15] - The company is making progress on Ignite migration initiatives, with approximately two-thirds of DOS clients expected to migrate by the end of 2025 [11][12] Q&A Session Summary Question: What is driving the longer timeline for Ignite migration? - Management noted that clients desire to stay on DOS longer due to its current value, and flexibility is being provided to meet client needs [26][27] Question: How does the sequential decline in tech revenue relate to dollar-based retention? - Management explained that the decline is influenced by DOS to Ignite headwinds and growth in the apps layer, with a mix of factors affecting revenue [32][33] Question: What is the value of one-time revenues and the outlook for positive revenue growth? - Management indicated that one-time revenues are becoming more common in professional services, and the pipeline remains robust, with expectations for growth in mid-2026 [37][38] Question: How are competing priorities affecting client decisions? - Management acknowledged that clients are focused on data quality and may prefer to leverage existing capabilities before migrating to Ignite [52][53] Question: What are the growth rates for Ignite versus DOS customers? - Management highlighted a shift in approach to provide flexibility for clients on DOS, allowing for growth opportunities in the apps layer [64][66]

Financial Data and Key Metrics Changes - The company reported Q2 2025 revenue of $80.7 million, representing a 6% year-over-year increase and exceeding guidance [31] - Adjusted EBITDA for Q2 2025 was $9.3 million, the highest in the company's history, and also above guidance [34] - The company revised its full-year 2025 revenue guidance to $310 million due to significant impacts from Medicaid and research funding cuts [6][7] - Adjusted gross margin for Q2 2025 was 50%, a decrease of approximately 30 basis points year-over-year [32] Business Line Data and Key Metrics Changes - Technology segment revenue for Q2 2025 was $52.9 million, reflecting an 11% year-over-year growth driven by recurring revenue from new and acquired clients [32] - Professional services revenue for Q2 2025 was $27.8 million, a 1% decline compared to Q2 2024 [32] - Adjusted technology gross margin was 66%, down approximately 140 basis points year-over-year, while adjusted professional services gross margin was 18%, down approximately 190 basis points year-over-year [32][34] Market Data and Key Metrics Changes - The company anticipates that the impacts of Medicaid and research funding cuts will be a headwind not only in 2025 but likely over the next few years [13] - The company has seen delays in signing new platform client contracts due to macroeconomic uncertainty and funding cuts [9][12] Company Strategy and Development Direction - The company is focused on improving profitability and has removed its previously shared 2028 revenue target of $500 million, emphasizing near-term profitability improvements [14] - The strategic focus is on expanding applications revenue, which has been growing at over 20% year-over-year, and leveraging the Ignite platform for cross-selling opportunities [16][17] - The company plans to complete the migration of platform clients to Ignite by mid-2026, which is expected to alleviate some revenue headwinds [27] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term strategy despite current macroeconomic challenges, including inflation and funding cuts [6][14] - The company expects to maintain adjusted EBITDA guidance of $41 million for 2025, despite the revenue reduction [21] - Management acknowledged the need for clients to adjust to new funding realities, which may take time [52] Other Important Information - The company announced a restructuring plan that will impact approximately 9% of its workforce, aimed at improving profitability by over $40 million annually [20] - A new director, Justin Spencer, will join the board effective September 1, bringing relevant experience from the healthcare technology sector [29] - The CEO announced plans to retire effective June 30, 2026, after 15 years in the role [30] Q&A Session Summary Question: How is the Life Science business performing and what level of investment is needed for growth? - Management noted delays in late-stage opportunities in the CareVive business due to research funding cuts but remains confident in the differentiated offering [41][42] Question: Can you explain the market reaction to the recent Medicaid cuts? - Management highlighted a conservative approach among not-for-profit clients, which has led to delays in project initiation as they adjust to funding cuts [50][51] Question: What is the expected EBITDA for 2026? - Management indicated a run rate of approximately $60 million of adjusted EBITDA going into 2026, with potential for additional operating leverage [52][54] Question: What is the contribution of app layer client wins versus external client wins for new platform clients? - Approximately two-thirds of new platform clients have come from existing clients, reflecting strong cross-sell momentum [58][59] Question: How should investors think about growth rates for 2026 and beyond? - Management suggested that growth may be in the low single digits for 2026 due to ongoing macro headwinds, but expects a return to growth as the Ignite migration is completed [66][71]

Financial Data and Key Metrics Changes - Total revenue for Q1 2025 was $79.4 million, representing a 6% year-over-year increase [26] - Adjusted EBITDA for Q1 2025 was $6.3 million, exceeding guidance [26] - Technology revenue for Q1 2025 was $51.5 million, reflecting a 10% year-over-year growth [27] - Professional services revenue for Q1 2025 was $27.9 million, a 1% increase compared to Q1 2024 [27] - Total adjusted gross margin was 49%, a decrease of approximately 210 basis points year-over-year [27] - Adjusted technology gross margin was 67%, a decrease of approximately 120 basis points year-over-year [27] - Adjusted professional services gross margin was 16%, a decrease of approximately 630 basis points year-over-year [27] Business Line Data and Key Metrics Changes - The technology segment showed strong performance with a 10% revenue growth year-over-year [27] - Professional services revenue growth was modest at 1% year-over-year [27] - The shift to the Ignite platform is expected to enhance profitability, with Ignite clients showing an 80/20 revenue mix favoring technology over services [52] Market Data and Key Metrics Changes - The company added 10 net new platform clients in Q1 2025, with two-thirds coming from existing app clients [6] - The average total ARR and non-recurring revenue per net new platform client was around the midpoint of $300,000 to $700,000 [6][23] - The company anticipates achieving approximately 40 net new platform clients for the full year 2025 [23] Company Strategy and Development Direction - The strategic shift to the Ignite platform is aimed at providing a more flexible, modular, and cost-effective solution compared to the legacy DOS model [8] - Ignite's lower entry price point is expected to accelerate sales cycles and enhance cross-selling opportunities [8] - The company is focusing on organic growth and capital allocation, with a recent $5 million share repurchase [24] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the resilience of Ignite in the face of macroeconomic challenges, including potential funding cuts [20] - The company expects to complete the majority of Ignite migrations by mid-2026, with two-thirds expected by the end of 2025 [11] - Management noted that the operating margins remain strong and stable, despite some uncertainties in the market [19] Other Important Information - The company ended Q1 2025 with $342 million in cash and short-term investments [30] - The face value of the term loan is $162 million, and the convertible notes were paid off in full on April 14, 2025 [30] - The company expects total revenue of approximately $80.5 million and adjusted EBITDA of approximately $8 million for Q2 2025 [31] Q&A Session Summary Question: Can you provide more color on the decision-making process with the modular strategy versus DOS? - The modularity and lower price point of Ignite allow for quicker decision-making and shorter sales cycles, making it easier to provide tangible value to clients [38][39] Question: Should we expect a different cadence in customer additions? - There may be a smoothing of customer additions throughout the year due to the flexibility of the offering, rather than being strictly aligned with budget seasons [44] Question: What is driving the higher weighting of tech versus services in Ignite? - The lower price point and specific use cases associated with Ignite lead to a higher technology-driven solution, requiring less service delivery compared to DOS [49][52] Question: How is the average starting ARR accounted for? - The $300,000 to $700,000 average applies to new net platform clients, with existing clients migrating to Ignite potentially reflecting a headwind in dollar-based retention metrics [57][59] Question: What is the expected timing for tech margins to improve? - An uplift in tech adjusted gross profit margins is expected in the second half of the year as the migration process progresses [80][81]

Financial Data and Key Metrics Changes - Total revenue for full year 2024 was $307 million, representing a 4% year-over-year growth, while adjusted EBITDA was $26 million, reflecting a 137% increase year-over-year [17][56] - For Q4 2024, total revenue was $80 million, a 6% increase year-over-year, and adjusted EBITDA was $8 million, above the midpoint of guidance [56][61] - Technology revenue for full year 2024 was $195 million, with Q4 2024 revenue at $52 million, marking a 10% growth year-over-year for the quarter [17][56] Business Line Data and Key Metrics Changes - Technology segment revenue for full year 2024 grew by 4% year-over-year, while professional services revenue was $112 million, representing a 3% increase year-over-year [56][58] - Adjusted gross margin for the Technology segment in Q4 2024 was 65%, a decrease of approximately 200 basis points year-over-year, primarily due to initial deployment costs [58][59] - Professional services segment adjusted gross margin for Q4 2024 was 13%, an increase of approximately 170 basis points year-over-year [59] Market Data and Key Metrics Changes - Health system operating margins are stabilizing and approaching pre-pandemic levels, which is expected to positively impact client adoption of the company's applications [33] - The company anticipates approximately 40 net new platform client additions in 2025, with an average range of $300,000 to $700,000 ARR plus nonrecurring revenue [35][39] Company Strategy and Development Direction - The company is focusing on profitable growth, with an emphasis on technology revenue, which is expected to grow approximately 13% year-over-year in 2025 [69] - The company plans to exit unprofitable ambulatory operations TEMS pilots by mid-2025 to prioritize profitable growth [37][69] - The modular and flexible Ignite platform is expected to drive cross-selling opportunities and improve client retention [78][121] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism regarding the operating environment, noting improvements in health system operating margins and the potential for increased client adoption of applications [33][78] - The company expects to see improvements in bookings metrics compared to 2024, driven by the strengthening end market and continued momentum from Ignite [34][39] - Management anticipates that dollar-based retention rate will be approximately 103% under the updated definition for 2025 [36][88] Other Important Information - The company ended Q4 2024 with $392 million in cash and cash equivalents, compared to $387 million in Q3 2024 [63] - The company has made several leadership updates, including the appointment of Dr. Jill Hoggard Green to the Board of Directors [47][50] Q&A Session Summary Question: What is driving the acceleration in platform bookings in 2025? - Management highlighted improvements in the end market, the modularity and lower price point of Ignite compared to DOS, and the ability to cross-sell to existing app clients as key factors driving the expected increase in platform bookings [76][78] Question: Can you discuss the differences in the new Ignite platform versus DOS regarding annual escalators? - Management noted that Ignite contracts typically have more modest annual escalators in the low to mid-single-digit range, making them easier for clients to digest [82][84] Question: How do you control the pace of migrations to Ignite? - Management is working closely with clients to manage the migration pace responsibly, aiming to complete the majority of migrations by mid-2026 [90][92] Question: What is the visibility into growth in technology revenue after Q1? - Management indicated good visibility into technology revenue growth, estimating approximately 10% year-over-year growth for Q1 2025 [130]

Financial Data and Key Metrics Changes - Total revenue for full year 2024 was $307 million, representing a 4% year-over-year growth [7][33] - Adjusted EBITDA for full year 2024 was $26 million, a significant increase from $11 million in 2023, reflecting a 137% year-over-year growth [7][37] - Adjusted gross margin for full year 2024 was 49%, an increase of approximately 10 basis points year-over-year [36] Business Line Data and Key Metrics Changes - Technology segment revenue for full year 2024 was $195 million, with a 4% year-over-year growth [33] - Professional services revenue for full year 2024 was $112 million, representing a 3% year-over-year growth [34] - Adjusted technology gross margin for Q4 2024 was 65%, a decrease of approximately 200 basis points year-over-year due to initial deployment costs [35] Market Data and Key Metrics Changes - The company reported a dollar-based retention rate of 100% under the legacy definition for 2024, and 102% under the new definition focusing on technology and TEMs segments [15][19] - The company has over 1,000 total clients, combining platform and app clients, indicating a strong client base for future growth [12][13] Company Strategy and Development Direction - The company is focusing on cross-selling Ignite-enabled offerings to existing app clients, which is expected to drive future growth [12][19] - The company plans to exit unprofitable ambulatory TEMS pilots, representing approximately $9 million of annual professional services revenue, to prioritize profitable growth [21] - The company anticipates technology revenue to grow approximately 13% year-over-year in 2025, driven by the momentum of Ignite sales [42] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the operating environment, noting that health system operating margins are stabilizing and approaching pre-pandemic levels [18] - The company expects to add approximately 40 net new platform clients in 2025, with a focus on converting existing app clients [19][20] - Management highlighted the importance of the Ignite platform in driving future growth and improving client retention [24][80] Other Important Information - The company ended Q4 2024 with $392 million in cash and short-term investments, up from $387 million in Q3 2024 [38] - The company raised its expected adjusted EBITDA for 2025 by $2 million to approximately $41 million, reflecting better-than-expected integration progress from recent acquisitions [22] Q&A Session Summary Question: What is driving the acceleration in platform bookings in 2025? - Management noted improvements in the end market and the modular, flexible nature of the Ignite platform as key drivers for increased bookings [48][49] Question: Can you discuss the differences in the new Ignite platform versus DOS regarding annual escalators? - Management indicated that Ignite contracts typically have more modest annual escalators in the low to mid single-digit range compared to larger escalators with DOS [53] Question: How is the company managing the pace of migrations to Ignite? - Management is working closely with clients to manage migration pace responsibly, aiming to complete the majority of migrations by mid-2026 [60] Question: What is the visibility into growth in technology revenue after Q1? - Management expressed confidence in visibility for technology revenue growth, estimating approximately 10% year-over-year growth for Q1 [85]