Core Insights - TruBridge has expanded its partnership with Java Medical Group to enhance technology and services at Russellville Hospital in Alabama, focusing on standardizing managed hospitals through TruBridge's nTrust offering, which includes financial health software, electronic health records (EHR), and business office outsourcing [1][2] Group 1: Partnership Details - The partnership aims to improve outcomes and workflow through a comprehensive EHR optimization initiative across the Java Medical Group system, with similar initiatives recently completed at Unity Medical Center in Tennessee [2] - Java Medical Group's founder and CEO emphasized that TruBridge acts as an extension of their mission to strengthen rural hospitals, showcasing a shared commitment to sustainable, community-focused healthcare solutions [2][3] Group 2: Company Background - TruBridge has over 45 years of experience in supporting community and rural healthcare providers, serving more than 1,500 clients nationwide [3] - The company offers a variety of services, including analytics, revenue cycle management, and EHR systems, specifically designed to address the unique challenges faced by rural healthcare [4] - Java Medical Group collaborates with rural hospitals in multiple states, including New Mexico, Alabama, Georgia, and Tennessee, to enhance financial performance and ensure high-quality patient care [4]

Financial Data and Key Metrics Changes - Adjusted EBITDA nearly doubled to $18,200,000 from $10,000,000 year-over-year, with cash flow from operations increasing over $7,000,000, and net leverage ratio improved to 2.4 times from 4.4 times [4][5][20] - Revenue for the quarter was $87,200,000, reflecting a year-over-year increase of 3.7%, with adjusted EBITDA margin at 20.9%, up 860 basis points from the prior year [24][27] Business Line Data and Key Metrics Changes - Bookings totaled $22,000,000, down from $24,000,000 year-over-year, but up from $14,000,000 in Q4 2024, with financial health bookings at $13,000,000, a 50% sequential increase [6][8] - Patient care bookings were $9,000,000, a 60% sequential increase, with customer retention at 98% excluding Sentric [8][15] Market Data and Key Metrics Changes - Financial health represented 64% of total revenue at $56,100,000, a 5% increase year-over-year, while patient care revenue was $31,100,000, up 1.3% year-over-year [25][26] - Gross margins improved to 54.7%, with financial health gross margins at 51.6%, up 700 basis points, while patient care gross margins remained flat at 60.4% [26][27] Company Strategy and Development Direction - The company is focusing on enhancing customer service and operational efficiency, with plans to standardize global hiring processes and increase offshore support to 60% by the end of 2025 [12][14] - There is a clear demand for automation in revenue cycle management, with plans to leverage AI to drive improvements [13][14] Management's Comments on Operating Environment and Future Outlook - Management noted a cautious sentiment among customers due to policy uncertainties and potential changes in Medicare expansion and reimbursement [36][38] - The company remains committed to improving profitability and cash flow management, with expectations for continued revenue growth despite external challenges [19][29] Other Important Information - The company will transition to reporting bookings solely on an annual contract value (ACV) basis by 2026, which is expected to clarify revenue potential [9][24] - Cash from operations was $5,400,000, with accounts receivable down 12% and days sales outstanding (DSO) improving by twelve days year-over-year [20][28] Q&A Session Summary Question: How are policy changes affecting customer purchasing decisions? - Management indicated that while there is caution among customers due to policy uncertainties, they have not seen immediate impacts on sales cycles [34][36] Question: What are the expected net savings from reducing staffing duplicity? - Expected savings from offshore staffing are projected in the mid-single-digit millions for the full year, with ongoing evaluations of staffing efficiency [40][42] Question: Can you elaborate on Meredith's plan for client retention? - The focus is on enhancing client satisfaction and retention through improved operational efficiency and quality output from the offshore team [47][49] Question: What is the strategy regarding automation and offshore labor? - The company aims for a 60% offshore staffing mix while continuing to invest in automation to improve efficiency and standardization of processes [51][53] Question: How should we view the decline in non-subscription patient care bookings? - The shift to a SaaS model has affected the revenue structure, with a focus on recurring revenue rather than one-time fees [68][70] Question: Were the recent financial health deals concentrated in the lower or upper end of the 100-400 bed range? - One deal was just over 100 beds, while the other was closer to the upper end, indicating a balanced approach in targeting this market segment [73][75]

Financial Data and Key Metrics Changes - Adjusted EBITDA for Q1 2025 nearly doubled to $18,200,000 compared to $10,000,000 in Q1 2024, with cash flow from operations increasing over $7,000,000 [5][20] - Revenue for Q1 2025 was $87,200,000, reflecting a year-over-year increase of 3.7%, and adjusted EBITDA margin improved to 20.9%, up 860 basis points from the prior year [24][28] - Net leverage ratio improved to 2.4 times in Q1 2025, down from 4.4 times a year ago [5][20] Business Line Data and Key Metrics Changes - Bookings for Q1 2025 totaled $22,000,000, down from $24,000,000 year-over-year, with financial health bookings at $13,000,000, a 50% sequential increase [6][7] - Patient care bookings were $9,000,000, a 60% sequential increase, with customer retention at 98% excluding Sentric [7][15] - Financial health represented 64% of total revenue at $56,100,000, a 5% increase year-over-year, while patient care revenue was $31,100,000, up 1.3% [26][27] Market Data and Key Metrics Changes - The company noted ongoing uncertainty related to future healthcare funding and potential impacts of tariffs on customer decision-making [10] - The shift to a SaaS model has affected the revenue mix, with a focus on recurring revenue rather than one-time fees [70] Company Strategy and Development Direction - The company is increasing investments in operational initiatives, including standardizing the global hiring process and enhancing customer service [12][14] - There is a focus on automation and leveraging AI to improve revenue cycle management [13][55] - The company aims to transition all bookings to an annual contract value (ACV) basis by 2026 for clearer revenue recognition [9][24] Management's Comments on Operating Environment and Future Outlook - Management expressed cautious optimism regarding customer sentiment amid policy changes and potential impacts on hospital budgets [40] - The company is committed to improving forecasting processes and maintaining revenue expectations while increasing adjusted EBITDA guidance for the full year [30][31] Other Important Information - The company ended Q1 2025 with $10,100,000 in cash, compared to $4,100,000 a year ago, and net debt of $158,000,000 [29] - Operating expenses decreased to 45.3% of total revenue, down from 51.1% a year ago, due to cost optimization actions [28] Q&A Session Summary Question: Impact of policy changes on sales cycle - Management noted that while there is cautious sentiment regarding policy changes, they have not seen immediate impacts on sales conversations [39] Question: Potential net savings from staffing changes - Management expects mid-single-digit million savings from reducing duplicity in offshore and onshore staffing [43] Question: Meredith's plan of action and client retention - Focus is on improving client delight and retention through better training and infrastructure as the offshore operations scale up [50] Question: Non-subscription component of patient care bookings - Management acknowledged a shift to recurring revenue models and noted that new offerings are primarily based on the SaaS model [70] Question: Financial health client wins in the hospital market - Management confirmed that recent wins were in both the lower and upper ends of the 100 to 400 bed range, emphasizing the need for RCM services in this segment [74]

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 a 44% increase compared to the previous year [8][10]. - The full year revenue for 2024 was $339 million, with adjusted EBITDA of $53 million, exceeding the high end of guidance ranges [10][56]. - Cash flow from operations improved to $10.3 million in Q4, a $23 million increase compared to the previous year, and full year cash flow from operations reached $32 million, up from just over $1 million in 2023 [9][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, driven by core CBO offerings and Viewgol [49]. - Patient Care revenue decreased by 6.3% year-over-year to $32.7 million, impacted by the divestiture of AHT and the sunsetting of Centriq, although excluding these, revenue was higher year-over-year [50]. - Total bookings for the year were $82 million, with Financial Health bookings flat year-over-year at $49 million and Patient Care bookings up 6% to $33 million [54][56]. Market Data and Key Metrics Changes - The company noted that 75% of the time, no decision remains the reason for not closing a deal, rather than losing to a competitor, indicating a potential market opportunity [17]. - The market for hospitals with 100 to 400 beds grew from 5% to over 20% of financial health opportunities in the pipeline from 2023 to 2024 [16]. Company Strategy and Development Direction - The company plans to continue focusing on improving customer satisfaction, retention, and profitability while expanding its presence in the 100 to 400 bed hospital market [18][34]. - A new leadership was brought in for the financial health business unit to enhance customer satisfaction and pipeline expansion [19][20]. - The company aims to double the percentage of CBO clients supported by the global workforce from 30% to 60% by the end of 2025 [24]. Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, despite some uncertainty regarding healthcare funding changes from the government, which could impact deal timing [13][106]. - The company expects to achieve mid-single digit revenue growth and EBITDA margins in the mid-20s over the next few years [32][60]. - Management highlighted the importance of improving forecasting and accounting processes to enhance predictability and control [46][47]. Other Important Information - The company reduced its leverage ratio from over 4 times to 3 times and plans to continue de-levering [11][40]. - Total gross margins improved to 53% in Q4, up 390 basis points year-over-year, with Financial Health gross margins at 49.1% and Patient Care gross margins at 59.6% [51][52]. Q&A Session Summary Question: Can you speak to the visibility on closing remaining deals expected to close in Q4? - Management indicated that some deals were delayed due to uncontrollable factors but remain optimistic about closing them in the first half of 2025 [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 and drive cross-sell opportunities, particularly targeting hospitals that do not currently use their EHR [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 metrics like pipeline and win rate? - The company noted that about 40% of bookings come from opportunities opened and closed within the same 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 renewals in 2025? - The renewals are spread throughout the year, and the company is focused on ensuring customer satisfaction to retain these clients [99][103].