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SEGMENT REPORTING | 6 Months Ended
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Jun. 30, 2024
Segment Reporting [Abstract] |
SEGMENT REPORTING | SEGMENT REPORTING Our chief operating decision makers ("CODM") previously identified the following three operating and reportable segments: RCM, EHR, and Patient Engagement. In May 2024, the Company made a number of changes to its organizational structure and management system to better align the Company's operating model with its strategic initiatives. As a result, the Company changed from three operating and reportable segments of (i) RCM, (ii) EHR and (iii) Patient Engagement to two operating and reportable segments of (i) EHR and (ii) RCM. These two segments are distinct business units with unique market dynamics and opportunities. They represent the components of the Company for which separate financial information is available and is utilized on a regular basis by the CODM in assessing segment performance and in allocating the Company's resources. The Patient Engagement segment results were transitioned into the EHR segment for all periods presented. Management evaluates the performance of the segments based on revenues and adjusted EBITDA. Management believes adjusted EBITDA is a useful measure to assess the performance and liquidity of the Company as it provides meaningful operating results by excluding the effects of expenses that are not reflective of its operating business performance. Our CODM group is comprised of the Chief Executive Officer, Chief Operating Officer, and Chief Financial Officer. Accounting policies for each of the reportable segments are the same as those used on a consolidated basis. Adjusted EBITDA consists of GAAP net income (loss) as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangibles; (iv) stock-based compensation; (v) severance; (vi) other non-recurring charges; (vii) interest expense and other, net; and (viii) the provision (benefit) for income taxes. There are no intersegment revenues to be eliminated in computing segment revenue. The CODM do not evaluate operating segments nor make decisions regarding operating segments based on assets. Consequently, we do not disclose total assets by reportable segment. The following table presents a summary of the revenues and adjusted EBITDA of our two operating segments for the three and six months ended June 30, 2024 and 2023:
| Three Months Ended June 30, |  | Six Months Ended June 30,
(In thousands) | 2024 |  | 2023 |  | 2024 |  | 2023
Revenues by segment: |  |  |  |  |  |  |
RCM | $ | 54,108 |  |  | $ | 47,760 |  |  | $ | 107,146 |  |  | $ | 96,391 |
EHR |  |  |  |  |  |  |
Recurring revenue |  |  |  |  |  |  |
Acute EHR | 26,666 |  |  | 30,013 |  |  | 54,160 |  |  | 59,353 |
Post-acute EHR | — |  |  | 3,729 |  |  | 582 |  |  | 7,636 |
Total recurring EHR revenue | 26,666 |  |  | 33,742 |  |  | 54,742 |  |  | 66,989 |
Non-recurring revenue |  |  |  |  |  |  |
Acute EHR | 3,956 |  |  | 2,775 |  |  | 6,008 |  |  | 6,750 |
Post-acute EHR | — |  |  | 345 |  |  | 81 |  |  | 725 |
Total non-recurring EHR revenue | 3,956 |  |  | 3,120 |  |  | 6,089 |  |  | 7,475 |
Total EHR revenue | $ | 30,622 |  |  | $ | 36,862 |  |  | $ | 60,831 |  |  | $ | 74,464 |
Total revenues | $ | 84,730 |  |  | $ | 84,622 |  |  | $ | 167,977 |  |  | $ | 170,855 |
Adjusted EBITDA by segment: |  |  |  |  |  |  |
RCM | $ | 7,804 |  |  | $ | 5,682 |  |  | $ | 14,202 |  |  | 13,580 |
EHR | 4,770 |  |  | 5,545 |  |  | 7,826 |  |  | 12,289 |
Total adjusted EBITDA | $ | 12,574 |  |  | $ | 11,227 |  |  | $ | 22,028 |  |  | $ | 25,869 |
The following table reconciles net income to adjusted EBITDA:
| Three Months Ended June 30, |  | Six Months Ended June 30,
(In thousands) | 2024 |  | 2023 |  | 2024 |  | 2023
Net income (loss), as reported | $ | (5,049) |  |  | $ | (2,837) |  |  | (7,565) |  |  | 247 |
Deferred revenue and other purchase accounting adjustments | — |  |  | — |  |  | — |  |  | — |
Depreciation expense | 400 |  |  | 597 |  |  | 800 |  |  | 1,095 |
Amortization of software development costs | 5,980 |  |  | 1,826 |  |  | 8,722 |  |  | 3,312 |
Amortization of acquisition-related intangibles | 3,126 |  |  | 4,014 |  |  | 6,253 |  |  | 8,029 |
Stock-based compensation | 1,501 |  |  | (123) |  |  | 2,300 |  |  | 1,124 |
Severance and other non-recurring charges | 4,586 |  |  | 6,819 |  |  | 8,430 |  |  | 7,920 |
Interest expense | 4,151 |  |  | 2,586 |  |  | 8,051 |  |  | 4,988 |
Gain on sale of AHT | — |  |  | — |  |  | (1,250) |  |  | — |
Provision (benefit) for income taxes | (2,121) |  |  | (1,655) |  |  | (3,713) |  |  | (846) |
Total adjusted EBITDA | $ | 12,574 |  |  | $ | 11,227 |  |  | $ | 22,028 |  |  | $ | 25,869 |
Certain of the items excluded or adjusted to arrive at adjusted EBITDA are described below: •Amortization of acquisition-related intangibles - Acquisition-related amortization expense is a non-cash expense arising primarily from the acquisition of intangibles in connection with acquisitions or investments. We exclude acquisition-related amortization expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of new acquisitions and full amortization of previously acquired intangible assets. •Stock-based compensation - Stock-based compensation expense is a non-cash expense arising from the grant of stock-based awards. We exclude stock-based compensation expense from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of the timing and valuation of grants of new stock-based awards, including grants in connection with acquisitions. •Severance and other non-recurring charges - We exclude severance expenses (primarily related to costs associated with our recent business transformation initiative) and other non-recurring charges (such as interest income, service charges, and other (income)/loss, and foreign currency (gain)/loss) from adjusted EBITDA because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods.

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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/exampleRef -Topic 280 -SubTopic 10 -Name Accounting Standards Codification -Section 55 -Paragraph 48 -Publisher FASB -URI https://asc.fasb.org/1943274/2147482785/280-10-55-48 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name Accounting Standards 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