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SEGMENT REPORTING | 12 Months Ended
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Dec. 31, 2024
Segment Reporting [Abstract] |
SEGMENT REPORTING | SEGMENT REPORTING Our chief operating decision makers ("CODM") previously identified the following three operating 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 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. During the Company’s realignment in May 2024 the reportable segments naming convention was updated. The previously reported RCM segment has been updated to Financial Health and the former EHR segment is now referred to as Patient Care. There were no additional changes to the composition of the Company’s reportable segments in connection with the name changes. The financial statements and accompanying footnotes have been updated with the new segment names. The CODM evaluates the performance of the segments based on revenues and Adjusted EBITDA 1, as well as the expenses within each segment including cost of sales, product development, sales and marketing, and general and administrative. The CODM considers revenue, Adjusted EBITDA, and the related expenses to allocate resources for each segment during the annual budgeting and forecasting process. Monthly, the CODM considers forecast-to-actual variances for each of these performance measures to assess the performance for each segment. 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 the Company’s operating business performance. Our CODM group is comprised of the Chief Executive Officer, Chief Operating Officer, and Chief Financial Officer. As of December 31, 2024, the Chief Operating Officer’s employment with the Company terminated and, as such, the CODM group will be comprised of the Chief Executive Officer and Chief Financial Officer going forward. 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 intangible assets; (iv) stock-based compensation; (v) severance; (vi) other non-recurring charges; (vii) interest expense and other, net; (viii) impairment of goodwill; (ix) impairment of trademark intangibles; (x) gain on contingent consideration; (xi) loss on disposal of property and equipment; (xii) gain on sale of AHT; and (xiii) 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 years ended December 31, 2024, 2023, and 2022:
| Year Ended December 31,
(In thousands) | 2024 |  | 2023 |  | 2022
Revenues: |  |  |  |  |
Financial Health | $ | 217,672 |  |  | $ | 192,325 |  |  | $ | 179,870 |
Patient Care | 124,974 |  |  | 143,630 |  |  | 146,778 |
Total consolidated revenues | 342,646 |  |  | 335,955 |  |  | 326,648 |
Less: |  |  |  |  |
Financial Health expenses: |  |  |  |  |
Cost of sales (excluding depreciation and amortization and stock compensation expense) | $ | 116,494 |  |  | $ | 108,498 |  |  | $ | 96,793 |
Product development | 8,197 |  |  | 9,362 |  |  | 6,609 |
Sales and marketing | 17,138 |  |  | 17,261 |  |  | 13,752 |
General and administrative expenses | 39,680 |  |  | 34,008 |  |  | 27,497 |
Total Financial Health expenses | $ | 181,509 |  |  | $ | 169,129 |  |  | $ | 144,651 |
Patient Care expenses: |  |  |  |  |
Cost of sales (excluding depreciation and amortization and stock compensation expense) | $ | 51,316 |  |  | $ | 65,116 |  |  | $ | 68,939 |
Product development | 25,352 |  |  | 27,878 |  |  | 25,290 |
Sales and marketing | 9,223 |  |  | 10,795 |  |  | 13,379 |
General and administrative expenses | 18,676 |  |  | 18,941 |  |  | 18,490 |
Total Patient Care expenses | $ | 104,567 |  |  | $ | 122,730 |  |  | $ | 126,098 |
Total segment expenses | $ | 286,076 |  |  | $ | 291,859 |  |  | $ | 270,749 |
Adjusted EBITDA by Segment: |  |  |  |  |
Financial Health | 36,163 |  |  | 23,196 |  |  | 35,219 |
Patient Care | 20,407 |  |  | 20,900 |  |  | 20,680 |
Total Adjusted EBITDA | $ | 56,570 |  |  | $ | 44,096 |  |  | $ | 55,899 |
The following table reconciles net income to adjusted EBITDA:
| Year Ended December 31,
(In thousands) | 2024 |  | 2023 |  | 2022
Net income (loss), as reported | $ | (20,439) |  |  | $ | (48,434) |  |  | $ | 15,867 |
Deferred revenue and other acquisition-related adjustments | — |  |  | — |  |  | 109 |
Depreciation expense | 1,346 |  |  | 1,946 |  |  | 2,443 |
Amortization of software development costs | 15,122 |  |  | 8,096 |  |  | 3,484 |
Amortization of acquisition-related intangibles | 12,505 |  |  | 16,426 |  |  | 17,403 |
Stock-based compensation | 5,520 |  |  | 3,271 |  |  | 5,173 |
Severance and other non-recurring charges | 15,442 |  |  | 22,186 |  |  | 4,504 |
Interest expense and other, net | 15,517 |  |  | 11,659 |  |  | 5,267 |
Impairment of goodwill | — |  |  | 35,913 |  |  | — |
Impairment of trademark intangibles | — |  |  | 2,342 |  |  | — |
Gain on contingent consideration | (1,044) |  |  | — |  |  | (565) |
Loss on disposal of property and equipment | 3,895 |  |  | 117 |  |  | — |
Gain on sale of AHT | (1,529) |  |  | — |  |  | — |
Provision (benefit) for income taxes | 10,235 |  |  | (9,426) |  |  | 2,214 |
Total adjusted EBITDA | $ | 56,570 |  |  | $ | 44,096 |  |  | $ | 55,899 |

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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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