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SEGMENT REPORTING
 3 Months Ended
Mar. 31, 2025
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.
During the Company’s realignment 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 evaluate the performance of the segments based on revenues and Adjusted EBITDA (as defined below)1, as well as the expenses within each segment including cost of sales, product development, sales and marketing, and general and administrative. The CODM consider revenue, Adjusted EBITDA, and the related expenses to allocate resources for each segment during the annual budgeting and forecasting process. Monthly, the CODM consider forecast-to-actual variances for each of these performance measures to assess the performance of each segment. The CODM believe 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 was formerly 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 is comprised of the Chief Executive 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 and other non-recurring charges; (vi) interest expense and other, net; (vii) gain on sale of AHT; 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 months ended March 31, 2025 and 2024:
Three Months Ended March 31,
(In thousands)20252024
Revenues:
Financial Health$56,133 $53,439 
Patient Care31,075 30,678 
Total revenues87,208 84,117 
Less:
Financial Health expenses:
Cost of sales (excluding depreciation and amortization and stock compensation expense)$27,073 $29,523 
Product development3,109 2,427 
Sales and marketing3,830 4,282 
General and administrative expenses10,840 10,410 
Total Financial Health expenses$44,852 $46,642 
Patient Care expenses:
Cost of sales (excluding depreciation and amortization and stock compensation expense)$12,241 $12,202 
Product development4,930 8,049 
Sales and marketing1,395 2,171 
General and administrative expenses5,559 4,729 
Total Patient Care expenses$24,125 $27,151 
Total expenses$68,977 $73,793 
Adjusted EBITDA by segment:
Financial Health11,281 6,797 
Patient Care6,950 3,527 
Total Adjusted EBITDA$18,231 $10,324 

The following table reconciles net income to Adjusted EBITDA:
Three Months Ended March 31,
(In thousands)20252024
Net income (loss), as reported$459 $(1,854)
Depreciation expense291 400 
Amortization of software development costs3,071 2,742 
Amortization of acquisition-related intangibles3,053 3,127 
Stock-based compensation1,213 800 
Severance and other non-recurring charges2,443 3,844 
Interest expense and other, net3,291 3,899 
Gain on sale of AHT(53)(1,250)
Provision (benefit) for income taxes4,463 (1,384)
Total Adjusted EBITDA$18,231 $10,324