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SEGMENT REPORTING | 9 Months Ended
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Sep. 30, 2025
Segment Reporting [Abstract] |
SEGMENT REPORTING | SEGMENT REPORTING The Company previously reported its financial results in 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. The Patient Engagement segment results were transitioned into the EHR segment for all periods presented. 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 chief operating decision maker (“CODM”) in assessing segment performance and in allocating the Company's resources. 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 condensed consolidated financial statements and accompanying footnotes have been updated with the new segment names. The Company’s CODM is its Chief Executive Officer. The CODM uses revenues and Adjusted EBITDA to assess the performance of and allocate resources to each of the reportable segments during the annual budgeting and forecasting process. The significant expenses regularly reviewed by the CODM include costs of revenues, product development, sales and marketing, and general and administrative expenses. Monthly, the CODM considers forecast-to-actual variances for each of these performance measures to assess the performance of each segment. The CODM 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. 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 income; (vii) gain on sale of AHT; (viii) gain on disposal of property and equipment; (ix) change in fair value of contingent consideration; and (x) the provision for (benefit from) income taxes. There are no intersegment revenues to be eliminated in computing segment revenue. The CODM does 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 nine months ended September 30, 2025 and 2024:
| Three Months Ended September 30, |  | Nine Months Ended September 30,
(In thousands) | 2025 |  | 2024 |  | 2025 |  | 2024
Revenues: |  |  |  |  |  |  |
Financial Health | $ | 54,501 |  |  | $ | 54,672 |  |  | $ | 164,918 |  |  | $ | 162,620 |
Patient Care | 31,605 |  |  | 30,028 |  |  | 94,125 |  |  | 91,796 |
Total revenues | 86,106 |  |  | 84,700 |  |  | 259,043 |  |  | 254,416 |
Less: |  |  |  |  |  |  |
Financial Health expenses: |  |  |  |  |  |  |
Cost of revenues (excluding amortization and depreciation and stock compensation expense) | $ | 29,208 |  |  | $ | 29,077 |  |  | $ | 85,123 |  |  | $ | 88,762 |
Product development (excluding stock compensation) | 3,249 |  |  | 1,888 |  |  | 9,360 |  |  | 6,219 |
Sales and marketing (excluding stock compensation) | 3,466 |  |  | 3,664 |  |  | 12,326 |  |  | 12,959 |
General and administrative expenses (excluding stock compensation) | 9,706 |  |  | 10,079 |  |  | 30,865 |  |  | 29,710 |
Total Financial Health expenses | $ | 45,629 |  |  | $ | 44,708 |  |  | $ | 137,674 |  |  | $ | 137,650 |
Patient Care expenses: |  |  |  |  |  |  |
Cost of revenues (excluding amortization and depreciation and stock compensation expense) | $ | 12,538 |  |  | $ | 13,069 |  |  | $ | 36,569 |  |  | $ | 38,220 |
Product development (excluding stock compensation) | 4,676 |  |  | 5,616 |  |  | 14,474 |  |  | 19,712 |
Sales and marketing (excluding stock compensation) | 1,990 |  |  | 2,067 |  |  | 6,169 |  |  | 6,830 |
General and administrative expenses (excluding stock compensation) | 5,001 |  |  | 4,548 |  |  | 15,912 |  |  | 13,544 |
Total Patient Care expenses | $ | 24,205 |  |  | $ | 25,300 |  |  | $ | 73,124 |  |  | $ | 78,306 |
Total segment expenses | $ | 69,834 |  |  | $ | 70,008 |  |  | $ | 210,798 |  |  | $ | 215,956 |
Adjusted EBITDA by segment: |  |  |  |  |  |  |
Financial Health | 8,872 |  |  | 9,964 |  |  | 27,244 |  |  | 24,970 |
Patient Care | 7,400 |  |  | 4,728 |  |  | 21,001 |  |  | 13,490 |
Total Adjusted EBITDA | $ | 16,272 |  |  | $ | 14,692 |  |  | $ | 48,245 |  |  | $ | 38,460 |
The following table reconciles Adjusted EBITDA to income (loss) before taxes:
| Three Months Ended September 30, |  | Nine Months Ended September 30,
(In thousands) | 2025 |  | 2024 |  | 2025 |  | 2024
Total Adjusted EBITDA | $ | 16,272 |  |  | $ | 14,692 |  |  | $ | 48,245 |  |  | $ | 38,460 |
Less: |  |  |  |  |  |  |
Interest expense and other income | 2,716 |  |  | 3,777 |  |  | 9,057 |  |  | 11,826 |
Depreciation expense | 243 |  |  | 279 |  |  | 846 |  |  | 1,079 |
Amortization of software development costs | 3,441 |  |  | 3,057 |  |  | 9,757 |  |  | 11,779 |
Amortization of acquisition-related intangibles | 3,046 |  |  | 3,126 |  |  | 9,144 |  |  | 9,379 |
Stock-based compensation | 1,788 |  |  | 1,398 |  |  | 5,098 |  |  | 3,698 |
Severance and other non-recurring charges | 3,686 |  |  | 4,018 |  |  | 7,545 |  |  | 12,449 |
Change in fair value of contingent consideration | — |  |  | (1,044) |  |  | — |  |  | (1,044) |
Loss (gain) on disposal of property and equipment | — |  |  | 1,648 |  |  | (120) |  |  | 1,648 |
Loss (gain) on sale of AHT | — |  |  | 28 |  |  | (53) |  |  | (1,221) |
Income (loss) before taxes | $ | 1,352 |  |  | $ | (1,595) |  |  | $ | 6,971 |  |  | $ | (11,133) |

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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/disclosureRef -Topic 280 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 21 -Subparagraph (b) -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-21 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name 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