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TruBridge, Inc. (TBRG)

Q4 2017 Earnings Call· Thu, Feb 8, 2018

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by. Welcome to the CPSI Fourth Quarter and Year-End 2017 Earnings Conference Call. During the presentation, all participants will be in a listen-only mode. Afterwards, we will conduct a question-and-answer session. As a reminder, this conference is being recorded, Thursday, February 8, 2018. I will now turn the conference over to Boyd Douglas, President and Chief Executive Officer of CPSI. Please go ahead, sir. John Boyd Douglas - Computer Programs & Systems, Inc.: Thank you, George. Good afternoon, everyone, and thank you for joining us. During this conference, we may make statements regarding future operating plans, expectations and performance that constitute forward-looking statements made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. We caution you that any such forward-looking statements only reflect management expectations and predictions based upon currently available information and are not guarantees of future results or performance. Actual results might differ materially from those expressed or implied by such forward-looking statements as a result of known and unknown risk, uncertainties, and other factors, including those described in our public releases and reports filed with the Securities and Exchange Commission including, but not limited to, our most recent Annual Report on Form 10-K. We also caution investors that the forward-looking information provided in this call represents our outlook only as of this date, and we undertake no obligation to update or revise any forward-looking statements to reflect events or developments after the date of this call. Joining me on the call today will be Matt Chambless, Chief Financial Officer; Chris Fowler, Chief Operating Officer; and David Dye, our Chief Growth Officer. At the conclusion of our prepared comments, we will be available to take any questions that you may have. Our fourth quarter of…

Operator

Operator

Certainly. Our first question is from the line of Jamie Stockton with Wells Fargo. Please go ahead with your question.

Jamie Stockton - Wells Fargo Securities LLC

Analyst

Yes. Thanks. Good evening, guys. I guess maybe first, Matt, and I'm sure you anticipated this, but the strength in system sales, should everyone basically interpret that as, hey, we signed some MU3 deals historically, that ultimately got delivered in Q4 and triggered revenue rec and that's why there was real bolus of system sales in Q4? Matt J. Chambless - Computer Programs & Systems, Inc.: Yes, Jamie. You're hitting it spot on. Throughout the year, we've been generating bookings for our MU3 products, really starting in the first quarter and starting to finally convert those into meaningful revenue in the fourth quarter. So you're right.

Jamie Stockton - Wells Fargo Securities LLC

Analyst

Just so that people model somewhat appropriately going forward, even though I know you guys aren't giving explicit guidance, is this going to be kind of a new seasonal pattern where there will be another bolus in Q4 of 2018, potentially, or is it going to be more spread out, just because it seemed to be so concentrated in Q4 of 2017? Just anything around that would be great. Matt J. Chambless - Computer Programs & Systems, Inc.: Yes. So our expectation right now, without getting into too much detail in numbers, is that there will be a bit of an MU3 pullback in the first quarter, and we'll start seeing it pick back up late second quarter and into the third quarter with kind of a tail in Q4 of next year. So you'll almost see something sort of like a bell-shaped curve throughout the year.

Jamie Stockton - Wells Fargo Securities LLC

Analyst

All right. That's great. And then maybe just one other one. I don't know if Boyd or David or whoever wants to take this, but just from a competitive standpoint, I mean, obviously you guys, I think, have been working hard to deliver and retain your client base over the last year or two. Allscripts has closed the McKesson deal. Theoretically, they're going to come a little more into the market with the Paragon product. Is there anything that's changing from a competitive dynamic standpoint? If you could touch on that, that'd be great. John Boyd Douglas - Computer Programs & Systems, Inc.: Yes. I guess, Jamie, it really depends on the timeframe we're describing. If it's the last three to six months, I would say no. We haven't seen any increase yet from Allscript/Paragon product, and I don't know if we will. There weren't a whole lot of Paragon customers sort of in our target market of under 100 beds. We would think of most of them more in that sort of Meditech market of 100 to 400 beds. Obviously, the degree to which they may play in our space remains to be seen. But certainly – as we've described in the last, I think, few calls, it's been a change, the last year or two from the last 30 years where it used to be us, Healthland, MEDHOST and Meditech. And now, on most deals, it's us and Cerner, occasionally an epic tie-in with a tertiary facility in Athena. It remains to be seen how much we're going to see – we haven't seen a lot of Meditech recently. Obviously, they've announced their web-based cloud solution recently. So that remains to be seen how much we'll see of that as well. But I think the short answer to your question is we haven't seen a whole lot of change in the last three to six months.

Jamie Stockton - Wells Fargo Securities LLC

Analyst

All right. That's great. Thank you. John Boyd Douglas - Computer Programs & Systems, Inc.: Thanks, Jamie.

Operator

Operator

Our next question is from the line of Jeff Garro with William Blair & Company. Please go ahead with your question. Jeff R. Garro - William Blair & Co. LLC: Yes. Good afternoon, guys, and thanks for taking the questions. I was hoping to dig more into the revenue outlook. And looking at bookings up 10.5% year-over-year and the backlog up 8%, trying to get a sense if those growth rates are good indicators of the type of revenue growth we can expect in 2018? Matt J. Chambless - Computer Programs & Systems, Inc.: Yes. So we think revenue growth in 2018, it's certainly what we're seeing but we would expect it at muted levels. John Boyd Douglas - Computer Programs & Systems, Inc.: And I think focused – the way we see the pipeline with new businesses – at this point our expectation is that we can sign more new business in 2018 than we did in 2017 because it's pretty robust. But with all of those bookings that we did in 2017, three out of four quarters were record TruBridge quarters. The vast majority of that stuff has started as of January 2018 at work. So we're looking for a pretty good growth year there from TruBridge in 2018, which as we pointed out I think a few times on the call is recurring revenue that we should see in 2019 and beyond. Jeff R. Garro - William Blair & Co. LLC: Great. That's helpful. Trying to dig in a little bit further on the segment level, it sounds like you've signed a lot of new Trubridge business here in 2017 and have got a lot of it implemented. But you – on the last call, you did set an expectation of close to 20% growth for TruBridge…

Operator

Operator

Our next question is from the line of David Larsen with Leerink Partners. Please go ahead.

David M. Larsen - Leerink Partners LLC

Analyst

Hey, guys. Congratulations on a fantastic revenue beat. Can you talk a bit about the rural ACO market and your ACO solution, what kind of traction you're seeing from that and what types of new products you bring to the market? Thanks. Christopher L. Fowler - Computer Programs & Systems, Inc.: Hi, David. Yes, we're just kind of getting started with it. Obviously, we started in January. Our hope is that we'll be able to see some success with it this first year and potentially start another three-year program next year or the year following. The Population Health models and services are obviously where we see opportunity developing out of the ACO, helping hospitals with their wellness programs and just that patient engagement around that process, and making the patient population of these hospitals a little more proactive.

David M. Larsen - Leerink Partners LLC

Analyst

Is all of that revenue flowing through the TruBridge line item on the P&L? Christopher L. Fowler - Computer Programs & Systems, Inc.: As it relates to the ACO program?

David M. Larsen - Leerink Partners LLC

Analyst

Yes. John Boyd Douglas - Computer Programs & Systems, Inc.: So as it relates to ACO program, our plan right now is for that to be below the line and not included in operating. Does that make sense?

David M. Larsen - Leerink Partners LLC

Analyst

Okay. John Boyd Douglas - Computer Programs & Systems, Inc.: On a net basis.

David M. Larsen - Leerink Partners LLC

Analyst

Okay. Yes. That's very helpful. And then can you just remind me, which vendors are you taking share from? So with these competitive wins, which vendors are you displacing typically? John Boyd Douglas - Computer Programs & Systems, Inc.: Yes. David, we typically, I think, stay away from name-calling on these calls.

David M. Larsen - Leerink Partners LLC

Analyst

Okay. John Boyd Douglas - Computer Programs & Systems, Inc.: I would say, there are certainly a few left that are the vendors that really haven't had the staying power post meaningful use that are still out there in some of the smaller hospitals. And then there are some legacy versions of systems that are still out there with vendors that still compete today. And when they're in a situation where they know they need to upgrade to the latest version, in many cases, they offer a competitive situation where they take a look before they just automatically upgrade with that vendor. So those are primarily the situations where we're seeing activity.

David M. Larsen - Leerink Partners LLC

Analyst

Okay. Great thanks again and congrats on a good quarter. John Boyd Douglas - Computer Programs & Systems, Inc.: Thanks, David.

Operator

Operator

Our next question is from the line of Sandy Draper with SunTrust. Please go ahead with your question.

Sandy Y. Draper - SunTrust Robinson Humphrey, Inc.

Analyst

Thanks very much. Just a couple of questions. One, I think you, Matt, mentioned and has commented on this before on prior calls, but obviously, if we look year end, a big jump in the – our use of cash flow from financing receivables. Remind is that – are you using that as a way to drive sales or is that just you responding to how customers want to do it? Is that essentially tied to cloud? I'm just trying to remember exactly when you guys are doing the customer financing, where that shows up in the income statement and how it ties the balance sheet and cash flow. Matt J. Chambless - Computer Programs & Systems, Inc.: So Sandy, most of that, so it's kind of broken into two different buckets, both of which are related to our system sales volumes. So one of the things we're seeing is nearly all of our new system installs or net new installs of Thrive are under some sort of long-term finance solution. But then secondly, specifically to our MU3 bundles, nearly all of the MU3 packages are being sold currently under a 12-month payment plan. So revenue is recognized at the time of delivery with the cash flow having a 12-month tail in that case. Does that answer your question?

Sandy Y. Draper - SunTrust Robinson Humphrey, Inc.

Analyst

Yes, that does. Very helpful. And then, I'm not sure if this is for David or Boyd or who does take this, and on the post-acute side, not as much on the actual write-down, I understand that. But I think it was – David, maybe you made the comments about you felt like the investment in the products were getting well set-up. So I guess one is remind me how big of a piece your business post-acute was or sort of is, and then had market been robust, the products just weren't there and now you think the products are there, just sort of help me understand in terms of why it seems like now on the heels of a write-down, you do feel like there's better prospects going forward? Thanks. John Boyd Douglas - Computer Programs & Systems, Inc.: Yes, Sandy. This is Boyd. That business – that piece of business is about 9% of the total revenue of the Company and we've got 3,400 buildings that run that software and we really thought there's an opportunity in that market. And I've said for several quarters now, that's more of a longer-term opportunity. The market is – a lot of those operators are really struggling financially right now. It's our position that with meaningful use in the acute side, the post-acute side at some point, all of those facilities will need or require an EHR. And so we want to position ourselves well. So we feel like while we've got a little bit of time to get it done, we want to go ahead and get it done sooner rather than later, which is why we're making the additional investment at this time to position us well. We've got a great relationship and great support services from that part as a company and the product needs some attention, and frankly, that's something we've been doing around here for over 30 years is writing good software. So we feel like we can do that. And we've got some real good opportunities, 2019 and beyond to start selling that product.

Sandy Y. Draper - SunTrust Robinson Humphrey, Inc.

Analyst

Okay. Great. Thanks so much, Boyd. And one last question and I had to jump off for a second so, just tell me to go back and read the transcripts if you already answered this. And I think this was David, you commented about the replacement market seemed to be pretty good. That actually sort of runs counter to what we've heard. And again, I know you guys operate in 100 bed and below markets are maybe different. But I'm just curious what it is – I mean, you talked about some older systems out there but without a specific catalyst from the government, what do you think is causing customers to be willing to look to make a replacement. because what we hear or I hear at least from a lot of other vendors is there's not – the replacement market we thought was going to be there isn't really moving. So I'm just curious what you're seeing or why you think it may be different in this small hospital market? Thanks. David A. Dye - Computer Programs & Systems, Inc.: Yes. The short answer to your question is doctors. As the, I would say, as the new crop of physicians move in, there's an expectation of the usability and completeness of the software that they use to help treat their patients and either underperforming or the legacy stuff just isn't acceptable to them. So, they're communicating that to their leadership and that's where we're seeing some activity. John Boyd Douglas - Computer Programs & Systems, Inc.: And this is Boyd. I'll just add on to that. With meaningful use, obviously it brought up a lot of new entrants to the market and they don't have the complete system. So, while it was a decent enough system to get them to meaningful use, overall, the end users specifically, as David said, the doctors with the nurses, really all the caregivers as well, they're frustrated with the workflows and the inefficiencies of the software and they're looking for a better and more robust system that really is the complete product suite (42:16) and obviously that's what we offer.

Sandy Y. Draper - SunTrust Robinson Humphrey, Inc.

Analyst

Great. Thanks so much, guys. David A. Dye - Computer Programs & Systems, Inc.: Thanks, Sandy.

Operator

Operator

Our next question is from the line of Donald Hooker with KeyBanc. Please go ahead.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Hey, good afternoon. So, with regards to MU3, maybe can you just remind us kind of where you are in that purchasing cycle? And I guess, if I think about – I guess, what's the penetration there in terms of sort of hospitals of yours who have adopted your MU3 package versus those who have not and kind of what the penetration could get to ultimately in your view? John Boyd Douglas - Computer Programs & Systems, Inc.: So, Donald, so, right now, bookings life-to-date for MU3 repackages within our customer base are just shy of $27 million and that's making up roughly two-thirds of what we see as being the total opportunity within our customer base. So, that's on the bookings front. Year-to-date, we've had revenue of $14.2 million. So that leaves what?

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Okay. John Boyd Douglas - Computer Programs & Systems, Inc.: $15.7 million worth of bookings that are yet to convert to revenue and still a third of the opportunity to go out and grab the sales dependent.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Okay. Great. And then, also interested in that – sort of that BI Dashboard, just generally kind of where you are kind of stepping back, kind of where you are with that kind of penetration-wise and what is a realistic sort of penetration target there? I guess are there particular clients that maybe that's not applicable to or is it really the whole base? Christopher L. Fowler - Computer Programs & Systems, Inc.: Donald, this is Chris. That's a good question you have. We're still rapidly developing those panels and obviously that's driving the value and the interest in the product. But what we're seeing as we're developing the panels is the opportunity for services to spin off of that. So, to your question about certain hospitals that's not being applicable to, we've got to be able to position services from TruBridge that can help those facilities as we identify opportunities via BI, via the Dashboard and be able to actually help them drive some change. And so, I think there's a twofold opportunity. The market is – we barely penetrated the client base with the product. As I said, we have 20 sites installed. So we're very optimistic for 2018 to see that grow and also see some services spin-off of that.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Okay. And then my last question maybe just kind of maybe high-level, your recurring revenues are certainly a large majority of your overall revenues. At what point, would you be comfortable pulling the trigger and giving guidance to your shareholders? David A. Dye - Computer Programs & Systems, Inc.: Yes. Donald, we evaluate that among management and even at the board level from time to time; I would say, on a regular basis, not necessarily quarterly but certainly multiple times per year, and I think due to the volatility that's come because of MU being off and on and with our revenue recognition techniques, our volatility as well, it was decided a year or so ago that we weren't going to pursue – weren't going to continue with guidance, and we're continuing with that path right now. That may change in the future. As I said, we evaluate it on a somewhat regular basis. But right now, there's no plans to do that. John Boyd Douglas - Computer Programs & Systems, Inc.: And, Donald, this is Boyd. One thing that we've added, we've thought about this a lot, and one thing that we actually have thought about is maybe not give full guidance but give guidance on that recurring revenue or something along those lines. So it's something that we talk about at the board level, like David said, and some more under consideration. But I certainly don't – I don't feel comfortable giving any kind of timeframe on that.

Donald H. Hooker - KeyBanc Capital Markets, Inc.

Analyst

Okay. Thank you so much. John Boyd Douglas - Computer Programs & Systems, Inc.: Thanks, Donald.

Operator

Operator

Our next question is from the line of Nicholas Jansen with Raymond James & Associates. Please go ahead with your question. Nicholas M. Jansen - Raymond James & Associates, Inc.: Hey, guys. Thanks for the questions. First, Matt, maybe for you in terms of the financing receivables. Are those going to be as big of a drag in 2018, or do we think we've seen the peak there where we'll get our cash flow lift in 2018 associated with some of that coming down? Matt J. Chambless - Computer Programs & Systems, Inc.: I think, we'll continue to see a number of our system sales revenues being financed, and we'll continue to see those numbers flowing into financing receivables. But the dynamic that should start swinging back the other way that will mute that impact to cash flow will actually be the collection of things that have been parked on the balance sheet during 2017. So we will continue to see current period revenues feeding financing receivables. But I think more than anything, 2018 might see a marginal increase, so definitely nowhere near to the magnitude we saw in 2017. Nicholas M. Jansen - Raymond James & Associates, Inc.: That's helpful. And then, my follow-up question just being in terms of your balance sheet capacity, I know you guys changed the covenants back in October. Certainly, cash flow is getting a bit better. Now how do you guys think about appetite for M&A? Is there anything you think about your customer base needing that you currently don't offer? Just your thoughts there, now that the Healthland deal is two years in the rear-view mirror? Thanks. John Boyd Douglas - Computer Programs & Systems, Inc.: Hi, Donald (sic) [Nicholas). This is Boyd. Certainly, it's something that's under consideration. I think one thing that's really been beneficial to us and we've enjoyed is what's happened with Rycan and it certainly showed us the ability to grow maybe a smaller tuck-in type company into our base. So I wouldn't say we're actively looking and have changed our strategy significantly, but we're certainly trying to look and see what's out there. And if we see anything, we want to be in a position to take advantage of it. Nicholas M. Jansen - Raymond James & Associates, Inc.: Thank you.

Operator

Operator

Our next question is from the line of Mike Ott with Oppenheimer. Please go ahead with your question. Mike Ott - Oppenheimer & Co., Inc.: Good afternoon. Thanks for taking my question. With the lower tax rate, do you yet how you might deploy some of the savings? John Boyd Douglas - Computer Programs & Systems, Inc.: So, Mike, right now I think an important thing for everyone to remember is that with the Healthland transaction, we acquired a considerable amount of net operating losses, and we still think right now that we have about three years' worth of NOLs to work through. So it's going to be some time before we really start seeing meaningful cash savings as a result of recent tax reform. Mike Ott - Oppenheimer & Co., Inc.: Okay. That makes sense. Thanks. And then as a follow-up, was there any common theme for why the three go-lives that's slipped into 2018, why those slipped in? Curious, when, if you know, they'll be landing, will they all fall into 1Q, do you think? John Boyd Douglas - Computer Programs & Systems, Inc.: So, one will land in the end of the first quarter, and the other two will land at the beginning of the second quarter. And the reasons were kind of – they're kind of all related reasons, but slightly different. One is a start-up facility, so we're kind of at the mercy of when they start seeing patients. Another was a facility that's undergoing a change in ownership, and that always can throw wrinkles in our implementation plans. And another was kind of a related issue where it was due to some hospital consolidation that benefited us, and we're just waiting on that legal arrangement to close. Mike Ott - Oppenheimer & Co., Inc.: Okay. Very helpful. Thanks so much. David A. Dye - Computer Programs & Systems, Inc.: Thanks, Mike.

Operator

Operator

Our next question is from the line of Gene Mannheimer with Dougherty & Company. Please go ahead. Eugene Mannheimer - Dougherty & Co. LLC: Thanks. Good afternoon and congrats on a strong finish to the year. I wanted to just ask about those seven hospital wins in the quarter. Did you say whether they included TruBridge or not in those? John Boyd Douglas - Computer Programs & Systems, Inc.: No, those were all net new evident EMR hospital wins. Eugene Mannheimer - Dougherty & Co. LLC: Okay. And so therefore, was there any component of TruBridge in those, or those are strictly software deals? John Boyd Douglas - Computer Programs & Systems, Inc.: Yes. I don't know that any of them were in trust deals. Yes, off the top of my head, we've kind of gone internally, Gene, in terms of thinking about the net new acute care business separately from the TruBridge business because we're getting so much new TruBridge business from outside our EMR customer base. That's a good question that I can get back to you offline. Eugene Mannheimer - Dougherty & Co. LLC: Sure. Okay. I was just curious about the cross-sell there. Matt J. Chambless - Computer Programs & Systems, Inc.: Hi, Gene. Just to add to that, whether or not they included the accounts receivable service, they surely included some services from TruBridge. Eugene Mannheimer - Dougherty & Co. LLC: Okay. Good. And then with respect to new products, you talked about the BI dashboard; you're seeing good progress there. Maybe the emergency department module that was released a couple of years ago, if you can sort of update where we are in the penetration of that and perhaps what new products down the road you might be thinking about that you'll either be…

Operator

Operator

And we have time for one more question. Our last question will be from the line of Stephanie Davis with Citigroup. Please go ahead.

Stephanie J. Davis - Citigroup Global Markets, Inc.

Analyst

Hey, guys. Thank you for taking my question. I just want to get an update on the rural ACO traction, kind of maybe the difference you're seeing within the existing client base versus outside of your core client base. And this is a follow up to that, what sort of demand dynamics you're seeing as the market warms up again to the shift to diabetes care? John Boyd Douglas - Computer Programs & Systems, Inc.: So I think something to understand about the ACO program that we've got going on. We opened and closed a window at the second half of last year. So right now, we're not accepting anymore hospitals into the program. And the 27 hospitals that are CPSI hospitals will be part of this for the next three years along with another 15 to 20 hospitals that are not on the CPSI platforms. So from a demand standpoint, I think we're kind of in a wait and see and let us get our feet under us with this program and get some momentum around it. And I would assume, based on our success, obviously with the help of Caravan, that we'll be ramping up additional enrollments maybe towards the end of next year or end of this year. I apologize.

Stephanie J. Davis - Citigroup Global Markets, Inc.

Analyst

What are your capacity limitations for that, if I may ask, for the end of next year when we think about the next round. Matt J. Chambless - Computer Programs & Systems, Inc.: I don't know if we necessarily have any capacity limitations that we've set so far. Again, we started in January. So from a management standpoint and our ability to coordinate these facilities, we're still trying to get our arms all the way around that. But leaning on our partner a little bit in the beginning and hopefully, we'll start being able to take on more of the lion's share of that. But as we see the success, the hospitals are taking on the ownership of it, I think that will allow us to increase the capacity that we're able to provide.

Stephanie J. Davis - Citigroup Global Markets, Inc.

Analyst

All right. Makes sense. Thank you, guys. John Boyd Douglas - Computer Programs & Systems, Inc.: Thanks, Stephanie.

Operator

Operator

I will now turn the call back to Boyd Douglas for his closing remarks. John Boyd Douglas - Computer Programs & Systems, Inc.: Yes. Certainly, I want to thank everyone for their time today and your interest in CPSI. As you can tell, we're pleased with the fourth quarter and how we ended 2017. We feel like it's given us good momentum moving into 2018, and we're real excited about the prospects for this year. So, thank you for your time, and I hope everyone has a good Friday and a good weekend. Thank you.

Operator

Operator

Ladies and gentlemen, that does conclude the conference call for today. We thank you for your participation and ask that you please disconnect your lines.