Operator
Operator
Ladies and gentlemen, thank you for standing by. And welcome to the CPSI First Quarter 2018 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 call is being recorded, Thursday, May 3, 2018. I'd now like to turn the call over to Mr. Boyd Douglas, President and Chief Executive Officer with CPSI. Please go ahead. John Boyd Douglas - Computer Programs & Systems, Inc.: Thank you, Aash. Good afternoon, everyone, and thank you for joining us. During this conference call, 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 you may have. Our first quarter of 2018 finished with the strong revenue and earnings performance, and we remain well-positioned for a good year ahead of us. As the market continues to shift to value-based care so does the revenue generated from our traditional software licenses to services from our company TruBridge. The community EHR business will always be core to the CPSI family, and it is foundational to the growth potential we see with TruBridge as that continues to fuel their sales engine. Maintaining the strength of our EHR foundation continues to be a priority, and our retention rates are reflective of our success today. We welcome 14 new community hospitals to the CPSI family in the first quarter of 2018, and the pipeline of activity tied to EHR buyers that are looking to return to us or replace their existing EHR vendor remains healthy, especially considering the dynamic of a saturated community EHR market. As we have outlined previously, the demand to improve the efficiency and utilization related to revenue cycle across our acute and post-acute client base provides good growth opportunity through cross-selling of the TruBridge revenue cycle management solution, accounts receivable management, private pay and coding services. TruBridge had 9% sequential revenue growth from Q4 of 2017; and 22% revenue growth year-over-year, while their margins at 47% improved from 42% in Q4 of 2017, and from 43% one year ago in Q1 of 2017. EHR clients within the CPSI family that purchased TruBridge services appreciate the benefits that naturally come from already-working with us where they have the long-term partnership, and most importantly, the trust factor already in place. Over the last four quarters, we have seen an upward trend from cross sales of all TruBridge services into the acute and post-acute base. And on average, our RCM sales into our acute client base are $1.5 million per quarter. To-date, the accounts receivable management service is the largest revenue generator from cross sales by TruBridge, and currently it has been sold into only a fraction of our acute care base. Similarly, the private pay service, which also generates decent revenues from cross sales is live in approximately 150 hospital facilities. In summary, there's clearly robust opportunity remaining throughout our entire EHR base before nearing penetration of our acute or post-acute client base. Turning back to our traditional software sales, MU3 once again generated healthy revenue in Q1 of $4.4 million, as the associated implementations have been moving along nicely. We are also pleased to report that in a year, that is still considered optional, attestations are well underway, and we have a number of clients that have already successfully tested on both our Thrive and Centriq products. The effort that has gone into our shared set of solutions over the last 12 months continues to drive some exciting innovation that is geared towards improving the experience providers have with our solution, across the inpatient, ambulatory and skilled nursing settings. From the recent business intelligence solution, to the new quality reporting product, and an improved user experience, these and other shared solutions are being designed and developed once to be shared across all of our EHR platforms. Building these solutions with an architecture, which depends upon a suite of containerized micro services accelerates the process of building functionality, expands future scalability, and allows us to bring valuable new solutions and improvements to our clients in a more efficient manner. With that, I'll turn the call over to Matt for a look at the financials. Matt J. Chambless - Computer Programs & Systems, Inc.: Thanks, Boyd, and good afternoon everyone. As Boyd just touched on, the first quarter of 2018 saw robust TruBridge revenue growth as our stellar bookings performance during 2017 has converted into meaningful top line improvements. This success, when coupled with our continued execution around CMS' healthcare IT initiatives, resulted in quarterly revenues and non-GAAP earnings per share that were our second highest since the Healthland acquisition, trailing only the fourth quarter of 2017's MU3-driven performance. In total revenues are up 11% from the first quarter of 2017, propelled by a 22% year-over-year top line TruBridge growth, which translated into a 54% increase in adjusted EBITDA, and an 86% increase in non-GAAP EPS. Recurring revenues increased 8% over the first quarter of 2017, and 3%, sequentially. From a cash flow and liquidity perspective, the recent strong top line performance at TruBridge, and the cash flow dynamics of our MU3 financing arrangements resulted in a $5.4 million expansion in total receivables, which when coupled with the timing of working capital cash outflows related to normal payroll and 2017 annual performance bonuses limited our ability to convert the period's improved profitability into improved operating cash flows. While we're always somewhat at the mercy of timing when it comes to working capital, there are no significant strategic working capital investments planned for the remainder of 2018, which bodes well for the remainder of the year's cash flow performance. As we've discussed on the past few earnings calls, our financing approach to MU3 add-ons and the market's shift away from upfront payment models to longer-term financing arrangements, whether it'd be SaaS or financed perpetual license sales has created a bit of a temporary disconnect between periodic profit and cash flows. Although, this cash flow trend hasn't quite reversed yet, we're clearly headed in that direction as total net financing receivables on our balance sheet increased only 4% during the first quarter of 2018, and we continued to expect financing receivables to be a net cash contributor in the back half of 2018. As it relates to our adoption of the new revenue recognition standards of ASC 606, we have opted not to translate current year amounts into old GAAP as the new standards have had an inconsequential impact on our revenues and earnings for the period with neither being impacted by more than $100,000. However, the new standard did have an impact on our balance sheet, most notably, increasing prepaid and other assets by $3.8 million, deferred revenue by $1.2 million, and deferred tax liabilities by $0.6 million. Lastly, the continued evolution of our operations after the Healthland acquisition resulted in a shift in the reporting structure for our interface services teams, resulting in some prior year reclassifications that increased cost of system sales and support, and decreased product development costs by roughly $850,000 each. Consolidated bookings of $22.1 million showed an 11% improvement over the fourth quarter of 2017 behind strong net new performance for Evident, but TruBridge bookings were admittedly softer than we'd like, resulting in a 6% decline in total bookings from the first quarter of 2017. We continue to execute on our TruBridge strategy by moving upmarket into larger healthcare facilities, while expanding the scope of our relationships with new and existing customers by increasing revenue generation touch points within those facilities. Our initial success in that endeavor has created a bit of bookings volatility as our bookings numbers are now heavily influenced by low-volume, high-value deals. For example, TruBridge closed no such large deals during the first quarter of 2018, whereas large deal bookings were $1.5 million in the first quarter of 2017 and $2.9 million in the first quarter of 2017. Of the $18.2 million in system sales and support bookings, roughly $1.7 million is included in our first quarter revenues. $16.4 million represents non-subscription sales that should trickle into revenue over the next 12 months with an average lag between booking and install of five to six months. $0.1 million represents EHR subscription revenue to be recorded over a weighted average period of five years with a start date in the next 12 months, and similar to our non-subscription sales and average lag between booking and install of five to six months. Our $3.8 million of bookings from TruBridge are mostly made up of recurring revenues to be recorded over a one-year period starting in the next four to six months. As for our Thrive implementation schedule, five customer sites went live with our Thrive acute care solution, compared to seven in the fourth quarter of 2017, and three during the first quarter of 2017. As for licensing mix, one of this quarter's five go-lives were under a cloud or subscription model compared to none in the fourth quarter of 2017, and one out of three during the first quarter of last year. At this time, we expect four new client facilities to go live with our Thrive solution in the second quarter of 2018 with one expected to go live in a cloud environment. Our employee head count as of March 31 was roughly 2,070, roughly a 1% increase over our December 31 numbers. On the revenue front, TruBridge posted a banner quarter, with revenues increasing 9% sequentially, and 22% year-over-year with accounts receivable management, insurance services and medical coding services continuing their upward trajectories. Accounts receivable management services increased 17%, sequentially and 47% year-over-year as hospital clients continue to partner with us for their full business office needs. Medical coding revenues increased 14% sequentially, and more than doubled year-over-year as providers continue to view TruBridge as a full-service RCM partner, and insurance services revenues increased 5% sequentially, and year-over-year. The top line success drove improved margins with margins improving to 47% during the first quarter of 2017, compared with 42% in the fourth quarter of 2017 and 43% during the first quarter of 2017 – correction the 47% was the first quarter of 2018 System sales and support revenues saw a $9.2 million or 17% sequential decrease as MU3-related revenues declined from $12.3 million to $4.4 million. This decrease was expected, given the current compliance deadlines, and we mentioned on the last earnings call that we expected a bit of a pullback during the first quarter of 2018 with volumes expected to pick back up in the second and third quarters, with a little remaining for the fourth quarter of 2018. Year-over-year, the contribution from MU3 drove system sales and support revenues to a $2.3 million or 5% increase, despite relative weakness in our post-acute segment in non-MU add-ons for our acute care segment. To-date, we've recognized $18.5 million in MU3-related revenue, with life-to-date bookings of $27.6 million. Although, we've been in continuous dialog with our clients regarding the recent proposed ruling from CMS allowing for a 90-day attestation for 2019, it's uncertain whether or how much that revenue cadence will shift or the related impact on the timing of the remaining bookings. Our cost of system sales and support revenues declined 10% from the fourth quarter, as travel costs improved and bonus expense normalized after the $1 million charge to the fourth quarter for the entire annual 2017 bonus. However, the 63% margins of the fourth quarter made for a tough comparative with this quarter's margins landing at 60%. Year-over-year, margins improved from 55% to 60% behind stronger top line results met with reduced costs, which were mostly due to favorable sales mix resulting in lower hardware costs. Product development costs showed a slight decrease of $200,000 or 3% sequentially, mostly due to the timing of bonus expense during 2017. Year-over-year costs have increased $700,000 or 8% due to our strategic initiatives designed to improve provider adoption and clinical workflow. Sales and marketing costs decreased sequentially by $2 million or 21% as the aforementioned decline in MU3 product revenues lowered commission expense. Conversely, top line growth related to both MU3 and TruBridge led to elevated commissions during the first quarter of 2018, when compared to the prior year resulting in sales and marketing costs that were $0.6 million or 8% higher year-over-year. General and administrative costs decreased $0.6 million or 5% from the fourth quarter of 2017 as bad debt expense and health claims normalized from the fourth quarter's elevated levels with a combined decrease of $2.8 million dollars. These improvements were partially offset by decreased vacation utilization as the fourth quarter benefited from the holidays. Increased costs related to our 401(k) employer match as our match structure essentially spreads the cost over the first nine months of the year, and increased legal and accounting fees resulting from our annual audit and ASC 606 implementation. Year-over-year, G&A costs increased $0.7 million or 6% mostly as changes in our Employee Prescription Drug Program drove a spike in volumes. Interest expense showed little movement either sequentially or year-over-year, as underlying rate increases on our variable rate debt have been mitigated by pay downs of principal. This quarter's effective tax rate of 32.4% was impacted by stock-based compensation shortfalls under ASU 2016-09, which resulted in $0.4 million of additional income tax expense. We also saw a $0.2 million of miscellaneous state notices. Absent these discrete items, our effective tax rate was just shy of 23%, and consistent with the expectations we communicated on the last earnings call. In wrapping up the financial discussion, we're pleased with what we view as a successful quarter, particularly with the results that we're seeing from TruBridge. As we continue to execute on our growth strategy and make progress towards our leverage goals, we believe there's much to be excited about at CPSI. And with that, I'll now turn things over to Chris Fowler, our Chief Operating Officer. Christopher L. Fowler - Computer Programs & Systems, Inc.: Thanks, Matt, and good afternoon, everyone. As Boyd and Matt stated, we're very pleased with the revenue and margin performance that was driven from TruBridge this period. From a bookings perspective, it is not uncommon to experience and manage the sales lumpiness from time-to-time. Often the deals we are cultivating can be large and require a fair amount of involvement from everyone. Many of our larger deals simply take time and patience, which can make the art of predicting a close day particularly challenging. Our level of satisfaction related to the inroads we are making with the cross-sell efforts into our post-acute EHR client base continues to increase. Our teams are making real progress each quarter as they become more attuned at communicating the value of revenue cycle outsourcing solutions within the post-acute setting. Similar to our penetration levels within the acute client base, we have a significant runway of opportunity remaining. Our reoccurring revenue stream associated with post-acute, if fully penetrated translates to approximately $25 million, annually. As sales advance, we are making continued headway within TruBridge operations. We are currently exploring and testing more efficient delivery methods for our accounts receivable management service. Our objective is to deliver a faster ROI, and improve affordability while maintaining or improving margins as we grow the business from within and outside the CPSI family of companies. In terms of our efforts around our community health offerings, the CPSI ACO program is well-underway, and we are enthused by the prospects this program brings to the participating member hospitals. In partnership with Caravan Health, each individual community is working towards improving care, while reducing cost. In addition to the local governance provided by ACO steering committees, we now have the CPSI ACO Board in place, which includes a representative from each community and provides broader ACO governance. We are gaining valuable learnings and understandings of how TruBridge and CPSI can best support our communities in their journey to value-based care. We foresee a roadmap of meaningful solutions, not just software, of TruBridge services that will revolve around integrating wellness visits, care coordination and a structured and measurable chronic care management program, all geared towards improving community health. And with that, Aash, please open up the call for questions.