CareCloud Inc (CCLD) 2022 Q4 法說會逐字稿

Welcome to the the CareCloud, Inc. Fourth Quarter and Full Year 2022 Post Results Conference Call. (Operator Instructions)

歡迎來到 CareCloud, Inc. 2022 年第四季度和全年業績公佈電話會議。 （操作員說明）

I will now turn the call over to your host, Kim Blanche a Cloud's General Counsel. Ms. Blanche, you may begin.

我現在將把電話轉給您的主持人 Kim Blanche a Cloud 的總法律顧問。布蘭奇女士，您可以開始了。

Good morning, everyone, and welcome to the CareCloud Fourth Quarter and Full Year 2022 Conference Call. On today's call are Mahmud Haq, our Founder and Executive Chairman; A. Chaudhry, our Chief Executive Officer, President and a Director; and Bill Korn, our Chief Financial Officer.

大家早上好，歡迎來到 CareCloud 第四季度和 2022 年全年電話會議。出席今天電話會議的有我們的創始人兼執行主席 Mahmud Haq； A. Chaudhry，我們的首席執行官、總裁兼董事；和我們的首席財務官 Bill Korn。

Before we begin, I would like to remind you that certain statements made during this conference call are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934 as amended. All statements other than statements of historical facts made during this conference are forward-looking statements including, without limitation, statements regarding our expectations and guidance for future financial and operational performance, expected growth, business outlook, and potential organic growth and acquisitions.

在我們開始之前，我想提醒您，在本次電話會議中所做的某些陳述是前瞻性陳述，符合經修訂的 1933 年證券法第 27A 條和 1934 年證券交易法第 21E 條的含義修改。除本次會議期間作出的歷史事實陳述外，所有陳述均為前瞻性陳述，包括但不限於關於我們對未來財務和運營業績、預期增長、業務前景以及潛在有機增長和收購的預期和指導的陳述。

Forward-looking statements may sometimes be identified with words such as will, may, expect, plan, anticipate, upcoming, believe, estimate or similar terminology and the negative of these terms. Forward-looking statements are not promises or guarantees of future performance and are subject to a variety of risks and uncertainties, many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward-looking statements.

前瞻性陳述有時可以用諸如 will、may、expect、plan、expected、coming、believe、estimate 或類似術語以及這些術語的否定詞來識別。前瞻性陳述不是對未來業績的承諾或保證，並受到各種風險和不確定性的影響，其中許多風險和不確定性是我們無法控制的，這可能導致實際結果與這些前瞻性陳述中預期的結果存在重大差異。

These statements reflect our opinions only as to the date of this presentation, and we undertake no obligation to revise these forward-looking statements in light of new information or future events. Please refer to our press release and our reports filed with the Securities and Exchange Commission, where you will find a more comprehensive discussion of our performance and factors that could cause actual results to differ materially from these forward-looking statements.

這些陳述僅反映我們對本演示文稿日期的看法，我們不承擔根據新信息或未來事件修改這些前瞻性陳述的義務。請參閱我們的新聞稿和我們向美國證券交易委員會提交的報告，您將在其中找到對我們的業績和可能導致實際結果與這些前瞻性陳述存在重大差異的因素的更全面討論。

For anyone who dialed into the call by telephone, you may want to download our fourth quarter 2022 earnings presentation. Please visit our Investor Relations site, ir.carecloud.com, click on News and Events, then click IR calendar, click on Fourth Quarter 2022 Results Conference Call and download the earnings presentation.

對於通過電話撥入電話的任何人，您可能需要下載我們的 2022 年第四季度收益演示文稿。請訪問我們的投資者關係網站 ir.carecloud.com，點擊新聞和事件，然後點擊 IR 日曆，點擊 2022 年第四季度業績電話會議並下載收益演示文稿。

Finally, on today's call, we may refer to certain non-GAAP financial measures. Please refer to today's press release announcing our fourth quarter 2022 results for a reconciliation of these non-GAAP performance measures to our GAAP financial results.

最後，在今天的電話會議上，我們可能會提到某些非 GAAP 財務指標。請參閱今天宣布我們 2022 年第四季度業績的新聞稿，以了解這些非 GAAP 績效指標與我們的 GAAP 財務業績的對賬。

And with that said, I'll now turn the call over to our CEO, Hadi Chaudhry. Hadi?

話雖如此，我現在將把電話轉給我們的首席執行官 Hadi Chaudhry。哈迪？

Thank you, Kim, and thanks to all of you for joining us for our fourth quarter and full year earnings call. 2022 was a big year for our company on several fronts, including record bookings, redefining the tech-enabled revenue cycle solutions. Our Wellness brand, which includes our chronic care management and remote patient monitoring is rapidly gaining traction in our user base. Our Wellness offering and another record booking quarter in the fourth quarter, ending the year with approximately $8 million of bookings. As a reminder, revenue recognized may differ from our bookings due to timing of go lives, patient adoption ramps or other factors.

謝謝 Kim，也感謝大家參加我們的第四季度和全年財報電話會議。 2022 年對我們公司來說在多個方面都是重要的一年，包括創紀錄的預訂量、重新定義技術支持的收入周期解決方案。我們的健康品牌，包括我們的長期護理管理和遠程患者監控，正在迅速吸引我們的用戶群。我們的健康產品和第四季度的另一個創紀錄的預訂季度，年底的預訂量約為 800 萬美元。提醒一下，由於上線時間、患者收養率上升或其他因素，確認的收入可能與我們的預訂不同。

2022 was also the first full year of operating medSR under the CareCloud's umbrella, and it delivered strong performance from both a revenue and margin contribution perspective. As a reminder, one of the key considerations of the acquisition was leveraging their 200-plus hospital relationships into cross-sell RCM-related services. We acquired them in 2021 and during that year, they generated an annualized revenue of $27 million. Last year, they recorded $30 million, a 9% increase, but that's not the full story. Over the last year, we reestablished and strengthened our relationships with several leading health system software vendors and confirmed our cross-selling thesis by increasing medSR RCM-related revenue by approximately 300%.

2022 年也是在 CareCloud 旗下運營 medSR 的第一個完整年度，從收入和利潤貢獻的角度來看，它都表現強勁。提醒一下，收購的主要考慮因素之一是利用他們與 200 多家醫院的關係來交叉銷售 RCM 相關服務。我們在 2021 年收購了他們，在那一年，他們產生了 2700 萬美元的年收入。去年，他們錄得 3000 萬美元，增長 9%，但這還不是全部。在過去的一年裡，我們重新建立並加強了與幾家領先的健康系統軟件供應商的關係，並通過將 medSR RCM 相關收入增加約 300% 證實了我們的交叉銷售論點。

We will continue to leverage our relationships for recurring revenue tech-enabled RCM deals, which will help overall growth. Shareholders will appreciate the improvement in its contribution margin increasing from 3% in 2021, the ERP bought them to 14% for all of 2022 and ending 2022 with a 24% run rate directly as a result of cross-selling and realizing the participated cost synergies.

我們將繼續利用我們的關係進行經常性收入技術支持的 RCM 交易，這將有助於整體增長。股東將欣賞其邊際收益的改善，從 2021 年的 3% 增加，ERP 將其購買到 2022 年全年和 2022 年底的 14%，直接由於交叉銷售和實現參與成本協同效應而達到 24% 的運行率.

I also want to highlight our tech-enabled revenue cycle management solution, which is truly differentiated in the market as it sits on top of our industry-leading state-of-the-art software technology products to help us drive better revenue growth in this mature EHR and practice management market. Not only is it an end-to-end solution for our physicians, but it is also vendor agnostic. Also during the fourth quarter, we hosted our first Analyst and Investor Day, where we shared details around our robust solutions, the value we provide to our clients, the depth and experience of our senior leadership, the benefits of our global workforce and participants were also able to hear from 2 of our clients.

我還想強調我們的技術支持的收入周期管理解決方案，它在市場上真正與眾不同，因為它位於我們行業領先的最先進軟件技術產品之上，幫助我們在這個領域推動更好的收入增長成熟的 EHR 和實踐管理市場。它不僅是我們醫生的端到端解決方案，而且與供應商無關。同樣在第四季度，我們舉辦了第一個分析師和投資者日，我們在會上分享了有關我們強大解決方案的詳細信息、我們為客戶提供的價值、我們高級領導層的深度和經驗、我們全球員工和參與者的好處也能聽到我們 2 位客戶的意見。

I thought it was very beneficial, not only in educating the investor community, but also the potential user base of our comprehensive capabilities. I'm very pleased so many of you could join us for the informative event. We also use this event as an opportunity to announce that we were changing our common stock ticker symbol from MTBC to CCLD to better align with our corporate brand. We started trading at CCLD on January 10 of this year.

我認為這非常有益，不僅在教育投資者社區方面，而且在我們綜合能力的潛在用戶群方面也是如此。我很高興你們中有這麼多人能加入我們參加這次信息豐富的活動。我們還以此事件為契機，宣布我們正在將我們的普通股代碼從 MTBC 更改為 CCLD，以更好地與我們的企業品牌保持一致。我們於今年 1 月 10 日開始在 CCLD 交易。

I will now turn to an update on the organic growth strategy that we initiated in 2020. We are pleased to report that in 2022, we recorded our highest organic bookings growth of 94%. Over the past 2 years, we expanded our sales team from 13 people to over 50, which we believe is a significant factor driving this growth. Taking a closer look, we more than doubled the level of bookings from recurring revenue opportunities from 2021 to 2022. We also appointed new sales and marketing leadership in 2022 to better capitalize on the opportunities ahead of us. We anticipate that these trends will continue into 2023.

我現在將介紹我們在 2020 年啟動的有機增長戰略的最新情況。我們很高興地報告，在 2022 年，我們錄得了 94% 的最高有機預訂增長。在過去的 2 年裡，我們將銷售團隊從 13 人擴大到 50 多人，我們認為這是推動這一增長的重要因素。仔細觀察，從 2021 年到 2022 年，我們的經常性收入機會的預訂量增加了一倍多。我們還在 2022 年任命了新的銷售和營銷領導層，以更好地利用我們面前的機會。我們預計這些趨勢將持續到 2023 年。

We are laser-focused on converting our 2022 booking success into revenue in 2023. Excluding revenue from 2 large health system customers that we acquired and migrated to their acquired systems, we are forecasting 12% organic growth in 2023. Bill will get into this in more detail in a minute. Our goal is to produce double-digit organic revenue growth, and we believe we have a path to achieve that. Our 2023 outlook is driven exclusively by organic growth and any acquisitions would be incremental to our forecast.

我們非常專注於將 2022 年的預訂成功轉化為 2023 年的收入。不包括我們收購併遷移到他們收購的系統的 2 個大型醫療系統客戶的收入，我們預計 2023 年將實現 12% 的有機增長。比爾將在稍後會詳細介紹。我們的目標是實現兩位數的有機收入增長，我們相信我們有辦法實現這一目標。我們的 2023 年展望完全由有機增長驅動，任何收購都將增加我們的預測。

Let's turn now to our physical therapy EHR solution. Subsequent to the end of the quarter, just last week, in fact, at the American Physical Therapy Association's Annual Meeting, we launched a version of CareCloud stock EHR that is specifically tailored to meet the demanding needs of the rehabilitation market. It includes comprehensive and easy-to-use end-to-end tools for managing patient information and tracking their progress. In terms of the market dynamics for software solutions in the rehab space, it is fairly mature and dominated by a couple of vendors. But it is our understanding that innovation has not been at the forefront for some time. That is where we see the biggest opportunity for us.

現在讓我們轉向我們的物理治療 EHR 解決方案。在本季度末之後，就在上週，事實上，在美國物理治療協會的年會上，我們推出了 CareCloud 庫存 EHR 版本，該版本專門為滿足康復市場的苛刻需求而量身定制。它包括全面且易於使用的端到端工具，用於管理患者信息和跟踪他們的進展。就康復領域軟件解決方案的市場動態而言，它相當成熟，由幾家供應商主導。但據我們了解，創新已經有一段時間沒有走在前列了。這就是我們看到最大機會的地方。

Our remote product is already being used by a leading rehab practice consists of over 2,500 clinicians. This is an example of CareCloud challenging the status quo with a solution that we believe to be technologically superior. We are seeing strong interest in this offering and look forward to keeping you posted on our progress moving forward.

我們的遠程產品已經被一家領先的康復診所使用，該診所由 2,500 多名臨床醫生組成。這是 CareCloud 以我們認為在技術上更優越的解決方案挑戰現狀的一個例子。我們看到對此產品的濃厚興趣，並期待讓您了解我們的進展情況。

Finally, as we look to 2023, we feel our current established position in the industry has set us up incredibly well to capitalize on a new era of growth, and we see an abundance of emerging opportunities in our future, including our first non-U.S. customers. The first area of focus for 2023 that we are actively exploring is entering the new market of the UAE, which represents a particularly attractive opportunity for CareCloud as the government will be mandating EHR adoption over the next few years. This has many parallels to the meaningful use initiatives in the U.S. that we benefited from a decade ago.

最後，當我們展望 2023 年時，我們認為我們目前在行業中的既定地位已經讓我們非常好地利用新的增長時代，我們看到了未來大量的新興機會，包括我們的第一個非美國。顧客。我們正在積極探索的 2023 年第一個重點領域是進入阿聯酋的新市場，這對 CareCloud 來說是一個特別有吸引力的機會，因為政府將在未來幾年強制採用 EHR。這與我們十年前在美國受益的有意義使用計劃有很多相似之處。

We see these opportunities in the health system space through our medSR division, our proprietary ambulatory EHR for the private practice space, which will need to be certified with the Ministry of Health and prevention in tech-enabled RCM space and with various other digital health initiatives. We hope to enter this new market in the upcoming year, and we'll keep you updated on our progress. The company's solid operational results in 2022 can be attributed largely to our powerful combination of the technology and services, which are redefining the next generation of RCM solutions for the ambulatory setting.

我們通過我們的 medSR 部門看到了衛生系統空間中的這些機會，我們專有的私人診所門診 EHR 需要在技術支持的 RCM 空間和其他各種數字健康計劃中獲得衛生和預防部的認證.我們希望在來年進入這個新市場，我們會及時向您通報我們的最新進展。公司在 2022 年取得的穩健運營業績在很大程度上歸功於我們強大的技術和服務組合，它們正在重新定義下一代門診 RCM 解決方案。

To summarize, first, we are optimistic about our organic growth initiatives that are starting to take hold. Our Wellness digital health offering, our medSR hospital offering, our workforce augmentation offering, our expansion to non-U.S. markets where we feel we have a distinctive competitive advantage. Second, one of our top priorities in 2023 is onboarding our new clients and turning over record bookings into revenue. And finally, we feel that our work in 2022 has left us well positioned in the industry to deliver continued growth moving forward.

總而言之，首先，我們對開始紮根的有機增長計劃持樂觀態度。我們的 Wellness 數字健康產品、我們的 medSR 醫院產品、我們的勞動力增強產品、我們向非美國市場的擴張，我們認為我們在這些市場具有獨特的競爭優勢。其次，我們 2023 年的首要任務之一是吸引新客戶並將創紀錄的預訂轉化為收入。最後，我們認為我們在 2022 年的工作使我們在行業中處於有利地位，可以實現持續增長。

Now I will turn the call over to Bill for a closer look at our fourth quarter and full year results. Bill?

現在我將把電話轉給比爾，讓他更仔細地了解我們的第四季度和全年業績。賬單？

Thanks, Hadi, and thank you all for joining today's call. In the fourth quarter, we reported revenue of $32.5 million, GAAP net income of $499,000 and adjusted EBITDA of $5.7 million. For the full year, we reported revenue of $139 million, GAAP net income of $5.4 million and adjusted EBITDA of $22 million. These results were in line with expectations. Approximately 88% of our 2022 revenue came from technology-enabled business solutions. Clients using our technology-enabled revenue cycle management services represented approximately 52% of our annual revenue, with over 90% of that revenue coming from clients who also utilized our EHR or practice management software as well as our services.

謝謝哈迪，也感謝大家參加今天的電話會議。第四季度，我們報告的收入為 3250 萬美元，GAAP 淨收入為 499,000 美元，調整後的 EBITDA 為 570 萬美元。全年，我們報告的收入為 1.39 億美元，GAAP 淨收入為 540 萬美元，調整後的 EBITDA 為 2200 萬美元。這些結果符合預期。我們 2022 年收入的大約 88% 來自技術支持的業務解決方案。使用我們的技術支持的收入周期管理服務的客戶約占我們年收入的 52%，其中超過 90% 的收入來自也使用我們的 EHR 或實踐管理軟件以及我們的服務的客戶。

Let's look at the full year on a same-store basis, which is highlighted in our earnings presentation deck. You'll see we stripped out the contribution of 2 large customers to highlight our annual revenue performance on a consistent basis. These were each unique instances and it's important to dig into the details here. These 2 health systems had been acquired in 2016 and 2018 before we started servicing them after our 2020 acquisition of Meridian Medical Management. And in 2022, they finally completed the migration onto their acquirers' software platforms winding down our services.

讓我們在同店的基礎上看一下全年，這在我們的收益演示文稿中突出顯示。您會看到我們剔除了 2 個大客戶的貢獻，以始終如一地突出我們的年度收入表現。這些都是獨特的實例，在這裡深入了解細節很重要。這兩個醫療系統是在 2016 年和 2018 年收購的，然後我們在 2020 年收購 Meridian Medical Management 之後開始為它們提供服務。 2022 年，他們終於完成了向收單方軟件平台的遷移，結束了我們的服務。

We knew this was a likely outcome when we bought Meridian and adjusted our purchase price accordingly. While the timing was later than what we were originally led to expect, this meant that we earned some extra revenue and profit margin for 2 years. But the end of the extra revenue for these 2 large customers means that reported results overall look less favorable. Normalizing to remove the impact of these 2 customers, our revenue increased $8.6 million or 7% from 2021 to 2022, driven by a combination of our medSR acquisition in mid-2021 and organic growth. 2023, we anticipate our revenue growth on a like-for-like basis will be around 12%, but without eliminating the impact of these 2 customers, that growth is clouded.

當我們購買 Meridian 並相應地調整我們的購買價格時，我們知道這是一個可能的結果。雖然時間晚於我們最初的預期，但這意味著我們在 2 年內獲得了一些額外的收入和利潤率。但是，這兩個大客戶的額外收入結束意味著報告的結果總體上看起來不太有利。正常化以消除這兩個客戶的影響，我們的收入從 2021 年到 2022 年增加了 860 萬美元或 7%，這得益於我們在 2021 年年中收購 medSR 和有機增長。到 2023 年，我們預計我們的收入同比增長將在 12% 左右，但如果不消除這兩個客戶的影響，這種增長將變得陰雲密布。

Our GAAP net income of $5.4 million in 2022 was almost double our net income of $2.8 million in 2021 and set a new record. Our adjusted EBITDA of $22.2 million was also a record. Our fourth quarter revenue of $32.5 billion was down year-over-year, but excluding those 2 customers, the revenue from our core business would essentially flat from the fourth quarter of last year. Our adjusted EBITDA of $5.7 million was down 7%, which is less than our top line decline as a result of improving margins in our medSR business.

我們 2022 年的 GAAP 淨收入為 540 萬美元，幾乎是 2021 年淨收入 280 萬美元的兩倍，並創下了新紀錄。我們調整後的 EBITDA 為 2220 萬美元，也創下了歷史新高。我們第四季度的收入為 325 億美元，同比下降，但不包括這兩個客戶，我們核心業務的收入與去年第四季度基本持平。由於我們的 medSR 業務利潤率提高，我們調整後的 EBITDA 為 570 萬美元，下降了 7%，低於我們的收入下降幅度。

Turning to the balance sheet and cash flow. We ended the year with $12.3 million of cash. We generated $21 million of cash flow from operations for the full year 2022, $6 million of which came from the fourth quarter. In terms of our outlook for 2023, we are reiterating the guidance we provided at our December Investor Day. We expect revenue of $142 million to $146 million, which represents 12% organic growth when we strip out those 2 large customers from both 2022 and 2023. We have only included organic growth in our guidance. So if we complete an acquisition, even a small tuck-in, it will bring incremental revenue.

轉向資產負債表和現金流量。我們以 1230 萬美元的現金結束了這一年。我們在 2022 年全年從運營中產生了 2100 萬美元的現金流，其中 600 萬美元來自第四季度。就我們對 2023 年的展望而言，我們重申了我們在 12 月投資者日提供的指導。我們預計收入為 1.42 億美元至 1.46 億美元，當我們從 2022 年和 2023 年剔除這兩個大客戶時，這意味著 12% 的有機增長。我們的指導中僅包括有機增長。因此，如果我們完成收購，即使是小規模的收購，也會帶來增量收入。

We expect adjusted EBITDA of $24 million to $27 million, which implies 15% growth at the midpoint. Our quarterly revenue distribution will look a little different this year for 2 primary reasons. First, the loss of the 2 customers, which contributed revenue in the first half of 2022 and second, the timing of new revenue from our wellness offering, which is expected to ramp up in the back half of this year. In 2023, revenue will be weighted with approximately 44% in the first half and the remaining 56% in the second half of the year. This compares to 2022 results with 52% generated in the first half and 48% in the back half.

我們預計調整後的 EBITDA 為 2400 萬美元至 2700 萬美元，這意味著中點增長 15%。由於兩個主要原因，我們今年的季度收入分配看起來會有所不同。首先，失去 2 位客戶，這在 2022 年上半年貢獻了收入；其次，我們的健康產品帶來新收入的時間，預計將在今年下半年增加。 2023年上半年收入佔比約為44%，下半年佔比56%。相比之下，2022 年上半年的結果為 52%，下半年為 48%。

Our profitability will also be impacted by the seasonality of our business. First quarter revenue is always hurt due to deductibles in most medical insurance plans, which typically depresses revenue by 5% to 8% without impacting our costs since we process the same value of claims, but payments are lower as individuals pay their deductibles much more slowly than insurance making primary payments. This year will be no different. As we continue to focus on lowering our costs, we are forecasting improvement in our margins throughout 2023, despite the loss of the 2 customers who are generating higher-than-average gross margins by the time they exited.

我們的盈利能力也將受到業務季節性的影響。由於大多數醫療保險計劃中的免賠額，第一季度的收入總是受到損害，這通常會使收入降低 5% 至 8%，而不會影響我們的成本，因為我們處理相同價值的索賠，但由於個人支付免賠額的速度要慢得多，因此支付額較低比保險支付主要費用。今年也不例外。隨著我們繼續專注於降低成本，我們預計整個 2023 年我們的利潤率將有所提高，儘管這兩個客戶在退出時產生的毛利率高於平均水平。

To conclude my remarks, I'll reiterate Hadi sentiment that we have built out our solution to meet the changing needs of our physician partners, while sticking to our true roots as a world-class RCM provider. I believe 2023 will be a pivot point for our business, where organic growth really begins to accelerate. Our overarching goal is to deliver double-digit organic growth, and we believe we have built the foundation to achieve it in the future with the combination of new customers and cross-selling.

在結束我的發言時，我將重申哈迪的觀點，即我們已經建立了我們的解決方案來滿足我們的醫生合作夥伴不斷變化的需求，同時堅持我們作為世界級 RCM 提供商的真正根源。我相信 2023 年將是我們業務的轉折點，屆時有機增長將真正開始加速。我們的總體目標是實現兩位數的有機增長，我們相信我們已經通過新客戶和交叉銷售的結合為未來實現這一目標奠定了基礎。

I thank you all for your participation in our call today and look forward to updating you throughout the course of the year. I'll now turn the floor over to our Chairman, Mahmud, for his concluding remarks.

我感謝大家今天參加我們的電話會議，並期待在整個一年中為您更新。現在請我們的主席 Mahmud 發表總結性發言。

Thank you, Bill. 2022 gave us our strongest year of organic sales activity, both new customers and new services for existing customers. We are proud of this accomplishment and look forward to seeing this new business turn into revenue during 2023. I would like to thank our customers, shareholders and all our associates for their trust, loyalty, support of CareCloud's mission.

謝謝你，比爾。 2022 年是我們有機銷售活動最強勁的一年，包括新客戶和為現有客戶提供的新服務。我們為這一成就感到自豪，並期待看到這項新業務在 2023 年轉化為收入。我要感謝我們的客戶、股東和所有員工對 CareCloud 使命的信任、忠誠和支持。

Let's open the call to questions. Operator?

讓我們打開問題的電話。操作員？

(Operator Instructions) We take our first question from the line of Jeffrey Cohen with Ladenburg Thalmann.

（操作員說明）我們從 Jeffrey Cohen 和 Ladenburg Thalmann 那裡提出我們的第一個問題。

So just to clarify, Bill, the 2 customers' contribution to 2022 revenue was that $8.6 million I heard you call out?

因此，比爾，我想澄清一下，這 2 個客戶對 2022 年收入的貢獻是我聽到你喊的 860 萬美元？

Jeff, I think we said that $8.6 million was the revenue growth that we would have had if you exclude those customers. Their contribution was actually in total, a little closer to $10 million.

傑夫，我想我們說過 860 萬美元是如果你排除這些客戶我們本來會有的收入增長。他們的貢獻實際上是總共的，接近 1000 萬美元。

And could you talk about bookings and trends on that front or perhaps any backlog related to your funnel? Do you anticipate that the growth you'll see in '23 is going to come from new customers, new accounts in new territories? Or will that be amped up by increased offerings on EHR practice management and Wellness?

你能談談這方面的預訂和趨勢，或者與你的渠道相關的任何積壓嗎？您是否預計在 23 年看到的增長將來自新客戶、新地區的新客戶？還是會通過增加 EHR 實踐管理和健康方面的產品來加強？

Great question, Jeff. And I think if you just look at the overall booking, as we mentioned, that for 2022, we grew our booking numbers by about roughly 94%. 1/3 of those approximately are about -- we mentioned $8 million we closed under the Wellness offering during 2022. We absolutely see the similar trend going forward. We probably should be closing somewhere close to the same 1/3 at least for the foreseeable future quarters in terms of the Wellness. But the overall, the growth -- the bookings should be coming from all of these places, whether it's the different EHR offering, our tech-enabled RCM services sitting on top of our technology suite, our force offering and by leveraging through over medSR relationships and selling into that space, the recurring revenue RCM deals.

好問題，傑夫。我認為如果你只看整體預訂，正如我們提到的那樣，到 2022 年，我們的預訂數量增長了大約 94%。其中大約 1/3 大約是——我們提到了 2022 年我們在健康產品下關閉的 800 萬美元。我們絕對看到類似的趨勢向前發展。至少在可預見的未來幾個季度，就健康而言，我們可能應該關閉接近相同的 1/3。但總的來說，增長 - 預訂應該來自所有這些地方，無論是不同的 EHR 產品，我們的技術支持的 RCM 服務位於我們的技術套件之上，我們的力量提供以及通過 medSR 關係的槓桿作用並向該領域銷售，經常性收入 RCM 交易。

But it consecutively in the last 3 quarters were -- the consecutive quarter was better than the previous month. And we foresee, yes, it has to stabilize. It had to just stay at a certain average. It cannot just be that every other quarter can be better than the next one. But overall, if you look at it, our goals are for this year, even higher than the 2022 overall booking numbers.

但它在過去 3 個季度連續 - 連續一個季度好於上個月。我們預見，是的，它必須穩定下來。它必須保持在某個平均值。不能只是每隔一個季度就比下一個季度好。但總的來說，如果你看一下，我們今年的目標甚至高於 2022 年的總體預訂數量。

And then I guess, lastly, we hear you on cadence and on seasonality. Could you talk about -- are you taking any price out there? And could you also talk about inflationary pressures that you're seeing anywhere or any effect, particularly on your labor costs?

然後我想，最後，我們聽到了你關於節奏和季節性的聲音。你能談談——你在那裡接受任何價格嗎？您能否也談談您在任何地方看到的通貨膨脹壓力或任何影響，特別是對您的勞動力成本？

Great. And I can start the answer, and Bill, please feel free to jump in. I think you probably would be referring to some of the conversion, the rupee to dollar conversion or the foreign currency conversion costs and the inflation factors there. I think it's because all the revenue for us being generated so far on the U.S. side. So even there is a devaluation of the foreign currency that goes in the short term to our favor, long term, because as inflation start kicking in, it still goes back to a normalized at the same level.

偉大的。我可以開始回答了，Bill，請隨時插話。我想你可能會提到一些轉換，盧比到美元的轉換或外幣轉換成本和那裡的通貨膨脹因素。我認為這是因為到目前為止我們的所有收入都是在美國方面產生的。因此，即使外幣貶值在短期內對我們有利，但從長期來看，因為隨著通脹開始出現，它仍會回到正常水平。

So we do not see anything in the long run. Short term, there could be some additional benefit to us because of that change. But in the long term, it should again goes back to our overall thesis of our overall model of the leveraging the offshore team.

所以從長遠來看，我們看不到任何東西。從短期來看，這種變化可能會給我們帶來一些額外的好處。但從長遠來看，它應該再次回到我們利用離岸團隊的整體模型的整體論點。

Bill, anything you would like to add?

比爾，你有什麼要補充的嗎？

Yes. I mean we are -- I think we are fortunate that we're operating in labor markets where there's still lots of people who want to work. So when we look for new employees, fortunately, as we look overseas, we get plenty of really qualified applicants. Again, I don't have scientific data, but I'd say anecdotally, I hear from people who are using India for offshore that they're under a lot of pressure. And I'd say we're doing fine. We're treating our employees well. We're helping them keep pace with inflation. But we're not seeing overall dollar-denominated costs going up, and we're not seeing positions going unfilled. So we're fortunate that we're open for business. And if we get new contracts, and we're easily able to staff up to do the work.

是的。我的意思是我們 - 我認為我們很幸運，我們在勞動力市場上運營，那裡仍然有很多人想工作。因此，當我們尋找新員工時，幸運的是，當我們放眼海外時，我們會找到很多真正合格的申請人。再一次，我沒有科學數據，但我會說一些有趣的事，我從那些使用印度進行離岸業務的人那裡聽說他們承受著很大的壓力。我會說我們做得很好。我們善待我們的員工。我們正在幫助他們跟上通貨膨脹的步伐。但我們沒有看到以美元計價的整體成本上升，也沒有看到職位空缺。因此，我們很幸運能夠開展業務。而且，如果我們獲得新合同，我們就可以很容易地配備人員來完成這項工作。

We take the next question from the line of Allen Klee with Maxim Group.

我們接聽 Maxim Group 的 Allen Klee 的下一個問題。

You talked about one of your goals for this year is translating your bookings into revenues. Can you give some -- I think, specifically on the remote patient monitoring and chronic care programs of what you're planning to do to execute on that?

您談到今年的目標之一是將預訂轉化為收入。你能提供一些——我認為，特別是關於遠程病人監測和你計劃執行的長期護理計劃嗎？

Thank you for your question. And so first talking about the non-wellness offering bookings, that's continued to be, as we have mentioned before, to at 6 months average because large clients could be between 6 to 8 or 10 months, smaller could be within 3 months. And on average, it's about 6 months go lifetime for non-wellness bookings. For Wellness bookings, whether it's the chronic care management or remote patient monitoring that adds another layer of complication, which is the adoption by the patients. And I think what we are looking at right now will we close about $8 million bookings in 2022 for under the Wellness. We anticipate in the first half of this year -- actually, let me step back.

謝謝你的問題。因此，首先談論非健康產品預訂，正如我們之前提到的那樣，平均持續 6 個月，因為大客戶可能在 6 到 8 或 10 個月之間，較小的客戶可能在 3 個月內。平均而言，非健康類預訂的有效期約為 6 個月。對於 Wellness 預訂，無論是慢性護理管理還是遠程患者監控，都會增加另一層複雜性，即患者的採用情況。而且我認為我們現在正在考慮的是，我們是否會在 2022 年完成約 800 萬美元的 Wellness 預訂。我們預計在今年上半年 - 實際上，讓我退後一步。

The roughly 70% of that already have been moved in production. But when I say moved in production, it's not that we have started to generate the revenue. Some of that could be that we are reviewing the eligibility of the patients. We may have been establishing the connections with the patient to bring them on board that can -- they be interested in participating in chronic care and remote patient monitoring.

其中大約 70% 已經投入生產。但是當我說開始生產時，並不是說我們已經開始產生收入。其中一些可能是我們正在審查患者的資格。我們可能一直在與患者建立聯繫，讓他們參與進來——他們有興趣參與長期護理和遠程患者監測。

In terms of the revenue recognition, we anticipate that roughly 25% of the 70% that we have moved in production will be realized or we will be able to realize in the first half of this year. The rest will be towards or most of it will be towards the second half of the year and some percent probably could even be pushed into 2020. This adoption absolutely will improve as there will be more and more awareness on the patient side as the more and more value-based care models will push in. I think that awareness will improve the patient adoption rates. But this is how we are forecasting. This is how we are looking at it right now.

在收入確認方面，我們預計我們在生產中轉移的 70% 中大約有 25% 將實現，或者我們將能夠在今年上半年實現。其餘的將在下半年或大部分將在下半年完成，甚至可能會推遲到 2020 年。這種採用絕對會有所改善，因為隨著越來越多和越來越多的患者方面將有越來越多的意識。更多基於價值的護理模式將會推進。我認為意識將提高患者的採用率。但這就是我們的預測方式。這就是我們現在的看法。

And my last question is you talked about expanding internationally. Could you just educate us a little bit on what the regulatory environment or what the other incentives are in those countries to adopt what you're offering?

我的最後一個問題是你談到了國際擴張。您能否簡單介紹一下這些國家/地區的監管環境或其他激勵措施以採用您所提供的產品？

Thanks,Allen. Just talking a bit about the high level. First of all, this is, for us, a work in progress. We are still in discussion and talking to even where possible, the government officials as well in that area. So it will take us a couple of more months to be able to exactly understand all the different incentives. But in terms of an opportunity, as I mentioned during the opening remarks, that similar to how the EMR adoption was conducted at the beginning of -- in the first -- around the 2000 time after the Obamacare and the meaningful use and those implementations started to take place.

謝謝，艾倫。只談一點高水平。首先，對我們來說，這是一項正在進行的工作。我們仍在與該地區的政府官員進行討論和交談，甚至在可能的情況下。因此，我們還需要幾個月的時間才能準確理解所有不同的激勵措施。但就機會而言，正如我在開場白中提到的那樣，這類似於在奧巴馬醫改和有意義的使用以及這些實施開始之後的 2000 年左右開始採用 EMR 的方式發生。

In this UAE market and more specifically, initially talking about the Dubai market, the UAE government is similarly pushing the implementation of adoption of the electronic health record systems. So we see our -- the opportunity in 3 areas. One is leveraging our medSR division and providing an opportunity for implementation, activation of these health systems in that space, UAE initially, and then we anticipate expanding to the other -- the GCC region could be Qatar, could be Saudi Arabia in that area.

在這個阿聯酋市場，更具體地說，最初談論的是迪拜市場，阿聯酋政府同樣在推動電子健康記錄系統的採用。因此，我們在 3 個領域看到了我們的機會。一個是利用我們的 medSR 部門，並提供在該領域實施、激活這些衛生系統的機會，最初是阿聯酋，然後我們預計會擴展到另一個——海灣合作委員會地區可能是卡塔爾，也可能是該地區的沙特阿拉伯。

The second opportunity is our own ambulatory EHR, which we need to get it certified first, but then we can start offering it in that area. And the third thing is the revenue cycle. And we understand the revenue cycle of that area is different than -- the definition of RCM is different than that of the U.S. because everything -- there's one standard platform, the practices we'll have to log on to the same platform to create the claims, the insurances and the government authorities have to log on to the same portal to pull the claim for processing. But our U.S.-based medSR trained staff and positioning and our workforce, the global workforce, primarily based out of Pakistan. These 2 combinations together, we believe, set us in a very unique position there, and that set us up for success in that area.

第二個機會是我們自己的門診 EHR，我們需要先對其進行認證，然後我們才能開始在該領域提供它。第三件事是收入周期。我們了解該地區的收入周期不同於 - RCM 的定義與美國不同，因為一切 - 都有一個標準平台，我們必須登錄到同一平台才能創建的做法索賠、保險公司和政府當局必須登錄同一門戶網站以提取索賠以進行處理。但是我們在美國的 medSR 訓練有素的員工和定位以及我們的勞動力，全球勞動力，主要來自巴基斯坦。我們相信，這兩種組合在一起，使我們在該領域處於非常獨特的位置，並為我們在該領域的成功奠定了基礎。

There are a lot of initiatives from government. There's -- we are initially reviewing. And again, once we get it finalized, we will communicate, there's a health city there. We probably may end up opening an office in the health city because that gets us connected with all the different players in the industry in the market there.

政府有很多舉措。有 - 我們最初正在審查。再一次，一旦我們完成它，我們將進行溝通，那裡有一個健康城市。我們可能最終會在健康城開設辦事處，因為這讓我們能夠與那里市場上的所有不同行業參與者建立聯繫。

We take the next question from the line of [Michael Donovan] with H.C. Wainwright.

我們從 [Michael Donovan] 和 H.C. 接聽下一個問題。溫賴特。

I'm calling on behalf of Kevin Dede as he's on the road. Hadi, you mentioned leveraging relationships to drive recurring revenue. Can you talk more to recurring revenue and how customers expand services with CareCloud once they're onboarded?

我代表 Kevin Dede 打電話給他，因為他正在路上。 Hadi，你提到了利用關係來推動經常性收入。您能否更多地談談經常性收入以及客戶在入職後如何使用 CareCloud 擴展服務？

Thank you, Michael. There are a couple of different ways we can look at it. One, I specifically made that comment from the medSR division's perspective. One of the reasons for the acquisition of the medSR business was because of their 200-plus relationships into the health system space into the hospitals, their connections, whether it's with the right decision-makers, whether it's the CFO or the head of the revenue cycle or the CIOs there. So with their help, we are able to now leverage those relationships and started to offer RCM recurring revenue deals in that space. As we explained earlier and build it too, that this is a onetime project-based revenue, most of the revenue of the medSR. But because of disconnection now, we are able to leverage those relationships and start selling our tech-enabled RCM solution.

謝謝你，邁克爾。我們可以通過幾種不同的方式來看待它。第一，我是專門從 medSR 部門的角度發表評論的。收購 medSR 業務的原因之一是因為他們在衛生系統領域與醫院的 200 多個關係，他們的聯繫，無論是與正確的決策者，無論是首席財務官還是收入負責人循環或那裡的首席信息官。因此，在他們的幫助下，我們現在能夠利用這些關係並開始在該領域提供 RCM 經常性收入交易。正如我們之前解釋並構建它的那樣，這是基於項目的一次性收入，是 medSR 的大部分收入。但由於現在斷開連接，我們能夠利用這些關係並開始銷售我們的技術支持 RCM 解決方案。

And the proof has already started to come in because this year, in 2022, the RCM-related revenue of medSR division has grown by over 300%. So that already have set us up for success in that area. So that's what we anticipate even growing further in 2024. And actually, I have Dwight with me who heads our medSR Division. Dwight, would you like to give some more color?

證據已經開始出現，因為今年，即 2022 年，medSR 部門與 RCM 相關的收入增長了 300% 以上。因此，這已經為我們在該領域的成功做好了準備。因此，這就是我們預計在 2024 年甚至會進一步增長的目標。實際上，我和 Dwight 一起領導我們的 medSR 部門。德懷特，你想再給點顏色嗎？

Sure. I'd be more happy to. And to kind of highlight Hadi's point, we saw several of our clients this year start out with something as simple as a technology system selection process. And then that ramps right into staffing an interim CIO right into taking over a lot of the RCM components to now management and doing things around where we really get true recurring -- our senior recurring revenue. And we've seen that in several of our clients this year.

當然。我會更樂意。為了強調 Hadi 的觀點，我們看到今年我們的一些客戶從技術系統選擇過程這樣簡單的事情開始。然後，這會直接為臨時 CIO 配備人員，接管許多 RCM 組件，現在進行管理，並圍繞我們真正獲得真正經常性收入的地方做事——我們的高級經常性收入。今年我們已經在我們的幾個客戶身上看到了這一點。

And to get better understanding on international expansion. So UAE's trying to position itself to also be a medical tourism hub. Is this something you take into consideration when looking for new markets?

並更好地了解國際擴張。因此，阿聯酋正試圖將自己定位為醫療旅遊中心。這是您在尋找新市場時考慮的因素嗎？

You hit it the nail on the head, Michael. Absolutely, that's one of our reasons on the digital health space because based on the different studies, we looked at places is one consistent number that market is expected to grow by 25% CAGR in the digital health space over the next few years. And we started a small project or initiative. I think probably 2 years back for the telehealth under creating a platform or providing a platform on which we can connect on one side, the doctors and the other side of patients. So with this introduction of it stepping into this, the Middle East side, we are planning on or thinking about trying to get that live. So with coming back to your point, yes, that is one of the reasons the medical tourism there.

你一針見血，邁克爾。當然，這是我們關注數字健康領域的原因之一，因為根據不同的研究，我們看到一個一致的數字，即未來幾年數字健康領域的市場預計將以 25% 的複合年增長率增長。我們開始了一個小項目或倡議。我認為遠程醫療可能在 2 年前就創建了一個平台或提供了一個我們可以在一側、醫生和患者的另一側進行連接的平台。因此，隨著它在中東方面的引入，我們正在計劃或考慮嘗試實現它。所以回到你的觀點，是的，這是那裡醫療旅遊的原因之一。

(Operator Instructions) Ladies and gentlemen, we have reached the end of the question-and-answer session. And I'd now like to turn the call back over to Kim Blanche for closing remarks. Over to you.

（操作員說明）女士們，先生們，我們的問答環節已經結束。現在，我想將電話轉回給 Kim Blanche，請其作結束語。交給你了。

We'd like to thank everyone who's joined us today. We appreciate your interest in us as a company and your participation on today's call. We look forward to speaking with you again next quarter. Thank you all, and have a great day.

我們要感謝今天加入我們的每一個人。感謝您對我們公司的關注以及您參與今天的電話會議。我們期待下個季度再次與您交談。謝謝大家，祝你有美好的一天。

Thank you. Ladies and gentlemen, this concludes today's teleconference. You may disconnect your lines at this time. Thank you for your participation.

謝謝。女士們，先生們，今天的電話會議到此結束。此時您可以斷開線路。感謝您的參與。