HealthStream Inc (HSTM) 2024 Q2 法說會逐字稿

Good morning, and welcome to HealthStream second quarter 2024 earnings conference call.

At this time, I would like to inform you that this conference is being recorded and that all participants are in a listen only mode.

At the request of the company, we will open the conference up for questions-and-answers after the presentation.

I will now turn the conference over to Mollie Condra, Vice President and Investor Relations and Communications.

Please go ahead, Ms. Condra.

Thank you.

Good morning, and thank you for joining us today to discuss our second quarter 2024 results.

Also in the conference call with me is Robert A. Frist, Jr, CEO and Chairman of HealthStream, and Scott A. Roberts, CFO and Senior Vice President of Finance and Accounting.

I would also like to remind you that this conference call may contain forward-looking statements regarding future events and the future performance of HealthStream that involve risks and uncertainties that could cause the actual results to differ materially from those projected in the forward-looking statements.

Information concerning these risks and other factors that could cause the results to differ materially from those forward-looking statements are contained in the company's filings with the SEC, including forms 10-K, 10-Q and our earnings release.

Additionally, we may refer to measures such as adjusted EBITDA, which is a non-GAAP financial measure.

A table providing supplemental information on adjusted EBITDA and reconciling to the net income attributable to HealthStream is included in the earnings release that we issued yesterday and may refer to in this call.

So at this time, I'll turn the call over to CEO, Bobby Frist.

Thank you, Mollie, good morning, everyone, and welcome to our second quarter 2024 earnings call.

We'll just jump right in and hit some of the key highlights.

Pleased to report, during the second quarter, our financial performance showed year-over-year increases in each of the major categories that we highlight earnings release.

So we finished the quarter with strong sales and solid sales pipeline, and we are able to reiterate our 2024 guidance ranges.

In particular, we're seeing strong sales pipelines on CredentialStream in our credentialing area, ShiftWizard in our scheduling area and our new enterprise competency suite in learning, and we'll talk more about some of these later in the call, which we believe that the emerging enterprise company suite is the most complete offering of its kind in the industry.

I'm also excited by ongoing progress towards key development milestones on our HealthStream platform and as I promised last time, we're going to give a bit of a platform update, at least through the technical lens of developmental progress.

We're beginning to see the first examples of interoperability between our applications, which is the kind of the great promise of the platform.

And we're seeing how customers and partners utilize components of the platform to enhance interoperability with their other systems like ERPs and EHRs.

Amid all those positive developments, we're going to have to talk about and continuing to one-time customer related events in the second quarter that resulted in some temporary headwinds that we're confident we'll push through over the course of the year.

So let's address those kind of upfront here.

One headwind impacting revenue growth in the quarter, was based on the timing anomaly at one of our larger customers.

Importantly, we believe this anomaly will self-correct over the remainder of the year, such that is not expected to negatively impact full year revenue.

What happened was both simple and understandable.

We'd like to avoid it next time, but simple and understandable.

Essentially, administrative responsibility for assigning and setting completion dates or completion requirements for a certain cohort of learners, it was obviously a big cohort, because it's a big customer, changed.

And what happened was thousands of learners who were previously required to complete certain courses in 90 days were given 365 days to complete the courses by the assignment.

And of course, if you're anything like me and someone says, well, you have to finish something in 90 days or you have to finish something in 365 days, what the most people do?

They I'd put it off.

That's exactly what happened here.

Once the customer realized kind of what had happened in this administrative function in our system were both taking steps to address it because they don't -- they also don't want tens of thousands of employees rushing on the last day to do that.

So kind of overwhelm the system any to take it throughout the year.

And so they're self-correcting this process.

And once we took steps on customer realize what happened, we think that it will get the completion rates will accelerate for the remainder of the year and come back in full year as originally forecasted despite the unexpected slowdown.

And the reason this happened and why it's tight economics is for a subset of content that we sell this customer, we bill and recognize revenue based on consumption that occurred in the quarter.

So again, for a subset of content we sell this customer is based on actual consumption.

So that is why slower consumption of certain content in the quarter resulted in lower revenue and while accelerated consumption in the rest of the year is expected to normalize for the revenue for the customer.

This is the only instance of consumption-based billing that we have at scale and we do not plan to expand this type of billing model going forward at any rate, we expect the revenue to catch up in the second half of the year.

So we're not particularly concerned about it.

The second one-time customer event that is in front of us and also currently in the quarter had an impact in the quarter and also, as you look forward is due to the widely publicized bankruptcy of one of our strategic accounts, Steward Health Care System.

Historically, a great customer, ran some financial difficulties and declared bankruptcy during the second quarter.

The impact of missed payments from periods prior to the bankruptcy filing had a negative impact on net income, adjusted EBITDA, earnings per share and operating income, in the second quarter.

We expected negative impacts to revenue and other financial metrics in the last half of the year as well.

We've estimated these negative impacts and they're factored into our reiterated guidance.

At present, we believe that the impact from this bankruptcy may move us toward the lower end of our revenue guidance range, we'll see how it impacts us as we move forward.

Because that said, it's possible that the bankruptcy will allow the customer to make payments in the second half of the year and as we continue to provide services.

And it's also possible that they've announced or divesting of facilities that some of those divested facilities, land and friendly places or places that also use our services, in which case we would be able to generate some of the business in the second half of the year.

Those are potential mitigating factors, and we're not counting on them, we expect this customer bankruptcy to have an ongoing negative impact to our financials this year.

Again, it's factored into our reiterated guidance, although I did note that we believe the impact may move us towards the lower end of our revenue guidance range.

Before we get any further the call, I want to summarize our business for the benefit of anyone who is new to HealthStream story.

First and foremost, HealthStream and health care technology company dedicated to developing credentialing and scheduling health care workforce through SaaS based solutions, each of which are becoming more valuable because of the interoperability they're achieving through our hStream technology platform.

Historically, we sell our solutions on a subscription basis under contracts that average three to five years in length, which makes our revenues recurring and predictable.

In fact, 96% of our revenues are subscription base.

As I just mentioned, we've also started to open our sales channels directly to health care professionals and nursing students across the continuum of health care training.

We are profitable, we have no interest bearing debt and a strong cash balance of $83 million, we're solely focused on health care, and more specifically the healthcare workforce.

The 12.3 million health care professionals and nursing students in the United States comprise the core addressable market for our SaaS solutions.

Before turning it over to our CFO, Scotty Roberts.

I'd like to highlight some successes that we've achieved in each of these core application areas.

Learning, scheduling, credentialing.

The accomplishments during the quarter made some really fantastic progress.

Let's start with our learning application suite, we've got some exciting announcements in the second half of the year related to enhancing the capabilities of this very powerful area of our business the learning application suite.

The HealthStream Learning Center application is the flagship product and continues to be strong in the market.

And importantly, when HealthStream Learning Centers up for renewal, it frequently presents customers an opportunity to purchase multiple new solutions along with it.

This results in expanding wallet share, we've talked about that on previous calls, and I want to give an example of expanding wallet share that happened on HealthStream Learning Center renewal in the second quarter.

One of our West Coast customers use their renewal of the HealthStream Learning Center and an opportunity to add additional products to those that were already using.

Including the adoption of our new insights plus reporting and analytics tool, due to the growth of the organization also added approximately 5,400 users to their base of 22,000.

So meaningful growth there.

The new five-year agreement includes 3.5% pricing escalator, and that's new we're really working hard now too work pricing escalators and the renewal contracts.

And in this case, we did a 3.5% annual pricing escalator, and that's going to give us a nice line of sight into year-over-year growth.

The annual recurring revenue from this renewal increased 111% from approximately $376,000 to $795,000, making this a really good example of expanding wallet share in our existing customer base.

Let's move to our scheduling application suite.

We believe that our SaaS application on a ship wizard is the best scheduling solution in healthcare, and that will only become more valuable customers as it begins to integrate with other applications through our eight stream technology platform.

In the second quarter, revenues from ship wizard grew 34% over the prior year quarter as customers continue to report high customer satisfaction with this application.

As of the second quarter of 2024 shifts wizard has become the largest revenue generator in our portfolio of scheduling products and services and that includes legacy applications like ANSOS and Enterprise Visibility.

So it's a nice milestone during the second quarter for the go forward application to become bigger in revenue mass than all the other legacy applications in the portfolio, the family of products, we call our scheduling family of products.

So that's an exciting kind of milestone was achieved during the second quarter.

We contracted a number of great new customers to ShiftWizard in the quarter, such as Stillwater Medical Center, Mary Free Bed Rehabilitation, Roswell Park and Read Hospital are really nice examples of the expansion of ShiftWizard.

I'll wrap up this portion of the call with an update on our credentialing solutions also enjoyed a successful quarter, both in terms of competitive takeouts and conversions from our legacy solutions to credential stream.

As reported on the G2 website, CredentialStream is best-in-class solution for credentialing, privileging, enrolling physicians.

In the second quarter, credential strain added 34 new customer organizations where approximately 65% of these customers were new and 35% were migrations from our legacy credentialing applications, which we really like to see that when they move up from the legacy applications to the CredentialStream application suite.

Representative of these CredentialStream customers in the second quarter are many highly respected health care organizations like Baptist South Florida, Oregon Health and Science Medicine, Penn Medicine and Pine Rest Christian Mental Health, so really nice broad spectrum of new customers, 34 in the quarter and that's interesting because that kind of matches the growth profile of that application at 34% as well.

So 34 and 34, it's fantastic results.

Good results team.

I'll turn it over to Scotty Roberts for the review of the financials and they'll come back to me and as promised, we'll get a platform update on a streaming platform, and we'll talk about a new market that's emerging for one of our exciting products CredentialStream will hit both of those.

And then I'll turn it over to Scotty for a few minutes.

All right.

Thanks, Bobby, and good morning, everyone.

So I'd like to begin my comments about the quarter's results by quantifying the customer bankruptcy matter and the negative impact it had on our results for the quarter.

As Bobby described a few moments ago, one of our customers filed for bankruptcy protection in the second quarter and at the time we had over $1 million of receivables owed by the customer, which led to us recording an operating loss of approximately $1 million during the quarter.

To be clear, there was no impact on revenue in the second quarter as the loss related to uncollected fees prior to their bankruptcy filing.

Due to the ongoing uncertainty about this customer's future.

And given they announced a plan to divest many of their facilities, we have factored the potential lost revenues of $1 million and lost profits of about $0.5 million into our financial expectations for the second half of the year.

To recap, the customer bankruptcy negatively impacted the second quarter's operating income by $1 million, net income by $0.8 million, earnings per share, about $0.02 per share and adjusted EBITDA by $1 million.

So now with that said, I'll now go over the results for the quarter.

Unless otherwise noted, the comparisons will be against the same period of last year.

Revenues for the quarter were $71.6 million, up 3.4%.

Operating income was $4.4 million, up 10.1%.

Net income was $4.2 million, up 0.8%.

Earnings per share were $0.14 per share, up from $0.13 per share and adjusted EBITDA was $15.8 million and was up 3.3%.

Our revenues increased about $2.4 million or 3.4% coming in at $71.6 million compared to $69.2 million in last year's second quarter.

Revenues from our subscription products accounted for 96% of total revenues and were $69 million, increasing by $2.5 million or 3.8% and professional services revenues were $2.5 million and declined by $1.1 million or 5.5%.

There are a few puts and calls on revenue that I want to provide some more color on.

First, the impact of the consumption variance from one of our larger accounts was approximately $0.5 million, specifically their consumption declined by this much compared to the first quarter.

So it was a timing variance against the run rate that we expected.

As Bobby mentioned earlier, we believe this decrease in consumption was an anomaly.

It will generally normalize and correct over the course of the last half of the year.

Overall, revenue from our scheduling application ShiftWizard grew 34% over the prior year quarter.

Our subscription revenue from ShiftWizard grew by 18% and its onetime implementation services revenue grew 145% over last year.

While we place a premium value on subscription revenue over time, strong services revenue from ShiftWizard is a positive indicator as it generally comes with implementation fees, meaning we were busy implementing new shipped with our customers in the quarter.

And once these customers are implemented, that's when they began contributing to the subscription based revenue, the counter to ShiftWizard strong growth as an ongoing attrition from the ANSOS scheduling products, which declined by 600,000 or 15% versus last year.

For example, within our scheduling application suite and soft attrition almost fully offset the solid growth that we achieved from ShiftWizard.

And lastly, our initiative to sell directly to professionals through our e-commerce channels delivered approximately $0.8 million of revenue in the quarter, which is up by 41% over the first quarter.

Our remaining performance obligations were $538 million as of the end of the second quarter, which compares to $511 million for the same period of last year.

And we expect approximately 43% of the revenue backlog.

So they converted over the next 12 months.

Gross margin came in at 66.8% compared to 65.9% last year.

This improvement is primarily due to the growth in revenues, while our costs increased by less than 1%.

Operating expenses, excluding cost of revenues increased by 4.3% and most of this year-over-year increase was from product development, which was up 9.5%, while G&A costs were up 5.4% and were primarily impacted by the bad debt charges that I previously mentioned.

Adjusted EBITDA was $15.8 million, which is up 3.3%.

And adjusted EBITDA margin was 22.1% compared to 22.2% last year.

Now, let's take a look at the balance sheet metrics, we ended the quarter with cash and investment balances of $83 million, down slightly from $83.7 million last quarter.

During the quarter, we deployed $6.7 million for capital expenditures and paid $0.8 million to shareholders through our dividend program.

We also made $5.5 million of income tax payments in the quarter and for comparison purposes in last year's second quarter, our income tax payments were $2.5 million.

Our days sales outstanding improved to 45 days compared to 50 days last year, which is a positive result despite the bad debt charges from the customer bankruptcy that we just mentioned earlier.

Year to date, our cash flows from operations were up 7% over the prior year, coming in at $27.4 million and free cash flows improved by $2.1 million or 20% and were $12.9 million, with a strong balance sheet containing $83 million of cash and no debt.

We are well positioned to deploy our available capital in a variety of ways, improve shareholder value, including pursuing acquisitions, paying dividends or making share repurchases.

From an M&A perspective, we maintain an active pipeline and continue to evaluate opportunities that fit our criteria, which include industry product and financial, among others.

In respect to our dividend program, yesterday, our Board of Directors declared a quarterly cash dividend of $0.28 per share to be paid in August, and we currently don't have an active share repurchase program in place.

Now moving on to guidance, as I mentioned in my opening remarks, we factored in the expected lost revenue and profit associated with the customer bankruptcy into our assumptions.

We continue to expect that consolidated revenues will range between $292 million and $296 million, though, given what I just said, we expect the bankruptcy impact may tend to move us towards the lower end of our revenue guidance range.

We expect net income to range between $16.7 million and $18.6 million, adjusted EBITDA to range between $64.5 million and $67.5 million and capital expenditures are expected to range between $28 million and $30 million.

This guidance does not include assumptions for any acquisitions that we may complete during the year.

Now looking at this to the second half of the year, we expect that sequential quarterly growth in our revenue and the combination of working through the backlog of contracts that we've sold but not implemented.

Particularly there was within our credentialing and scheduling application suites.

Revenue contributions from strong bookings that we experienced at the end of the second quarter, a solid sales pipeline and the catch-up from the consumption shortfall in Q2 are factored into our revenue guidance range.

So that concludes my comments for this quarter's earnings call.

And thanks for your time this morning.

And I'll now turn it back over to Bobby for some additional updates.

Thank you, Scotty.

We'll wrap up here with a platform update as I mentioned and a new market that we're beginning to pursue with our CredentialStream application at this time.

Let's talk about some key hStream platform initiatives.

If you think overall our focus is to cement our position as health care's people platform.

We believe there is a place alongside the ERP vendors and the EHR systems for an integrated set of application suites providing functionality specific to the needs of the healthcare organizations and their workforce.

The management of and development of their people.

At the center of our strategy is building a platform that we call hStream, that provides the foundation for these application suites as well as some applications and analytics that overlay and enrich those suites.

The primary way we monetize this platform today is through three subscription products, one for each of our application suites in learning, credentialing and scheduling.

We have sold hStream for learning and hStream for credentialing for several years, and we introduced a stream for scheduling in late 2023.

Since then, we have been selling hStream for scheduling with our core scheduling product ShiftWizard, each of these subscription products provides customers access to the hStream platform and exclusive applications, services, content and other benefits that come with that subscription.

We continue to add new benefits to each of these three hStream packages, a key component of both our platform strategy and the functioning of the platform itself is having a single identifier for all those individuals in our ecosystem we call this their hStream ID.

We continue to increase the number of individuals with hStream IDs in significant part by adding hStream ID functionality to more of our own applications.

For example, in April 2023, we began requiring students using our myClinicalExchange application to create or add an hStream ID.

And we have added over 110,000 new hStream IDs through to myClinicalExchange app.

Since that time of our initial -- of our 23 internal applications that are candidates for integration with hStream ID. 14 now have some integration using hStream ID as a native login or enabling a user to link an hStream ID.

Four are in the process of actively developing hStream integration and the remaining five have hStream integration on their near term roadmaps.

Another key component of our platform strategy and the functioning of the platform itself is centralizing certain functional domains, particularly around people into platform services and APIs.

Currently, we have three of these services live, professional license service and API, professional certification service and API and a learning transcript service and API, each of these services and APIs acts as both a clearinghouse and a source of validation or verification for the data within, for example, all applications can write professional licenses to the professional license service or read licenses from it.

The service is also connected to our validate service and API.

So that licenses may be primary source verified against thousands of official endpoints.

Rather than have this functionality scattered and managed by each individual application that is now shared service.

We're adding large numbers of licenses, certifications and learning events to the services.

And we are continuing to build out other services and the people domains like education history, work history, volunteer activities, and others.

We expose access to these services and APIs through our hStream developer portal.

There are now 12 APIs and web books available on the portal, comprising hundreds of endpoints, enabling customers and partners to integrate interact with most of our key applications.

Since its launch at the end of 2022, nearly 400 developers representing over 120 customer organizations have been permitted access to the developer portal.

These developers and organizations have built nearly 30 live integrations with another 30 integrations in development.

These integrations, tire applications to other key applications like ERP and the EHR systems in ways that make our applications mission critical and essential to key workflows.

We continue to add APIs to the portal and engage with more customers and developers in the portal.

Another and shifting gears, another exciting update today, I want to share is that our credentialing business is expanding to address the health plan market and some of you asked in previous quarters because we announced the win at Blue Cross Blue Shield, Arkansas, would we be pursuing the market?

I guess I'm here today to say, yes, it's early stages.

But we have signed 10 health plans in the last, say, two years, including the Blue Cross Blue Shield of Arkansas that I mentioned, but also some health plans attached health systems like the Banner Health Plan, the Providence Health Plan and our tailored solution for this market is called network by HealthStream, and it offers the industry's only network relationship management system we call it in our end, in the future, we believe HealthStream will be in a unique position to connect payers and healthcare system in a way that will enhance the credentialing and verification abilities of both.

We are planning an expanded marketing approach for network the product by HealthStream later this year.

And to the extent we begin to see greater market expansion in the health plan market, who will update you later in the year for now, I'll just note that we're excited to be addressing this new set of buyers, and we obviously made some progress with the 10 accounts that we've already secured for the network product.

I'll also note the large majority of the revenue from our sales to health plan customers is yet to be recognized as these are new sales and we're still in the process of implementing them again, another competence factory in the second half of the year.

As I think about summarizing, I'd say, kind of a profile our company and before we go to questions is your view the investors are instantly profitable, highly recurring revenue, SaaS, past healthcare technology company expect to deliver steady growth and has determined to share some of its games directly shareholders in the form of dividend.

Maybe HealthStream is a good company and stock for you to look at, I want to close by sharing that in June, HealthStream was ranked as the ninth best company to work for among US health services companies by US News & World Report.

The panel of experts who selected us for this prestigious recognition weighed the comments and sentiments from our employees heavily into their analysis.

I want to thank all of our employees for making HealthStream our company culture and very positive on how we work together to improve the quality of health care by developing the people who deliver care, turn it back over to operator for Q&A.

And Scott, he is on board to help answer questions.

Thank you, sir.

The question-and-answer session will begin at this time.

(Operator Instructions)

Matt Hewitt, Craig-Hallum.

Good morning and congratulations on the progress.

Maybe first up just because it's front of mind for a lot of people on the CrowdStrike situation.

Obviously, there's been a lot of commentary about hospitals being impacted it.

Was there any impact for HealthStream directly?

And what are you hearing from customers?

And are they able to get back up and running here quickly?

Great question.

From our perspective, the impact was minimal on us.

And therefore, I guess by extrapolation as it relates to our products, our customers, and we did find one or two of a few isolated cases where it was impactful.

But I think we were able to work through that fairly quickly.

And so I haven't gotten the full briefing from our team, but the first quick reports were that the impact on our base as it relates to the use of our products was minimal and almost non-existent across our broader network.

That's great.

And then kind of following up on your last commentary there about the network by HealthStream, how much does that increase your end market opportunity?

I mean, I think the last count we were up to like $8 million potential employees that could be using one or more applications from HealthStream, this obviously expands that market, but how should we be thinking about size of that opportunity?

We haven't really scoped it yet.

We're working on that as we recalibrate our launch, we've got initial success, as we mentioned, in 10 locations, mostly health plans attached to health systems currently, but that Blue Cross Blue Shield of Arkansas and several in the pipeline.

We feel good about our opportunity there.

Work on quantifying we intentionally didn't add it yet to our TAM.

We want to see it see a progress a little more, but it's an official target of our marketing team.

We've tailored the product and rebranded it.

I guess we'll report on how it impacts the way we think about TAM in the coming quarters.

Thanks for the question, though.

Got it.

And then maybe one last one.

I'll hop back in the queue, but I think you mentioned on the West Coast customer that you called out with the price escalator, 3.5% increase with the renewal.

Is it fair to look at it broadly across your customers and maybe on an annualized basis looking at those, the price is a component and how should we be thinking about that 3% is kind of a base growth for your revenues and then obviously, the cross-selling and the new opportunities with new customers and all of that you get with this, what can get you to back to maybe a double digit type growth rate on the top line?

Well, it could be a component, of course, adding to our growth.

Well, we've never really used escalators at any scale at all across all of our contracting.

Our pricing models are based on term, they get a discount for term, a discount for volume commitments.

So term and volume has been our primary drivers, which, as you can imagine, a tech firm generally has a slight downward pressure as people grow and add volume or agree to add term of their contracts.

This is a new it took us over a year of planning to roll out the escalator model includes educating your sales teams, changing legal documents, teach them how to negotiate with renewals and include price escalators.

What I'd say is that a very low sub single digit -- in the single digits, low single digits of our contracts, even have escalators at all.

Now we've signed three to five year agreements.

And so escalators can only be infused as renewals come up and they take place over time.

And so I think it's going to take several years to have a really meaningful impact.

But it's nice that we're beginning to work it into our either the way we operate now.

We've been able to put dozens and dozens of contracts given our training and sales training and tools and automation and contracting fairly easily without much resistance from customers.

I think they expect in some ways it helps them plan their budgets better than going three years and facing a bigger price increase.

And so those two things will play off each other, help us move our prices forward over time.

What I would think of as a long-term, slow catalyst to growth.

I'm not quite model yet now because it's such a low, not just single digits, low single digit number of contracts of our 10 of our contract base have escalators built in.

So but we're looking forward to make it a standard practice.

And so far it's been received by customers as well, again, as I mentioned some ways, it helps them plan their budgets better in the coming years.

That's very helpful.

Thank you.

Stephanie Davis, Barclays.

Hey, guys.

This is Anna Kruszenski on for Stephanie.

Congrats on the quarter and thank you for taking my question.

The first one, I was wondering if you could talk about how you're thinking about the evolution of your sales force as you move to more of this cross sales motion?

And just what sort of investments that will take and how are you incentivizing our salesforce?

Sure.

Great question.

We feel that we have the sales organization about the size we need now the nature of some of the positions may shift over time.

For example, our current mix is, I believe around, let's just say 200 people that are focused on selling products about 60 of them are what we call account managers and they focus on growing the accounts, revenue per account, the product mix in the accounts, identifying the multiple buyers in the accounts and they in turn introduce the specialists that are about 140 strong spread across product categories.

They tend to focus more on a specific buyer and they know which parts of our broad and growing platform portfolio are applicable to that buyer.

And so the account managers, brand specialists, to your question, I don't envision a future.

I need really many more people.

There's several trends that make me think that and even if the sales pitch changes or the method changes, maybe we have a little higher ratio of account managers to salespeople over time, maybe commerce, our new e-commerce capabilities built into our platform, help relieve the burden, say on salespeople of renewals so that the sales can focus on the new accounts more.

But I think we have -- and so again, the shift that e-commerce comes have helped people automate renewals and more and more focused by those 200 people on acquiring new business can be a focus and a big part of the job being renewals.

And so I think we're right at about the right investment level in our sales organization, marketing, is around 30 people, I believe, fairly stable from a rate of investment.

Where we are increasing investment a little bit in building our commerce teams as our commerce capabilities provided by hStream platform take hold.

And you did just here of 40%, -- just 41% sequential growth in direct commerce sales, which we're super excited about, going from 0.5 million to nearly 800,000 between the first quarter and second quarter in commerce.

So we added, for example, a merchandiser in our commerce team.

Our commerce team is growing now, but overall I'd say around the 230 headcount personnel and talent is about right.

You may see trade-offs over time, but I know between the types of roles we have, I think that's about the right size for the markets and the three core products we have today.

Got it.

And thank you for all that color.

That's super helpful.

And then just as a follow-up.

I was wondering if you could talk more about how you're approaching the move to a single sign-on and where you guys are in terms of tech investments and just how you're rolling that out to clients?

As I mentioned, one of the core ones, there are many, many exciting things about the platform we're building, probably the central feature of it, though, that's kind of most important that will distinguish us when it's fully deployed, I'll think of our software suites instead of a standalone SaaS applications as a suite of suites like integrated applications and data mobility across users across those suites.

So we're supersized.

So one of the central themes of lower build the platform is this idea service.

And as I called out during the call, we're kind of midway through implementing this this core service.

There are other services, I mentioned my credential management and others, but the idea is a central function.

And I called out that I believe when we look at the number again, but about 14 of our 27 apps are implemented on a stream ID.

So halfway might be a fair way to think about.

There's a lot to go there, but the tools are built.

So to your concept of investment, we have a steady state of investment we've built our platform development teams out.

We've hired the senior leadership over the platform, platform kind of making platform as a service as a product.

And so we have both the CTO and as Senior Vice President together over the platform.

The development teams are in place, so we don't expect to have to add developers to further develop the platform it's more of a sequencing of the features and platform that we're adding.

That's maybe more important.

We are building the platform in the right order.

But again, I don't think we need to add more CapEx or more onto the platform, get all used more as what we'd love to build more faster.

But I think we're at a steady state of releases and enhancements that I'm pretty excited about the platform.

Hope that answered your question, but there's a lot to do, the platform has many, many, many components, and ID is just one of them and happens to be one of the more exciting pieces.

Because it lets us know a lot more about the people in our network allows us to do things like the commerce that we talked about where we're able to grab a piece of data from one part of our network identity demographic from another, identify channel, in other words, an app and has high traffic of that type of user and then maybe target them with a message about a federal requirement and then ultimately use the commerce capabilities and platform to sell them of course.

So ID management is very important.

I'd characterize it's going to still be a multiyear journey to get fully where we want to be, but we are seeing exciting benefits of platform capabilities like ID, as reflected in our eCommerce growth, 41% and some visibility by customers and the benefits of the hStream ID.

Thank you.

Jared Haase, William Blair.

Hey, good morning.

And thanks for taking the questions.

Maybe just to start, Bobby, was hoping to get some additional color on the strong selling trends to close out the quarter.

I guess are you seeing any kind of incremental improvement in the client base or anything that's changing from a competitive landscape perspective that's sort of driving the strength there?

I mean, I'd be curious I know it's early, but any thoughts on what that could imply just in terms of the growth setup for 2025?

Thanks.

Yeah, you always looking to layer subscriptions and that it's a great thing to do.

When you when you build a layer and we gave an example of an account where we're able to layer in more at renewal, that's kind of the model those 60 account managers work on.

And so we had been a little a little short of our desired outcomes in Q1 and sales pipeline.

So it's really exciting and kind of a nail biters to watch that last month of the second quarter really perform well, make up for a lot of the of the earlier push deals I guess is what I'd say.

And so and the I think the nature of the pipeline has shifted.

We're doing a better job of describing value publishes bundling of products.

I mentioned this competency suite, which is really exciting way to position a group of our products as a complete toolset for managing workforce.

And I think that's resonating, it's bigger dollar orders for a more complete set of tools and there -- and we've got a really nice way of showing how they work together to manage the competency profiles of your workforce and so what I'd say is also towards end of the quarter, we're seeing a bigger pipeline of bigger deals.

Now as far as second half impact, we've already we've already factored all that and it's been offset by the timing anomaly we talked about in the bankruptcy.

And so some of our excitement is muted because of these, what we call temporary headwinds.

That said, it was great to see the last month of the quarter perform well.

And also when we assess the pipeline on a go-forward basis, more larger deals, possibly because the way we're bundling now are just getting better at describing the value prop of the way these two or three applications work together to solve a problem.

Our competency suite is really exciting what's happening with that.

And we have probably the largest pipeline we've ever had on a greatest mix of products in that area because of the way those tools work together to manage the workforce.

I do think there's probably a macro trend of healthcare systems realizing they need to invest more in that workforce to reduce turnover and to attract talent.

And so they compete for a limited resource pool of people.

I think our tool sets are more relevant in the recruiting process and retention strategies.

That's great.

I appreciate that color.

And then maybe just as a follow-up, I'll ask about the health plan opportunity in a slightly different way now.

Obviously, nice to add a new market opportunity to drive growth.

And I know it's still early days here, but I'm wondering, does that have a sort of and I guess compounding impacts in terms of making your offerings for providers more attractive or strategic?

It seems like there would be synergies just in terms of sort of sitting in between payers and providers with this network type of offerings.

I'm wondering if you're seeing additional tailwinds to growth with sort of the core customer base?

Well, I think we're really excited about what it could mean if the data is easily portable between the plans and health systems and they're using the similar CredentialStream system or in another version of it, same architectural and some of the added features for the network products.

So I do think there could be some medium and long-term applications in marketplaces that where the plans have adopted nearly identical architecture for credential management as the health systems.

And so, what that impact is going to take time to play out because we're new to the plan market.

But you know, they obviously the plans and manage a resource pool doctors and the hospital do as well.

And the plans overlap with some houses and not others.

And so and you can envision a future where data sharing between those organizations be easier.

It's there on this common architecture that we've been building.

So yeah, I think we see promise for but not enough yet to model it, we need to make sure we can gain share in the health plan market and before we start touting the interoperability benefits between plans and health systems.

So I think that they had some idea.

We spent a lot of time talking about it.

That will be a key doctors and health plans that will help us maintain rosters for the health plans using this as hStream ID system that we've been talking about as it gets more deployed into our network.

And so super excited about the interplay between plans and health systems.

And so exciting to see us make some progress in the health plan markets.

Absolutely makes sense.

And I'll go ahead and hop back in the queue.

Thank you.

Thank you.

Richard Close, Canaccord Genuity.

Yes.

Thanks for the questions.

Congratulations given the couple of headwinds there in the quarter.

But maybe just clarifying on the escalators, I want to make sure I understand is that like 3.5% each year of the term of the contract or just went the contract comes up for renewal.

Scott, do you want to comment on that?

Yeah, sure, Richard.

It's an annual escalator.

So each year that price would increase by that 3.5%.

Richard, I do want to add some color to that because we're super excited about, I think in the long run analyst should be too, but I want to caveat that less than 1% of our contracts has that built in.

And again, as I mentioned, it's going to take several years to get through renewal cycles and get that customer acceptance and all that.

So it's really early days.

But what's exciting is it did take a year to modify contracts train salespeople, enhance the accounting system, teach the negotiating strategies to deploy it, and the last several months we've been including and in almost every contract that's related to our learning business and our workforce development businesses, bit product lines.

And so it's exciting to see, but I just want to caveat it less than 1% of our contracts have escalators today.

Excellent.

And then on the 34%, I guess new bookings and ShiftWizard.

Can you talk a little bit about how much of that is like net new customers versus I guess the replacement of the legacy?

Yeah, sure.

So I think about we had 34 customers and 22 of them were new, like new from the market, new to HealthStream, they might have been a competitive takeout or been using pen and paper, but they were new.

And the remaining, I guess 12 of the 34 were transitioning customers.

They were essentially moving from a legacy application that we have acquired to the new application.

So I believe those are the numbers that we just gave.

Hold on, let me make sure I didn't just talk about credentialing or scheduling.

Yeah, that's credentialing you just described, I think Richard was asking

--

I'm sorry, I just did everything wrong.

That was all related to credentialing.

So SwiftWizard, I'm not sure that we split it out like that from migrating

(multiple speakers)

It's mostly net new.

Okay.

And then just a follow on ShiftWizard.

Bobby, I think last quarter you said you're really strong in the small and mid on the scheduling with ShiftWizard, are you seeing any success moving upmarket at all to larger health systems?

Yeah, I think what we're doing monthly releases on shift was enhancing it every month making it more what we call enterprise appropriate.

And so I think it's getting more and more capabilities that can address the different needs of large enterprises.

The competitive landscape, and we're positioning well and fighting hard.

And I do expect progress and at all levels.

But you're right to point out, our relative strengths are probably medium and small system not the super large ones yet, but again, progress on both the feature development, the rate of release in customer engagements high and just for clarity, I've just gotten some background info for ShiftWizard since I cited all the wrong numbers.

There are the right numbers.

If you're listening to me for credential stream, 34 customers, 22 new and 12 migrating.

But in this one, it was eight new customers on ShiftWizard, all new 34% revenue growth and included -- we mentioned PrimeHealth and Baptist Memorial and UF Health Shands.

So I hope that helps clarify on the eight new customers on ShiftWizard.

If I could slip one, in Scotty, well or Bobby, on this consumption headwind, you mentioned, it should have been a 90 day requirement.

It ended up being in 365 days.

So just to be clear, was something done to make sure that it's done by the end of 2024 and that, it doesn't slip into 2025?

Well, we have assurance -- no, we don't make the settings and so we can't change them.

It's up to the customer to change them, but we have had more than a meeting with them and they've realize it's kind of an operational inefficiency for them.

So they're working hard to correct it.

So is our expectation, but we don't have direct control over.

So I can't say that we did something other than make the customer aware of it and they don't want to have that way either.

If you think about you really want to stagger such a large workforce to spread the work out over time, both good from a planning standpoint, operation standpoint and a financial standpoint.

So we have no reason to believe it won't come back.

And in fact, the organization is growing as well.

And so they're often ending up short and needing to have more subscriptions anyway.

And so we expect a return to normalcy at that account.

Okay.

Thank you.

But to your question, we don't we don't actually control it.

And so I can't I can't say we did something on the system that affirmatively make that change.

We were relying on the customer to make those corrections.

But again, I just I can't see how they would operate with that as the operating principle.

In other words, they really need to spread the work out to get everybody compliant.

So I think we're going to be good.

Would there be any opportunity to change from if this is the only consumption contract that you have?

Like, change them to the normal contract?

Probably not in the short run.

I think on this last collaborative purchasing, we allow them to move to the consumption model and some of the courses they bought in the collaborative, mainly for their own budget planning reasons in there such as their strong customer, so we gave that flexibility.

But again, it's not a model we're promoting.

We don't plan to expand it.

I don't know if we'll change that a customer would be probably up to that customer, how to work with them and their budget planning process.

But given that it is -- of course, an anomaly and it did make us have to explain this awkwardly in the quarter.

But I just I see it as a true onetime anomaly.

I think of their multiyear 10 year plus consumption history would indicate that this is an anomaly.

Okay, great, thanks.

Constantine Davides, Citizens JMP.

Thanks, Bobby.

Nice pickup there in the commerce revenue.

I was wondering if you could just drill into what kind of activity that was in the second quarter, just given that the first quarter was more the way you guys kind of frame that a little bit more one-time in nature with the DEA program.

So just wondering if you can give us a little more color there and then tell us what kind of line of sight you have into the rest of 2024 on the commerce side?

Yeah, it's interesting.

We have three forms of commerce.

We have the big collaboratives, which are some of our top accounts to annual purchase cycles on a large content libraries, and that's now getting more commerce enabled, meaning it's a more automated process and it was the passive side about that.

Then we have a new type of commerce that we're launching in the next month, which is what I'd call, B2B commerce at the manager level, we believe there might be entire budgets that are discretionary now at the manager level where they order more directly from a competing vendors and historically sell kind of at the enterprise level up to the CNO and the top officers when they want to buy something on behalf of all their employees.

But we missed, we think we missed a lot of budgets that might be discretionary and a little bit of a reimbursement budget for a manager to employers for education.

And so we have this new, we'll be piloting next month.

This what I guess I'll call it manager level purchasing commerce, which we really haven't ever had.

And so that will be interesting.

And then the third category is, of exciting and problematic at the same time because it's a little less predictable.

As you point out, it's direct to professional marketing in our ecosystem and we're getting better at it, which is cool, but it is way harder to project.

And you're right to note that the primary driver of success right now is it a federal requirement around opioid training for doctors to renew their DEA, their prescribing license basically the DEA.

And so we're doing our best to forecast what that would look like because we've gotten good at finding those doctors at the right time and offer the right product in the right place and they're buying.

And so now we have a few other products that are really suitable for commerce.

And we just launched six new packages in our nurse channels so that we're talking about our physician channels at cmecourses.com, but our nurse channels are on Nurse Grid Learn to and revenue in Nurse Grid Learn is growing as well.

We just launched six new state-specific education packages, again purchased by the individual as an individual.

And so these commerce, we're getting better at it, but it's harder to predict.

And in the case of the biggest driver right now, still the DEA MATE opioids course.

We think that has a year of being strong, but still variable might have a strong quarter and a weak one.

But we think it'll take an over a year for call it positioned to get through this renewal cycle essentially on their licenses, which has a federal requirement.

So we project a few more quarters strong on DEA MATE or the DEA content.

And meanwhile, we're growing in strengthen in our nurse channels, as I mentioned, and just getting better at Commerce overall, adding to our digital marketing teams to strengthen our commerce abilities.

But just note there is three forms of commerce, two are B2B, and one is B2C, or we call it B2P, business to professional direct and constant it will be just a little harder project.

So it's definitely a sign, we're becoming an ecology where we have channels that we can sell content into inside of our own application network.

So it's exciting that it is high.

It is good margin or resell content that we own and which cases the course we own it.

So it has really good margins.

That said, you've highlighted the problem on a go forward basis.

As it grows, it becomes a little bigger and a little less predictable.

But we'll take it.

We call it money while we sleep and will take money while we sleep, we think it's a good idea.

That's good color, Bobby, thanks.

And then one just quick housekeeping item.

The $1 million charge, I guess, associated with Steward.

Did that impact the P&L in the G&A line Just wondering if you can give a little color there, Scotty.

Yeah, that's where our bad debt charges flow through on our income statement is that category.

Great.

And then last one here.

The share repurchase program expired in March, and I don't think that's been renewed just wondering if you could give us an update there and are you signalling more of a preference for the dividend?

Are my reading too much into that?

Thanks.

You're probably overthinking it a little bit, but we've put a few buyback programs in over 24 years as a public company.

This last one was, I believe, for about $10 million worth and we view it opportunistically and the money able to buy back shares.

I think we bought about $8 million of the $10 million worth at an average price in the low $20, like $22, $23.

So far it looks effective.

And that, with that as a history, that makes all three of our buybacks, again, spread out over 24 years in the money for and for shareholders.

So we generally put a program in place and put the purchase requirements around it that reflect our Board's position on where we should be buying.

And so the whole program didn't execute because of the discipline of our Board and creating the program itself.

But it has expired and the Board has not elected to put another program in place at this time, but they are the Board takes up these capital allocation discussions every quarter and we're excited to see them approve another dividend consistent with the prior quarter and but did not put a share repurchase -- a new share repurchase program into place currently.

All right.

Thank you.

Vincent Colicchio, Barrington Research.

Yes, Scott, you had said a 15% decline.

And so I wasn't clear on if that was for subscribers or revenue.

How does that compare to recent quarters?

And wondering if things are worsening or stabilizing.

And so that I guess that decline was 15% on last year's revenue.

So it's about a $600,000 decline versus same period last year.

And I think the rate of attrition has kind of been at that rate for probably at least the past four to six quarters.

Okay.

And then one more for me, Bobby, are there any other clients or Bobby or Scotty that are in financial distress we should be concerned about?

I think, on the whole, we're not seeing any change patterns in payments yet we hope this is not a bellwether for the industry.

It's just an isolated problem and we have not seen any our macro trends as reflected in our DSO or collectibility that are different than in the prior, say, 18 months.

And so and we hope it stays an isolated story, I would say and maybe some of our submarkets skilled nursing.

There's a lot more change in that market, not necessarily bankruptcies, but mergers and acquisitions, changing landscape, changing contracts.

And so maybe in that submarket of markets, there's a little bit more distress and what I guess I'd call the skilled nursing market or and skilled nursing facility market, but our largest base of acute hospitals, we haven't seen any changes in patterns yet.

I mean, obviously, this is a chain of ourselves stewards, but other than that, our DSO remains good and consistent with the past couple of years.

Thank you.

Thank you.

And I'm showing no further questions.

And I'd like to hand the conference back over to Robert Frist, CEO for closing or further remarks.

Thank you everyone.

Friends and family on the journey with our 1,100 employees, working hard, it's fun to hear Trisha Coady's father listens in, one of our senior officers to our earnings calls, a big fan shout out to the family participants that support our hard working employees.

We're trying to build a great company here and put a lot of energy and time and to appreciate our analysts that follow our stories and write about them so that we can tell the ups and downs business is never easy.

There's puts and takes in this quarter had some -- we have a long history just fighting through them and moving on to the next exciting thing and trying to build that energy in our company and culture and shareholders.

And we feel like we're doing that.

So no small incremental steps this quarter, but nonetheless, incremental and positive.

So we'll take them and keep working hard in the next couple of quarters trying to get us make solid in our commitments on our achieving our guidance.

I think we're positioned to do that.

So we'll keep you guys posted and look forward to next earnings call.

Thank you to everyone involved.

This concludes today's conference call.

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