TruBridge Inc (TBRG) 2022 Q4 法說會逐字稿

Greetings, and welcome to the CPSI Fourth Quarter Earnings Conference Call. (Operator Instructions) And as a reminder, this conference is being recorded. It is now my pleasure to introduce to you Dru Anderson. Thank you, Dru. You may begin.

您好，歡迎來到 CPSI 第四季度收益電話會議。 （操作員說明）作為提醒，正在錄製此會議。現在我很高興向您介紹 Dru Anderson。謝謝你，德魯。你可以開始了。

Thank you. Good afternoon, and welcome to the CPSI Fourth Quarter and Year-End 2022 Earnings Conference Call. Leading today's call are Chris Fowler, President and Chief Executive Officer; and Matt Chambless, Chief Financial Officer.

謝謝。下午好，歡迎來到 CPSI 第四季度和 2022 年年底收益電話會議。主持今天電話會議的是總裁兼首席執行官 Chris Fowler；和首席財務官 Matt Chambless。

This call may include statements regarding future operating plans, expectations and performance that constitute forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. The company cautions you that any such forward-looking statements only reflect management expectations and predictions based upon currently available information and are not guarantees of future results or performance.

此電話會議可能包括有關未來運營計劃、預期和業績的陳述，這些陳述構成根據 1995 年《私人證券訴訟改革法案》安全港條款作出的前瞻性陳述。公司提醒您，任何此類前瞻性陳述僅反映管理層基於當前可用信息的期望和預測，並不是對未來結果或表現的保證。

Actual results might differ materially from those expressed or implied by such forward-looking statements as a result of known and unknown risks, uncertainties and other factors, including those described in public releases and reports filed with the Securities and Exchange Commission, including, but not limited to, the most recent annual report on Form 10-K. The company also cautions investors that the forward-looking information provided in this call represents their outlook only as of this date, and they undertake no obligation to update or revise any forward-looking statements to reflect events or developments after the date of this call.

由於已知和未知的風險、不確定性和其他因素，包括公開發布和向美國證券交易委員會提交的報告中描述的那些因素，實際結果可能與此類前瞻性陳述明示或暗示的結果存在重大差異，包括但不限於僅限於 10-K 表格的最新年度報告。該公司還提醒投資者，本次電話會議中提供的前瞻性信息僅代表他們截至該日期的展望，他們沒有義務更新或修改任何前瞻性陳述以反映本次電話會議日期之後的事件或發展。

At this time, I will now turn the call over to Mr. Chris Fowler, President and Chief Executive Officer. Please go ahead, sir.

現在，我將把電話轉給總裁兼首席執行官克里斯福勒先生。請繼續，先生。

Thanks, Dru, and thank you to everyone for joining us this afternoon. I'll start the call today with a quick review of our financial and operational highlights from the fourth quarter, and then I'll share some of my thoughts on the past year and where I envision CPSI going in 2023. For the fourth quarter of 2022, we delivered total revenue of $83 million, of which roughly 55% was derived from our RCM offering, TruBridge. Our RCM offering has 98% recurring revenue and grew 29% from the fourth quarter of 2021, further demonstrating our progress towards improving the consistency and predictability of our top line. We generated $13 million in adjusted EBITDA during that quarter, a decrease of 7.7% over the prior year, which Matt will elaborate on. Our total bookings for the quarter were $25 million, an increase of 59% year-over-year and 20% sequentially.

謝謝 Dru，感謝大家今天下午加入我們。我將在今天開始電話會議，快速回顧我們第四季度的財務和運營亮點，然後我將分享我對過去一年的一些想法以及我對 CPSI 2023 年的展望。第四季度到 2022 年，我們實現了 8300 萬美元的總收入，其中大約 55% 來自我們的 RCM 產品 TruBridge。我們的 RCM 產品有 98% 的經常性收入，比 2021 年第四季度增長了 29%，進一步證明了我們在提高收入的一致性和可預測性方面取得的進展。我們在該季度產生了 1300 萬美元的調整後 EBITDA，比上年下降 7.7%，Matt 將對此進行詳細說明。我們本季度的總預訂量為 2500 萬美元，同比增長 59%，環比增長 20%。

Looking at a level deeper, bookings from our RCM solution alone increased 1.6x year-over-year and 19% sequentially with RCM bookings from cross-sell alone up 98% from the fourth quarter last year. Cross-selling into our EHR customer base is the foundation of our growth strategy, so the recent strength in this bucket of bookings is particularly pleasing.

從更深層次來看，僅來自我們 RCM 解決方案的預訂量同比增長 1.6 倍，環比增長 19%，僅來自交叉銷售的 RCM 預訂量比去年第四季度增長了 98%。向我們的 EHR 客戶群進行交叉銷售是我們增長戰略的基礎，因此最近這部分預訂量的增長特別令人高興。

As our business continues to evolve into more RCM dominant themes and to provide more transparency into the health of our business, we are going to start providing net patient revenue under contract or NPR on a quarterly basis. We believe this will be a meaningful metric to track our progress. After all, improving the financial strength of our hospital customers is the problem that TruBridge strives to solve, and there's arguably no better metric to measure our performance in scale than NPR. Matt will also share some more about this a bit later on the call. On the operational side of things, during the fourth quarter, we have a few things to highlight.

隨著我們的業務繼續發展成為更多的 RCM 主導主題，並為我們的業務健康提供更高的透明度，我們將開始按季度提供合同或 NPR 下的患者淨收入。我們相信這將是一個有意義的指標來跟踪我們的進展。畢竟，提高我們醫院客戶的財務實力是 TruBridge 努力解決的問題，而且可以說沒有比 NPR 更好的衡量我們規模績效的指標了。 Matt 稍後還將在電話會議上分享更多相關信息。在運營方面，在第四季度，我們有幾件事要強調。

In our RCM business, we have 30 go-lives across all of the RCM offerings. Additionally, we continued our expansion of offshore resources ending 2022 with more than 100 offshore employees with the ambitious target of quadrupling that rate of offshore utilization as we exit 2023. This not only represents an abundant margin expansion opportunity for us going forward, but also a strategic imperative to ensure our RCM business can scale as our solutions continue to gain momentum. In our patient engagement business, I want to briefly touch on the 2 contracts that we noted were delayed on our previous call. The first is Steward Health in Florida, which was impacted by Hurricane Ian. We've been working hand in hand with that team, and we are now live and have rolled out our solution to the majority of their facilities.

在我們的 RCM 業務中，我們有 30 個跨所有 RCM 產品的上線。此外，我們在 2022 年底繼續擴大離岸資源，擁有 100 多名離岸員工，我們的雄心勃勃的目標是到 2023 年離岸利用率翻兩番。這不僅代表了我們未來的大量利潤擴張機會，而且確保我們的 RCM 業務能夠隨著我們的解決方案繼續獲得發展勢頭而擴展的戰略要務。在我們的患者參與業務中，我想簡要談談我們注意到在我們之前的電話會議中被延遲的 2 份合同。第一個是佛羅里達州的 Steward Health，它受到了颶風伊恩的影響。我們一直與該團隊攜手合作，現在我們已經上線並已將我們的解決方案推廣到他們的大部分設施。

In regards to the second delay, we anticipate the international implementation to happen in the second quarter. Our conversations with our telecom partner continue to be optimistic as we work through governmental delays in these markets. It's also worth highlighting that our revenue recognition and our patient engagement solution is a little different than the rest of our business. We recognize revenue once implementation is complete and the solution is turned on only when a patient signs up for the solution.

關於第二次延遲，我們預計國際實施將在第二季度進行。我們與我們的電信合作夥伴的對話繼續保持樂觀，因為我們正在努力解決這些市場的政府拖延問題。還值得強調的是，我們的收入確認和患者參與解決方案與我們的其他業務略有不同。我們在實施完成後確認收入，並且只有在患者註冊該解決方案時才啟用該解決方案。

While the revenue ramp may not be as steep as it is in the RCM business, it's a higher margin than RCM, and it's very sticky once the patient signs on. Finally, in our EHR business, we continue to realize and focus on adoption and utilization of our products by our customers. Many of our long-term customers, those who have been with us more than 7 years have not stayed on track with software utilization, but we're going to fix that. The client executive role we've been bolstering this past year will be key to our success in this area. As a testament to our dedication to improve our customer experience and overall satisfaction with our product, we made the necessary investment to improve our client executive to customer ratio to less than 1/3 of what it has been.

雖然收入增長可能不像 RCM 業務那樣陡峭，但它的利潤率高於 RCM，而且一旦患者簽約，它就會非常粘。最後，在我們的 EHR 業務中，我們繼續意識到並專注於客戶對我們產品的採用和利用。我們的許多長期客戶，已經與我們合作超過 7 年的客戶，在軟件使用方面沒有保持正軌，但我們將解決這個問題。過去一年我們一直在加強的客戶執行角色將是我們在這一領域取得成功的關鍵。為了證明我們致力於改善我們的客戶體驗和對我們產品的整體滿意度，我們進行了必要的投資，以將我們的客戶主管與客戶的比率提高到低於過去的 1/3。

Additionally, this increased investment triples the workforce that is focused on generating the opportunity for us to capture the $400 million of RCM cross-sells. As we close out 2022, I want to spend a few minutes looking back at what we've accomplished this past year and why I was so excited to take on the role of CEO. When I accepted the position this past spring, my goal is to build upon our well-established foundation to drive innovation and growth. CPSI is a very mature company founded almost 50 years ago with a large loyal customer base and a comprehensive suite of solutions.

此外，這項增加的投資使專注於為我們創造 4 億美元 RCM 交叉銷售機會的員工隊伍增加了兩倍。在我們結束 2022 年之際，我想花幾分鐘回顧一下過去一年我們取得的成就，以及為什麼我對擔任首席執行官一職感到如此興奮。當我在今年春天接受這個職位時，我的目標是在我們穩固的基礎上再接再厲，推動創新和增長。 CPSI 是一家非常成熟的公司，成立於將近 50 年前，擁有大量忠實的客戶群和一套全面的解決方案。

This is a critical time to remain acutely focused on what's gotten us to this point and to acknowledge that we've hit some bumps along the way. Moving forward, we will continue to improve as we pivot towards not just execution but also towards growth. One of my priorities this past year was to strengthen our relationships with our customers, especially since cross-sell conversion will be paramount to our success in 2023 and beyond. To that end, it has been a high priority during the back half of 2022 to meet face-to-face with as many of our clients' CEOs and CFOs as possible to hear directly from them and to share my vision for CPSI.

這是一個關鍵時刻，我們要繼續敏銳地關注是什麼讓我們走到這一步，並承認我們一路上遇到了一些坎坷。展望未來，我們將繼續改進，因為我們不僅轉向執行，而且轉向增長。過去一年我的首要任務之一是加強我們與客戶的關係，特別是因為交叉銷售轉化對於我們在 2023 年及以後的成功至關重要。為此，在 2022 年下半年與盡可能多的客戶的 CEO 和 CFO 進行面對面會面，直接聽取他們的意見並分享我對 CPSI 的願景一直是當務之急。

Through a half a dozen regional customer events and getting out to our client sites weekly, the connection has been invaluable. And this commitment to strengthen customer relationships extends beyond me. It includes our senior management team and our client-facing executives. Not only does this provide scale, but the client executive role, which I mentioned earlier, is key to our customer satisfaction and ultimately, redemption.

通過六次區域客戶活動和每周訪問我們的客戶站點，這種聯繫非常寶貴。這種加強客戶關係的承諾超出了我的範圍。它包括我們的高級管理團隊和麵向客戶的高管。這不僅提供了規模，而且我之前提到的客戶執行角色是我們客戶滿意度和最終贖回的關鍵。

With the pandemic behind us, we are leaning in heavily to an in-person high-touch strategy for our clients. We offer solutions for community health systems and their leadership teams. It's essential that our customers have a good understanding of our solutions as well as our organization and our people because building trust by getting to know each other is an important success factor for our customers.

隨著大流行病的過去，我們非常傾向於為客戶提供面對面的高接觸策略。我們為社區衛生系統及其領導團隊提供解決方案。我們的客戶必須充分了解我們的解決方案以及我們的組織和我們的員工，因為通過相互了解建立信任是我們客戶成功的重要因素。

After talking with our customers lately, I'm particularly pleased with the sentiment they've shared with me that they -- that as we invest in our clients, we will see the return materialize into their reengagement with our offerings. The increase in customer-facing activities also raises awareness of our RCM offering and I believe have a real impact on our RCM bookings, which increased 2.4x in 2022 versus 2021.

在最近與我們的客戶交談之後，我對他們與我分享的情緒感到特別高興，即當我們投資於我們的客戶時，我們將看到回報體現在他們對我們產品的重新參與中。面向客戶的活動的增加也提高了我們 RCM 產品的知名度，我相信這對我們的 RCM 預訂量產生了真正的影響，2022 年與 2021 年相比增長了 2.4 倍。

Our customer retention rate of 95% in 2022 is consistent with the high marks we've achieved in years prior, but we will strive to do even better in coming years. I view 2022 as a year that we put the pieces into place with new leaders at the home, and I feel good about all the work we've done. Our expansion of the RCM business opens up a new part of the market, expanding beyond hospitals of less than 100 beds where we have historically focused our EHR efforts. We are laser-focused on our vision of selling our RCM solution to both our existing customer base as well as to hospitals of 400 beds or under. There are more than 4,500 hospitals in the U.S. that fit that criteria, representing a total addressable market north of several billion. It's very clear that RCM is the key to our future growth as these hospitals will increasingly look to outsource partner all of their RCM processes to trusted partners like CPSI to simplify their revenue cycle needs.

我們 2022 年的客戶保留率為 95%，與我們前幾年取得的高分一致，但我們將在未來幾年努力做得更好。我認為 2022 年是我們與國內新領導人一起落實各項工作的一年，我對我們所做的所有工作感到滿意。我們對 RCM 業務的擴展開闢了一個新的市場部分，擴展到床位少於 100 張的醫院之外，我們歷來專注於 EHR 工作。我們非常專注於將我們的 RCM 解決方案銷售給現有客戶群以及 400 張床位或以下的醫院的願景。美國有超過 4,500 家醫院符合該標準，代表著一個超過數十億的可尋址市場。很明顯，RCM 是我們未來增長的關鍵，因為這些醫院將越來越多地尋求將其所有 RCM 流程的合作夥伴外包給 CPSI 等值得信賴的合作夥伴，以簡化他們的收入周期需求。

By the end of 2023, we feel that RCM will represent close to 60% of our total revenue. We've laid the foundation necessary to seize the opportunities ahead of us. We've added the right people to our team, and we have the solution that our customers need. I'm incredibly excited to see what 2023 has in store for CPSI, and I look forward to updating you on our progress.

到 2023 年底，我們認為 RCM 將占我們總收入的近 60%。我們已經為抓住我們面前的機遇奠定了必要的基礎。我們已經為我們的團隊添加了合適的人員，並且我們擁有客戶需要的解決方案。我非常興奮地看到 2023 年 CPSI 會發生什麼，我期待著向您通報我們的最新進展。

I'll now turn the call over to Matt for a closer look at the financials.

我現在將電話轉給馬特，以便更仔細地了解財務狀況。

Thank you, Chris, and thanks to everyone on the call. As Chris shared, we ended the year on a solid footing, and I'll run through the numbers in just a minute. Before I jump into the financial results, though, I want to spend some time explaining how Chris and I have evolved our thinking on the business and the metrics we'll share with you to assess the progress we're making. The business of CPSI has evolved meaningfully with RCM now representing over half of our revenue and a significant portion of our growth. Recognizing that evolution, you'll notice that we've slightly changed the presentation of our revenue streams to better reflect the 3 distinct business units that we see within CPSI: TruBridge's RCM business, the combined acute and post-acute EHR business and our nascent high-potential patient engagement unit.

謝謝你，克里斯，也感謝電話中的每一個人。正如克里斯分享的那樣，我們以穩固的基礎結束了這一年，我將在一分鐘內完成這些數字。不過，在我進入財務結果之前，我想花一些時間解釋克里斯和我如何發展我們對業務的看法，以及我們將與您分享的指標，以評估我們正在取得的進展。 CPSI 的業務取得了有意義的發展，RCM 現在占我們收入的一半以上，也是我們增長的很大一部分。認識到這種演變，您會注意到我們略微改變了收入流的呈現方式，以更好地反映我們在 CPSI 中看到的 3 個不同的業務部門：TruBridge 的 RCM 業務、合併的急性和急性後 EHR 業務以及我們新生的高潛力患者參與單位。

Also, as Chris mentioned, we're going to start providing net patient revenue under contract or NPR on a quarterly basis. And with that in mind, we ended the year at a hair below $3 billion of net patient revenue under contract, an increase of 37% year-over-year and a 3-year CAGR of roughly 17.5%. This NPR was comprised of $2.4 billion from TruBridge and $600 billion or $0.6 billion from the recent HRG acquisition. To help you understand this new metric in the context of our past performance, we've included a table in the press release with our historical NPR data for each of fiscal years 2019, 2020 and 2021, along with each of the quarterly periods of 2022 for your reference. Our intent with this new NPR metric is to supplement our bookings disclosures to provide a more complete picture of growth and scale as bookings alone have proven to be an imperfect metric. If you followed the CPSI story for a while, you know that our bookings metric is quite lumpy as the deal population is characterized by a relatively small number of high-value deals.

此外，正如克里斯提到的，我們將開始按季度提供合同或 NPR 下的患者淨收入。考慮到這一點，我們在今年年底的合同患者淨收入略低於 30 億美元，同比增長 37%，3 年復合年增長率約為 17.5%。該 NPR 包括來自 TruBridge 的 24 億美元和來自最近 HRG 收購的 6000 億美元或 6 億美元。為了幫助您結合我們過去的表現了解這一新指標，我們在新聞稿中包含了一張表格，其中包含我們 2019 年、2020 年和 2021 年每個財政年度以及 2022 年每個季度的歷史 NPR 數據供你參考。我們使用這個新的 NPR 指標的目的是補充我們的預訂披露，以提供更完整的增長和規模圖，因為單獨的預訂已被證明是一個不完美的指標。如果您關注 CPSI 故事一段時間，您就會知道我們的預訂指標非常不穩定，因為交易人群的特點是高價值交易數量相對較少。

The end result is a 90-day measure that oftentimes is more a function of timing for a handful of deals than reflective of any true strength or weaknesses in our sales environment, which can undermine the usefulness of this measure for investors. On that topic, bookings for the fourth quarter totaled $24.7 million, driven by continued strength in our RCM business with the EHR business unit closing out strong with its best bookings performance of the year driven by net new hospital client wins.

最終結果是一個 90 天的衡量標準，它通常更多地是少數交易時間的函數，而不是反映我們銷售環境中任何真正的優勢或劣勢，這可能會破壞該衡量標準對投資者的有用性。在這個主題上，第四季度的預訂總額為 2470 萬美元，這得益於我們的 RCM 業務的持續強勁，EHR 業務部門在淨新醫院客戶贏得的推動下以年度最佳預訂業績收官。

RCM bookings were up 163% year-over-year and 19% sequentially, continuously earning its title as growth agent for CPSI. In looking at the individual components of RCM bookings, cross-sell bookings were up 98% compared to the fourth quarter of last year, while bookings from outside of our EHR customer base increased to 7.6x the prior year amount as the strength of HRG's sales force has made this a core competency. Turning to the income statement.

RCM 預訂量同比增長 163%，環比增長 19%，繼續贏得 CPSI 增長推動力的稱號。在查看 RCM 預訂的各個組成部分時，交叉銷售預訂與去年第四季度相比增長了 98%，而來自我們 EHR 客戶群之外的預訂增加到去年同期的 7.6 倍，因為 HRG 的銷售強勁Force 使它成為核心競爭力。轉向損益表。

Fourth quarter revenue of $83 million compared to $74 million last year. RCM contributed $45.7 million. EHR revenue was $36 million and patient engagement made up the remaining $1.6 million. Our gross margins of 44.6% for the fourth quarter were down 520 basis points year-over-year due to the increase in our RCM services business, whether through acquisition of HRG or through organic bookings driven growth, the lion's share of 2023's top line gains came from high touch point lower margin service lines causing a heavy shift in revenue mix that pulled gross margins down.

第四季度收入為 8300 萬美元，而去年同期為 7400 萬美元。 RCM 貢獻了 4570 萬美元。 EHR 收入為 3600 萬美元，患者參與收入佔剩餘的 160 萬美元。我們第四季度的毛利率為 44.6%，同比下降 520 個基點，原因是我們的 RCM 服務業務有所增加，無論是通過收購 HRG 還是通過有機預訂推動增長，這在 2023 年的收入增長中佔最大份額來自高接觸點低利潤服務線導致收入結構發生重大變化，從而拉低毛利率。

As we look to the future, the acceleration of our offshore initiative will be key to the margin expansion. Our operating expenses as a percentage of revenue were 40% in the quarter, the same as last year. Adjusted EBITDA of $13.2 million decreased by $1.1 million year-over-year. Despite the year-over-year revenue growth, the gross margin gains by the RCM business were offset by gross margin losses in our nascent patient engagement business as high incremental margin nonrecurring revenues declined. The end result was a gross profit number that was flat, while higher benefits cost and strategic investments in our public cloud migration efforts created further headwinds for EBITDA.

展望未來，我們離岸計劃的加速將是利潤率擴張的關鍵。本季度我們的運營費用佔收入的百分比為 40%，與去年相同。調整後的 EBITDA 為 1320 萬美元，同比減少 110 萬美元。儘管收入同比增長，但由於高增量利潤率的非經常性收入下降，RCM 業務的毛利率增長被我們新生的患者參與業務的毛利率損失所抵消。最終結果是毛利潤數字持平，而更高的福利成本和對我們公共雲遷移工作的戰略投資為 EBITDA 帶來了進一步的阻力。

Turning to the rest of the financials. Operating cash flows for the quarter were relatively low at $2.2 million. This is unusual for us and is a direct result of timing issues related to the collections associated with the integration of our recent acquisition. The slowdown in collections negatively impacted the fourth quarter, but we are making progress and saw an improvement in DSOs in January. While we haven't quite reversed the trend just yet, we're heading in the right direction, but it may take until early Q2 to fully unwind. Finally, I'll conclude my remarks by providing some color on our initial 2023 outlook. For full year 2023, we expect revenue to be in the range of $340 million to $350 million and adjusted EBITDA to be between $59 million and $63 million. As for how revenue and EBITDA will be distributed throughout the year, revenue is expected to be slightly weighted toward the back.

轉向其餘的財務狀況。本季度的運營現金流相對較低，為 220 萬美元。這對我們來說是不尋常的，並且是與我們最近收購的整合相關的集合相關的時間問題的直接結果。收款放緩對第四季度產生了負面影響，但我們正在取得進展，1 月份 DSO 有所改善。雖然我們還沒有完全扭轉趨勢，但我們正朝著正確的方向前進，但可能要到第二季度初才能完全放鬆。最後，我將通過對我們最初的 2023 年展望提供一些顏色來結束我的發言。對於 2023 年全年，我們預計收入將在 3.4 億美元至 3.5 億美元之間，調整後的 EBITDA 將在 5900 萬至 6300 萬美元之間。至於全年營收和EBITDA如何分配，預計營收略偏後。

And from an EBITDA perspective, in the second quarter, we see our heaviest cost due to the hosting of our National Client Conference in the fourth quarter is generally our lightest cost quarter as a result of the timing of benefits and vacation utilization. One final note on the topic of guidance. The company had previously provided an $80 million EBITDA target for 2024, but we now feel the more appropriate target is returned to double-digit organic revenue growth over the next 24 months, with strategic acquisitions being additive to that growth.

從 EBITDA 的角度來看，在第二季度，由於福利和假期利用的時間安排，我們認為由於第四季度舉辦全國客戶會議而導致的成本最高的季度通常是我們成本最低的季度。關於指導主題的最後一個說明。該公司此前曾為 2024 年設定了 8000 萬美元的 EBITDA 目標，但我們現在認為更合適的目標是在未來 24 個月內恢復兩位數的有機收入增長，戰略收購有助於實現這一增長。

From a margin perspective, we believe we can achieve 20% adjusted EBITDA margins over the same time period. Chris and I feel very good about everything we've put into place this year and look forward to continuing to update you on our progress in 2023 and beyond. Thank you all again for joining us today, and we'll now open the line up for questions. Operator?

從利潤率的角度來看，我們相信我們可以在同一時期實現 20% 的調整後 EBITDA 利潤率。克里斯和我對我們今年所做的一切感到非常滿意，並期待繼續向您介紹我們在 2023 年及以後的進展情況。再次感謝大家今天加入我們，我們現在開始提問。操作員？

(Operator Instructions) And our first question comes from the line of George Hill with Deutsche Bank.

（操作員說明）我們的第一個問題來自喬治希爾與德意志銀行的合作。

Can you hear me okay?

你能聽到我說話嗎？

Yes, we can.

我們可以。

The first question is a point of clarification where I want to make sure I heard your commentary correctly. So the expectation is that you guys expect to return to double-digit organic revenue growth, and that's for the composite, not just for TruBridge with 20% adjusted EBITDA margins and M&A will be additive. And I guess can you kind of frame up how you're thinking about the delivery of that result from the timing? First, did I get it right? And second, I'd like to hear about your thinking about the delivery of that from a timing perspective.

第一個問題是澄清一點，我想確保我正確地聽到了你的評論。因此，期望你們期望恢復兩位數的有機收入增長，這是針對複合材料的，而不僅僅是針對具有 20% 調整後 EBITDA 利潤率的 TruBridge，併購將是累加的。我猜你能不能構想一下你是如何考慮從時間上交付結果的？首先，我做對了嗎？其次，我想听聽您從時間的角度考慮如何交付。

Yes. So I'll jump in there, George, and thanks for being on the call today. You did hear that right. What we see is return to organic revenue growth for the company returning to double digits as we exit 2024. So we obviously don't see that in the cards for 2023, but particularly as we get into the back half of 2024, we see the growth opportunity within the RCM business being sufficient enough to pull us across that line returning to double-digit growth.

是的。所以我會跳進去，喬治，感謝你今天接聽電話。你沒聽錯。我們看到的是，到 2024 年結束時，公司收入將恢復兩位數的有機增長。因此，我們顯然不會在 2023 年的卡片中看到這一點，但特別是當我們進入 2024 年下半年時，我們看到RCM 業務中的增長機會足以讓我們跨越這條線，恢復兩位數的增長。

Okay. And I guess kind of the implication there then is that the RCM business is going to have to accelerate to a number that approaches 20% growth. I guess could you talk about kind of the visibility that you have that gets you there?

好的。我猜這意味著 RCM 業務將不得不加速到接近 20% 的增長。我想你能談談讓你到達那裡的那種知名度嗎？

And you talked about off-shoring as contributing to the margin expansion. Is there anything else that we should be looking for as contributing to the margin expansion? And I asked these questions because I think delivering upon these 2 goals would kind of, I think, dramatically change the kind of the profile of the stock price.

你談到了離岸外包對利潤率擴張的貢獻。還有什麼我們應該尋找的有助於利潤率擴張的東西嗎？我問這些問題是因為我認為實現這兩個目標會極大地改變股票價格的類型。

Yes. I think you're right on it, George. The way we're looking at it, again, if you go back to the -- we exited 2022 with 100 offshore employees, and we're looking to quadruple that number by the end of this year. So when you look out exiting 2024 you will continue to see that growth is obviously related to the expense side, it has a bit of a slingshot effect.

是的。我認為你是對的，喬治。我們看待它的方式，再一次，如果你回到——我們在 2022 年退出時有 100 名離岸員工，我們希望到今年年底將這個數字翻兩番。因此，當您展望 2024 年之後，您會繼續看到增長顯然與費用方面有關，它有點彈弓效應。

It will be incremental as we go. But when we hit that 400 number by the end of this year and then we continue at that pace, it really has a multiplier effect. And quite honestly, the same is true on the top line. The big changes we finally hit that point. Matt's been talking about this for quarters of hitting the bottom of this conversion from onetime revenue on the EHR side to now all -- basically all contributions of revenue being recurring, and there's a bit of a slingshot effect there.

隨著我們的進行，它將是漸進的。但是，當我們在今年年底達到 400 個數字，然後我們繼續保持這個速度時，它確實具有乘數效應。老實說，頂線也是如此。我們終於達到了這一點的重大變化。幾個季度以來，馬特一直在談論這個問題，從 EHR 方面的一次性收入到現在的所有收入——基本上所有的收入貢獻都是經常性的，並且那裡有一點彈弓效應。

So we see both of those. Modest growth in 2023, but that multiplier effect really taking a hold as we exit 2024. Now you put that on the back of the strong retention that we've had, we've put together some nice quarters back to back as it relates to the RCM bookings. Our pipeline continues to be healthy. So it's a matter of the market being here for that real conversion of the RCM potential that's been talked about for the last several years.

所以我們看到了這兩個。 2023 年適度增長，但當我們退出 2024 年時，乘數效應真正發揮作用。現在你把它放在我們擁有的強大保留的背後，我們已經將一些不錯的季度放在一起，因為它與RCM 預訂。我們的管道繼續健康。因此，過去幾年一直在討論的 RCM 潛力的真正轉換是市場的問題。

No, that's helpful. And if you guys maybe give me another second or 2. I guess I feel like in the RCM market, I know that it's right, the evolution of TruBridge has been a long time in coming. You guys have kind of flown under the radar in this market and by not going after the larger health systems, you've competed in a more fragmented segment of the market.

不，那很有幫助。如果你們再給我一兩秒鐘。我想我覺得在 RCM 市場上，我知道這是對的，TruBridge 的發展已經進行了很長時間。你們在這個市場上有點低調，不去追求更大的衛生系統，你們在一個更分散的市場領域競爭。

I guess to the degree to which you can, I'd love you to just kind of -- like I asked about visibility, but maybe can you talk a little bit, anything you could say about competitive environment? I recognize a lot of this market is either going to be hospitals that either in-source now or there's a lot of regional mom and pops who participate in this space and maybe kind of pricing environment.

我想在你能做到的程度上，我希望你有點——就像我問的關於知名度的問題，但也許你能談談，關於競爭環境你能說些什麼嗎？我認識到這個市場的很多部分要么是現在採購的醫院，要么有很多地區性的媽媽和流行音樂參與這個領域，也許還有某種定價環境。

I guess are you seeing terms that we would traditionally attribute to some of the larger RCM vendors and outsourcers in the space? I guess kind of more on kind of visibility and differentiation, and then I'll hop back in the queue.

我想您是否看到了我們傳統上認為該領域一些較大的 RCM 供應商和外包商的術語？我想更多的是關於可見性和差異化，然後我會跳回到隊列中。

All right. I'll try to break that apart a little bit. You almost started answering your own question there. I think you're absolutely right in the fact that still today in our market, the competition for RCM is primarily the hospital itself.

好的。我會試著把它分開一點。你幾乎開始在那裡回答你自己的問題。我認為你是完全正確的，因為今天在我們的市場上，RCM 的競爭主要是醫院本身。

We referenced that stat. You can go to just about any rag and find this anywhere from 85% to 90% of all hospitals are still doing the billing and RCM management themselves. So that's really the main competition.

我們參考了該統計數據。你幾乎可以去任何地方找到它，85% 到 90% 的醫院仍在自己進行計費和 RCM 管理。所以這才是真正的主要競爭。

And to your point, if it's not the hospital themselves, it is predominantly a regional player. We're not seeing a lot of RFPs at that level. And so a lot of it becomes our ability to go -- in the past, it has been much more from an outbound process of us going and drumming up opportunities.

就你的觀點而言，如果不是醫院本身，它主要是區域參與者。我們沒有看到很多該級別的 RFP。因此，其中很多成為我們前進的能力——在過去，它更多地來自我們前進和鼓起機會的出境過程。

What we've seen that gives us increased optimism going forward is the increase in inbound requests that we're receiving for information on these services as well, which I think kind of leads to your second part of the question that relates to the pricing pressure on this.

我們所看到的讓我們對未來更加樂觀的是，我們收到的關於這些服務的信息的入站請求也在增加，我認為這會導致你提出與定價壓力相關的問題的第二部分對此。

The labor market, the challenges in the labor market are really the driver here. And so where pricing was probably the #1 concern, let's say, 24 months ago, right now, the driver is let's continue to make sure that the cash is coming into the facility.

勞動力市場，勞動力市場的挑戰才是真正的驅動力。因此，定價可能是第一大問題，比方說，24 個月前，現在，司機讓我們繼續確保現金進入設施。

And so the pricing pressure that we may have seen a couple of years ago is not as prevalent today. However, we are optimistic as we continue to be successful with our conversion offshore that we'll be able to capture more opportunities because we will be more competitive at scale with the offshore operation.

因此，我們可能在幾年前看到的定價壓力在今天並不普遍。然而，我們很樂觀，因為我們在離岸轉換方面繼續取得成功，我們將能夠抓住更多機會，因為我們將在離岸業務的規模上更具競爭力。

Okay. And then I'm going to sneak in one last one, which is how would you think about deployment of capital as the business accelerates and deployment of -- accelerating cash as the business accelerates. You've got some debt on the balance sheet, but you're also talking about M&A. Would love to hear you talk about capital deployment priorities.

好的。然後我要偷偷摸摸最後一個，這就是你如何考慮隨著業務加速部署資本和部署 - 隨著業務加速加速現金部署。你的資產負債表上有一些債務，但你也在談論併購。很想听聽您談論資本部署的優先事項。

Yes. So George, I love the way that each question is prefaced by this is my last question. But when it comes to capital allocation, we really haven't changed our thought process on that so much. At the end of the day, the decision on capital allocation is going to be determined by what the alternative set looks like, right?

是的。所以喬治，我喜歡每個問題都以這是我的最後一個問題開頭的方式。但在資本配置方面，我們真的沒有太大改變我們的思維過程。歸根結底，資本配置的決定將取決於備選方案的樣子，對吧？

So repaying debt in an inflationary economy does become, obviously, a bit more attractive to us. But at the same time, we still think that there are lots of opportunities to continue to grow inorganically. And we think there are still some investment opportunities to make inside of the company. So I know that's a bit of a nonanswer answer, but going forward, it's really hard to stay with specificity, not knowing what the alternatives are going to be out there.

因此，在通貨膨脹經濟中償還債務顯然對我們更具吸引力。但與此同時，我們仍然認為有很多機會繼續無機增長。我們認為公司內部仍有一些投資機會。所以我知道這是一個沒有答案的答案，但展望未來，真的很難保持具體，不知道那裡會有什麼替代方案。

Yes. The only thing I -- I'm sorry, George. The only thing I would add on top of Matt's comment there is probably maybe a little more aggressiveness as it relates to that internal investment and seeing where there are opportunities for us to continue to drive the different parts of the business that we see opportunity in.

是的。我唯一的事——對不起，喬治。除了 Matt 的評論之外，我唯一要補充的是，可能會更積極一些，因為它與內部投資有關，並看到我們有機會繼續推動我們看到機會的業務的不同部分。

And the call out there is obviously the EHR market is not our growth opportunity by itself as historically, everybody has thought about it. But it is the foundation for $400 million worth of opportunity in that cross-sell market.

顯然，EHR 市場本身並不是我們的增長機會，因為從歷史上看，每個人都考慮過這一點。但它是該交叉銷售市場價值 4 億美元機會的基礎。

And so we've got to remain vigilant in delivering that value back to that customer set. So they remain our customers, and we have that connection relationship in place. And so we're going to be more aggressive as we look at -- to Matt's point, we've got to weigh the different options and make sure the return is there, but looking to make sure that as there are options for us or opportunities for us to put more back into the product that we're going to be doing so.

因此，我們必須保持警惕，將價值回饋給該客戶群。所以他們仍然是我們的客戶，我們已經建立了這種聯繫關係。因此，我們將更加積極地看待 - 就馬特的觀點而言，我們必須權衡不同的選擇並確保回報存在，但希望確保我們有選擇或我們有機會把更多的東西投入到我們將要這樣做的產品中。

Yes. And to follow up on that, if we did have to give some sort of general prioritization, I would say that reinvesting back in the business would be priority #1. Again, we do think there are inorganic opportunities there.

是的。為了跟進這一點，如果我們確實必須給出某種一般優先順序，我會說對業務進行再投資將是優先事項 #1。同樣，我們確實認為那裡存在無機機會。

So to the extent that the valuations make sense and that it fits from a product strategy and from a service delivery standpoint, inorganic growth through M&A would certainly be another opportunity that we'd look at. Now all of that being said, we want to make sure that we protect and that we defend the financial health of our balance sheet and we maintain our target leverage ratio of 2.5x that we've set a few years ago, and we've stuck pretty diligently through since.

因此，就估值的合理性以及從產品戰略和服務交付的角度來看，通過併購實現無機增長肯定是我們關注的另一個機會。綜上所述，我們要確保保護和捍衛資產負債表的財務健康，並維持我們幾年前設定的 2.5 倍的目標槓桿率，我們已經從那以後就非常努力地堅持了下來。

And our next question comes from the line of Stephanie Davis with SVB Securities.

我們的下一個問題來自 SVB 證券公司的斯蒂芬妮·戴維斯 (Stephanie Davis)。

I left you guys, and you're an EHR company. Now you're a rev cycle company. What happened? So maybe let's dig in there a little bit first. Talk to me about why these businesses are still together. You've got one hypergrowth company. It sounds like you're selling a lot outside of your base. Is it capital needs that keeps it together? Is it the cross-sell up? Why do we not think of splitting this up?

我離開了你們，而你們是一家 EHR 公司。現在你是一家轉速循環公司。發生了什麼？所以也許讓我們先深入了解一下。和我談談為什麼這些企業仍然在一起。你有一家高速增長的公司。聽起來你在你的基地之外賣了很多東西。是資本需求使它保持在一起嗎？是交叉銷售嗎？我們為什麼不考慮將其拆分？

Yes. Stephanie, first of all, welcome back. Obviously, we enjoy -- have enjoyed, but glad to have you back. I would say you hit the nail on the head with the second one. One, we have -- and let me back up beyond that.

是的。斯蒂芬妮，首先，歡迎回來。顯然，我們很享受——很享受，但很高興你回來。我會說你用第二個擊中了頭。第一，我們有——讓我支持更多。

Obviously, we've had a rich tradition serving this traditionally underserved market in the rural health -- rural and community health care. So we have been in that business since 1979.

顯然，我們有豐富的傳統服務於這個傳統上服務不足的農村衛生市場——農村和社區衛生保健。所以我們從 1979 年就開始從事這項業務。

We do see, obviously, the growth for the company going forward is predominantly being RCM, but we don't want to leave those roots. And so it does provide an opportunity for us to continue to help serve that segment of the market more holistically. So not only are we providing a quality and value product on the EHR front, but also being able to deliver in RCM and patient engagement and other services going forward.

我們確實看到，很明顯，公司未來的增長主要是 RCM，但我們不想離開這些根源。因此，它確實為我們提供了一個機會，讓我們可以繼續更全面地幫助這部分市場。因此，我們不僅在 EHR 方面提供優質和有價值的產品，而且能夠在 RCM 和患者參與以及未來的其他服務中提供。

So I guess with that question in mind, could we dig a little bit deeper and see what sort of products would be valuable to cross sell both to your existing base as well as the rev cycle clients that are outside of your base when you think about M&A?

所以我想考慮到這個問題，我們能否更深入地挖掘一下，看看什麼樣的產品對交叉銷售給你現有的基礎以及你基礎之外的翻新周期客戶是有價值的，當你考慮嘛？

So okay. I'm sorry, I wasn't following you to that last little part. I would say that we're -- if you look at our most recent M&A transactions, it's kind of a nice little nod to how we're thinking about pulling opportunities in.

好吧。對不起，我沒有跟你講到最後一小部分。我會說我們是——如果你看看我們最近的併購交易，這是對我們如何考慮吸引機會的一個很好的點頭。

HRG is obviously a consolidation play with a pure service company with almost like-for-like services that TruBridge already offered. And then you go one more back and you see TruCode, which was a strategic partner of ours for 5 years but delivered and had a technology that our customers need and also one that we can leverage on the TruBridge side.

HRG 顯然是一家純服務公司的整合遊戲，TruBridge 已經提供了幾乎類似的服務。然後你再往前看，你會看到 TruCode，它是我們 5 年的戰略合作夥伴，但交付並擁有我們客戶需要的技術，也是我們可以在 TruBridge 方面利用的技術。

So -- but I would say, if we're looking at the suite of TruBridge services holistically, the area from a tech standpoint would be on the front end. We're pretty good from the middle all the way to the end.

所以——但我想說，如果我們從整體上看 TruBridge 服務套件，那麼從技術角度來看，該領域將位於前端。我們從中間一直到最後都很好。

Where I think we may have some opportunity is looking at the very front end. Now obviously, you couple that with what we're getting excited about from a Get Real Health standpoint and the digital front door there. So that's M&A plus internal investment opportunity kind of competing against each other.

我認為我們可能有機會的地方是關注最前端。現在很明顯，你將它與我們從 Get Real Health 的角度和那裡的數字前門感到興奮的東西結合起來。所以這是併購加上內部投資機會相互競爭。

Understood. All right, last one. I promise this is my real last one. Looking at you, George. You started talking about scaling up offshore. And that makes a lot of sense as you grow your revenue cycle business. But have you thought about any AI tools or robotic process automation tools that could also improve upon your cost structure beyond just geography?

明白了。好吧，最後一個。我保證這是我真正的最後一個。看著你，喬治。你開始談論擴大海外業務。當您發展收入周期業務時，這很有意義。但是你有沒有想過任何人工智能工具或機器人過程自動化工具也可以改善你的成本結構而不僅僅是地理？

Yes, 100%. And it's a tale very similar to the offshore initiative. We started in earnest our AI or bringing in RPA about the same time we started with the offshore processes. And remember, we're not the biggest company in the world, and so we've got to be mindful about execution and what it is that we can take on and remain focused.

是的，100%。這是一個與離岸計劃非常相似的故事。在我們開始離岸流程的同時，我們認真地開始了我們的 AI 或引入 RPA。請記住，我們不是世界上最大的公司，因此我們必須注意執行以及我們可以承擔並保持專注的內容。

And so we feel like we've got our hands around the offshore initiative really nicely now and see that scaling out over the coming years. And so we're really turning our efforts to that AI initiative that we started.

因此，我們覺得我們現在已經很好地掌握了離岸計劃，並看到在未來幾年擴大規模。因此，我們真正將我們的努力轉向了我們開始的 AI 計劃。

We have a team, an internal team that is dedicated to building bots, for lack of a better term, specifically focused on the RCM transactional work that we can deploy into the services that we have. And so the hope is that as we continue to execute on that through 2023 that we'll be -- we'll see numbers very similar to what we've seen from an offshore perspective, which is what gives us a lot of confidence in that returning to the 20-plus percent EBITDA margin in the end of 2024.

我們有一個團隊，一個致力於構建機器人的內部團隊，因為沒有更好的術語，專門專注於我們可以部署到我們擁有的服務中的 RCM 事務性工作。因此，希望隨著我們繼續執行到 2023 年，我們將看到與我們從離岸角度看到的非常相似的數字，這讓我們對到 2024 年底，EBITDA 利潤率將恢復到 20% 以上。

Yes. And Stephanie, we're obviously fairly excited about the opportunity for offshore, especially seeing how early we are in the development of that lever for margin optimization. But we're equally excited about the potential for automation. And frankly, we're probably a little bit earlier in the game there than we are on the automation side.

是的。斯蒂芬妮，我們顯然對離岸機會感到非常興奮，尤其是看到我們在開發利潤優化槓桿方面有多早。但我們同樣對自動化的潛力感到興奮。坦率地說，與自動化方面相比，我們在遊戲中的應用可能要早一些。

We still have a lot of business processes within TruBridge that need to be streamlined and consolidated to make them good candidates for automation. So we've got a lot of righting the ship internally process-wise to do to really take advantage of those opportunities, but they're there. And we're very early in that ball game right now.

我們在 TruBridge 中仍有許多業務流程需要簡化和整合，以使其成為自動化的理想候選者。因此，我們在內部流程方面做了很多調整，以真正利用這些機會，但它們就在那裡。我們現在還處於球賽的早期階段。

There are no further questions at this time. And I would like to turn the floor back over to Chris for any closing comments.

目前沒有其他問題。我想將發言權轉回給 Chris，請他發表任何結束評論。

Absolutely. Thanks again for everybody joining today and for your continued interest in CPSI. I hope everybody has a wonderful week. And Matt, Happy Valentine's Day, buddy.

絕對地。再次感謝大家今天的加入以及您對 CPSI 的持續關注。我希望每個人都有一個美好的一周。還有馬特，情人節快樂，伙計。

This concludes today's conference. You may disconnect your lines at this time. Thank you for your participation, and have a great day.

今天的會議到此結束。此時您可以斷開線路。感謝您的參與，祝您有美好的一天。