TruBridge Inc (TBRG) 2023 Q3 法說會逐字稿

Greetings, and welcome to the CPSI Third Quarter Earnings Conference Call. (Operator Instructions). As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Dru Anderson, Investor Relations. Thank you. You may begin.

您好，歡迎參加 CPSI 第三季財報電話會議。 （操作員說明）。提醒一下，本次會議正在錄製中。現在我很高興向您介紹主持人，投資者關係部門的德魯·安德森 (Dru Anderson)。謝謝。你可以開始了。

Good afternoon, and welcome to the CPSI Third Quarter 2023 Earnings Conference Call. Leading today's call are Chris Fowler, President and Chief Executive Officer; Matt Chambless, Chief Financial Officer.

下午好，歡迎參加 CPSI 2023 年第三季財報電話會議。今天的電話會議由總裁兼執行長 Chris Fowler 主持。馬特·錢伯斯，財務長。

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. Actual results may 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.

本次電話會議可能包括有關未來營運計畫、預期和績效的陳述，這些陳述構成根據1995 年《私人證券訴訟改革法案》安全港條款做出的前瞻性陳述。本公司提醒您，任何此類前瞻性陳述僅反映管理層的情況是基於當前可用資訊的預期和預測，並不保證未來的結果或績效。由於已知和未知的風險、不確定性和其他因素（包括向美國證券交易委員會提交的公開發布和報告中描述的因素），實際結果可能與此類前瞻性陳述明示或暗示的結果有重大差異，包括但不限於至 10-K 表上的最新年度報告。

The company also cautions investors that the forward-looking information provided on 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. At this time, I will turn the call over to Mr. Chris Fowler, President and Chief Executive Officer. Please go ahead, sir.

該公司還提醒投資者，本次電話會議中提供的前瞻性資訊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之後的事件或發展。此時，我將把電話轉給總裁兼執行長克里斯·福勒先生。請繼續，先生。

Thanks, Dru, and thank you to everyone for joining us this afternoon. Unfortunately, this was another tough quarter for CPSI with metrics around the top line, bottom line and growth-oriented bookings all underperforming our expectations and surely those of our shareholders. Three months ago, we acknowledged the reality of our historical tendency of allowing optimism to trump realism, and we told you those days were behind us.

謝謝 Dru，也謝謝大家今天下午加入我們。不幸的是，對於 CPSI 來說，這又是一個艱難的季度，圍繞營收、利潤和成長導向的預訂的指標均低於我們的預期，當然也低於我們股東的預期。三個月前，我們承認我們的歷史趨勢是讓樂觀主義克服現實主義，我們告訴你們那些日子已經過去了。

While our mindset and outlook have definitely shifted, it's taking time for that to flow through to our operations. Pulling this all down, what it means for the third quarter is that our results came in below our expectations on the top and bottom line as well as soft on bookings. Our revenue of $84.7 million was about $2 million short of our plan. Adjusted EBITDA of $9.7 million was light as a result of revenue mix as well as some unexpected out-of-period vendor expenses of around $0.5 million. And bookings in the third quarter came in at $16.2 million, also well below our target. Finally, the growth of our RCM business continues to be sluggish.

雖然我們的思維方式和前景確實發生了變化，但這種變化需要時間才能反映在我們的營運中。綜上所述，第三季的結果意味著我們的營收和利潤低於我們的預期，而且預訂量也疲軟。我們的收入為 8,470 萬美元，比計劃少了約 200 萬美元。由於收入結構以及約 50 萬美元的一些意外的期外供應商費用，調整後 EBITDA 為 970 萬美元。第三季的預訂量為 1,620 萬美元，也遠低於我們的目標。最後，我們的RCM業務成長持續低迷。

However, our -- however, our EHR business performed slightly better than expected, and we saw continued strength in our existing customer base with retention coming in above our expectations for the quarter. This gives us optimism around our right to win in those cross-sell opportunities for RCM.

然而，我們的 EHR 業務表現略好於預期，我們看到現有客戶群持續強勁，保留率超出了我們對本季的預期。這讓我們對贏得 RCM 交叉銷售機會的權利感到樂觀。

Let me start by saying that, over the course of this year, revenue has come in slower than we anticipated. And at the same time, as we discussed last quarter, we did not scale back the additional investments we have been making in our future. With that backdrop, we have increased our vigor in making the operational adjustments in the core business that will serve to increase profitability once sales emerge from what has been a more elongated cycle than originally expected. I'll get into more of the operational initiatives in a moment, but I also want to comment on some external pressures we're facing as an organization as we continue to shepherd our sales opportunities to close.

首先我要說的是，今年以來，營收成長速度比我們預期的要慢。同時，正如我們上季度討論的那樣，我們沒有縮減未來的額外投資。在此背景下，我們加大了對核心業務進行營運調整的力度，一旦銷售擺脫了比最初預期更長的周期，這將有助於提高獲利能力。稍後我將討論更多營運舉措，但我也想評論一下我們作為一個組織在繼續把握銷售機會時所面臨的一些外部壓力。

Externally, hospitals, especially the smaller ones with less than 100 beds where we have identified cross-sell opportunities, are under tremendous cost pressure related to labor and many of them have simply paused making decisions on nonclinical spending like new technology solutions and RCM services. While this is not a new pressure on our end market, we did experience an uptick in prospective deals where no decision was made this quarter.

從外部來看，醫院，尤其是我們發現交叉銷售機會的床位不足100 個的小型醫院，面臨著與勞動力相關的巨大成本壓力，其中許多醫院只是暫停了對新技術解決方案和RCM 服務等非臨床支出的決策。雖然這對我們的終端市場來說並不是新的壓力，但我們確實經歷了潛在交易的增加，但本季尚未做出任何決定。

As we strategically move upstream to large hospitals with 100 to 400 beds, the decision-making process in those institutions just takes longer due to the greater complexity and the involvement of multiple decision makers. We're managing the challenging environment and staying in front of these opportunities. I have spent the last few weeks meeting with existing customers and new targets. These meetings have reinforced our belief that eventually all providers will move to an outsourced model. As I have met with dozens of CEOs, what I have found is that they tend to fall into one of 2 camps: either their hospitals are underperforming and they know they need help now; or they're performing okay, but could be doing a little bit better and they typically have employees, key employees that they just aren't ready to outsource yet.

當我們策略性地向上游轉移到擁有 100 至 400 個床位的大型醫院時，由於更複雜且涉及多個決策者，這些機構的決策過程需要更長的時間。我們正在應對充滿挑戰的環境並抓住這些機會。過去幾週我一直在與現有客戶和新目標會面。這些會議增強了我們的信念：最終所有提供者都將轉向外包模式。我與數十位執行長會面後發現，他們往往屬於兩個陣營之一：要么他們的醫院表現不佳，他們知道自己現在需要幫助；要么他們的醫院表現不佳，他們知道自己現在需要幫助；要么他們的醫院表現不佳，他們知道自己現在需要幫助；要么他們的醫院表現不佳，他們知道自己現在需要幫助。或者他們表現不錯，但可能會做得更好一點，他們通常有員工，關鍵員工，但他們還沒準備好外包。

But the headline here is that they all agree that it's a foregone conclusion, they will ultimately need to outsource and in time will become prospects for us. As all this unfolds, we will be laser-focused internally, improving the efficiency of our operations, which will also ensure that we'll be in a position to take advantage of future opportunities.

但這裡的標題是，他們都同意這是已成定局，他們最終需要外包，並最終成為我們的潛在客戶。隨著這一切的展開，我們將專注於內部，提高我們的營運效率，這也將確保我們能夠利用未來的機會。

Operationally, we're actively working to fine-tune or accelerate the following initiatives that we laid out for ourselves in the beginning of the year. First, availability of domestic and global resources have put pressure on timely deliveries and performance in our RCM business. This isn't really anything new to us as the scarcity of domestic resources was essential motivation behind our global workforce strategy. What's incremental, however, over the last 90 days has been the inconsistent resourcing from our global partners, which has led to some delayed go-lives for RCM services.

在營運方面，我們正在積極調整或加速我們在年初為自己制定的以下舉措。首先，國內和全球資源的可用性給我們的RCM業務的及時交付和績效帶來了壓力。這對我們來說並不是什麼新鮮事，因為國內資源的稀缺是我們全球勞動力策略背後的重要動力。然而，在過去 90 天裡，我們的全球合作夥伴提供的資源不一致，這導致了 RCM 服務的一些延遲上線。

Global partners will continue to be an important contributor to our workforce strategy. However, they are now part of a broader solution for us. Our sole reliance on partners put us at a disadvantage as we were working to scale our global workforce. With the acquisition of Viewgol, I am confident that we are on a better path to eliminate this bottleneck.

全球合作夥伴將繼續為我們的勞動力策略做出重要貢獻。然而，它們現在是我們更廣泛解決方案的一部分。當我們努力擴大全球勞動力規模時，我們對合作夥伴的完全依賴使我們處於不利地位。透過收購 Viewgol，我相信我們正走在消除這瓶頸的更好道路上。

For context, we expect to have 400 global resources by the end of this year and a total of 800 global resources by the end of 2024. And we anticipate 30% at a minimum of these global resources to be CPSI employees, thanks to this acquisition. This deal also provides some wow factor margin expansion potential by bringing these efforts in-house. Initially, our offshore partners helped us lower our labor expense by 41% for each FTE but the Viewgol transaction will enable us to bring offshore capabilities in-house, bringing the savings opportunity closer to 75% per FTE.

就背景而言，我們預計到今年底將擁有 400 名全球資源，到 2024 年底總共將擁有 800 名全球資源。得益於此次收購，我們預計這些全球資源中至少有 30% 是 CPSI 員工。透過將這些工作引入內部，該交易還提供了一些令人驚嘆的利潤擴張潛力。最初，我們的離岸合作夥伴幫助我們將每個 FTE 的勞動力成本降低了 41%，但 Viewgol 交易將使我們能夠將離岸能力引入內部，從而使每個 FTE 的節省機會接近 75%。

Lastly, beyond the improved access to global resources and the margin expansion that comes with Viewgol, it's also opening up a new market for us in ambulatory RCM services. Second, as noted in our 8-K last week, we made another push towards the ramping of our enterprise-wide offshoring initiatives by shifting 2% of our current domestic workforce to the global or outsourced model. This is an additional $2 million in cost savings to the voluntary retirement program that kickstarted our efforts to streamline our organization, leading to the roughly $3 million in savings this year and $6 million on an annualized basis.

最後，除了 Viewgol 改善了對全球資源的獲取和利潤成長之外，它還為我們在門診 RCM 服務領域開闢了一個新市場。其次，正如我們上週的 8-K 所指出的，我們透過將 2% 的現有國內勞動力轉移到全球或外包模式，再次推動了企業範圍內的離岸外包計畫。這為自願退休計畫額外節省了 200 萬美元的成本，該計畫啟動了我們精簡組織的努力，導致今年節省了約 300 萬美元，每年節省了 600 萬美元。

Third, while the quarter's bookings results are disappointing, the visibility we have in the pipeline gives me confidence that this team is curating an impressive set of opportunities. There's good reason to believe that our deal flow will likely pick up and, longer term, we can achieve the consistency in sales performance needed to take advantage of this finite window for RCM market share gains.

第三，雖然本季的預訂結果令人失望，但我們在管道中的可見度讓我相信團隊正在策劃一系列令人印象深刻的機會。我們有充分的理由相信，我們的交易量可能會增加，而且從長遠來看，我們可以實現銷售業績的一致性，從而利用這個有限的窗口來擴大 RCM 市場份額。

Our total 3-month weighted pipeline has increased 20% from the third quarter of 2022, and we have also closed several significant deals in the first month of the fourth quarter, which are both promising indicators. Make no mistake, we are bullish on the RCM opportunity ahead of us. However, there is a real nuance in how we must manage the current fluctuation in market demand.

我們的 3 個月加權管道總額較 2022 年第三季增加了 20%，我們也在第四季度第一個月完成了幾筆重大交易，這都是有希望的指標。毫無疑問，我們看好擺在我們面前的 RCM 機會。然而，我們必須如何管理當前市場需求的波動，並存在著真正的細微差別。

Our recently reorganized sales team must balance being assertive with a stronger consultative, even educational approach with buyers. Motivating hospitals that are performing okay, but could be doing better, takes time and comes with a variety of complexities, especially when people's jobs are potentially impacted.

我們最近重組的銷售團隊必須在自信與對買家進行更有力的諮詢甚至教育方法之間取得平衡。激勵表現良好但可能做得更好的醫院需要時間，並且會帶來各種複雜性，特別是當人們的工作可能受到影響時。

We've been aggressively deploying a successful land-and-expand strategy of pursuing short-term contracts and AR work-down opportunities. While we are -- while we continue to see this as an effective foot-in-the-door strategy, these opportunities have greater risk compared to our long-term, full-service model where we manage the hospital's entire net patient revenue. While we're very motivated to perform well against short-term contracts and, in turn, convert them to long-term deals, it is never a guarantee and therefore, creates risk of lumpy revenue recognition due to the potential onetime nature of these project-based arrangements.

我們一直在積極部署成功的土地擴張策略，以尋求短期合約和 AR 工作機會。雖然我們仍然認為這是一種有效的入門策略，但與我們管理醫院全部病患淨收入的長期全方位服務模式相比，這些機會具有更大的風險。雖然我們非常有動力在短期合約上表現良好，進而將其轉換為長期交易，但這永遠不是保證，因此，由於這些項目潛在的一次性性質，會產生收入確認不穩定的以風險為基礎的安排。

Lastly, while overall bookings for our encoder solution came in near expected levels, these wins were heavily weighted toward the last week of the quarter with a high mix of SaaS and roughly half of the win is not expected to go live until 2025, creating real challenges versus historical bookings to revenue conversion time frames.

最後，雖然我們的編碼器解決方案的總體預訂量接近預期水平，但這些勝利在本季度最後一周佔據了很大比重，其中SaaS 的比例很高，並且大約一半的勝利預計要到2025 年才會上線，從而創造了真正的收入轉換時間表與歷史預訂之間的挑戰。

And finally, as our business has evolved, our pace of acquisition has picked up. Our workforce has become more global, and our financial infrastructure needs to be modernized. We've obviously struggled with our cost structure and budgeting. We've been operating with dated financial software and some mismatch skill sets that haven't served us well during our dynamic transformation over the last 12 months.

最後，隨著我們業務的發展，我們的收購步伐也加快了。我們的勞動力隊伍變得更加全球化，我們的金融基礎設施也需要現代化。顯然，我們在成本結構和預算方面遇到了困難。我們一直在使用過時的財務軟體和一些不匹配的技能，這些技能在過去 12 個月的動態轉型過程中並沒有為我們帶來很好的幫助。

To address the former issue, we will be updating our financial operating system to Microsoft Dynamics with a planned go-live of September in 2024. And on the latter point, recognizing that the skill set of our financial team needs to evolve over time, we're pleased to announce that Vinay Bassi will be assuming the role of CFO effective January 1. Vinay brings much-needed maturity to our FP&A function including the experience from his tenure at Nielsen that will benefit our own transformation journey and his deep experience in offshore operations that has become a key need with our acquisition of Viewgol.

為了解決前一個問題，我們將把我們的財務作業系統更新為 Microsoft Dynamics，計劃於 2024 年 9 月上線。對於後一點，我們認識到我們財務團隊的技能需要隨著時間的推移而發展，我們我們很高興地宣布，Vinay Bassi 將於1 月1 日起擔任首席財務官。Vinay 為我們的FP&A 職能帶來了急需的成熟度，包括他在尼爾森任職期間的經驗，這將有利於我們自己的轉型之旅以及他在離岸業務方面的豐富經驗隨著我們收購 Viewgol，營運已成為關鍵需求。

We're confident Vinay's background and pedigree will bring our budgeting and financial operations to the next level, holding us accountable, not allowing us to get ahead of ourselves and ensuring that there is a business case to support us and not work against us.

我們相信，Vinay 的背景和血統將把我們的預算和財務運營提升到一個新的水平，讓我們承擔責任，不允許我們超前，並確保有商業案例支持我們而不是對我們不利。

As you'd expect, our third quarter financial results and our booking performance is going to have an impact on our outlook for the year. We're lowering our 2023 guidance to account for these factors and now expect revenue of between $337 million and $342 million and adjusted EBITDA to be between $47 million and $49 million.

正如您所期望的，我們第三季的財務業績和預訂業績將對我們今年的前景產生影響。考慮到這些因素，我們正在降低 2023 年的指導，目前預計收入將在 3.37 億美元至 3.42 億美元之間，調整後的 EBITDA 將在 4,700 萬美元至 4,900 萬美元之間。

Before turning things back over to Matt, I want to reiterate that there's a lot for us to be excited about. But we're also realistic about the frustrations from the shareholder community around the lack of growth and what seems like a terrific RCM opportunity and the need for greater scrutiny on the cost side of the P&L. We believe that patience is a virtue as the RCM opportunity market for community hospitals continues to develop. And we're pursuing cost strategies that are both intentional and surgical, ensuring that we have the organizational health necessary to deliver on the needs of our loyal customer base.

在將事情轉回給馬特之前，我想重申一下，有很多事情讓我們感到興奮。但我們也現實地認識到股東群體對缺乏成長、看似絕佳的 RCM 機會以及對損益表成本方面進行更嚴格審查的必要性的挫敗感。我們相信，隨著社區醫院 RCM 機會市場的不斷發展，耐心是一種美德。我們正在推行有意而為之的成本策略，以確保我們擁有滿足忠實客戶群需求所需的組織健康狀況。

The continued execution of our voluntary early retirement program, the continued transition to a global and outsourced workforce and the recent acquisition of Viewgol have all been with a keen focus on improving profitability in advance of any revenue gains. We're evolving and adapting our leadership team to the changing needs of the organization as we continue down this path of transformation.

我們繼續執行自願提前退休計劃、繼續向全球外包勞動力過渡以及最近收購 Viewgol，所有這些都非常注重在收入成長之前提高獲利能力。隨著我們繼續沿著這條轉型之路前進，我們正在不斷發展和調整我們的領導團隊，以適應組織不斷變化的需求。

We look forward to showing you what this team of now more than 3,000 people across multiple countries can accomplish, and we thank everyone for their willingness to endure this bumpy road to success. We believe in the future of community health care and remain convicted that community hospitals need a robust and healthy CPSI to help them thrive in delivering care to their communities. And we're dedicated to returning to operational excellence and making the tough decisions necessary to ensure that a vibrant, healthy CPSI is here to shepherd community healthcare into a bright future. And with that, I'll turn it over to Matt for a bit more color on the financials.

我們期待向您展示這個由來自多個國家的 3,000 多人組成的團隊能夠取得的成就，我們感謝每個人願意忍受這條坎坷的成功之路。我們對社區醫療保健的未來充滿信心，並堅信社區醫院需要強大而健康的 CPSI 來幫助他們在為社區提供護理方面蓬勃發展。我們致力於恢復卓越運營，並做出必要的艱難決定，以確保一個充滿活力、健康的 CPSI 能夠引領社區醫療保健走向光明的未來。接下來，我將把它交給馬特，讓他對財務狀況有更多的了解。

Thanks, Chris, and thanks to everyone for joining the call. I'm going to quickly cover the Viewgol transaction and then dive into the third quarter's results. The purchase price for view include upfront cash consideration of $36 million using amounts available under our $160 million revolver. The purchase agreement includes additional earn-out incentives of up to $31.5 million based on a combination of a minimum 2024 EBITDA contribution threshold and Viewgol's ability to provide offshore employees dedicated to our existing RCM services within TruBridge. For the full year 2023, Viewgol should ride a roughly 45% annual revenue increase to generate a top line of about $17 million and roughly $3 million in adjusted EBITDA. With the acquisition taking place in the fourth quarter, we expect our financials to see incremental revenues of around $3.9 million and $1 million of EBITDA for 2023 as a result of the acquisition.

謝謝克里斯，也謝謝大家加入電話會議。我將快速介紹 Viewgol 交易，然後深入討論第三季的表現。 View 的購買價格包括 3,600 萬美元的預付現金對價，使用我們 1.6 億美元循環資金下的可用金額。該購買協議包括高達 3,150 萬美元的額外獎勵，該獎勵基於 2024 年 EBITDA 最低貢獻門檻以及 Viewgol 提供專門從事 TruBridge 內現有 RCM 服務的離岸員工的能力。 2023 年全年，Viewgol 的年營收成長約 45%，營收約 1,700 萬美元，調整後 EBITDA 約為 300 萬美元。隨著收購在第四季度進行，我們預計收購後我們的財務收入將增加約 390 萬美元，2023 年 EBITDA 將增加 100 萬美元。

Looking forward to 2024, we believe stand-alone Viewgol should deliver at least $4.5 million of EBITDA, and that's without the synergies of transitioning our offshore workforce to the combined business.

展望 2024 年，我們認為獨立的 Viewgol 應實現至少 450 萬美元的 EBITDA，而這還不包括將我們的離岸員工轉移到合併後的業務所產生的協同效應。

Moving on to the quarter's results. Net patient revenue, which represents our total NPR of just our end-to-end RCM customers was just shy of $3.5 billion, an increase of 17% year-over-year. Total bookings in the quarter were $16.2 million. RCM bookings of $9.1 million comprised 56% of total bookings but underperformed versus internal expectations and year-over-year as the cross-sell decision pace which Chris touched on earlier.

接下來是本季的業績。患者淨收入（僅代表我們的端對端 RCM 客戶的 NPR 總額）略低於 35 億美元，年增 17%。該季度的總預訂量為 1,620 萬美元。 RCM 預訂量為 910 萬美元，佔總預訂量的 56%，但與克里斯早些時候提到的交叉銷售決策速度相比，其表現低於內部預期和同比。

Total revenue of $82.7 million was effectively flat compared to last year. For the quarter, RCM represented 56% of total revenue. EHR was 42% and patient engagement rounded out the remaining 2%. While revenues were flat, our cost of revenues increased by $600,000 as the RCM margin headwinds we discussed on the last call offset most of the cost reductions we've achieved within our EHR business through our scaled agile implementation and the voluntary early retirement program we announced last -- on the last call.

總收入為 8,270 萬美元，與去年持平。本季度，RCM 佔總收入的 56%。 EHR 為 42%，病患參與度為剩下的 2%。雖然收入持平，但我們的收入成本增加了600,000 美元，因為我們在上次電話會議上討論的RCM 利潤逆風抵消了我們通過大規模敏捷實施和我們宣布的自願提前退休計劃在EHR 業務中實現的大部分成本削減最後——最後一次通話。

Outside of cost of revenues, we saw operating expenses increased by $9.5 million to 53.3% of total revenues compared to only 41.7% in the third quarter of last year. Roughly 70% of that increase came from EBITDA-neutral nonrecurring acquisition costs and severance costs associated with cost-cutting efforts like the voluntary early retirement program. Other major cost increases were seen in product development as costs associated with our Microsoft Azure cloud migration and other workplace modernization efforts increased $1.4 million while G&A costs on a combined $1.3 million increase in benefits costs and bad debt expense. These all resulted in adjusted EBITDA of $9.7 million compared to $13.3 million a year ago.

除收入成本外，我們發現營運支出增加了 950 萬美元，佔總收入的 53.3%，而去年第三季僅為 41.7%。其中約 70% 的成長來自 EBITDA 中性的非經常性收購成本以及與自願提前退休計畫等成本削減措施相關的遣散費。其他主要成本增加出現在產品開發中，因為與我們的 Microsoft Azure 雲端遷移和其他工作場所現代化工作相關的成本增加了 140 萬美元，而福利成本和壞帳費用總共增加了 130 萬美元的一般管理費用。所有這些都導致​​調整後 EBITDA 達到 970 萬美元，而一年前為 1,330 萬美元。

Adjusted EBITDA margin of 11.8% was down 440 basis points due to growth in operating costs. Wrapping up the financials. Operating cash flow for the third quarter was $3.1 million.

由於營運成本成長，調整後 EBITDA 利潤率為 11.8%，下降了 440 個基點。總結財務。第三季營運現金流為 310 萬美元。

Turning to guidance. While we certainly didn't want to be in a position to adjust guidance again following the third quarter, the top line challenges that have unfolded in the back half of the year have us adjusting guidance yet again with the details as follows: we're reducing our expected revenue range to a range of $337 million to $342 million from the previous expectation of $340 million to $350 million. Reducing adjusted EBITDA expectations to a range of $47 million to $49 million from the previous expectation of $52.5 million to $54.5 million.

轉向指導。雖然我們當然不希望在第三季之後再次調整指導，但今年下半年出現的頂線挑戰使我們再次調整指導，具體如下：將我們的預期收入範圍從之前的3.4 億美元至3.5 億美元下調至3.37 億美元至3.42 億美元。將調整後 EBITDA 預期從先前的 5,250 萬美元至 5,450 萬美元下調至 4,700 萬美元至 4,900 萬美元。

And reducing our non-GAAP net income to a range of $24.5 million to $26.5 million from the previous expectation of $25.6 million to $27.6 million. These new guidance ranges are inclusive of Viewgol's contribution to the fourth quarter. And with that, I'll turn the things back over to the operator for questions.

並將我們的非 GAAP 淨利潤從先前預期的 2,560 萬美元至 2,760 萬美元下調至 2,450 萬美元至 2,650 萬美元。這些新的指導範圍包括 Viewgol 對第四季的貢獻。然後，我會將這些東西轉回給接線生詢問。

(Operator Instructions) Our first question comes from George Hill with Deutsche Bank.

（操作員說明）我們的第一個問題來自德意志銀行的喬治·希爾。

I guess Chris, I'll probably start off with the one that's on the top of everybody's mind right now. I know you guys are not in a position to talk about 2024 guidance yet. But I missed -- I guess, maybe can you talk about given how you guys see the market environment right now, what might be the big puts and takes or the big moving pieces as we think about 2024? And I know you talked about some of the new wins not going on until 2025. So there's clearly some push out. But kind of any early color you can give, I think, would be super helpful.

我想克里斯，我可能會從現在大家最關心的問題開始。我知道你們還沒有資格談論 2024 年指導。但我錯過了——我想，鑑於你們現在如何看待市場環境，也許你們能談談我們對 2024 年的看法，大的看跌期權或大變動的部分可能是什麼？我知道你談到了一些新的勝利要到 2025 年才會發生。所以顯然有一些推出。但我認為，你可以提供的任何早期顏色都會非常有幫助。

And obviously, we want to be really mindful as we continue to sharpen our pencil a little bit here, George, and thinking about 2024. Again, also not falling into some of the tracks that we have up to this point. But with that said, as I said in the prepared remarks, we're thinking about this from a "Let's make sure that we've got the business healthy as we prepare for the revenue to unlock."

顯然，喬治，在我們繼續削尖鉛筆並思考 2024 年時，我們要真正保持警惕。同樣，也不要陷入我們迄今為止的一些軌道。但話雖如此，正如我在準備好的發言中所說，我們正在從「讓我們確保我們的業務健康發展，同時為收入釋放做好準備」的角度來思考這個問題。

We have been very intentional about the moves that we've made to prepare the business to be ready to take on these opportunities and to address the margin compression that we've seen happen over the last 24 to 18 months. And I think that we're going to see those come through nicely in 2024.

我們非常有意識地採取了行動，讓業務做好準備，抓住這些機會，並解決我們在過去 24 到 18 個月中看到的利潤壓縮問題。我認為我們將在 2024 年看到這些進展順利。

On the revenue side, on the bookings opportunity, as I said, I've been on the road the last couple of weeks, I intend to continue to be on the road in front of these opportunities, where I think that I can be helpful from the CEO level, the CEO at the facility to help push them a little bit over the edge of understanding that this is an eventuality.

在收入方面，在預訂機會方面，正如我所說，過去幾週我一直在路上，我打算在這些機會面前繼續前進，我認為我可以提供幫助從首席執行官層面來看，該工廠的首席執行官幫助他們稍微理解這是一種可能性。

I had 5 one-on-one meetings over the last week with CEOs where, again, the posture, the position is that this is going to happen. Whether they're operating well today or whether they're not, is really kind of the throttle on how that's going to shake out. Again, we continue to look for opportunities for us to show them ease of the strain of managing this operation by themselves and also areas of opportunity where we can bring along new revenues for them through either better efficiencies, better processes, whether it's through programs that we can bring in.

上週我與執行長們進行了 5 次一對一的會議，會議的態度和立場是這將會發生。無論它們今天運作得好還是不好，都確實是影響其擺脫困境的因素。再次，我們繼續尋找機會，向他們展示如何減輕自行管理營運的壓力，以及我們可以透過更高的效率、更好的流程為他們帶來新收入的機會領域，無論是透過以下項目：我們可以帶進來。

And so what I continue to hear more and more from these hospitals and the CEOs is that the cash collections, while it's vital to their operation, it's not their mission and it's not their focus. And it is ours. And so where we're going and where they are as well lines up nicely. And so as we continue to work over the last part of this year, as we onboard Vinay in January, we'll look forward to providing what 2024 looks like then.

因此，我越來越多地從這些醫院和執行長那裡聽到的是，現金籌集雖然對他們的營運至關重要，但這不是他們的使命，也不是他們的重點。這是我們的。所以我們要去的地方和他們所在的地方也很好地對齊。因此，當我們在今年下半年繼續工作時，當我們在一月份加入 Vinay 時，我們將期待提供 2024 年的情況。

Yes. And then George, I'll just hop in -- George, I'll just hop in quickly. Yes, tack on to that just a little bit. We've been decisioning items throughout the year really to make sure the cost structure is in order and the decisions are being made in 2023, so that in 2024, we're not as reliant on growth to drive margin expansion. So trying to do what we can now, make the smart decisions, get lean, get fit, get in shape so we can grow margins next year and not be so dependent on top line trajectory.

是的。然後喬治，我會跳進去──喬治，我會很快跳進去。是的，稍微補充一下。我們全年都在做出決策，真正確保成本結構井然有序，決策將在 2023 年做出，這樣到 2024 年，我們就不會那麼依賴成長來推動利潤率擴張。因此，我們要盡力做現在能做的事情，做出明智的決定，變得精益，健身，保持體形，這樣我們明年就能增加利潤，而不是太依賴營收軌跡。

Okay. That's helpful. I have a couple more, I'll hop in real quick. On the core RCM business, I know that you guys are disappointed by kind of the pace of new business wins. Can you talk about what's going on in that business from a same-store sales basis? And kind of how should we think about what same-store billings volume looks like and kind of your ability to achieve operating leverage there?

好的。這很有幫助。我還有幾個，我會很快加入。關於核心 RCM 業務，我知道你們對新業務獲勝的速度感到失望。您能從同店銷售的角度談談該業務的情況嗎？我們應該如何考慮同店營業額以及您在那裡實現營運槓桿的能力？

Yes. So we do typically see some changes from time-to-time in what happens in the same-store sales side of things. Sometimes what we see in the same-store sales part of the business is a function of kind of pending attrition which does happen from time-to-time. We do see real actual, like, volume changes from period-to-period that hit us as well. We can also have same-store declines or same-store changes depending on the nature of contracts, so if it's a short-term contract or project related.

是的。因此，我們通常會不時看到同店銷售方面發生的一些變化。有時，我們在業務的同店銷售部分中看到的是一種時不時發生的待定損耗的函數。我們確實看到了不同時期的實際成交量變化，也為我們帶來了打擊。根據合約的性質，我們也可能會出現同店拒絕或同店變更的情況，如果是短期合約或專案相關的話。

Those can obviously have a long tail on them. But as time goes on, the revenue opportunity and revenue profile decreases. It is same-store change. It's one of the dynamics that has impacted us here in the past couple of quarters. And we do think that part of the reason for that and the lack of visibility that we've had in that has been the prevalence of these kind of project-oriented, short-term major contracts that aren't quite CPSI taking over the entire book of business for the hospital. We're focusing on only a small slice, and that certainly increases forecast risk for us.

那些顯然可能有很長的尾巴。但隨著時間的推移，收入機會和收入狀況會減少。這是同店變更。這是過去幾季影響我們的動態之一。我們確實認為，造成這種情況的部分原因以及我們在這方面缺乏可見性的原因是此類以項目為導向的短期重大合約盛行，而這些合約並未完全由 CPSI 接管。醫院的業務手冊。我們只專注於一小部分，這肯定會增加我們的預測風險。

Okay. Two more and then I'll stop being selfish and can get off the line. Any change in the competitive environment in RCM? And I guess, are you seeing any new competitors show up that you guys think could be elongating the sales cycle or impacting your win rate?

好的。再打兩個，我就不再自私了，就可以掛斷電話了。 RCM的競爭環境有什麼改變嗎？我想，你們是否看到任何新的競爭對手出現，你們認為這可能會延長銷售週期或影響你們的獲勝率？

No. Again, George, the dynamic here is super fascinating from that respect in that the competition still widely remains to be the hospital themselves. And the analogy for good or for bad is we're moving through 2 different phases here of sales cycles.

不。再次強調，喬治，從這方面來看，這裡的動態非常令人著迷，因為競爭仍然廣泛地仍然是醫院本身。好或壞的類比是我們正在經歷銷售週期的兩個不同階段。

We're doing the education and selling the benefit of outsourcing in the first place. And then we're selling TruBridge by itself. And the beauty of having this captive audience of customers on the EHR is that we have an open door into them to have these conversations. And so while it may be middle to bottom of their list of priorities, we have the ability through our conversations through our continued education of what we can deliver for them, moving that up the priority list. But from a competitive landscape standpoint, I would say by and large, we're still more fighting against the hospital themselves than we are competition, especially in the 400 beds and under in the space that we play.

我們首先進行教育並銷售外包的好處。然後我們自行銷售 TruBridge。在 EHR 上擁有這些忠實的客戶受眾的好處在於，我們向他們敞開了進行這些對話的大門。因此，雖然這可能位於他們優先事項清單的中下位置，但我們有能力透過我們的對話，透過繼續教育我們可以為他們提供什麼，從而將其提升到優先事項清單的位置。但從競爭格局的角度來看，我想說，總的來說，我們更多是在與醫院本身對抗，而不是在競爭，特別是在我們的比賽場地有400 張床位及以下的情況下。

Helpful. And my last one is on the Viewgol deal. And I'll say I get the outsourcing aspect of the deal, but I was a little confused as to why you guys would target a company with such a strong ambulatory footprint as opposed to your legacy hospital footprint. So I guess, could you kind of talk about the ability to achieve synergies and whether or not there's a cross-sell opportunity as a result of that transaction? And then I'll hop back in the queue.

有幫助。我的上一篇文章是關於 Viewgol 的交易。我會說我了解了這筆交易的外包方面，但我有點困惑為什麼你們會瞄準一家擁有如此強大的門診足跡的公司，而不是你們的傳統醫院足跡。所以我想，您能否談談實現協同效應的能力以及該交易是否會帶來交叉銷售機會？然後我會跳回隊列中。

Yes. I don't know if I look at it as so much of a cross-sell opportunity. I think there is that, but it's really opening up a whole new market. I mean we have been very much focused in the acute space for 40-plus years. We've dabbled in ambulatory we made -- through the acquisition of Healthland. We bought our way into post-acute. But the nature of health care seems to be moving in the direction towards outside the four walls of the hospital. So this was an opportunity for us to marry up two things that we were looking to solve for, one, creating our own workforce globally and also how do we break into that ambulatory market, where we see opportunities going forward.

是的。我不知道我是否將其視為交叉銷售機會。我認為是這樣，但它確實開闢了一個全新的市場。我的意思是，我們 40 多年來一直非常專注於急性領域。透過收購 Healthland，我們涉足了我們自己製造的門診設備。我們進入了急性後期。但醫療保健的性質似乎正朝著醫院四面牆外的方向發展。因此，這對我們來說是一個機會，可以將我們想要解決的兩件事結合起來，一是在全球範圍內創建我們自己的勞動力，二是我們如何打入流動市場，我們看到了未來的機會。

Where we think that there is a cross-sell opportunity is some of the analytics, the analytics platform that Viewgol developed and really started as a tech company, bringing some of those tech services opportunities into either our TruBridge-only business line or even some of our hospitals, where they may have disparate PMs for their providers that are connected to their network. And so that's where those 2 things start to marry up.

我們認為交叉銷售機會的是一些分析，Viewgol 開發的分析平台實際上是一家科技公司，將其中一些技術服務機會帶入我們的 TruBridge-only 業務線，甚至是一些我們的醫院，他們可能有不同的PM 為其提供者連接到他們的網路。這就是這兩件事開始結合的地方。

But again, really as over the last 18, 24 months, as we've gone down this journey of the expansion of the global workforce, we very quickly realized that we needed to have our own operation, where we could create the opportunity and have the rigor around the delivery of the service for our customers. And that was really at the forefront of this. The ambulatory market was a very nice secondary component to how we thought about the deal.

但同樣，在過去的 18、24 個月裡，當我們經歷了全球勞動力擴張的旅程時，我們很快意識到我們需要擁有自己的業務，在那裡我們可以創造機會並擁有為客戶提供服務的嚴格性。這確實是最重要的。流動市場是我們如何看待這筆交易的一個非常好的次要組成部分。

Our next question comes from Jeff Garro with Stephens.

我們的下一個問題來自傑夫·加羅和史蒂芬斯。

I'll start on the demand side of things. Just want to get any further color from you guys on what might catalyze customer prospect decisions from here. And then the second part of it is while you're trying to create some urgency with these prospects, how do you simultaneously set the appropriate expectations on the cash collection performance as one metric and your ability to deliver the resources necessary to improve their financial outlook? So you just don't want to overpromise while trying to get them over the line, and you've talked about some of the operational hiccups that you've seen over the last 6 to 9 months.

我將從需求方面開始。只是想從你們這裡得到更多關於什麼可能會促進客戶潛在決策的資訊。第二部分是，當您試圖為這些潛在客戶創造一些緊迫感時，您如何同時對現金收款績效設定適當的期望作為一項指標，以及您提供改善他們的財務前景所需的資源的能力？因此，您只是不想在試圖讓他們越線時做出過度承諾，並且您已經談到了過去 6 到 9 個月中看到的一些營運問題。

Yes. Let's see where to start with that. Let's see, I guess, on the hand, if I look at it from the operational standpoint. Obviously, we've got the Viewgol team in here this week talking through what the integration plan looks like and how we can rapidly onboard staff inside of their operation and start delivering to the TruBridge operations. We've also expanded our partner set from the outsourced model to where we're not reliant on not a single, but not being quite a single-threaded on where that delivery comes from and, again, continuing to push hard on exactly what our expectations there are.

是的。讓我們看看從哪裡開始。我想，讓我們從操作的角度來看。顯然，Viewgol 團隊本週在這裡討論了整合計畫的內容，以及我們如何快速讓員工加入其營運部門並開始向 TruBridge 營運部門交付服務。我們還將我們的合作夥伴集從外包模式擴展到我們不依賴任何一個，但也不完全依賴交付的來源，並且再次繼續努力推動我們的目標期望是有的。

And I think the interest of our own operation is going to create some urgency from those organizations as well to deliver to make sure that they're still partners with us going forward. So that's one part of it. I guess the catalyst -- again, I'll go back to, Jeff, from my perspective. There's a couple of pieces of this. One, you've got the hospitals that probably their house is, I would say, a little bit on fire from the perspective of they're not collecting the cash that's available to go get.

我認為我們自己運作的利益也會讓這些組織產生一些緊迫感，以確保他們在未來仍然是我們的合作夥伴。這就是其中的一部分。我猜想催化劑——再次，我將從我的角度回到傑夫。這個有幾個片段。第一，我想說的是，從醫院沒有籌集到可用現金的角度來看，他們的房子可能有點著火。

They're in the high 80% of net cash collections, maybe low 90s. And there is plenty of meat on the bone for us to jump in and immediately be able to deliver that return for them. I think the other thing really is just the distraction of things. When I think about specifically at our hospitals, 400 beds and under, if I'm the CEO there and I've got 400 priorities on my desk, very few of those am I able to do outsource or give to somebody else. There are things that have to be dealt with inside the facility, whether it's new providers, new nurses, new facilities, new services, upgrades of facilities, going on and on and on, on negotiation of contracts. A lot of that has to be done internally.

他們的淨現金收入佔 80% 以上，也許 90% 以下。我們有足夠的資源可以投入其中，並且立即能夠為他們帶來回報。我認為另一件事確實只是分散注意力。當我具體考慮我們擁有400 張床位及以下的醫院時，如果我是那裡的首席執行官，並且我的辦公桌上有400 個優先事項，那麼我能夠將其中的很少一部分外包或交給其他人。有些事情必須在設施內部處理，無論是新的提供者、新的護理人員、新的設施、新的服務、設施的升級，等等，以及合約談判。其中許多工作必須在內部完成。

This piece of work, this RCM work on the back end is something that can be given away and can be very metric-driven to make sure that we're delivering on what it is. And now with this component of us being able to -- be able to get the cost structure even better related to our own workforce offshore, where it's not -- maybe it's not quite so cost-prohibitive for them to go forward with it.

這項工作，後端的 RCM 工作是可以贈送的，並且可以非常指標驅動，以確保我們交付它的內容。現在，我們的這一部分能夠 - 能夠使成本結構與我們自己的海外勞動力更好地相關，而事實並非如此 - 也許對於他們來說，繼續這樣做的成本並不是那麼高。

So I think those are the catalysts as we think about going forward is driving home for our providers and our facilities, what is your mission, give yourself more bandwidth to be able to focus there, let us focus on the things that we are great at as well, and we continue to expand our partnership.

因此，我認為這些是催化劑，因為我們認為未來正在推動我們的提供者和我們的設施回家，您的使命是什麼，給自己更多的頻寬以便能夠專注於此，讓我們專注於我們擅長的事情我們也將繼續擴大我們的合作關係。

Makes sense. I appreciate those comments. One more for me. I want to ask about the revised guidance. And just want to get a sense of your visibility into the rest of the year. Q4, usually a seasonally strong quarter and would expect quarter-over-quarter increases in revenue and profitability. But if you talk about specific drivers that would lead to those typical seasonal trends this year, I think it would be helpful.

說得通。我很欣賞這些評論。再給我一份。我想問一下修改後的指南。只是想了解一下您對今年剩餘時間的了解。第四季度，通常是季節性強勁的季度，預計收入和盈利能力將環比增長。但如果你談論導致今年典型季節性趨勢的具體驅動因素，我認為這會有所幫助。

Yes. So the visibility into the next 90 days is generally going to be fairly strong from a bookings to revenue conversion time frame. We don't have a lot of bookings that we expect to convert to revenues in that sort of a period of time. So it's really the expectations with the existing book of business for the top line revenue. So that visibility, we feel like is there.

是的。因此，從預訂到收入轉換的時間範圍內，對未來 90 天的可見性通常會相當強。我們沒有太多的預訂量可以在這段時間內轉化為收入。因此，這實際上是現有業務對頂線收入的期望。所以我們感覺這種可見性就在那裡。

And the cost side of the P&L where we do see some subjectivity and some seasonality, Jeff, most of that's going to be seen down in the benefits area where the seasonality of people taking vacations can throw some noise into the P&L, but it's usually to the benefit. So I'd say that from a seasonality standpoint, benefits primarily in G&A is where we expect to see the most movement.

在損益表的成本方面，我們確實看到了一些主觀性和季節性，傑夫，其中大部分都將在福利領域中看到，人們度假的季節性可能會給損益表帶來一些噪音，但通常是的好處。因此，我想說，從季節性的角度來看，我們預計主要在一般管理費用方面的收益將出現最大的變化。

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

目前沒有其他問題。我現在想把發言權交還給克里斯·福勒以徵求結束意見。

Thank you, Maria, and thank you, everyone, for your time this afternoon. And real quickly in closing, I'd like to acknowledge the hard work and passion that the people of CPSI bring each day to our company, our clients and the communities we serve. Clearly, the way for care is not always a straight line nor an easy path. But we are driven to overcome challenges so that, together, we can make a difference. Thanks again, and I hope everyone has a wonderful weekend.

謝謝瑪麗亞，也謝謝大家今天下午抽出寶貴的時間。最後，我要感謝 CPSI 員工每天為我們公司、我們的客戶和我們所服務的社區所做的辛勤工作和熱情。顯然，護理之路並不總是一條直線，也不是一條平坦的道路。但我們有動力去克服挑戰，這樣我們就能共同做出改變。再次感謝，希望大家週末愉快。

This concludes today's teleconference. You may disconnect your lines at this time. Thank you for your participation.

今天的電話會議到此結束。此時您可以斷開線路。感謝您的參與。