TruBridge Announces Second Quarter 2024 Results

MOBILE, Ala.--(BUSINESS WIRE)--TruBridge, Inc. (NASDAQ: TBRG), a healthcare solutions company, today announced financial results for the second quarter ended June 30, 2024.

Second Quarter 2024 Highlights

All comparisons are to the quarter ended June 30, 2023, unless otherwise noted

• Total bookings of $23.3 million compared to $21.0 million
• Total revenue of $84.7 million compared to $84.6 million
• Revenue Cycle Management (RCM) revenue of $54.1 million compared to $47.8 million
  • RCM revenue represented 63.9% of TruBridge’s total revenue
• GAAP (loss) earnings per diluted share of $(0.34) compared to $(0.20)
• Non-GAAP earnings per diluted share of $0.16 compared to $0.40
• Adjusted EBITDA of $12.6 million compared to $11.2 million

Chris Fowler, chief executive officer of TruBridge, Inc., stated, “We are pleased with our second quarter performance, both operationally and financially. The team continued to build on our bookings momentum and cross-selling efforts, while we further enhanced our financial operations. Our solid revenue performance and adjusted EBITDA margin expansion in the quarter was punctuated by a significant improvement in cash flow from operations.

“Given the health of our pipeline and clear line of sight for the remainder of the year, we are reiterating guidance and are enthusiastic about our future outlook,” concluded Fowler.

Financial Guidance

For the third quarter of 2024, TruBridge expects to generate:

• Total revenue between $82 million and $85 million
• Adjusted EBITDA between $11.5 million and $13.5 million

For the full year 2024, TruBridge reiterates prior outlook of:

• Total revenue between $330 million and $340 million
• Adjusted EBITDA between $45 million and $50 million

Conference Call

TruBridge will hold a conference call and live webcast to discuss second quarter 2024 results on Thursday, August 8, 2024, at 3:30 p.m. Central time/4:30 p.m. Eastern time. To access this interactive teleconference, dial [phone] and request connection to the TruBridge earnings conference call. A 30-day online replay will be available approximately one hour following the conclusion of the live webcast. To listen to the live webcast or access the replay, visit the Company’s investor relations website, investors.trubridge.com.

About TruBridge

We are a trusted partner to more than 1,500 healthcare organizations with a broad range of technology-first solutions that address the unique needs and challenges of diverse communities, promoting equitable access to quality care and fostering positive outcomes. TruBridge has over four decades of experience in connecting providers, patients and communities with innovative data-driven solutions that create real value by supporting both the financial and clinical side of healthcare delivery. Our industry leading HFMA Peer Reviewed® suite of revenue cycle management (RCM) offerings combine unparalleled visibility and transparency to enhance productivity and support the financial health of healthcare organizations across all care settings. We support efficient patient care with electronic health record (EHR) product offerings that successfully integrate data between care settings. Above all, we believe in the power of community and encourage collaboration, connection, and empowerment with our customers. We clear the way for care. For more information, please visit www.trubridge.com.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements can be identified generally by the use of forward-looking terminology and words such as “expects,” “anticipates,” “estimates,” “believes,” “predicts,” “intends,” “plans,” “potential,” “may,” “continue,” “should,” “will” and words of comparable meaning. Without limiting the generality of the preceding statement, all statements in this press release relating to the Company’s future financial and operational results are forward-looking statements. We caution investors that any such forward-looking statements are only predictions and are not guarantees of future performance. Certain risks, uncertainties and other factors may cause actual results to differ materially from those projected in the forwardlooking statements. Such factors may include: saturation of our target market and hospital consolidations; unfavorable economic or market conditions that may cause a decline in spending for information technology and services; significant legislative and regulatory uncertainty in the healthcare industry; exposure to liability for failure to comply with regulatory requirements; pandemics and other public health crises and related economic disruptions; transition to a subscription-based recurring revenue model and modernization of our technology; competition with companies that have greater financial, technical and marketing resources than we have; potential future acquisitions that may be expensive, time consuming, and subject to other inherent risks; our ability to attract and retain qualified client service and support personnel; disruption from periodic restructuring of our sales force; potential delay in the development of markets for our RCM service offering; potential inability to properly manage growth in new markets we may enter; potential disruption of our business due to our ongoing implementation of a new enterprise resource planning software solution; exposure to numerous and often conflicting laws, regulations, policies, standards or other requirements through our international business activities; potential litigation against us; our reliance on an international workforce which exposes us to various business disruptions; our utilization of artificial intelligence, which could expose us to liability or adversely affect our business if we cannot compete effectively with others using artificial intelligence; potential failure to develop new products or enhance current products that keep pace with market demands; failure of our products to function properly resulting in claims for medical and other losses; breaches of security and viruses in our systems resulting in customer claims against us and harm to our reputation; failure to maintain customer satisfaction through new product releases free of undetected errors or problems; failure to convince customers to migrate to current or future releases of our products; failure to maintain our margins and service rates; increase in the percentage of total revenues represented by service revenues, which have lower gross margins; exposure to liability in the event we provide inaccurate claims data to payors; exposure to liability claims arising out of the licensing of our software and provision of services; dependence on licenses of rights, products and services from third parties; misappropriation of our intellectual property rights and potential intellectual property claims and litigation against us; interruptions in our power supply and/or telecommunications capabilities, including those caused by natural disaster; potential inability to secure additional financing on favorable terms to meet our future capital needs; our substantial indebtedness, and our ability to incur additional indebtedness in the future; pressures on cash flow to service our outstanding debt; restrictive terms of our credit agreement on our current and future operations; changes in and interpretations of financial accounting matters that govern the measurement of our performance; significant charges to earnings if our goodwill or intangible assets become impaired; fluctuations in quarterly financial performance due to, among other factors, timing of customer installations; volatility in our stock price; failure to maintain effective internal control over financial reporting; inherent limitations in our internal control over financial reporting; vulnerability to significant damage from natural disasters; market risks related to interest rate changes; potential material adverse effects due to macroeconomic conditions, including bank failures or changes in related regulation; and other risk factors described from time to time in our public releases and reports filed with the Securities and Exchange Commission, including, but not limited to, our most recent Annual Report on Form 10-K and our Quarterly Report on Form 10-Q for the quarter ended June 30, 2024. We also caution investors that the forward-looking information described herein represents our outlook only as of this date, and we undertake no obligation to update or revise any forward-looking statements to reflect events or developments after the date of this press release.

TruBridge, Inc.
Condensed Consolidated Statements of Income
(In '000s, except per share data)
(Unaudited)
	Three Months Ended June 30,						Six Months Ended June 30,
		2024			2023			2024			2023
Revenues
RCM	$	54,108		$	47,760		$	107,146		$	96,391
EHR		30,622			36,862			60,831			74,464
Total revenues		84,730			84,622			167,977			170,855
Expenses
Costs of revenue (exclusive of amortization and depreciation)
RCM		30,269			27,119			59,866			54,302
EHR		13,073			17,014			25,237			34,008
Total costs of revenue (exclusive of amortization and depreciation)		43,342			44,133			85,103			88,310
Product development		8,207			8,769			18,894			17,121
Sales and marketing		7,815			8,132			14,408			15,089
General and administrative		18,878			19,057			38,274			33,510
Amortization		9,107			5,858			14,975			11,341
Depreciation		400			579			800			1,095
Total expenses		87,749			86,528			172,454			166,466
Operating income (loss)		(3,019	)		(1,906	)		(4,477	)		4,389
Other income (expense):
Other income		91			78			1,514			346
Interest expense		(4,242	)		(2,664	)		(8,315	)		(5,334	)
Total other expense		(4,151	)		(2,586	)		(6,801	)		(4,988	)
Loss before taxes		(7,170	)		(4,492	)		(11,278	)		(599	)
Income tax benefit		(2,121	)		(1,655	)		(3,713	)		(846	)
Net income (loss)	$	(5,049	)	$	(2,837	)	$	(7,565	)	$	247
Net income (loss) per common share—basic	$	(0.34	)	$	(0.20	)	$	(0.51	)	$	0.02
Net income (loss) per common share—diluted	$	(0.34	)	$	(0.20	)	$	(0.51	)	$	0.02
Weighted average shares outstanding used in per common share computations:
Basic		14,313			14,200			14,273			14,168
Diluted		14,313			14,200			14,273			14,168

TruBridge, Inc.
Condensed Consolidated Balance Sheets
(In '000s, except per share data)
	June 30, 2024 (Unaudited)			Dec. 31, 2023
Assets
Current assets
Cash and cash equivalents	$	7,709		$	3,848
Accounts receivable, net of allowance for expected credit losses of $3,315 and $3,631, respectively		59,603			59,723
Financing receivables, current portion (net of allowance for expected credit losses of $332 and $319, respectively)		4,137			3,997
Inventories		793			475
Prepaid income taxes		2,307			1,628
Prepaid expenses and other		17,034			15,807
Assets of held for sale disposal group		-			25,977
Total current assets		91,583			111,455
Property & equipment, net		8,479			8,974
Software development costs, net		39,741			39,139
Operating lease assets		3,861			5,192
Financing receivables, net of current portion (net of allowance for expected credit losses of $56 and $97, respectively)		607			1,226
Other assets, net of current portion		8,337			7,314
Intangible assets, net		82,960			89,213
Goodwill		172,573			171,909
Deferred tax assets		4,146			-
Total assets	$	412,287		$	434,422
Liabilities & Stockholders' Equity
Current liabilities
Accounts payable	$	15,854		$	10,133
Current portion of long-term debt		3,074			3,141
Deferred revenue		9,842			8,677
Accrued vacation		5,458			5,410
Liabilities of held for sale disposal group		-			977
Other accrued liabilities		17,481			19,892
Total current liabilities		51,709			48,230
Long-term debt, net of current portion		176,964			195,270
Operating lease liabilities, net of current portion		2,512			3,074
Deferred tax liabilities		-			1,230
Total liabilities		231,185			247,804
Stockholders' Equity
Common stock, $0.001 par value; 30,000 shares authorized; 15,561 and 15,121 shares issued, respectively		15			15
Treasury stock, 615 and 572 shares, respectively		(17,434	)		(17,075	)
Accumulated other comprehensive gain		108			-
Additional paid-in capital		197,846			195,546
Retained earnings		567			8,132
Total stockholders' equity		181,102			186,618
Total liabilities and stockholders' equity	$	412,287		$	434,422

TruBridge, Inc.
Condensed Consolidated Statements of Cash Flows
(In '000s)
(Unaudited)
	Six Months Ended June 30,
		2024			2023
Operating activities:
Net income (loss)	$	(7,565	)	$	247
Adjustments to net income (loss):
Provision for credit losses		358			181
Deferred taxes		(5,224	)		(1,533	)
Stock-based compensation		2,300			1,124
Depreciation		800			1,095
Gain on sale of business		(1,250	)		-
Amortization of acquisition-related intangibles		6,253			8,029
Amortization of software development costs		8,722			3,312
Amortization of deferred finance costs		213			180
Non-cash operating lease costs		897			1,211
Loss on disposal of property and equipment		-			117
Changes in operating assets and liabilities:
Accounts receivable		654			(3,806	)
Financing receivables		506			940
Inventories		(318	)		(178	)
Prepaid expenses and other		1,502			(2,017	)
Accounts payable		5,750			7,448
Deferred revenue		1,769			(1,705	)
Operating lease liabilities		(583	)		(1,067	)
Other liabilities		(2,375	)		(2,278	)
Prepaid income taxes		(679	)		(1,110	)
Net cash provided by operating activities		11,730			10,190
Investing activities:
Purchase of business, net of cash acquired		(664	)		-
Sale of business, net of cash and cash equivalents sold		21,410			-
Investment in software development		(9,324	)		(12,143	)
Purchases of property and equipment		(306	)		(72	)
Net cash provided by (used in) investing activities		11,116			(12,215	)
Financing activities:
Treasury stock purchases		(358	)		(2,532	)
Payments of long-term debt principal		(5,750	)		(1,750	)
Proceeds from revolving line of credit		21,072			11,602
Payments of revolving line of credit		(33,379	)		(5,000	)
Debt issuance cots		(529	)		-
Net cash provided by (used in) financing activities		(18,944	)		2,320
Increase in cash and cash equivalents		3,902			295
Change in cash and cash equivalents included in assets sold		(41	)
Cash and cash equivalents, beginning of period		3,848			6,951
Cash and cash equivalents, end of period	$	7,709		$	7,246

TruBridge, Inc.
Consolidated Bookings
(In '000s)
(Unaudited) (Non-GAAP)
		Three Months Ended June 30,				Six Months Ended June 30,
	In '000s	2024		2023 ^(3)		2024		2023 ^(3)
	RCM^(1)	$	13,458	$	13,648	$	27,849	$	25,748
	EHR^(2)		9,832		7,322		19,010		15,069
	Total	$	23,290	$	20,970	$	46,859	$	40,817
^(1)	Generally calculated as the total contract price (for non-recurring, project-related amounts) and annualized contract value (for recurring amounts).
^(2)	Generally calculated as the total contract price (for system sales) and annualized contract value (for support) for perpetual license system sales and total contract price for SaaS sales.
^(3)	Adjustment was made to the 2023 bookings, due to 3rd Party Software, and Forms and Supplies being doubled accounted for in the total EHR bookings.

TruBridge, Inc.
Bookings Composition
(In '000s, except per share data)
(Unaudited) (Non-GAAP)
		Three Months Ended June 30,				Six Months Ended June 30,
		2024		2023 (3)		2024		2023 (3)
	RCM
	Net new^(1)	$	6,453	$	3,395	$	15,446	$	9,749
	Cross-sell^(1)		7,004		10,253		12,402		15,999
	EHR
	Non-subscription sales^(2)		4,084		4,458		7,534		10,506
	Subscription revenue^(3)		5,749		2,864		11,477		4,563
	Total	$	23,290	$	20,970	$	46,859	$	40,817
^(1)	“Net new” represents bookings from outside the Company’s core EHR client base, and “Cross-sell” represents bookings from existing EHR customers. In each case, such bookings are generally comprised of recurring revenues to be recognized ratably over a one-year period and an average timeframe for commencement of bookings-to-revenue conversion of four to six months following contract execution.
^(2)	Represents nonrecurring revenues that generally exhibit a timeframe for bookings-to-revenue conversion of five to six months following contract execution.
^(3)	Represents recurring revenues to be recognized on a monthly basis over a weighted-average contract period of five years, with a start date in the next 12 months and an average timeframe for commencement of bookings-to-revenue conversion of five to six months following contract execution.

TruBridge, Inc.
Adjusted EBITDA - by Segment
(In '000s)
(Unaudited) (Non-GAAP)
	Three Months Ended June 30,				Six Months Ended June 30,
In '000s	2024		2023		2024		2023
RCM	$	7,804	$	5,682	$	14,202	$	13,580
EHR		4,770		5,545		7,826		12,289
Total	$	12,574	$	11,227	$	22,028	$	25,869

TruBridge, Inc.
Reconciliation of Non-GAAP Financial Measures
(In '000s)
(Unaudited)
	Three Months Ended June 30,						Six Months Ended June 30,
Adjusted EBITDA:		2024			2023			2024			2023
Net income (loss), as reported	$	(5,049	)	$	(2,837	)	$	(7,565	)	$	247
Net Income Margin		(6.0	%)		(3.4	%)		(4.5	%)		0.1	%
Depreciation expense		400			597			800			1,095
Amortization of software development costs		5,980			1,826			8,722			3,312
Amortization of acquisition-related intangibles		3,126			4,014			6,253			8,029
Stock-based compensation		1,501			(123	)		2,300			1,124
Severance and other non-recurring charges		4,586			6,819			8,430			7,920
Interest expense		4,151			2,586			8,051			4,988
Gain on sale of AHT		-			-			(1,250	)		-
Provision (benefit) for income taxes		(2,121	)		(1,655	)		(3,713	)		(846	)
Total Adjusted EBITDA	$	12,574		$	11,227		$	22,028		$	25,869
Adjusted EBITDA Margin		14.8	%		13.3	%		13.1	%		15.1	%

TruBridge, Inc.
Reconciliation of Non-GAAP Financial Measures
(In '000s, except per share data)
(Unaudited)
	Three Months Ended June 30,						Six Months Ended June 30,
Non-GAAP Net Income and Non-GAAP EPS:		2024			2023			2024			2023
Net income (loss), as reported	$	(5,049	)	$	(2,837	)	$	(7,565	)	$	247
Pre-tax adjustments for Non-GAAP EPS:
Amortization of acquisition-related intangible assets		3,126			4,014			6,253			8,029
Stock-based compensation		1,501			(123	)		2,300			1,124
Severance and other nonrecurring charges		4,586			6,819			8,430			7,920
Non-cash interest expense		107			90			213			180
After-tax adjustments for Non-GAAP EPS:
Tax-effect of pre-tax adjustments, at 21%		(1,957	)		(2,269	)		(3,611	)		(3,623	)
Tax shortfall (windfall) from stock-based compensation		4			7			113			57
Non-GAAP net income	$	2,318		$	5,701		$	6,133		$	13,934
Weighted average shares outstanding, diluted		14,313			14,200			14,273			14,168
Non-GAAP EPS	$	0.16		$	0.40		$	0.43		$	0.98

TruBridge, Inc.
Electronic Health Record (EHR) Revenue Composition
(In '000s)
(Unaudited)
	Three Months Ended June 30,				Six Months Ended June 30,
	2024		2023		2024		2023
Recurring revenues - EHR
Acute Care EHR	$	26,666	$	30,013	$	54,160	$	59,353
Post-acute Care EHR		-		3,729		582		7,636
Total recurring revenues - EHR		26,666		33,742		54,742		66,989
Non-recurring revenues - EHR
Acute Care EHR		3,956		2,775		6,008		6,750
Post-acute Care EHR		-		345		81		725
Total non-recurring revenues - EHR		3,956		3,120		6,089		7,475
Total EHR revenues	$	30,622	$	36,862	$	60,831	$	74,464

Explanation of Non-GAAP Financial Measures

We report our financial results in accordance with accounting principles generally accepted in the United States of America, or “GAAP.” However, management believes that, in order to properly understand our short-term and long-term financial and operational trends, investors may wish to consider the impact of certain non-cash or non-recurring items, when used as a supplement to financial performance measures that are prepared in accordance with GAAP. These items result from facts and circumstances that vary in frequency and impact on continuing operations. Management uses these non-GAAP financial measures in order to evaluate the operating performance of the Company and compare it against past periods, make operating decisions, and serve as a basis for strategic planning. These non-GAAP financial measures provide management with additional means to understand and evaluate the operating results and trends in our ongoing business by eliminating certain non-cash expenses and other items that management believes might otherwise make comparisons of our ongoing business with prior periods more difficult, obscure trends in ongoing operations, or reduce management’s ability to make useful forecasts. In addition, management understands that some investors and financial analysts find these non-GAAP financial measures helpful in analyzing our financial and operational performance and comparing this performance to our peers and competitors.

As such, to supplement the GAAP information provided, we present in this press release and during the live webcast discussing our financial results the following non-GAAP- financial measures: Adjusted EBITDA, Adjusted EBITDA Margin, Non-GAAP net income, and Non-GAAP earnings per share (“EPS”).

We calculate each of these non-GAAP financial measures as follows:

• Adjusted EBITDA – Adjusted EBITDA consists of GAAP net income as reported and adjusts for (i) depreciation expense; (ii) amortization of software development costs; (iii) amortization of acquisition-related intangibles; (iv) stock-based compensation; (v) severance and other nonrecurring charges; (vi) interest expense; (vii) gain on sale of AHT; and (xiii) the provision (benefit) for income taxes.
• Adjusted EBITDA Margin – Adjusted EBITDA Margin is calculated as Adjusted EBITDA, as defined above, divided by total revenue.
• Non-GAAP net income – Non-GAAP net income consists of GAAP net income as reported and adjusts for (i) amortization of acquisition-related intangible assets; (ii) stock-based compensation; (iii) severance and other non-recurring charges; (iv) non-cash interest expense; (v) gain on sale of AHT; and (vi) the total tax effect of items (i) through (v).
• Non-GAAP EPS – Non-GAAP EPS consists of Non-GAAP net income, as defined above, divided by weighted average shares outstanding (diluted) in the applicable period.

Certain of the items excluded or adjusted to arrive at these non-GAAP financial measures are described below:

• Amortization of acquisition-related intangibles – Acquisition-related amortization expense is a non-cash expense arising primarily from the acquisition of intangible assets in connection with acquisitions or investments. We exclude acquisition-related amortization expense from non-GAAP financial measures because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of new acquisitions and full amortization of previously acquired intangible assets. Investors should note that the use of these intangible assets contributed to revenue in the periods presented and will contribute to future revenue generation, and the related amortization expense will recur in future periods.
• Stock-based compensation – Stock-based compensation expense is a non-cash expense arising from the grant of stock-based awards. We exclude stock-based compensation expense from non-GAAP financial measures because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods as a result of the timing and valuation of grants of new stock-based awards, including grants in connection with acquisitions. Investors should note that stock-based compensation is a key incentive offered to employees whose efforts contributed to the operating results in the periods presented and are expected to contribute to operating results in future periods, and such expense will recur in future periods.
• Severance and other nonrecurring charges – Non-recurring charges relate to certain severance and other charges incurred in connection with activities that are considered non-recurring. We exclude non-recurring expenses (primarily related to costs associated with our recent business transformation initiative and transaction-related costs) from non-GAAP financial measures because we believe (i) the amount of such expenses in any specific period may not directly correlate to the underlying performance of our business operations and (ii) such expenses can vary significantly between periods.
• Non Cash Interest expense – Non-cash interest expense includes amortization of deferred debt issuance costs. We exclude non-cash interest expense from non-GAAP financial measures because we believe these non-cash amounts relate to specific transactions and, as such, may not directly correlate to the underlying performance of our business operations.
• Interest expense: Interest incurred on our term loan and revolving credit facility.
• Gain on sale of AHT: Represents the excess of proceeds received over the net assets sold from our sale of AHT, our previously wholly-owned post-acute business, in January 2024.
• Tax shortfall (windfall) from stock-based compensation – ASU 2016-09, Improvements to Employee Share-Based Payment Accounting, became effective for the Company during the third quarter of 2017 and changes the treatment of tax shortfall and excess tax benefits arising from stock based compensation arrangements. Prior to ASU 2016-09, these amounts were recorded as an increase (for excess benefits) or decrease (for shortfalls) to additional paid-in capital. With the adoption of ASU 2016-09, these amounts are now captured in the period’s income tax expense. We exclude this component of income tax expense from non-GAAP financial measures because we believe (i) the amount of such expenses or benefits in any specific period may not directly correlate to the underlying performance of our business operations; and (ii) such expenses or benefits can vary significantly between periods as a result of the valuation of grants of new stock-based awards, the timing of vesting of awards, and periodic movements in the fair value of our common stock.

Management considers these non-GAAP financial measures to be important indicators of our operational strength and performance of our business and a good measure of our historical operating trends, in particular the extent to which ongoing operations impact our overall financial performance. In addition, management may use Adjusted EBITDA, Non-GAAP net income and/or Non-GAAP EPS to measure the achievement of performance objectives under the Company’s stock and cash incentive programs. Note, however, that these non-GAAP financial measures are performance measures only, and they do not provide any measure of cash flow or liquidity. Non-GAAP financial measures are not alternatives for measures of financial performance prepared in accordance with GAAP and may be different from similarly titled non-GAAP measures presented by other companies, limiting their usefulness as comparative measures. Non-GAAP financial measures have limitations in that they do not reflect all of the amounts associated with our results of operations as determined in accordance with GAAP. Additionally, there is no certainty that we will not incur expenses in the future that are similar to those excluded in the calculations of the non-GAAP financial measures presented in this press release. Investors and potential investors are encouraged to review the “Unaudited Reconciliation of Non-GAAP Financial Measures” above.