Gabrielle Ingoglia

Gabrielle Ingoglia asked about TruBridge's Q3 bookings of $15.5 million, inquiring how this figure compared to internal expectations and if future bookings should be anticipated to have higher EBITDA margins. She also followed up on commonalities in hospital decisions to delay implementations, specifically referencing Medicaid funding cuts from the Big Beautiful Bill and the potential tailwind from the $50 billion rural hospital fund in 2026.

Answer

CEO Chris Fowler stated that Q3 bookings were about 20% below expectations due to delayed, not negative, decisions, which is reflected in a strong start to Q4. He noted intentional focus on higher-margin SaaS conversions in patient care and optimism for financial health opportunities. CFO Vinay Bassi confirmed improved booking quality, citing a doubling of Encoder business bookings (70-80% margin) year-to-date 2025. Chris Fowler added that delays are influenced by hospital calendar year budget cycles and uncertainty around the OBBB's impact on 2026 spending, but decisions are now accelerating.

Gabrielle Ingoglia, on for Sarah James at Cantor Fitzgerald, asked about any potential weather impacts on facilities and requested an update on the performance of the underperforming facilities mentioned in the previous quarter.

Answer

Executive Heather Dixon reported no material weather impacts. Executive Christopher Hunter stated the underperforming facilities performed in line with expectations, creating a 90 basis point headwind to same-facility patient growth in Q1. He reiterated the full-year $20 million EBITDA headwind assumption and noted the underperformance is correlated with local, not national, media coverage.

Gabrielle Ingoglia, on for Sarah James, questioned the discrepancy between the stated $100 million government revenue removal and the total guidance reduction of approximately $115 million. She also asked if the 2026 positive EBITDA projection excludes government contributions and if positive 2026 MA rates are driving more payer conversations.

Answer

CFO Norman Rosenberg clarified that the delta in the guidance reduction reflects prudence and a range for possibilities across all business lines, as the sum of individual segment targets ($325M) is higher than the midpoint of the new guidance range. CEO Lee Bienstock confirmed the 2026 positive EBITDA projection excludes potential upside from the municipal government vertical and affirmed that MA market dynamics are a tailwind, strengthening their value proposition with payers.

Gabrielle Ingoglia, on for Sarah James, inquired if the company has discussed the potential impact of healthcare policies, such as enhanced marketplace subsidies or site neutrality, with its end-market clients.

Answer

CEO Dan Burton responded that they maintain close contact with C-suite executives and are monitoring the policy environment. While clients are watching potential changes to research funding and Medicaid under the new administration, he stated that Health Catalyst has not observed any negative impact on its sales pipeline. He believes significant changes to popular programs like Medicaid would be complex to implement, mitigating near-term risk.

Gabrielle Ingoglia of Cantor Fitzgerald asked for the drivers behind the strong acute revenue per admission and for color on inpatient surgical trends.

Answer

Steve Filton attributed the strong revenue per admission to a difficult comparison with the prior year, which saw high volumes of lower-acuity, deferred procedures. As those catch-up procedures subsided, the acuity mix improved in Q3 2024. He noted that inpatient surgical volumes were soft, declining slightly, due to the same dynamic of strong but lower-acuity surgical catch-up in the prior-year quarter.