Executive Summary

Q4 2024 delivered solid profitability: GAAP net income of $3.3M, adjusted EBITDA of $7.1M (25% margin), and revenue of $28.2M; revenue was essentially flat YoY due to medSR softness while margins expanded meaningfully .
Management issued FY 2025 guidance calling for revenue of $111–$114M, adjusted EBITDA of $26–$28M, and EPS of $0.10–$0.13, targeting the first positive annual EPS since IPO, reflecting cost structure transformation and AI-driven efficiencies .
Capital structure improved via mandatory conversion of 3.5M Series A preferred shares into ~26M common shares, eliminating ~$7M+ annual dividends; company also fully repaid its SVB credit line in 2024 using internally generated cash .
Consensus estimates from S&P Global for Q4 2024 were unavailable due to a system access limit; beat/miss analysis vs Street cannot be determined and should be refreshed as access permits.

What Went Well and What Went Wrong

What Went Well

Record profitability metrics: Q4 adjusted EBITDA $7.1M (25% margin) and full-year adjusted EBITDA $24.1M, up 56% YoY; “this is our third consecutive quarter of positive GAAP net income and our largest quarterly net income since Q4 2021” (Norman Roth) .
Strategic capital actions: Series A preferred conversion (3.5M shares → ~26M common) satisfied $11.4M accrued dividends and eliminated a large monthly dividend burden; “will eliminate approximately $7 million or more in annual dividend obligations” (Norman Roth) .
AI product momentum: CirrusAI Notes expanded across multiple specialties and demonstrated time savings; new AI call-center QA launched internally for >80 agents; “AI is supercharging our operations” (Co-CEO Hadi Chaudhry) .

What Went Wrong

Top-line growth remained constrained: Q4 revenue was $28.2M vs $28.4M YoY; medSR nonrecurring services continued to be a drag, with ~-$0.4M YoY decline in Q4 nonrecurring revenue .
GAAP EPS optics impacted by preferred dividend mechanics: Q4 GAAP EPS printed $0.00 per share due to net loss attributable to common shareholders after preferred dividends, despite positive GAAP net income .
Limited ability to benchmark vs Street for traders: S&P Global consensus for Q4 was unavailable at time of this analysis due to system limits; investors should recheck to assess potential estimate revisions or sentiment shifts.

Financial Results

Metric	Q2 2024	Q3 2024	Q4 2024
Revenue ($USD Millions)	$28.090	$28.546	$28.239
GAAP Net Income ($USD Millions)	$1.674	$3.122	$3.296
GAAP Operating Margin (%)	8.1%	11.4%	12.2%
Adjusted EBITDA ($USD Millions)	$6.389	$6.840	$7.141
Adjusted Operating Margin (%)	11.6%	12.9%	14.0%
GAAP EPS ($/share)	$(0.14)	$(0.04)	$0.00
Adjusted EPS ($/share)	$0.18	$0.21	$0.24

Q4 2024 YoY comparison:

Metric	Q4 2023	Q4 2024
Revenue ($USD Millions)	$28.416	$28.239
GAAP Net Income (Loss) ($USD Millions)	$(43.692)	$3.296
GAAP Operating Margin (%)	(153.6%)	12.2%
Adjusted EBITDA ($USD Millions)	$4.128	$7.141
Adjusted EPS ($/share)	$0.05	$0.24

Segment revenue (mix and trend):

Segment	Q3 2024	Q4 2024
Recurring Technology-Enabled Solutions ($USD Millions)	$24.2	$24.8
Nonrecurring Professional Services (medSR) ($USD Millions)	$4.3	~$3.4 (computed from total less recurring)

Key KPIs and balance sheet:

KPI	Q3 2024	Q4 2024
Free Cash Flow ($USD Millions)	$5.395	$2.967
Cash and Equivalents ($USD Millions)	$2.782	$5.145
Net Working Capital ($USD Millions)	$0.732	$5.2
Line of Credit Outstanding ($USD Millions)	$0 (fully repaid by end-Q3)	$0 (fully repaid; facility available)

Note: “vs estimates” unavailable — S&P Global consensus data could not be retrieved at time of writing (system access limit).

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue ($USD Millions)	FY 2024	$109–$111	Actual: $110.8	In line (met)
Adjusted EBITDA ($USD Millions)	FY 2024	$23–$25 (raised in Q3)	Actual: $24.1	In line (upper-mid)
Revenue ($USD Millions)	FY 2025	—	$111–$114	New (growth)
Adjusted EBITDA ($USD Millions)	FY 2025	—	$26–$28	New (higher)
EPS ($/share)	FY 2025	—	$0.10–$0.13	New (positive EPS target)
Preferred Dividends (cash outlay)	2025 run-rate	—	~$5.5M annualized; ~$450k/month after catch-up	New disclosure

Management rationale: 2025 guidance assumes organic growth (upsell into existing base, specialty EHR launches, RPM/CCM, life sciences), AI-driven efficiency, and potential tuck-ins; material M&A not embedded in revenue guidance timing .

Earnings Call Themes & Trends

Topic	Q2 2024 (Prev-2)	Q3 2024 (Prev-1)	Q4 2024 (Current)	Trend
AI/Technology Initiatives	Introduced CirrusAI Notes; trials; pricing $199/provider/month; early revenues expected Q3	Expanded AI across EHR/PM/RCM; ~70% time savings in claim notes; 75%+ reduction in manual appeals; >100 providers enabled	CirrusAI Notes expanded to more specialties; AI call-center QA deployed for >80 agents; specialty EHRs slated through Q2 2025	Strengthening, broader deployment
Cost Structure & Free Cash Flow	Identified $26M annualized cuts; $20M in-year; paid down credit line to $2.5M	Record YTD FCF $10.3M; fully repaid $10M credit line; raised FY24 adj. EBITDA guidance	FY24 FCF $13.2M; SVB line fully repaid; higher EBITDA/margins; working capital improved	Sustained discipline; balance sheet stronger
medSR (Nonrecurring)	Softness persists; uncertain quarterly visibility	Nonrecurring revenue fell to $4.3M; Epic-related constraints discussed	Q4 nonrecurring down ~$0.4M YoY; continued drag on top-line	Stabilizing but subdued
Capital Structure (Preferreds)	Special proxy to equalize A/B to 8.75%; exchange feature; strong shareholder support	Plan to resume preferred dividends Mar-2025	Mandatory Series A conversion; eliminate ~$7M+ annual dividends; ~$11.4M accrued caught up via shares; delist CCLDP	Simplified; equity-heavy
Growth/M&A	Focus on organic upsell; partnerships; quasi-acquisitions to preserve FCF	Preparing for pivot to growth in 2025; RPM in-house	Reentry to M&A (MesaBilling); 2025 guide excludes material M&A; pipeline disciplined on valuation	Selective tuck-ins resuming
Wellness (RPM/CCM)	CCM/RPM revenue +154% YoY in Q2; >$1M quarterly	RPM brought in-house; 9M CCM $2.2M; RPM $0.544M	RPM/CCM part of 2025 growth drivers	Building as upsell lever

Management Commentary

“AI is supercharging our operations… making us faster, smarter, and more efficient. This will fuel even greater profitability in 2025.” — Co-CEO A. Hadi Chaudhry .
“We anticipate positive earnings per share for the first time since we went public in 2014.” — Co-CEO Stephen Snyder .
“We will realize more than $10 million of annual cash savings on Series A preferred stock dividends as compared to our dividend obligations as they existed prior to the September 11 proxy… We have accomplished what we set out to achieve in 2024.” — Interim CFO Norman Roth .
“This acquisition [MesaBilling], though very small, marks our reentry into the acquisition market... we are well-equipped to pursue high-value acquisitions.” — Co-CEO Stephen Snyder .

Q&A Highlights

Revenue growth drivers: Mix expected from upsells (RCM, digital health, life sciences), specialty EHR launches, and small tuck-ins; Q1 seasonality noted; FY25 guide excludes material M&A .
M&A pipeline/valuations: Re-entered acquisitions with small deal; targeting value-driven transactions with more rational pricing akin to pre-COVID multiples; disciplined approach to accretion .
Customer base and upsell strategy: Diversified specialties; focus on converting EHR-only into full RCM, expanding digital health (RPM/CCM), and rolling out AI broadly .
Preferred dividends run-rate: ~ $450k/month going forward; ~ $5.5M annualized; special catch-ups handled via conversion mechanics, reducing cash burden .
RPM execution: RPM now in-house (Miami); better margins; 9M 2024 CCM $2.2M and RPM $0.544M baseline for upsell expansion .

Estimates Context

Street consensus (S&P Global) for Q4 2024 was unavailable at time of analysis due to system access limit; no beat/miss assessment vs revenue/EPS/EBITDA estimates can be provided now. Please refresh consensus to evaluate revisions and sentiment.

Key Takeaways for Investors

Margin-led turnaround is intact: sequential margin expansion, record adjusted EBITDA, and positive GAAP net income despite flat revenue — positioning for positive FY25 EPS .
Capital structure de-risked: Series A conversion materially reduces cash dividend outflows and simplifies equity, improving flexibility to reinvest in growth and M&A .
AI as a competitive wedge: Embedded AI across clinical and RCM workflows enhances efficiency and supports upsell/pricing power; specialty EHR rollout can broaden TAM .
Revenue mix still needs rebuilding: medSR nonrecurring pressures persist; watch adoption of RPM/CCM, specialty EHR, and reseller partnerships to drive sustained top-line growth .
Liquidity and FCF: With SVB line repaid and FCF positive, 2025 runway supports cash accumulation and working capital strengthening, enabling selective tuck-ins .
Near-term trading lens: Monitor follow-through on FY25 guide, specialty EHR launch cadence (Q1–Q2), and any additional small acquisitions; absence of Street estimates today is a temporary data gap to close.
Medium-term thesis: If revenue stabilizes and AI-enabled upsell gains traction, operating leverage plus reduced dividend burden can support consistent EPS and cash generation.

Document and Data Citations

Q4 2024 8-K and press release:
Q4 2024 earnings call transcript:
Q3 2024 press release and call:
Q2 2024 press release and call:
Series A conversion PR: ; Delisting notice: ; MesaBilling acquisition PR:

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