Executive Summary

Q2 2024 revenue was $84.7M, modestly above Q1 2024’s $83.2M and essentially flat YoY vs $84.6M; Adjusted EBITDA improved to $12.6M (14.8% margin) vs $9.5M (11.4%) in Q1 and $11.2M (13.3%) a year ago, reflecting margin progress despite mixed GAAP results .
GAAP diluted EPS was $(0.34) vs $(0.17) in Q1 and $(0.20) in Q2 2023; Non‑GAAP EPS was $0.16 vs $0.19 in Q1 and $0.40 in Q2 2023, driven by higher interest expense and continued non‑recurring charges offset partly by EBITDA expansion .
Segment mix continued to favor RCM: RCM revenue rose to $54.1M (63.9% of total) from $53.0M in Q1 and $47.8M YoY, while EHR revenue declined to $30.6M from $36.9M YoY; bookings remained solid at $23.3M (vs $23.6M in Q1) .
Guidance was reiterated: Q3 revenue $82–$85M and Adjusted EBITDA $11.5–$13.5M; FY 2024 revenue $330–$340M and Adjusted EBITDA $45–$50M; management cited “significant improvement in cash flow from operations” and pipeline visibility as reasons for confidence .
Additional Q2 press items: company pre-announced the call timing on July 25 and released full results Aug 8, reinforcing the messaging cadence and guidance reiteration .

What Went Well and What Went Wrong

What Went Well

Bookings and cross-sell momentum: Total bookings were $23.3M, above $21.0M YoY, with management highlighting “bookings momentum and cross‑selling efforts” and improved financial operations .
RCM strength and mix: RCM revenue grew to $54.1M (63.9% of total), up from $47.8M YoY, supporting consolidated Adjusted EBITDA of $12.6M (14.8% margin) .
Profitability and cash flow: Adjusted EBITDA rose both sequentially and YoY, and management cited a “significant improvement in cash flow from operations,” improving the quality of earnings and liquidity trends .

What Went Wrong

GAAP losses widened: Net loss was $(5.0)M with diluted EPS of $(0.34), worse than Q1 $(0.17) and Q2 2023 $(0.20), reflecting higher interest expense and non‑recurring costs .
EHR softness: EHR revenue declined to $30.6M vs $36.9M a year ago, weighing on total growth despite RCM strength .
Elevated interest burden: Interest expense increased to $(4.242)M vs $(2.664)M YoY, and long‑term debt remained sizable at $177.0M, pressuring GAAP earnings and cash interest outlays .

Financial Results

Consolidated summary (chronological: Q2 2023 → Q1 2024 → Q2 2024)

Metric	Q2 2023	Q1 2024	Q2 2024
Revenue ($M)	84.622	83.247	84.730
GAAP Diluted EPS ($)	(0.20)	(0.17)	(0.34)
Non‑GAAP EPS ($)	0.40	0.19	0.16
Adjusted EBITDA ($M)	11.227	9.454	12.574
Adjusted EBITDA Margin (%)	13.3%	11.4%	14.8%
Operating Income (Loss) ($M)	(1.906)	(1.458)	(3.019)
Interest Expense ($M)	(2.664)	(4.072)	(4.242)
Net Income (Loss) ($M)	(2.837)	(2.516)	(5.049)

Segment revenue breakdown

Metric	Q2 2023	Q1 2024	Q2 2024
RCM Revenue ($M)	47.760	53.038	54.108
EHR Revenue ($M)	36.862	28.022	30.622
RCM as % of Total	—	—	63.9%
Total Revenue ($M)	84.622	83.247	84.730

KPIs and additional detail

KPI	Q2 2023	Q1 2024	Q2 2024
Total Bookings ($M)	20.970	23.569	23.290
RCM Adjusted EBITDA ($M)	5.682	6.396	7.804
EHR Adjusted EBITDA ($M)	5.545	2.929	4.770
EHR Recurring Revenue ($M)	33.742	26.492	26.666
EHR Non‑recurring Revenue ($M)	3.120	1.530	3.956
Cash & Cash Equivalents ($M)	—	4.115 (3/31/24)	7.709 (6/30/24)
Long‑term Debt, net of current ($M)	—	181.732 (3/31/24)	176.964 (6/30/24)

Notes: Patient engagement revenue was reported separately in Q1 2024 (legacy divestiture context), contributing $2.187M in Q1; it is not separately itemized in Q2 disclosure .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue	Q3 2024	N/A	$82M–$85M	First provided for Q3
Adjusted EBITDA	Q3 2024	N/A	$11.5M–$13.5M	First provided for Q3
Revenue	FY 2024	$330M–$340M (revised from $340M–$350M in Q1)	$330M–$340M	Maintained
Adjusted EBITDA	FY 2024	$45M–$50M	$45M–$50M	Maintained

Earnings Call Themes & Trends

Topic	Previous Mentions (Q-2, Q-1)	Current Period (Q2 2024)	Trend
Bookings momentum & cross-sell	Q-1: “continued momentum in bookings… wins in both our RCM and EHR business” ; Q-2: n/a	“continued to build on our bookings momentum and cross‑selling efforts”; bookings $23.3M	Positive, sustained
Large‑deal timing variability	Q-1: larger deals add timing complexity; revenue range revised, EBITDA maintained	Guidance reiterated; implies improved visibility into conversion	Stabilizing
RCM mix/expansion	Q-1: RCM $53.0M (63.7% of total)	RCM $54.1M (63.9% of total), YoY growth	Strong mix support
EHR trajectory	Q-1: EHR $28.0M (lower YoY)	EHR $30.6M vs $36.9M YoY; recurring $26.7M	Mixed, still below YoY
Cash flow and balance sheet	Q-1: operating cash flow negative in Q1 but improving process focus	“significant improvement in cash flow from operations”; cash $7.7M; LT debt $177.0M	Improving cash ops; leverage elevated
Costs/interest headwinds	Q-1: interest expense $(4.072)M	interest expense $(4.242)M; GAAP loss $(5.0)M	Continues to weigh on GAAP EPS

Additional Q2 press items: Company announced Q2 call date on July 25, 2024 .

Management Commentary

“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.” — Chris Fowler, CEO .
“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.” — Chris Fowler, CEO .

Q&A Highlights

Full Q2 2024 earnings call transcript was not available in the document repository; third‑party sources list the transcript but restrict full text access. We therefore relied on the company’s press release for verified commentary and will update Q&A specifics upon transcript access .

Estimates Context

S&P Global (Capital IQ) consensus estimates for Q2 2024 were unavailable via our SPGI endpoint at time of analysis due to data access limits. As a result, we cannot quantify beats/misses vs consensus. We will update when access is restored. Values retrieved from S&P Global.*

Key Takeaways for Investors

RCM-led execution is supporting margins and cash generation: RCM grew to $54.1M with mix at 63.9% and Adjusted EBITDA improved to $12.6M (14.8%) .
EHR remains a drag YoY, but sequential improvement and recurring revenue stability ($26.7M) point to a more balanced H2 if bookings convert on plan .
GAAP losses persist on interest and non‑recurring items; sustained de‑leveraging and lower non‑recurring costs are key to EPS inflection (interest expense $(4.242)M; LT debt $177.0M) .
Guidance credibility improved: FY revenue and EBITDA ranges maintained; Q3 guide ($82–$85M revenue; $11.5–$13.5M EBITDA) sets a reasonable bar for sequential execution .
Watch conversion of larger deals and cross‑sell into revenue, particularly the bookings‑to‑revenue lag cited previously (4–6 months typical), as the main H2 revenue unlock .
Near‑term setup: Stock may react to continued cash flow improvements and proof of sustained EBITDA margin expansion; risks include EHR softness and elevated interest expense .

Appendix: Additional Q1 2024 context (prior quarter)

Q1 2024 revenue $83.2M; GAAP diluted EPS $(0.17); Non‑GAAP EPS $0.19; Adjusted EBITDA $9.5M (11.4% margin); bookings $23.6M; FY revenue range was revised to $330–$340M (from $340–$350M), EBITDA $45–$50M unchanged .

Sources:

Q2 2024 8‑K press release and financial schedules .
Q1 2024 8‑K press release and financial schedules .
Company press releases (Q2 call date; Q2 results) .
Third‑party transcript listings (restricted access) .

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