Executive Summary

Q4 2024 revenue was $79.6M, within prior guidance ($78–$84M), with adjusted EBITDA of $7.9M and 10% margin; technology revenue grew 10% year-over-year while total adjusted gross margin was 47% .
Management raised FY2025 adjusted EBITDA target by $2M to ~$41M and guided FY2025 total revenue to ~$335M and technology revenue to ~$220M, citing faster-than-expected integration progress from recent acquisitions .
Platform Clients reached 130 (+19% YoY), with dollar-based retention of 100% (legacy) and 102% on updated Tech+TEMS definition; management expects ~40 net new Platform Clients in 2025 and ~103% dollar-based retention (Tech+TEMS) .
Strategic actions include exiting the pilot Ambulatory Operations TEMS offering by mid-2025 (~$9M annual services revenue) to focus on profitable growth and closing the Upfront Healthcare acquisition (patient activation), strengthening engagement capabilities .
Near-term margin headwinds stem from Ninja Universe deployments (HIE implementations) before revenue ramp and Ignite migrations; Q4 professional services gross margin dipped to 13% on ambulatory resourcing and seasonality, but management sees improvement in 2H 2025 as implementations go live .

What Went Well and What Went Wrong

What Went Well

Technology segment outperformed: Q4 technology revenue was $51.6M (+10% YoY), with adjusted technology gross margin of 65%; total adjusted gross margin was 47% .
Strong bookings momentum and clearer 2025 roadmap: management raised FY2025 adjusted EBITDA to ~$41M and expects technology to have a “Rule of 30” profile (13% growth, ~18% adj. EBITDA margin) .
Strategic portfolio expansion: closed Upfront Healthcare (patient engagement) and launched AI-enabled BluePrint Protect cybersecurity capabilities, enhancing cross-sell and adjacent markets (payer/life sciences) .

Quote: “We anticipate a continued reacceleration of topline growth for full year 2025, with our Tech segment growing faster than the total business…and we have raised our target for 2025 Adjusted EBITDA by $2 million, to approximately $41 million.” — CEO Dan Burton .

What Went Wrong

GAAP profitability remains negative: Q4 net loss was $(20.7)M; diluted EPS was $(0.33) as stock-based compensation and acquisition-related costs weighed on results .
Segment margin pressure: adjusted technology gross margin declined vs prior year due to Ninja Universe deployment costs before revenue and Ignite migration effects; professional services gross margin fell to 13% in Q4 on ambulatory TEMS resourcing and seasonality .
Minor project timing and mix: Q4 revenue landed inside guidance but management cited “a few minor project delays” and lower-than-anticipated TEMS bookings, prompting a strategic exit of unprofitable ambulatory TEMS pilots (~$9M annual revenue) .

Financial Results

Metric	Q2 2024	Q3 2024	Q4 2024
Total Revenue ($USD Millions)	$75.9	$76.353	$79.606
Net Loss ($USD Millions)	$(13.516)	$(14.726)	$(20.673)
Diluted EPS ($USD)	$(0.23)	$(0.24)	$(0.33)
Gross Margin % (GAAP)	38%	36%	36%
Adjusted Gross Margin %	50%	48%	47%
Adjusted EBITDA ($USD Millions)	$7.522	$7.295	$7.911

Segment breakdown:

Segment Metric	Q2 2024	Q3 2024	Q4 2024
Technology Revenue ($USD Millions)	$47.635	$48.653	$51.598
Professional Services Revenue ($USD Millions)	$28.267	$27.700	$28.008
Adjusted Technology Gross Margin %	67%	65%	65%
Adjusted Professional Services Gross Margin %	20%	17%	13%

KPIs:

KPI	Value
Platform Clients (as of Dec 31, 2024)	130
Dollar-based Retention (legacy, 2024)	100%
Dollar-based Retention (Tech + TEMS, 2024)	102%

Performance vs prior guidance:

Metric	Prior Guidance	Actual Q4 2024	Outcome
Total Revenue ($USD Millions)	$78.0–$84.0 (Q4 guide at Q3)	$79.606	Within range
Adjusted EBITDA ($USD Millions)	$6.8–$8.8 (Q4 guide at Q3)	$7.911	Above midpoint

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total Revenue ($USD Millions)	Q1 2025	N/A	~$79M	New
Adjusted EBITDA ($USD Millions)	Q1 2025	N/A	~$4M	New
Total Revenue ($USD Millions)	FY 2025	N/A	~$335M	New
Technology Revenue ($USD Millions)	FY 2025	N/A	~$220M	New
Adjusted EBITDA ($USD Millions)	FY 2025	~$39M	~$41M	Raised
Technology BU Adjusted EBITDA ($USD Millions)	FY 2025	~$38M (implied prior)	~$40M	Raised

Notes:

Management also targets 2025 Tech BU “Rule of 30” (13% growth; ~18% adj. EBITDA margin) .
No tax/OI&E/dividend guidance provided in Q4 materials .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q2 and Q3)	Current Period (Q4 2024)	Trend
Ignite migration and pricing	Modular, lower starting price; migrations over next couple years; consumption-based pricing emerging	Migrations continue; pricing more consumption-based; annual escalators low-to-mid single digits; temporary retention headwind subsides by mid-2026	Continued adoption with near-term retention/margin headwinds improving over time
HIE/Ninja Universe implementations	Several HIE wins; longer implementation timelines before revenue	Margin headwinds from Ninja Universe deployment costs prior to revenue; improvement expected 2H 2025	Near-term drag; improving later in 2025
Bookings momentum and net new Platform Clients	Low-20s net new Platform Clients in 2024, strongest year; cross-sell from >900 app clients	Target ~40 net new Platform Clients in 2025; 6 added YTD by Q1 with pace of ~10 by Q1-end	Acceleration anticipated
TEMS strategy and ambulatory exit	TEMS margins improve in core areas (chart abstraction); ambulatory ops learning curve	Strategic exit of pilot Ambulatory Operations TEMS by mid-2025 (~$9M annual services revenue)	Portfolio optimization toward higher margins
AI initiatives	Healthcare.AI used in client outcomes; growing demand (e.g., chart abstraction AI efficiency)	Launch of AI-powered BluePrint Protect cybersecurity risk manager	Expanding AI-enabled offerings
Macro and policy	Health system margins stabilizing; improved end-market; election impact minimal	Continued stabilization; monitoring Medicaid/research funding; no pipeline impact noted	Supportive demand environment

Management Commentary

Profitability and growth: “We anticipate…Tech segment growing faster than the total business…raised our target for 2025 Adjusted EBITDA…to approximately $41 million.” — CEO Dan Burton .
Bookings acceleration drivers: “Ignite is…at a lower price point than DOS…we’re often twice as likely to close [cross-sell]…sales cycle is a little shorter.” — CEO Dan Burton .
Margin cadence: “Adjusted technology gross margin…in line with Q4 2024…higher in the second half of 2025 as…Ignite migration [progresses] and revenue ramp from our health information exchange clients.” — CFO Jason Alger .
Strategy shift: “Strategic decision made to exit pilot Ambulatory Operations TEMS…representing ~$9M of annual services revenue.” — Company one-pager (EX-99.2) .
M&A posture: “We are…focused on…getting a great return on [recent acquisitions]…less likely in the near to midterm…to pursue other acquisition opportunities.” — CEO Dan Burton .

Q&A Highlights

Platform bookings doubling: Management expects ~40 net new Platform Clients in 2025 (vs ~21 in 2024), driven by improved end-market, lower Ignite price point, and cross-sell into >900 app clients; early Q1 pace supports target .
Dollar-based retention and pricing: Ignite annual escalators generally low-to-mid single digits; updated retention definition (Tech+TEMS) better reflects recurring nature; near-term retention headwind (~couple points) expected to subside by mid-2026 .
EBITDA cadence: Step-down in Q1 from acquisitions (Upfront integration), salary increases, and restructuring timing; revenue ramp through 2025 from deployments and closed deals; HAS event costs down to ~$1–1.5M .
Consumption-based pricing and app expansion: Shift to modular, consumption-based model; confidence in app cross-sell as clients migrate to Ignite; average Platform Client consumes only 1–2 apps today, leaving runway .
HIE/Ninja Universe: Longer ramp timelines acknowledged; go-lives expected later in 2025; near-term margin headwinds easing over the year .

Estimates Context

Wall Street consensus via S&P Global was unavailable due to data access limits during retrieval. As a proxy, Q4 revenue and adjusted EBITDA were within and above the midpoint of the company’s Q3-issued guidance ranges, respectively .
Implication: In absence of published consensus figures, results appear broadly in line with internal guidance; FY2025 adj. EBITDA raised suggests estimates may need upward revision on profitability while near-term margins remain mixed due to implementation timing .

Key Takeaways for Investors

Technology-led mix shift is intact: 2025 guide implies Tech revenue growth (~13%) outpacing services; expect margin leverage as Ignite migrations complete and HIE contracts go live in 2H 2025 .
Profitability inflection: FY2025 adjusted EBITDA raised to ~$41M; management targets “Rule of 30” for Tech BU (~18% adj. EBITDA margin), supported by M&A integration and cost actions (R&D/pro services) .
Strategic pruning boosts margins: Exiting ambulatory TEMS pilots (~$9M revenue) and focusing on higher-margin tech and nonrecurring services should lift professional services gross margin into the high teens in 2025 .
Bookings momentum and cross-sell: Early 2025 net new clients tracking ahead; cross-sell into >1,000 combined Platform/App clients provides durable growth runway .
Near-term headwinds are transitory: Ninja Universe and Ignite migration costs pressure margins near term; expect improvement in 2H 2025 as deployments convert to revenue .
Adjacent markets expansion: Cybersecurity (BluePrint Protect) and patient activation (Upfront) add high-value app-layer offerings and cross-sell opportunities across payer and life sciences .
Watch execution and cadence: Track quarterly go-live timing (HIE/Ninja), retention trends under the updated metric, and Q1 EBITDA cadence versus guide; any slippage in deployments could push margin recovery later in 2025 .

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