Performant Financial - Q2 2024

Executive Summary

• Q2 2024 delivered double-digit growth: total revenue $29.4M (+15% YoY) and healthcare revenue $27.9M (+17% YoY), with positive adjusted EBITDA of $0.5M; diluted EPS was $(0.04).
• Management reiterated FY2024 guidance: healthcare revenue $117–$122M, total revenue $124–$129M, adjusted EBITDA $4–$5M, citing strong commercial implementations and RAC Region 2 ramp; Q2 results were “ahead of expectations” per CFO.
• Claims-based services were the growth engine (~$13.7M, ~+40% YoY), while eligibility-based services were steady (~$14.3M, ~+1% YoY); customer care revenues fell slightly to $1.4M.
• Catalysts: reaffirmed guidance and positive EBITDA; expanding commercial implementations (10 in Q2; 20 YTD worth ~$9M annualized at steady state) and AI-driven efficiency (Project Turing/RecordsOne).
• Wall Street consensus via S&P Global was unavailable for PFMT; internal commentary characterized Q2 as ahead of expectations.

What Went Well and What Went Wrong

What Went Well

• Strong revenue growth and profitability momentum: healthcare revenue +17% YoY to $27.9M and positive adjusted EBITDA of $0.5M; “results ahead of expectations” and guidance reaffirmed.
• Claims-based services accelerated: ~$13.7M in Q2, roughly +40% YoY, driven by commercial scale and CMS RAC Region 2 ramp.
• Execution on growth initiatives: 10 Q2 implementations (20 YTD) expected to contribute ~$9M annualized at steady state, plus integration of AI RecordsOne tech into Project Turing to improve audit accuracy/efficiency.

What Went Wrong

• Net loss persisted: GAAP net loss $(3.0)M (EPS $(0.04)), though improved YoY from $(4.0)M (EPS $(0.05)).
• Eligibility-based services growth muted (+~1% YoY to $14.3M), with MSP government eligibility now at steady-state; customer care revenue declined to $1.4M.
• External headwinds: more conservative federal oversight during election cycle and Change Healthcare outage causing slower client decision-making and isolated delays (though long-term impact expected to be limited).

Transcript

Operator (participant)

Good afternoon, ladies and gentlemen, and welcome to Performant Financial's Q2 2024 earnings conference call. At this time, all lines are in a listen-only mode. Following the presentation, we will conduct a question-and-answer session. This call is being recorded on Wednesday, August 7, 2024. I would now like to turn the conference over to John Pizzuto, Head of Investor Relations. Please go ahead.

John Pizzuto (Head of Investor Relations)

Thank you, operator. Good afternoon, everyone. By now, you should have received a copy of the earnings release for the company's Q2 2024 results. If you have not, a copy is available on the investor relations portion of our website. On today's call will be Simeon Kohl, Chief Executive Officer, and Rohit Ramchandani, Chief Financial Officer. Before we begin, I'd like to remind you that some of the comments made today, including our financial guidance, are forward-looking statements. These statements are subject to risks and uncertainties, including those described in the company's filings with the SEC. Actual results may differ materially from those described during the call. In addition, all forward-looking statements are made as of today, and the company does not undertake to update any forward-looking statements based on new circumstances or revised expectations.

Also, all non-GAAP financial measures discussed during this call are reconciled to the most directly comparable GAAP measures in the table attached to our press release. I would now like to turn the call over to Simeon Kohl. Sim?

Simeon Kohl (CEO)

Thank you, John. Good afternoon, everyone, and thank you for joining us for our earnings call. This afternoon, we reported Q2 results, highlighted by 17% growth in healthcare revenues compared to the Q2 of 2023 and positive EBITDA of $500,000. I will share our operational accomplishments, followed by Rohit, who will walk you through our financial results. In the Q2, our double-digit quarter-over-quarter revenue growth and positive EBITDA demonstrate our effectiveness in penetrating the significant market opportunity that lies before us, as well as our disciplined approach to driving profitability. Our strategy to deliver these results has remained unchanged: prioritize client needs, continuously innovate, and achieve operational excellence. I'll touch on each of these as we highlight our Q2 results. Demand for our services remains strong as we continue to effectively demonstrate our value proposition to both current and prospective clients.

This past quarter, we implemented 10 statements of work, including adding 2 new clients to our roster. In year to date, we have implemented 20 new statements of work, which we estimate will collectively generate approximately $9 million in annualized revenue at steady state. And despite the significant client bandwidth required for implementations, it is encouraging to see our clients continue to switch from their legacy partners and choose Performant, a testament to our ability to deliver timely and meaningful returns on their trust and investment. Our business started with a single CMS RAC engagement, and government contracts remain an important backbone of our operations today. We have built credibility through our strong relationship with CMS, and we are optimistic about growing our business with the federal government as we continue to ramp RAC Region Two. This election year, however, presents potential uncertainty for our industry.

We are seeing several agencies take a more conservative approach with oversight programs. Though we anticipate this more measured approach will be limited to the current election cycle, having navigated multiple prior elections, we are confident that both the state and federal government's commitment to payment accuracy and transparency will likely remain unchanged, no matter the election outcome. Staying on the government theme, we continue to see an opportunity in the $300 million-$500 million state market. We have been active with state RFPs and continue to refine our strategy as we wait for the first contract award for both our recovery audit and third-party liability solutions. Change is constant within healthcare, and our clients face numerous challenges, including adjustments in reimbursements and evolving risk pools due to Medicaid redeterminations.

One challenge we would highlight is the Change Healthcare outage, which has had a meaningful impact on claims processing, adjudication, and care delivery. The Change Healthcare outage has fortunately only had a minor impact on Performant to date. From an implementations and new sales standpoint, we are seeing slower decision-making by clients as they adjust their near-term priorities. While we have seen isolated delays, the strength of our services continues to drive positive results for our clients, and we do not expect the Change Healthcare incident to impact our long-term growth strategy. We initially anticipated the operational impact of the Change Healthcare outage to be temporary delays in receiving claims, likely resulting in quick restoration with no loss in opportunity for Performant, and the results we have seen to date on our existing operations continues to support that assessment.

We will continue to monitor for downstream impacts to our operations, but again, to date, we have seen minimal operational disruption. On the topic of data security, I'd underscore our dedication to safeguarding the data entrusted to us through our robust multi-tiered security strategy. This includes encryption, role-based access controls, anomaly detection, and comprehensive vulnerability and vendor management. We undergo regular internal and external audits and penetration tests to ensure compliance with industry standard data protection requirements and best practices. Performant's rigorous security standards are validated by certifications including HITRUST, SOC, and SOX, along with annual CMS control audits. While there will always be challenges for our clients to contend with, I firmly believe that our value proposition remains consistent… as we help our clients more accurately pay claims, yielding greater predictability and allowing them to focus on what matters most, ensuring the delivery of high-quality, cost-effective patient care.

Turning to our operational efforts, in the Q2, we achieved positive EBITDA of $500,000, $1.8 million ahead of the prior year's quarter. To achieve this, we have prioritized productivity and efficiency to drive profitability. Rohit has often shared that while our primary path to profitability is through increased revenues, we do have opportunities to drive greater efficiency, particularly in our claims-based business. The acquisition of RecordsOne technology earlier this year, which has folded in nicely to Project Turing, will be one of the major components in achieving these margin gains. As a reminder, this artificial intelligence-based solution integrates into our audit workflow, improving the accuracy and efficiency of our medical auditors.

The integration plan for this technology has been progressing according to plan, and we are pleased to be doing so alongside key team members from RecordsOne, who have joined Performant and remain active in the integration, adoption, and development process. We remain highly encouraged by the prospects of this powerful AI technology. As we continue our journey to becoming a best-in-class, pure-play healthcare company, I am thrilled that our shareholders have approved an employee stock purchase plan. This initiative is a significant step towards fostering a culture of ownership, which is one of our core corporate pillars. By encouraging an ownership mentality, we empower our employees to deliver the best results for our clients, and there's palpable excitement when I speak to our team about the direction and growth of our company.

This plan will enable a greater number of team members to share in that growth, aligning personal success with the company's accomplishments. I couldn't be prouder of this development, and I am confident that it will strengthen our commitment to excellence and accelerate our collective success. Overall, I am encouraged by our Q2 results. We continued to deliver for our clients, which has led to more opportunities for future growth. Operationally, our technology investments to increase productivity and efficiency gains are paying tangible dividends. And finally, from a macro perspective, the need for payment integrity solutions to help control costs within our healthcare system remains as strong as ever. With that, I'll hand it over to Rohit Ramchandani, our Chief Financial Officer, for a discussion of the financials. Rohit?

Rohit Ramchandani (CFO)

Thanks, Sim. Our results in the Q2 of 2024 have exceeded expectations, and we remain encouraged by our prospects for the remainder of the year. Total company revenues in the quarter were $29.4 million, which included healthcare revenues of $27.9 million. Our customer care outsource services business accounted for $1.4 million of the revenue during the quarter, a decline of $0.1 million from the previous year. We are eagerly anticipating a resumption of numerous federal student loan programs, which would allow us to achieve our guided targets and the future growth expectations for this service line. Our Q2 healthcare revenue grew 17% quarter-over-quarter as a result of successfully ramping prior year implementations.

Our claims-based business, also known as claims auditing, led the way with revenues of almost $14 million in the quarter, representing an increase of roughly 40% year over year. Both our government and commercial clients contributed to this growth. Within commercial, existing implementations scaled as expected, contributing to this strong top-line growth, while the RAC Region Two contract in the government sector continued to successfully scale. We anticipate continued growth with our commercial clients, as well as continued scale of RAC Region Two, though we do recognize the more conservative approach that federal oversight programs have taken as the election draws near. Looking forward, we continue to anticipate healthy growth with commercial clients alongside a strong CMS foundation. State RAC or other federal RAC region wins would support meaningful growth in the government beyond the ebbs and flows of existing programs and the ramping of RAC Region Two.

Eligibility revenues for the quarter were $14.3 million, representing an increase of roughly 1% in comparison to last year. As we think about 2024, a reminder that the eligibility business includes our mature relationship with CMS MSP, now on our new CRC contract. With our commercial eligibility clients and opportunities, we continue to refine and optimize our data assets, aiming to use our data more effectively. Additionally, we leverage advanced analytics and additional services to eliminate false positives from our workflow, further improving our operational efficiency. This approach not only streamlines our processes, but also ensures we deliver high-quality, accurate results to our clients. We are setting ourselves up well for sustainable future growth. As Sim mentioned, we are now at year-to-date implementations worth approximately $9 million in annualized revenues at steady state.

As we've often discussed, the value of these statements of work can fluctuate on a quarterly basis. This quarter, we did welcome two net new clients, continuing to support our value thesis amongst middle-market players. Our ongoing efforts to secure and execute these sticky contracts are a testament to our strong market position and commitment to growth. We remain confident in our anticipation that the total annualized revenues from new implementations in 2024 will match or exceed the $18 million in estimated annualized revenues from 2023 implementations. Shifting to operating expenses, these represented $32.1 million in the Q2, or roughly $3 million higher when compared to the Q2 of last year. This was primarily driven by an increased spend to scale implementations, IT investments related to Project Turing, and investments in sales and business development, all of which we discussed earlier this year.

We are encouraged by the early results of Project Turing, as we see positive scale and incremental margin growth in adding roughly $4 million of revenues quarter-over-quarter, while only adding $3 million of operating expense. We have strategically positioned our business to drive profitability and sustainable growth. We are pleased to report an Adjusted EBITDA of $500,000 in the Q2, or $1.8 million ahead of the prior year period. Over the past several quarters, we have emphasized our commitment to efficiency and productivity initiatives, notably through Project Turing, which, as Sim noted, is progressing well. We have been focused on this operational efficiency without compromising our capacity for top-line growth. This balance ensures that while we streamline processes and reduce costs, we continue to expand our market presence and seize new growth opportunities.

We are confident that these initiatives will not only sustain, but accelerate our profitability trajectory. As we reflect on our strong H1 performance, alongside taking into consideration the indirect impacts of the Change Healthcare outage and this tumultuous election cycle, we are excited to reaffirm our guidance for revenues and profitability. This confidence is bolstered by the success we are seeing in our commercial growth strategies and operations. To be clear, we are reiterating our guidance for 2024 healthcare revenues to be in the range of $117 million-$122 million. Full company revenues to be between $124 million and $129 million, and for the full year 2024 Adjusted EBITDA to be in the range of $4 million-$5 million.

In looking at our balance sheet, as anticipated, we have marginally drawn down on our debt facility in support of our ongoing implementation ramps and recent technology acquisition. We are pleased to see our credit relationship with Wells Fargo continuing to grow in a positive manner. The investments we are making in our people, technology, sales, and business development efforts are on track with what we communicated earlier this year. This measured approach is already showing progress as we push toward our 20%+ Adjusted EBITDA margin targets. From a scale perspective, we anticipate being able to achieve such margins if healthcare revenues reach $150 million-$160 million.

We maintain our goal of hitting our EBITDA inflection point in the near term and achieving self-sustaining cash flows at some point in the next year, without sacrificing the ability to invest in future growth. I'm very pleased with the revenue growth and profitability scale we have demonstrated thus far in the H1 of the year, giving me confidence in the remainder of 2024. Operator, will you please open up the lines for questions?

Operator (participant)

Thank you. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. Our first question is from George Sutton with Craig-Hallum Capital Group. Please proceed.

George Sutton (Senior Research Analyst)

Thank you. Good afternoon, guys. So I wondered if you could walk through the Medicaid opportunities more broadly that you're seeing now. You mentioned some activity there. Obviously, we know New York's coming up. So has there been any changes to the New York timing? I assume not, and I'm just curious about other opportunities outside of New York.

Simeon Kohl (CEO)

Yeah. Hi, George. So specific to New York, to your point, we, that did get rebid, and we went ahead and submit our proposals. The timeframe on that is, looks to be what they originally committed, sometime early September for decisioning with implementation early next year. So that looks to be on track. We remain excited about that. Look, anytime you go through a rebid, there's things that you have to step through, et cetera, but I think we were pretty confident on the first round for good reasons, and we continue to be, you know, cautiously optimistic on the rebid. And yes, we are actually seeing quite a bit of activity with other states. And so, our team is working very closely in responding.

We have a few proposals out right now with other states. We're watching closely with additional states, et cetera. So as we've indicated on the last call, you know, our team is really focused in making sure that we are closely watching new opportunities, as well as kind of refining our proposals and our responses.

George Sutton (Senior Research Analyst)

Great. I wondered if you could explain the conservative oversight that we might see relative to the election, just what's happened in past election cycles?

Simeon Kohl (CEO)

Yeah.

George Sutton (Senior Research Analyst)

What exactly do you mean by the more conservative oversight?

Simeon Kohl (CEO)

Yeah. So, and look, we've seen this before, right? Anytime there is an election period, especially when you're dealing with some of these oversight programs that the agencies are managing through, you have, you know, legislative constituents that are involved. You have folks that are being audited, pushing back a little bit. You have policy determination, you have concepts that get reviewed, et cetera. And so, you know, history has shown that when you get into those cycles, things tend to delay a little bit more. There's some more sensitivities. There's lots of eyes on things, if you will. And so as you move through that cycle, you know, it gets a little bit more and more focused around some of those concerns and having the eyes on the agency.

And I think this, this particular cycle, just how unique it is, which I don't think anyone will doubt that-

... I think is disproportionately driving it. But as I said in the prepared remarks, and we've been through this, regardless of the administration change, you know, we fully believe that whether it's CMS, HHS, or any federal government agency, the focus on payment accuracy and transparency is likely always to remain.

George Sutton (Senior Research Analyst)

Gotcha. One other thing, I wondered if you could give us a broader update on Project Turing, and, in particular, any impacts you're starting to see from the RecordsOne integration.

Simeon Kohl (CEO)

Yeah. I think as Rohit called out, we, you know, we have a number of initiatives underway that are kind of grouped under the Project Turing, all driving all aspects of our business, right? Trying to drive greater efficiencies. The RecordsOne AI piece, the team has done a fantastic job tightly integrating that into the overall architecture of Project Turing. And so as we've talked about, it's not just simply one claims aspect. We're really excited about how this technology could be broadly applicable to our business. And so we're already seeing... It's gonna be a bit of an iterative process, right? There's not a big bang, it's complete on X dates, right? We are working through a process, really trying to prioritize areas that we think we get the largest bang for our buck.

I think Rohit noted that the claims business probably is the first one out of the gate, and we are already seeing some impact and some value props in terms of, you know, how we are selecting claims and how the technology is helping us just improve the process. But again, we're, you know, we have lots of areas of spend, and so we're prioritizing where we think we get the largest bang for the buck out of the gate.

George Sutton (Senior Research Analyst)

Perfect. Thank you, guys.

Rohit Ramchandani (CFO)

Sure.

Operator (participant)

Our next question is from Kyle Bauser, with B. Riley Securities. Please proceed.

Kyle Bauser (Managing Director and Senior Equity Research Analyst)

Great. Thanks for the updates and for taking my questions. So, so you implemented 21 commercial programs in 2022, and then 41 in 2023, and 20 year to date. So, really strong tailwind, that should just get stronger over time, given the ramp to scale is about 12-24 months. Going forward, can we expect kind of quarter-over-quarter steps up, step up in earning leverage? I know there's seasonality, but, perhaps the tailwinds are strong enough that we could potentially see a step up. And maybe a follow-up to that is, do you expect to kind of continue at this clip of 10-ish per quarter? Just kind of curious on how we should think about that too.

Rohit Ramchandani (CFO)

Yeah, Kyle, good, good questions. Happy to take those. So in terms of, of your first piece of the question, I think, yes, we, we do anticipate that leverage to start clipping up. It, it kind of aligns with what I was mentioning in the prepared remarks about getting close to an EBITDA inflection point, and at some point next year, the self-sitting cash flows. What that means, right, is as we continue to sign up new implementations, that the old existing ones have generated enough profitability to, to start paying for itself. And so we do see that coming in the, the near-term horizon here with some of those older implementations.

As we think about the go-forward implementations, we have been sort of reorienting due to the fact that, you know, they can range in size and scale of focusing more on the dollar impact of the estimated ACVs. And so that's where, as I shared, you know, last year, our estimate was $18 million in annualized revenues added from implementations. This year, with 9 in the H1, we remain committed to meeting or beating that 18, as we think about what we bring on this year and then into next year. So I can't tell you whether it's gonna be 10 a quarter, but as we do look at the year, we're committed to getting ahead of that 18 number.

Kyle Bauser (Managing Director and Senior Equity Research Analyst)

Got it. Appreciate that. And maybe just following up there, is capacity an issue? I mean, it, it's a lot. It's, you know, a really impressive number of new implementations over the past couple of years. Do you feel like you've got the ability to add headcount, and you've got the infrastructure to kinda support this clip?

Rohit Ramchandani (CFO)

Yes, we, we do. And I think you, you might be remembering, I know, some previous years, hiring would come up from time to time, but we're not having any of those capacity issues in the current macroclimate. And as we think about the implementations, I think we've already seen a lot of good work in the fact that we were able to hit that 40+, with a similar size team that was doing the 20s in the other years you mentioned. And, and so I think from that standpoint, we're, we're feeling pretty good from a capacity point as well.

Now, if you were to say, you know, go do 80, 90, 100 implementations in a year, then I think that will require the completion of some of the pieces of Project Turing to be able to handle, but it's, well underway.

Kyle Bauser (Managing Director and Senior Equity Research Analyst)

Okay, yeah, appreciate that. Maybe just, lastly, your, your goal of, 20% EBITDA margin on, you know, I'm guessing in the next few years, will the commercial side of the business have an inherently higher profit margin than the government side? Just curious if you could talk about how these businesses would differ from a, a margin perspective at scale. Thank you.

Rohit Ramchandani (CFO)

Yeah, great question. I think we generally view them similar. Now, I think one typically would have expected that our government side would have a slightly lower margin, but I think where that balances itself out is the efficacy of how much of our work converts into a final dollar back in the door, if you will, and that's where the government tends to follow stricter rules in general than some of the commercial plans, and so they tend to end up pretty balanced.

Kyle Bauser (Managing Director and Senior Equity Research Analyst)

... Okay. Got it. Well, thanks all for the updates and for taking my questions. I'll jump back in queue.

Operator (participant)

Our next question is from Jacob Stephan with Lake Street. Please proceed.

Jacob Stephan (Equity Research Analyst)

Hey, guys. Thanks for taking my question. Apologies if I double cover something here. But yeah, I just kinda wanted to get an update on Project Turing. You know, obviously, RecordsOne, it sounds like things are integrating nicely. You're kind of finding new things that may provide kind of synergies across the business. But I'm curious, you know, what is there any kind of additional things that you're finding that you know may not have expected originally, any color there?

Simeon Kohl (CEO)

Hey, Jacob. Not at this point, right? I mean, I think we have a pretty good handle on how the technology can help us as we think about kind of our core offerings that we have today, as we've discussed, kind of driving efficiencies in various selections, and then how the technology can help us, you know, decision, if you will. There's some interesting opportunities downstream, but I think, you know, it's too early in the game yet, and we're so focused at really trying to apply the technology where we know there's some immediate benefit.

Operator (participant)

If there are no further questions from Jacob, we will conclude the question and answer session. I would like to hand the conference back over to Simeon for closing remarks.

Simeon Kohl (CEO)

Thanks, operator. As we wrap our Q2 earnings call, I really want to extend my gratitude to our dedicated team, our customers, our shareholders, for their unwavering support. We're so proud of the accomplishments this quarter, and we remain super focused on driving growth, innovation and continued value to our stakeholders. Thank you again, everyone, for joining us, and we look forward to reconnecting in Q3.

Operator (participant)

Thank you. This does conclude today's conference. You may disconnect your lines at this time, and thank you for your participation.