Health Catalyst, Inc. (NASDAQ:HCAT) Q4 2023 Earnings Call Transcript

Dan Burton: Yes. Thank you for the question, Daniel. And we have wanted to make sure that we are carefully following what our clients and what the end market is needing and demanding and be reflective and responsive to that. We have found, as we mentioned previously, over the last few months, late last year and into this year that while there is significant financial pressure still in our end market, it is starting to subside and it is improving. And there is more of an openness to talk about our full portfolio and more a discussion around our technology offerings. And I think we have wanted to be responsive to that. And we have shifted some of our growth resources both now. And as we think about the future, we see more of those opportunities for balanced growth.

And I think we want to prioritize the technology growth as more profitable growth, which can lead to a really meaningful EBITDA growth over the next 4 years as a company. And so we are prioritizing that profitable growth as what we feel is very important to drive shareholder value at a primary level. We continue to be really excited about the other opportunities for growth, and we will continue in a balanced way to pursue opportunities like tech-enabled managed services. But I think as the end market is improving, and there is more of an openness to talk about the technology components of our portfolio a little bit more than what we have been able to do over the last 18 months. And that coupled with the fact that we have confidence and we are excited about our next-generation data platform, I think we have shifted some resources and we are planning on continuing to focus on that tech component of our value proposition in a balanced way such that we would project forward more balanced growth that is similar between our technology revenue growth and our services growth.

The last thing that I will share and then see if Bryan would like to add anything is we do take these targets very seriously as we have in the past when we share a profitability target, for example, we have striven to meet or exceed that timeline that we have shared. And we have done that recently in multiple regards. And I think as we think towards those targets for 2028, we want to have confidence that we can meet or exceed those targets, including from a top line revenue growth perspective.

Bryan Hunt: Agree, Dan, yes. And I think that last point is important around as we think about from a financial guidance standpoint, these targets, we do think of them as threshold level targets and a little bit different from long-term profiles that we had shared previously in that these targets are more specific. So, therefore 2025, specifically in 2028 real meaningful milestones with levels of both revenue and EBITDA that we think are threshold level that we will strive to meet and exceed. So, to Dan’s point, we take those very seriously.

Operator: Our next question comes from David Larsen with BTIG.

David Larsen: Hi. Can you talk a little bit more about these TEMS deals that have pushed, it sounds like you signed one of them. Is there any color on like how many more TEMS deals there may be, what the incremental revenue contribution could be for each of those? And then it sounds like you are pretty confident with your 2025 revenue growth guide of, I think 10% to 15%. Is that really going to be driven by these TEMS deals that you expect to kind of sign in the near-term? Thanks.

Dan Burton: Yes, great questions, David. So, first, as it relates to the TEMS deals that we were originally projecting to close by the end of the year, we were encouraged to see one of those just a few days ago to come through and sign. That was a meaningful TEMS chart abstraction opportunity for us with an existing client that already had some meaningful TEMS activity going on. So, it was encouraging to see that there continues to be expansion opportunity. The size of that particular deal was a little below the average for TEMS contract that we have seen over the last little while. And we do have other TEMS opportunities in the pipeline that continue to progress. Importantly, over the last few months as we have seen improvement in the end market and more of an openness to talk about more of our portfolio, not just TEMS or not just those elements of the portfolio that offer cost savings, we have proactively shifted some of our growth resources towards more of those tech-oriented conversations, both with existing clients as well as more new client discussions.

And we have started to see the positive results of that and that our pipeline is growing. We saw a very active Q4, a very strong Q4 in terms of our new client conversions. And we move in with momentum to 2024 along those lines. That is, we believe, the result of the end market improving as well as our shift of resources towards those other opportunities. And what I would share as it relates to thinking forward to what that means for 2025, we believe that 10% to 15% growth will be pretty balanced between tech and services. And it won’t heavily skewed towards TEMS. It will meaningfully have TEMS contributing to that overall growth, but there will be meaningful tech growth as well. And as part of that balanced theme that I think we are excited about, we are encouraged by that we see in our pipeline that there are meaningful tech growth opportunities and meaningful TEMS growth opportunities.

We are shifting some growth resources a little bit more towards those tech opportunities because that represents really meaningful profitable growth. And we do believe that profitability will be the primary way we can create shareholder value from a shareholder return perspective. So, we are prioritizing that, but we will still continue to have a mix of meaningful tech opportunities, meaningful services opportunities that we pursue. And a large proportion of those services opportunities are proving to be those TEMS opportunities.

Bryan Hunt: To your question, Dave, around kind of in-year P&L contribution dynamics, what we are anticipating for revenue in 2024 is just given the bookings results in 2023 with that 100% dollar-based retention rate as well as a little bit heavier weighting towards Q4 2023 bookings for new client additions. We will see a little lower revenue growth in the first half of 2024, as those new deals do take a couple of few months to start ramping onto the P&L. And then with the deal that we just recently signed, the TEMS expansion, we mentioned that, that will start ramping towards mid-year and so we do anticipate to what Dan shared, that both technology and services will ramp from a revenue growth standpoint in the second half of 2024.

As we ramp towards that 10% to 15% growth rate in 2025, we likely won’t be at the 10% to 15% growth rate in the second half of 2024, but we will be ramping towards that. And then we will have a meaningful, as you would expect, bookings season in the back half of 2024 as well that will lead to that confidence in that revenue trajectory for 2025.

Operator: Our next question comes from Scott Schoenhaus, KeyBanc.

Unidentified Analyst: Hey guys. This is Steve on for Scott. I just want to ask about the margin cadence on tech-enabled managed services. Should we continue to expect no margin contribution in the first year for technology help to augment this? Thanks.

Dan Burton: Yes. Great question, Steve. So, we continue to see the tech-enabled managed services client relationships and margin profile that is actually occurring consistent with what we have seen in the past. And we do have optimism about the impact that some of our technology investments, both in terms of technology that we have acquired recently with the ERS acquisition, with the ARMUS acquisition as well as some of our AI pilots, where generative AI is providing us, for example, in charter traction with some meaningful efficiency gains, but that will be a tailwind for us as we think about the gross margin profile evolution. That has helped us to kind of stay on track and we hope in the future, but we are early to have some tailwind as it relates to that progression. But we continue to see consistency of margin expansion and improvement in those tech enabled managed services opportunities like what we have seen in the past.

Operator: Our next question comes from Sarah James, Cantor Fitzgerald.

Sarah James: Thank you and congratulations to Bryan, Jason, and Dan on your new positions. Can you talk about your assumptions on cross-selling embedded in your 2025 and ‘28 guide, does that assume that the dollar-based retention stays in the 104 to 110 range? And how much of the top line growth is coming from cross-selling? And where do you think penetration into your existing book will be when you hit the ‘28 numbers?

Dan Burton: Yes, great question, Sarah. Thank you. I will share a few thoughts and then Bryan, please add as well. So, when we think about the cross-selling motion, first of all, one of the things that we are encouraged by is the fact that over the last several years, we have dramatically expanded the number of clients where we have some form of existing client relationship. We are now over 600 healthcare organizations, where we have an existing client relationship. Now, 109 of those are a more full enterprise level DOS kind of client relationship. But that does offer us more than 500 existing clients that are more at the apps layer that provide us with a meaningful opportunity for cross-sell of DOS or our data platform into that base.

And then in the other direction as well, meaningful opportunities with our DOS subscription base to sell into more applications and see expansion there. On that first motion, that really shows up when we sell an app layer client on the data platform, that contributes to our ability to add more and more net new DOS subscription clients over time. As a note, last year, a majority of the net new DOS subscription clients that we added came from that pool of existing clients at the apps layer that hadn’t yet adopted the data platform. So, we are encouraged to see that cross-selling motion adding to our confidence level in 2024 and beyond in adding more and more data platform clients. And then going the other direction, we are also encouraged to see meaningful interest, meaningful opportunity within our DOS subscription client base to cross-sell new application capabilities that we have either built or we have recently acquired.