HealthStream, Inc. (NASDAQ:HSTM) Q3 2023 Earnings Call Transcript

And I think our goal is to get to a place where we can say that, Bobby the nurse on credentialing, is the same Bobby the nurse on NurseGrid, is the same Bobby, the nurse on our learning application, and they spend 3 hours here and 1 hour here and 10 minutes there each week. And this hStream ID technology that we’re rolling out now will help us reconcile all that. And we’ll get to a better numerator-denominator around the subscriber number versus the subscriptions sold to these kind of application suites and their supporting infrastructure. So that’s a long way of saying we’re trying to move to a single platform metric kind of goal where we can get to this revenue per person per year. And then we may or may not break it down by categories like learning and scheduling, but you can see our extreme focus on at the account level to grow the revenue per person per year.

And — we’re just not quite there yet. The metric itself isn’t mature enough and it’s not wired to all of our applications, so it can’t be used yet like a cable company would, where you can say revenue per person per year company-wide per product category. But that’s where we’re headed. And we’ve launched new scorecards internally so our product managers can start to know like, “Well, my product adds $2 per person per year to the overall metric. And so my hope is the next year or so, we can refine these metrics further. So they’ll be a little bit more correlated to the growth trajectory. We’ll get them connected technologically to more of the application so that all applications are contributing to the denominator of that measure, adding hStream subscribers.

And also, we’ve got a team of people working hard to reconcile the unique subscribers. So that we know that Bobby on hStream for learning is the same Bobby on hStream for scheduling. So that’s a long way of saying, you’re right. We don’t want to be segmented into these 3 application suites. Instead, we want to be thought of a single platform, almost the way you think Apple issues 1 billion Apple IDs, and that’s the way they think of 1 billion users of their ecosystem, and then they start to think about where they’re getting them to invest and spend money across that ecosystem. So we’re trying to be a single platform company and we’re working hard at structuring our application suites and our infrastructure to support that form of metric instead of breaking out per product.

Because we have so many products in the eco of the system that it makes a little less sense, maybe the product managers in my company, they all know that I have 300,000 subscribers at $2 per year on my product, but we already have over 50 products that generate $1 million a year. And so we’re thinking much more portfolio-like and then aggregating it around the users, and that’s where we want to get with the hStream metric someday. But right now, it’s a little bit of a disconnected metric. We’ve been reporting it for a while. Definitely better up and down. But in the coming quarters and years, it’s going to be much more meaningful.

Richard Close: Okay. That’s very helpful. And then Scotty, I was going to ask with the subscription model, I thought the guidance range for revenue seemed a little bit wide, but just wanted to go back in terms of your added commentary. So you’re expecting to be roughly at the trending towards the midpoint of the revenue range?

Scott Roberts: Yes. Richard, that’s where we are forecasting. That’s the remarks that I made.

Richard Close: Okay. I just wanted to clarify that. That’s really helpful. And then, Scotty, maybe on the product expenses, I was curious, it declined sequentially. Was there — if I go back to last quarter, I thought you said you’re going to continue to invest and whatnot. But I was just curious if there was anything specific from, call it, second quarter to third quarter that led to that sequential step down I’m not mistaken?

Scott Roberts: Yes. No. I think relative to last year, it was down. I have to go check my numbers on sequential. But I think in my remarks, just pointing out that capitalized software development continues to increase for us. We’re obviously putting more emphasis on product development and just the mix of projects that are ongoing and how that translated into what was capital versus expense implants year-over-year. I’ll go back and look at sequential activity. But I think — as we mentioned, as Bobby mentioned just a few moments ago about staffing and it was fairly flat in the quarter. And so from a cost perspective, a lot of movement in the cost structure. And as Bobby also mentioned, as we have departures, we’re looking strategically at how to reinvest those freed up dollars to put back into the company may not be an equal trade-off on 1 position leaving and no one coming in.

So we’re being more strategic about how we deploy those funds back into the business as well.

Richard Close: Okay. I guess my final question is, I thought it was interesting on the $3 million of revenue year-to-date. I believe that’s myClinicalExchange. And Bobby, can you just remind me like who’s paying you guys that $3 million? Is that the nursing schools or the nursing students themselves?

Robert Frist: Yes, yes, that’s great question. It’s a really fascinating model, we’re excited about it. Here’s how it works. The software — the hospital gets some software as part of the solution set. It allows them to pick through the students and choose who get a rotation and also take their preliminary application in for the rotation. So the hospital has some software. The nursing school did some software. So they can see the profile of their students that they’re pushing forward into the hospital network. And the student also has software access. They get access to build their profile, essentially a little bit like LinkedIn, so they can kind of profile themselves. And the model is set up so that along that chain, almost anyone can choose to pay for it.

And so it’s about — I believe it’s about $30 per person per applicant essentially. And about half of the market lets the student pay. And so when the student enters their credit card and they pay the $29, they get access to this network and that helps them find a rotation. In some cases, about the other half, I’d say, the hospitals choose to pay as part of almost recruiting future talent. And so it’s about 50-50 of the $3 million, I believe, half paid by hospitals and half paid by the student. And in some cases, they make it kind of part of the program at the nursing school. So it would be almost like the school pays and gets reimbursed. But the easiest way to think about it, about 50% is paid self-paid by the student and about 50% by the hospital.

And the hospitals are largely the ones that decide which model to adopt. They can say, push the application fee out to the applicant or they can choose to pay for, for their network.

Richard Close: And then is there any tie-in to like myClinicalExchange and the nursing app that — what was it nurse…

Robert Frist: NurseGrid.

Richard Close: Is there — is there any integration between these 2 things?