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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, DC 20549


Form 10-Q


(Mark One)

 

    QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2017

OR

 

    TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

Cotiviti Holdings, Inc.

(Exact name of registrant as specified in its charter)


Delaware

(State or other jurisdiction of incorporation)

 

001-37787
(Commission
File Number)

46-0595918
(IRS Employer
Identification No.)

115 Perimeter Center Place
Suite 700
Atlanta, GA 30346
(Address of principal executive offices)

30346
(Zip Code)

 

(770) 379-2800

(Registrant’s telephone number, including area code)


 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes ☒   No ☐

 

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).  Yes ☒  No ☐

 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b‑2 of the Exchange Act. (Check one):

 

Large accelerated filer

Accelerated filer

 

 

 

 

Non-accelerated filer

☒ (Do not check if a smaller reporting company)

Smaller reporting company

Emerging growth company

 

 

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☒

 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes ☐   No ☒

 

The number of shares of the registrant’s common stock, $0.001 par value, outstanding as of June 30, 2017 was 92,168,017.

 

 

 


 

i


 

Definitions

 

As used in this Quarterly Report on Form 10-Q for the period ended June 30, 2017 (this “Quarterly Report on Form 10‑Q” or this “Report”), the following abbreviations and terms have the meanings as listed below. Additionally, the terms “Cotiviti,” “we,” “us” and “our” refer to Cotiviti Holdings, Inc. and its consolidated subsidiaries, unless the context clearly indicates otherwise. The term “Cotiviti Holdings” refers only to Cotiviti Holdings, Inc. and not to any of its subsidiaries. Unless and as otherwise stated, any references in this Quarterly Report to any agreement means such agreement and all schedules, exhibits and attachments in each case as amended, restated, supplemented or otherwise modified to the date of filing this Quarterly Report.

 

2016 Plan: refers to the Cotiviti Holdings, Inc. 2016 Equity Incentive Plan.

 

Adjusted EBITDA: refers to net income (loss) to Cotiviti before depreciation and amortization, interest expense, other non-operating (income) expense, income tax expense (benefit), transaction-related expenses and other and stock-based compensation.

 

Affordable Care Act: refers to the Patient Protection and Affordable Care Act of 2010.

 

ASC: refers to the FASB Accounting Standards Codification.

 

ASU: refers to Accounting Standards Update issued by the FASB.

 

CMS: refers to the Centers for Medicare and Medicaid Services, the United States federal agency which administers Medicare and Medicaid.

 

EPS: refers to earnings per share.

 

Exchange Act: refers to the United States Securities Exchange Act of 1934, as amended.

 

FASB: refers to the Financial Accounting Standards Board.

 

First Lien Credit Facilities: refers to the First Lien Term A Loan in the original principal amount of $250.0 million, the First Lien Term B Loan in the original principal amount of $550.0 million and the $100.0 million Revolver under the Restated Credit Agreement.

 

First Lien Term A Loan: refers to the first lien term A loan in the original principal amount of $250.0 million under our Restated Credit Agreement.

 

First Lien Term B Loan: refers to the first lien term B loan in the original principal amount of $550.0 million under our Restated Credit Agreement.

 

First Lien Term Loan: refers, collectively, to the First Lien Term A Loan and the First Lien Term B Loan under our Restated Credit Agreement.

 

GAAP: refers to generally accepted accounting principles in the United States.

 

HIPAA: we collectively refer to the United States Health Insurance Portability and Accountability Act of 1996, as amended by the HITECH Act, together with their implementing regulations including the Omnibus Final Rule, as “HIPAA”.

 

HITECH: refers to the United States Health Information Technology for Economic and Clinical Health Act of 2009, enacted as part of the American Recovery and Reinvestment Act of 2009, which amended HIPAA.

 

ICD-10: refers to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical classification list adopted by the World Health Organization containing codes for, among other things, diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases.

ii


 

 

iHealth Technologies: refers to iHealth Technologies, Inc., a predecessor name of a wholly-owned subsidiary.

 

Initial First Lien Credit Facilities: refers to the Initial First Lien Term Loan and the Initial First Lien Revolver.

 

Initial First Lien Term Loan: refers to the first lien term loan in the original principal amount of $810.0 million under our Initial Secured Credit Facilities.

 

Initial First Lien Revolver: refers to the $75.0 million first lien revolving facility under our Initial Secured Credit Facilities.

 

Initial Second Lien Credit Facility: refers to the second lien term loan in the original principal amount of $265.0 million under our Initial Secured Credit Facilities.

 

Initial Secured Credit Facilities: refers to the loans provided pursuant to the First Lien Credit Agreement, dated as of May 14, 2014, entered into by our subsidiary Cotiviti Corporation and certain of our other subsidiaries, as borrowers and/or guarantors, the lenders named therein, as lenders, and the agents named therein, pursuant to which the lenders agreed to provide the Initial First Lien Credit Facilities, comprising the $810.0 million Initial First Lien Term Loan and the $75.0 million Initial First Lien Revolver, and the $265.0 million Initial Second Lien Credit Facility. The Initial Secured Credit Facilities were refinanced in September 2016 with the First Lien Credit Facilities pursuant to the Restated Credit Agreement.

 

IPO: refers to an initial public offering of common equity.

 

IT: refers to information technology.

 

JOBS Act: refers to the United States Jumpstart Our Business Startups Act of 2012.

 

LIBOR: refers to the London inter-bank offered rate.

 

Medicaid: refers to the means-tested United States government health care insurance program for people of all ages, jointly funded by state and federal governments and managed by the states. The Social Security Amendments of 1965 created Medicaid by adding Title XIX to the Social Security Act of 1935.

 

Medicare: refers to the United States government health care insurance program providing health insurance to people age 65 and older, regardless of income or medical history, as well as people of all ages with disabilities and certain medical conditions. The Social Security Amendments of 1965 created Medicare by adding Title XVIII to the Social Security Act of 1935.

 

Medicare RAC: refers to a Medicare Recovery Audit Contractor; we are one of the Medicare RACs for CMS under the Medicare Recovery Audit Program.

 

NYSE: refers to the New York Stock Exchange, on which our shares are listed under the symbol “COTV.”

 

Omnibus Final Rule: refers to the Final Omnibus Privacy, Security, Breach Notification and Enforcement Rules, implemented in 2013, which amended the original Privacy, Security, Breach Notification and Enforcement Rules under HIPAA, as directed pursuant to the HITECH Act.

 

Restated Credit Agreement: refers to the Amended and Restated First Lien Credit Agreement, dated as of September 28, 2016, as amended on April 7, 2017, entered into by our subsidiary Cotiviti Corporation and certain other of our subsidiaries, as borrowers and/or guarantors, the lenders named therein, as lenders, and the agents named therein, pursuant to which the lenders agreed to provide the First Lien Credit Facilities comprising the First Lien Term A Loans in the original principal amount of $250.0 million, the First Lien Term B Loans in the original principal amount of $550.0 million and the $100.0 million Revolver.

 

Revolver: refers to the $100.0 million first lien revolving credit facility under our Restated Credit Agreement.

 

iii


 

RSUs: refers to restricted stock units.

 

Sarbanes-Oxley Act: refers to the United States Sarbanes-Oxley Act of 2002.

 

SEC: refers to the United States Securities and Exchange Commission.

 

SG&A: refers to selling, general and administrative.

 

iv


 

PART I - FINANCIAL INFORMATION

 

ITEM 1.   Consolidated Financial Statements

 

Cotiviti Holdings, Inc.

Consolidated Balance Sheets

(In thousands, except share and per share amounts)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

June 30, 

 

December 31, 

 

 

    

2017

    

2016

 

 

 

(Unaudited)

 

 

 

 

ASSETS

 

 

 

 

 

 

 

Current assets:

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

137,426

 

$

110,635

 

Restricted cash

 

 

8,548

 

 

9,103

 

Accounts receivable, net of allowance for doubtful accounts of $275 and $851 at June 30, 2017 and December 31, 2016, respectively; and net of estimated allowance for refunds and appeals of $32,648 and $41,020 at June 30, 2017 and December 31, 2016, respectively

 

 

87,215

 

 

67,735

 

Prepaid expenses and other current assets

 

 

29,860

 

 

14,957

 

Total current assets

 

 

263,049

 

 

202,430

 

Property and equipment, net

 

 

73,928

 

 

67,640

 

Goodwill

 

 

1,196,389

 

 

1,196,024

 

Intangible assets, net

 

 

502,997

 

 

533,305

 

Other long-term assets

 

 

2,415

 

 

2,864

 

TOTAL ASSETS

 

$

2,038,778

 

$

2,002,263

 

LIABILITIES AND STOCKHOLDERS' EQUITY

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

 

 

Current maturities of long-term debt

 

$

18,000

 

$

18,000

 

Customer deposits

 

 

8,548

 

 

9,103

 

Accounts payable and accrued other expenses

 

 

27,370

 

 

23,162

 

Accrued compensation costs

 

 

37,967

 

 

58,589

 

Estimated liability for refunds and appeals

 

 

57,635

 

 

62,539

 

Total current liabilities

 

 

149,520

 

 

171,393

 

Long-term liabilities:

 

 

 

 

 

 

 

Long-term debt

 

 

757,218

 

 

762,202

 

Other long-term liabilities

 

 

5,758

 

 

8,799

 

Deferred tax liabilities

 

 

123,178

 

 

120,533

 

Total long-term liabilities

 

 

886,154

 

 

891,534

 

Total liabilities

 

 

1,035,674

 

 

1,062,927

 

Commitments and contingencies (Note 6)

 

 

 

 

 

 

 

Stockholders' equity:

 

 

 

 

 

 

 

Common stock ($0.001 par value; 600,000,000 shares authorized, 92,168,017 and 90,748,740 issued, and 92,168,017 and 90,741,340 outstanding at June 30, 2017 and December 31, 2016, respectively)

 

 

92

 

 

91

 

Additional paid-in capital

 

 

926,548

 

 

911,582

 

Retained earnings

 

 

81,980

 

 

33,917

 

Accumulated other comprehensive loss

 

 

(5,516)

 

 

(6,156)

 

Treasury stock, at cost (7,400 shares at December 31, 2016)

 

 

 —

 

 

(98)

 

Total stockholders' equity

 

 

1,003,104

 

 

939,336

 

TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY

 

$

2,038,778

 

$

2,002,263

 

 

See accompanying notes to consolidated financial statements.

1


 

Cotiviti Holdings, Inc.

Consolidated Statements of Comprehensive Income

(In thousands, except share and per share amounts)

(Unaudited)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

    

2016

    

2017

    

2016

    

Net revenue

 

$

167,611

 

$

158,291

 

$

327,744

 

$

301,009

 

Cost of revenue (exclusive of depreciation and amortization, stated separately below):

 

 

 

 

 

 

 

 

 

 

 

 

 

Compensation

 

 

58,870

 

 

55,285

 

 

115,158

 

 

108,746

 

Other costs of revenue

 

 

6,123

 

 

5,275

 

 

12,809

 

 

10,673

 

Total cost of revenue

 

 

64,993

 

 

60,560

 

 

127,967

 

 

119,419

 

Selling, general and administrative expenses (exclusive of depreciation and amortization, stated separately below):

 

 

 

 

 

 

 

 

 

 

 

 

 

Compensation

 

 

25,564

 

 

23,176

 

 

50,257

 

 

42,286

 

Other selling, general and administrative expenses

 

 

15,300

 

 

14,945

 

 

32,179

 

 

30,174

 

Total selling, general and administrative expenses

 

 

40,864

 

 

38,121

 

 

82,436

 

 

72,460

 

Depreciation and amortization of property and equipment

 

 

5,896

 

 

4,811

 

 

11,471

 

 

9,646

 

Amortization of intangible assets

 

 

15,201

 

 

15,208

 

 

30,400

 

 

30,415

 

Transaction-related expenses

 

 

661

 

 

653

 

 

1,392

 

 

893

 

Total operating expenses

 

 

127,615

 

 

119,353

 

 

253,666

 

 

232,833

 

Operating income

 

 

39,996

 

 

38,938

 

 

74,078

 

 

68,176

 

Other expense (income):

 

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense

 

 

8,538

 

 

14,660

 

 

16,959

 

 

30,720

 

Loss on extinguishment of debt

 

 

3,183

 

 

7,068

 

 

3,183

 

 

7,068

 

Other non-operating (income) expense

 

 

(556)

 

 

(359)

 

 

(1,009)

 

 

(658)

 

Total other expense (income)

 

 

11,165

 

 

21,369

 

 

19,133

 

 

37,130

 

Income before income taxes

 

 

28,831

 

 

17,569

 

 

54,945

 

 

31,046

 

Income tax expense

 

 

7,743

 

 

6,676

 

 

6,882

 

 

12,069

 

Net income

 

$

21,088

 

$

10,893

 

$

48,063

 

$

18,977

 

Other comprehensive (loss) income, net of tax:

 

 

 

 

 

 

 

 

 

 

 

 

 

Foreign currency translation adjustments

 

 

452

 

 

(645)

 

 

509

 

 

(671)

 

Change in fair value of derivative instruments

 

 

193

 

 

(84)

 

 

131

 

 

(566)

 

Total other comprehensive (loss) income

 

 

645

 

 

(729)

 

 

640

 

 

(1,237)

 

Comprehensive income

 

$

21,733

 

$

10,164

 

$

48,703

 

$

17,740

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic

 

$

0.23

 

$

0.13

 

$

0.52

 

$

0.24

 

Diluted

 

 

0.22

 

 

0.13

 

 

0.51

 

 

0.24

 

 

See accompanying notes to consolidated financial statements.

2


 

Cotiviti Holdings, Inc.

Consolidated Statements of Cash Flows

(In thousands)

(Unaudited)

 

 

 

 

 

 

 

 

 

 

 

Six Months Ended

 

 

 

June 30, 

 

 

    

2017

    

2016

 

Cash flows from operating activities:

 

 

 

 

 

 

 

Net income

 

$

48,063

 

$

18,977

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

 

 

Deferred income taxes

 

 

2,588

 

 

(9,797)

 

Depreciation and amortization

 

 

41,871

 

 

40,061

 

Stock-based compensation expense

 

 

4,538

 

 

4,502

 

Amortization of debt issuance costs

 

 

1,494

 

 

2,675

 

Accretion of asset retirement obligations

 

 

98

 

 

92

 

Loss on extinguishment of debt

 

 

3,183

 

 

7,068

 

Changes in operating assets and liabilities:

 

 

 

 

 

 

 

Restricted cash

 

 

555

 

 

3,176

 

Accounts receivable

 

 

(19,480)

 

 

4,182

 

Other assets

 

 

(14,471)

 

 

8,937

 

Customer deposits

 

 

(555)

 

 

(3,176)

 

Accrued compensation

 

 

(20,622)

 

 

(5,127)

 

Accounts payable and accrued other expenses

 

 

(194)

 

 

(1,295)

 

Estimated liability for refunds and appeals

 

 

(4,904)

 

 

2,799

 

Other long-term liabilities

 

 

372

 

 

98

 

Other

 

 

(236)

 

 

(598)

 

Net cash provided by operating activities

 

 

42,300

 

 

72,574

 

Cash flows from investing activities:

 

 

 

 

 

 

 

Expenditures for property and equipment

 

 

(16,593)

 

 

(14,019)

 

Other investing activities

 

 

 —

 

 

1,181

 

Net cash used in investing activities

 

 

(16,593)

 

 

(12,838)

 

Cash flows from financing activities:

 

 

 

 

 

 

 

Net proceeds from issuance of common stock

 

 

 —

 

 

226,929

 

Proceeds from exercise of stock options

 

 

10,546

 

 

56

 

Dividends paid

 

 

 —

 

 

(150,000)

 

Payment of debt issuance costs

 

 

(661)

 

 

 —

 

Repayment of debt

 

 

(9,000)

 

 

(240,150)

 

Net cash provided by (used in) financing activities

 

 

885

 

 

(163,165)

 

Effect of foreign exchanges on cash and cash equivalents

 

 

199

 

 

(233)

 

Net increase (decrease) in cash and cash equivalents

 

 

26,791

 

 

(103,662)

 

Cash and cash equivalents at beginning of period

 

 

110,635

 

 

149,365

 

Cash and cash equivalents at end of the period

 

$

137,426

 

$

45,703

 

Supplemental disclosures of cash flow information:

 

 

 

 

 

 

 

Cash paid for income taxes

 

$

16,977

 

$

11,268

 

Cash paid for interest

 

 

14,343

 

 

27,795

 

Noncash investing activities (accrued property and equipment purchases)

 

 

9,340

 

 

11,779

 

 

See accompanying notes to consolidated financial statements

 

 

3


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements

(In thousands, except shares and per share amounts)

(Unaudited)

 

Note 1. Description of Business

 

Cotiviti Holdings, Inc. (collectively with its subsidiaries, “we,” “our,” “Cotiviti” or the “Company”) is a leading provider of payment accuracy and analytics‑driven solutions that help risk-bearing healthcare organizations and retailers achieve their business objectives. Through a combination of analytics, technology and deep industry experience, our solutions create insights that unlock value from the complex interactions between clients’ and their stakeholders. We work with over 60 healthcare organizations, including more than 20 of the 25 largest U.S. commercial, Medicare and Medicaid managed health plans, as well as CMS. We are also a leading provider of payment accuracy solutions to approximately 35 retail clients, including eight of the ten largest retailers in the United States.

 

Note 2. Summary of Significant Accounting Policies

 

Basis of Presentation

 

Our accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. Generally Accepted Accounting Principles (“GAAP”). All significant intercompany balances and transactions have been eliminated in consolidation. These consolidated financial statements are unaudited and have been prepared by us following the rules and regulations of the SEC. In our opinion they reflect all adjustments, including normal recurring items, that are necessary to present fairly the results of interim periods. Certain information and footnote disclosures normally included in financial statements prepared in accordance with GAAP have been condensed or omitted as permitted by such rules and regulations; however, we believe that the disclosures are adequate to make the information presented not misleading. Operating results for the periods presented herein are not necessarily indicative of the results that may be expected for other interim periods or the entire fiscal year. Certain prior year amounts have been reclassified to conform to the current year presentation.

 

Estimated Liability for Refunds and Appeals and Unbilled Receivables

 

The estimated liability for refunds and appeals representing our estimate of claims that may be overturned related to revenue which had already been received was $57,635 and $62,539 at June 30, 2017 and December 31, 2016, respectively. The estimated allowance for refunds and appeals representing our estimate of claims that may be overturned related to amounts in accounts receivable was $32,648 and $41,020 at June 30, 2017 and December 31, 2016, respectively.

 

Unbilled receivables represent revenue recognized related to claims for which clients have received economic value that were not invoiced at the balance sheet date. Unbilled receivables of approximately $57,340 and $51,643 as of June 30, 2017 and December 31, 2016, respectively, are included in accounts receivable on our Consolidated Balance Sheets.

 

Certain unbilled receivables arise when a portion of our earned fee is deferred at the time of the initial invoice. At a later date (which can be up to a year after original invoice, and at other times during the year after completion of the audit period based on contractual terms or as agreed with our client), we invoice the unbilled receivable amount. Notwithstanding the deferred due date, our clients acknowledge we have earned this unbilled receivable at the time of the original invoice, but we have agreed to defer billing the client for the related services. Unbilled receivables of this nature were approximately $5,732 and $6,137 as of June 30, 2017 and December 31, 2016, respectively, and are included in accounts receivable on our Consolidated Balance Sheets.

 

We record periodic changes in unbilled receivables and refund liabilities as adjustments to revenue.

 

4


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

Recently Issued Accounting Standards

 

In April 2017, the FASB issued ASU 2017-09, Scope of Modification Accounting (“ASU 2017-09”), which addresses what constitutes a modification when applying the guidance in ASC 718 Compensation- Stock Compensation in order to reduce diversity in practice. The guidance is effective for public companies with annual reporting periods beginning after December 15, 2017,  including interim periods within that reporting period. Early adoption is permitted. We are evaluating this new guidance and its impact on our consolidated financial statements and related disclosures.

 

In January 2017, the FASB issued ASU 2017-04, Simplifying the Test for Goodwill Impairment (“ASU 2017-04”), which is intended to simplify how an entity is required to test goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Step 2 measures a goodwill impairment loss by comparing the implied fair value of a reporting unit’s goodwill with the carrying amount of the goodwill. Instead, an entity should compare the fair value of a reporting unit with its carrying amount and recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value. The loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. The guidance is effective for public companies with annual reporting periods beginning after December 15, 2019, including interim periods within those annual periods. We have early adopted the provisions of ASU 2017-04 as of April 1, 2017. As the fair values of our reporting units exceed their carrying values, there has been no impact on our consolidated financial statements.

 

In November 2016, the FASB issued ASU 2016-18, Restricted Cash (“ASU 2016-18”), which requires that restricted cash be included with cash and cash equivalents when reconciling the beginning and end of period total amounts shown on the statement of cash flows. The guidance is effective for public companies with annual reporting periods beginning after December 15, 2017, including interim periods within those annual periods. Early adoption is permitted. We are evaluating this guidance and its impact on our consolidated financial statements and related disclosures and expect the adoption of this ASU could impact the disclosure of our cash flows from operations.

 

In August 2016, the FASB issued ASU 2016-15, Classification of Certain Cash Receipts and Cash Payments (“ASU 2016-15”) which addresses eight specific cash flow issues in order to reduce diversity in practice. The guidance is effective for public companies with annual reporting periods beginning after December 15, 2017, including interim periods within those annual periods. Early adoption is permitted. We are evaluating this guidance and its impact on our consolidated financial statements and related disclosures.

 

In February 2016, the FASB issued ASU 2016-02, Leases (“ASU 2016-02”) which changes the accounting recognition, measurement and disclosure for leases in order to increase transparency. ASU 2016-02 requires lease assets and liabilities to be recognized on the balance sheet and key information about leasing arrangements to be disclosed. The guidance is effective for public companies with annual reporting periods beginning after December 15, 2018, including interim periods within that reporting period. Early adoption is permitted. We are evaluating this new guidance and its impact on our consolidated financial statements and related disclosures.

 

In January 2016, the FASB issued ASU 2016-01, Recognition and Measurement of Financial Assets and Financial Liabilities (“ASU 2016-01”) which changes the current financial instruments model primarily impacting the accounting for equity investments, financial liabilities under the fair value option, and the presentation and disclosure requirements for financial instruments. The guidance is effective for public companies with annual reporting periods beginning after December 15, 2017, including interim periods within that reporting period. We are evaluating this new guidance and do not believe it will have a material impact on our consolidated financial statements and related disclosures.

 

In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers (Topic 606) (“ASU 2014-09”), which supersedes existing revenue recognition guidance and provides clarification of principles for recognizing revenue from contracts with customers. ASU 2014-09 sets forth a five-step model for determining when and how revenue is recognized. The core principle of the new standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. Additional disclosures will be required to describe the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts. The two permitted transition methods

5


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

under ASU 2014-09 are the full retrospective method, in which case the new guidance would be applied to each prior reporting period presented and the cumulative effect of applying the standard would be recognized at the earliest period shown, or the modified retrospective method, in which case the cumulative effect of applying the standard would be recognized at the date of the initial application. The guidance is effective for public companies with annual periods beginning after December 15, 2017, including interim periods within that reporting period. The FASB will permit companies to adopt the new standard early, but not before the original effective date of annual reporting periods beginning after December 15, 2016.

 

In 2016, we formed an internal team to evaluate and quantify the potential impact of this new revenue guidance. As of the date of this filing, we have completed our contract review and policy drafting. Based on our review, we believe the timing of revenue recognition will not change from current practice. We are in the process of completing a contract review and evaluating the impact of this new guidance as it relates to the RowdMap, Inc. acquisition as discussed in Note 15. We plan to adopt as of January 1, 2018 using the modified retrospective method. Adoption of this standard will require changes to our business processes, systems and controls to support the additional required disclosures. We are in the process of identifying and designing such changes to ensure our readiness. We will provide additional information about the impact of this new guidance, including enhanced disclosure requirements, in future filings. 

 

Note 3. Property and Equipment

 

Property and equipment by major asset class for the periods presented consisted of the following:

 

 

 

 

 

 

 

 

 

 

    

June 30, 

    

December 31, 

 

 

    

2017

    

2016

 

Computer equipment

 

$

43,371

 

$

40,349

 

Software

 

 

60,991

 

 

42,614

 

Furniture and fixtures

 

 

8,969

 

 

8,652

 

Leasehold improvements

 

 

5,104

 

 

4,392

 

Projects in progress

 

 

6,897

 

 

12,001

 

Property and equipment, gross

 

$

125,332

 

$

108,008

 

Less: accumulated depreciation and amortization

 

 

51,404

 

 

40,368

 

Property and equipment, net

 

$

73,928

 

$

67,640

 

 

In December 2015, we purchased a perpetual software license, which is included in the software total above. We are paying for this software over a two year period ending in January 2018. As such, there is approximately $3,287 and $3,351 included in accounts payable and accrued other expenses on our Consolidated Balance Sheets as of June 30, 2017 and December 31, 2016, respectively, and $3,225 included in other long-term liabilities on our Consolidated Balance Sheets as of December 31, 2016.

 

Total depreciation and amortization expense related to property and equipment, including capitalized software costs, was $5,896 and $4,811 for the three months ended June 30, 2017 and 2016, respectively, and $11,471 and $9,646 for the six months ended June 30, 2017 and 2016, respectively.

 

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Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

Note 4. Intangible Assets

 

Intangible asset balances by major asset class for the periods presented were as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    

 

 

    

 

 

    

 

 

    

Weighted

 

 

 

Gross

 

 

 

 

Net

 

Average

 

 

 

Carrying

 

Accumulated

 

Carrying

 

Amortization

 

 

    

Amount

    

Amortization

    

Amount

    

Period

 

June 30, 2017:

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer relationships

 

$

640,214

 

$

168,366

 

$

471,848

 

13.7

years

 

Acquired software

 

 

82,400

 

 

55,451

 

 

26,949

 

6.2

years

 

Connolly trademark

 

 

4,200

 

 

 —

 

 

4,200

 

   indefinite-lived

 

Total

 

$

726,814

 

$

223,817

 

$

502,997

 

12.8

years

 

December 31, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer relationships

 

$

640,052

 

$

144,768

 

$

495,284

 

13.7

years

 

Acquired software

 

 

82,400

 

 

48,579

 

 

33,821

 

6.2

years

 

Connolly trademark

 

 

4,200

 

 

 —

 

 

4,200

 

   indefinite-lived

 

Total

 

$

726,652

 

$

193,347

 

$

533,305

 

12.8

years

 

 

Amortization expense was $15,201 and $15,208 for the three months ended June 30, 2017 and 2016, respectively, and $30,400 and $30,415 for the six months ended June 30, 2017 and 2016, respectively.

 

As of June 30, 2017 amortization expense for the next 5 years is expected to be:

 

 

 

 

 

 

Remainder of 2017

   

$

27,434

 

2018

 

 

53,909

 

2019

 

 

53,909

 

2020

 

 

53,909

 

2021

 

 

49,586

 

 

 

Note 5. Goodwill

 

Total goodwill in our Consolidated Balance Sheets was $1,196,389 and $1,196,024 as of June 30, 2017 and December 31, 2016, respectively.

 

Changes in the carrying amount of goodwill by our Healthcare and Global Retail and Other segments for the six months ended June 30, 2017 were as follows:

 

 

 

 

 

 

 

 

 

 

    

 

 

    

Global Retail

 

 

 

Healthcare

 

and Other

 

December 31, 2016

 

$

1,147,771

 

$

48,253

 

Foreign currency translation

 

 

 —

 

 

365

 

June 30, 2017

 

$

1,147,771

 

$

48,618

 

 

There was no impairment related to goodwill for any period presented.

 

Note 6. Commitments and Contingencies

 

We may be involved in various legal proceedings and litigation arising in the ordinary course of business. While any legal proceeding or litigation has an element of uncertainty, management believes the ultimate disposition of these matters will not have a material adverse effect on our consolidated financial position, results of operations, or liquidity.

 

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Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

Medicare RAC Contract Contingency

 

In August 2014, CMS announced it would allow providers to remove all eligible claims currently pending in the appeals process by offering to pay hospitals 68% of the original claim amount. This settlement was offered to the providers and it was unknown what, if any, impact there would be for the Medicare RACs. On July 1, 2015, CMS issued a Technical Direction Letter to the Medicare RACs, including ourselves, indicating that Medicare RACs will only be entitled to the contract contingency fee on the settled amounts of the claims, or 32% of the original inpatient claim amounts. Based on the initial lists of finalized settlements provided by CMS, we would be required to refund CMS approximately $22,308 due to the related adjustments in Medicare RAC contingency fees. CMS further advised that as the hospital settlement project continues, additional settlement lists will be matched to Medicare RAC claims which may result in updated refund amounts to those initially provided. While there are uncertainties in any dispute resolution and results are uncertain, we have disputed CMS’s findings based on our interpretation of the terms of the Medicare RAC contract and our belief that the backup data provided by CMS is inaccurate and/or incomplete. Our liability for estimated refunds and appeals includes amounts for these settled claims based on our best estimates of the amount we believe will be ultimately payable to CMS based on our interpretation of the terms of the Medicare RAC contract. We believe that it is possible that we could be required to pay an additional amount up to approximately $13,000 in excess of the amount we accrued as of June 30, 2017 based on the claims data we have received from CMS to date. As CMS completes its settlement process with the providers and updated files are provided to us, the potential amount owed by us may change. On September 28, 2016, CMS announced a second settlement process to allow eligible providers to settle their inpatient claims currently under appeal beginning December 1, 2016. This second settlement process could result in additional amounts owed to CMS. CMS has not yet provided us with any information and accordingly the amount of any such additional claims cannot presently be determined.

 

Note 7. Long‑term Debt

 

In April 2017, we entered into and executed the First Amendment Agreement to the then outstanding Restated Credit Agreement, which, among other things, provided for a 25 basis point reduction in applicable interest rate spread over LIBOR associated with the First Lien Term B Loan. As a result, we recognized a loss on extinguishment of $3,183 during the three and six months ended June 30, 2017, which consists of fees paid and write-offs of unamortized debt issuance costs and original issue discount.

 

Long‑term debt for the periods presented was as follows:

 

 

 

 

 

 

 

 

 

 

    

June 30, 

    

December 31, 

 

 

    

2017

    

2016

 

First Lien Term A Loan

 

$

240,466

 

$

246,694

 

First Lien Term B Loan

 

 

542,982

 

 

544,345

 

Revolver

 

 

 —

 

 

 —

 

Total debt

 

 

783,448

 

 

791,039

 

Less: debt issuance costs

 

 

8,230

 

 

10,837

 

Less: current portion

 

 

18,000

 

 

18,000

 

Total long-term debt

 

$

757,218

 

$

762,202

 

 

The Restated Credit Agreement includes certain binding affirmative and negative covenants, including delivery of financial statements and other reports, maintenance of existence and transactions with affiliates. The negative covenants restrict our ability, among other things, to incur indebtedness, grant liens, make investments, sell or otherwise dispose of assets or enter into a merger, pay dividends or repurchase stock. There is a required financial covenant applicable only to the Revolver and the Term A Loan, pursuant to which we agree not to permit our Secured Leverage Ratio to exceed 5.50:1.00 through September 2018, 5.25:1.00 through September 2019 and 5.00:1.00 through June 2021. In addition, the Restated Credit Agreement includes certain events of default including payment defaults, failure to perform affirmative covenants, failure to refrain from actions or omissions prohibited by negative covenants, the inaccuracy of representations or warranties, bankruptcy and insolvency related defaults and a change of control default. We were in compliance with all such covenants as of June 30, 2017 and December 31, 2016, respectively.

 

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Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

The Restated Credit Agreement requires mandatory prepayments based upon our leverage ratio at the time payment is required and an annual excess cash flow calculation commencing with the year ended December 31, 2017. The mandatory prepayment is contingently payable in the second quarter of each year based on an annual excess cash flow calculation for the preceding year as defined within the Restated Credit Agreement. 

 

As of June 30, 2017, the aggregate maturities of long‑term debt (excluding any amounts that may become payable with respect to the aforementioned mandatory prepayment provision for annual excess cash flows) for each of the next five years are expected to be $9,000 for the remainder of 2017, $18,000 in 2018, $24,250 in 2019, $30,500 in 2020 and $183,625 in 2021. 

 

Note 8. Derivative Instruments

 

We are exposed to fluctuations in interest rates on our long‑term debt. We manage our exposure to fluctuations in the 3‑month LIBOR through the use of interest rate cap agreements designated as cash flow hedges. We are meeting our objective by hedging the risk of changes in cash flows related to changes in LIBOR by capping the interest on our floating rate debt linked to LIBOR to approximately 3%. We do not utilize derivatives for speculative or trading purposes.

 

As of June 30, 2017 and December 31, 2016, we had $540,000 in notional debt outstanding related to these interest rate caps, which cover quarterly interest payments through September 2019. The notional amount decreases over time.

 

All of our outstanding interest rate cap contracts qualify for cash flow hedge accounting treatment in accordance with ASC 815, Derivatives and Hedging. Cash flow hedge accounting treatment allows for gains and losses on the effective portion of qualifying hedges to be deferred in accumulated other comprehensive (loss) income until the underlying transaction occurs, rather than recognizing the gains and losses on these instruments in earnings during each period they are outstanding. When the actual interest payments are made on our variable rate debt and the related derivative contract settles, any effective portion of realized interest rate hedging derivative gains and losses previously recorded in accumulated other comprehensive (loss) income is recognized in interest expense. We recognized interest expense of $398 and $62 related to interest rate caps during the three months ended June 30, 2017 and 2016, respectively, and $599 and $144 during the six months ended June 30, 2017 and 2016, respectively.  

 

Ineffectiveness results, in certain circumstances, when the change in total fair value of the derivative instrument differs from the change in the fair value of our expected future cash outlays for the related interest payment and is recognized immediately in interest expense. There was no ineffectiveness recorded during the three and six months ended June 30, 2017 and 2016, respectively. Likewise, if the hedge does not qualify for hedge accounting, the periodic changes in its fair value are recognized in the period of the change in interest expense. All cash flows related to our interest rate cap agreements are classified as operating cash flows.

 

Any outstanding derivative instruments expose us to credit loss in the event of nonperformance by the counterparties to the agreements, but we do not expect that the counterparty will fail to meet their obligations. The amount of such credit exposure is generally the positive fair value of our outstanding contracts. To manage credit risks, we select counterparties based on credit assessments, limit our overall exposure to any single counterparty and monitor the market position of any counterparty.

 

The table below reflects quantitative information related to the fair value of our derivative instruments and where these amounts are recorded in our consolidated financial statements as of the period presented:

 

 

 

 

 

 

 

 

 

 

    

June 30, 

    

December 31, 

 

 

    

2017

    

2016

 

Liability fair value recorded in other long-term liabilities

 

$

1,507

 

$

1,729

 

Liability fair value recorded in accounts payable and accrued other expenses

 

 

1,019

 

 

1,065

 

Estimated amount of existing losses expected to be reclassified into earnings in the next 12 months

 

 

(2,446)

 

 

(1,783)

 

 

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Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

We record deferred hedge premiums which are being paid over the life of the hedge in accumulated other comprehensive (loss) income until the related hedge ultimately settles and interest payments are made on the underlying debt. As of June 30, 2017, we have made payments of $3,301 related to these deferred premiums. We expect to pay an additional $3,093 in deferred premiums through 2019 related to our outstanding interest rate cap agreements which is reflected in the fair value of these derivatives in the table above.

 

Comprehensive income includes changes in the fair value of our interest rate cap agreements which qualify for hedge accounting. Changes in other comprehensive income for the periods presented related to derivative instruments classified as cash flow hedges were as follows:

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended June 30, 

 

 

    

2017

    

2016

 

 

 

 

 

 

 

 

 

Balance at beginning of period, April 1

 

$

(3,396)

 

$

(3,450)

 

Reclassifications in earnings, net of tax of $150 and $24, respectively

 

 

249

 

 

38

 

Change in fair value of derivative instrument, net of tax of $35 and $184, respectively

 

 

(56)

 

 

(122)

 

Balance at end of period, June 30

 

$

(3,203)

 

$

(3,534)

 

 

 

 

 

 

 

 

 

 

 

 

Six Months Ended June 30, 

 

 

    

2017

    

2016

 

 

 

 

 

 

 

 

 

Balance at beginning of period, January 1

 

$

(3,334)

 

$

(2,968)

 

Reclassifications in earnings, net of tax of $225 and $56, respectively

 

 

374

 

 

88

 

Change in fair value of derivative instrument, net of tax of $150 and $509, respectively

 

 

(243)

 

 

(654)

 

Balance at end of period, June 30

 

$

(3,203)

 

$

(3,534)

 

 

 

Note 9. Fair Value Measurements

 

We measure assets and liabilities at fair value based on assumptions market participants would use in pricing an asset or liability in the principal or most advantageous market. Authoritative guidance on fair value measurements establishes a consistent framework for measuring fair value whereby inputs are assigned a hierarchical level. The hierarchical levels are:

 

Level 1: Unadjusted quoted prices in active markets for identical assets or liabilities accessible to the reporting entity at the measurement date.

 

Level 2: Observable prices, other than quoted prices included in Level 1 inputs for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability.

 

Level 3: Unobservable inputs for the asset or liability used to measure fair value to the extent observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at measurement date.

 

10


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

The following table summarizes our financial instruments measured at fair value within the Consolidated Balance Sheets:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

June 30, 2017

 

December 31, 2016

 

 

    

Level 1

    

Level 2

    

Level 3

    

Level 1

    

Level 2

    

Level 3

 

Liabilities:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Long-term debt

 

$

 —

 

$

 

$

783,448

 

$

 

$

 

$

791,039

 

Interest rate cap agreements

 

 

 

 

2,526

 

 

 

 

 

 

2,794

 

 

 

Total

 

$

 —

 

$

2,526

 

$

783,448

 

$

 —

 

$

2,794

 

$

791,039

 

 

The fair value of our private debt is determined based on fluctuations in current interest rates, the trends in market yields of debt instruments with similar credit ratings, general economic conditions and other quantitative and qualitative factors. The carrying value of our debt approximates its fair value. Refer to Note 7 for more information on our long-term debt.

 

The fair value of the interest rate cap agreements is determined using the market standard methodology of discounting the future expected variable cash receipts that would occur if interest rates rose above the strike rate of the caps. The analysis reflects the contractual terms of the derivatives, including period to maturity and remaining deferred premium payments, and uses observable market‑based inputs, including interest rates and implied volatilities. The variable cash receipts are based on an expectation of future interest rates (forward curves) derived from observable market interest rates. As such, the estimated fair values of these liabilities are classified as Level 2 in the fair value hierarchy. Refer to Note 8 for more information on our interest rate cap agreements.

 

Note 10. Income Taxes

 

The following table presents our income tax provision and effective income tax rate: 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

 

Six Months Ended

 

 

 

June 30, 

 

 

June 30, 

 

 

    

2017

    

2016

 

    

2017

    

2016

 

Income tax expense

 

$

7,743

 

$

6,676

 

 

$

6,882

 

$

12,069

 

Effective income tax rate

 

 

26.9

%  

 

38.0

%  

 

 

12.5

%  

 

38.9

%

 

Our effective income tax rate was 26.9% and 38.0% for the three months ended June 30, 2017 and 2016, respectively.  The decrease in the effective tax rate is primarily due to a $2,619 tax benefit related to stock option exercises during the quarter. Additionally, we realized a tax benefit of $660 related to the filing of amended state tax returns as a result of certain tax planning during the three months ended June 30, 2017. 

 

Our effective income tax rate was 12.5% and 38.9% for the six months ended June 30, 2017 and 2016 respectively. The decrease in the effective tax rate is primarily due to a $13,041 tax benefit related to stock option exercises, a tax benefit of $337 related to the settlement of an uncertain tax position due to the closure of our audit with the Internal Revenue Service as well as a tax benefit of $660 related to the filing of amended state tax returns as a result of certain tax planning. The decrease in income tax expense during the six months ended June 30, 2017 as compared to 2016 was primarily driven by these same tax benefits. 

 

We file income taxes with the U.S. federal government and various states and foreign jurisdictions. We operate in a number of state and local jurisdictions and as such are subject to state and local income tax examinations based upon various statutes of limitations in each jurisdiction. We are currently under audit by the State of New York for the tax year ended December 31, 2014 and for iHealth Technologies for the tax years ended December 31, 2012, December 31, 2013, May 13, 2014 and December 31, 2014.

 

11


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

Note 11. Stockholders’ Equity

 

Secondary Offering

 

On March 7, 2017 we completed a secondary offering of 9,683,000 shares of our common stock by certain of our stockholders, including 1,263,000 shares sold to the underwriters pursuant to their option to purchase additional shares, at an offering price of $36.00 per share. All of the shares offered were sold by selling stockholders. Accordingly, we did not receive any proceeds from the sale of the shares. In connection with this offering, we incurred approximately $600 in professional services expenses, which are included in transaction-related expenses on our Consolidated Statements of Comprehensive Income for the six months ended June 30, 2017.

 

Note 12. Earnings per Share

 

Basic earnings per share (“EPS”) is computed based on the weighted average number of shares of common stock outstanding during the period. Diluted EPS is computed based on the weighted average number of shares of common stock plus the effect of dilutive potential common shares outstanding during the period. For all periods presented, potentially dilutive outstanding shares consisted solely of equity incentive awards. Our potential common shares consist of the incremental common shares issuable upon the exercise of stock options or vesting of restricted stock units (“RSUs”). The dilutive effect of outstanding equity incentive awards is reflected in diluted earnings per share by application of the treasury stock method. For all periods presented, all outstanding common stock consisted of a single class.

 

Basic and diluted earnings per share are computed as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

    

2016

    

2017

    

2016

    

Net income available to common stockholders

 

$

21,088

 

$

10,893

 

$

48,063

 

$

18,977

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average outstanding shares of common stock

 

 

92,017,662

 

 

82,348,189

 

 

91,580,438

 

 

79,789,693

 

Dilutive effect of stock-based awards

 

 

3,237,257

 

 

764,846

 

 

3,510,428

 

 

729,249

 

Adjusted weighted average outstanding and assumed conversions for diluted EPS

 

 

95,254,919

 

 

83,113,035

 

 

95,090,866

 

 

80,518,942

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic

 

$

0.23

 

$

0.13

 

$

0.52

 

$

0.24

 

Diluted

 

 

0.22

 

 

0.13

 

 

0.51

 

 

0.24

 

 

Employee stock options and RSUs that were excluded from the calculation of diluted earnings per share because their effect is anti‑dilutive for the periods presented were as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

    

2016

    

2017

    

2016

    

 

 

 

 

 

 

 

 

 

 

Employee stock-based awards

 

572,623

 

1,598,231

 

467,677

 

1,598,231

 

 

The criteria associated with all of our outstanding performance-based stock options as defined in the terms of the applicable award agreements, were satisfied as of September 30, 2016 and, as a result, outstanding performance-based stock options were included in the calculation of diluted earnings per share for the three and six months ended June 30, 2017. Performance-based stock options of 2,788,817 were not included in the calculation of diluted earnings per share for the three and six months ended June 30, 2016 as the vesting conditions had not yet been satisfied.

 

12


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

Note 13. Stock‑Based Compensation

 

Stock Options

 

The following is a summary of stock option activity under the Plans:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted

 

 

 

 

 

    

Weighted

    

average

    

 

 

 

 

average

 

remaining

 

Aggregate

 

Outstanding

 

exercise price

 

contractual life

 

Intrinsic Value

 

Options

 

per share

 

(Years)

 

(in thousands)

Outstanding at December 31, 2016

5,997,372

 

$

10.18

 

7.30

 

$

145,270

Granted

573,601

 

 

34.76

 

 

 

 

 —

Forfeited

(60,017)

 

 

14.22

 

 

 

 

 —

Exercised

(1,362,367)

 

 

7.09

 

 

 

 

 —

Expired

(2,893)

 

 

13.79

 

 

 

 

 —

Outstanding at June 30, 2017

5,145,696

 

$

13.69

 

7.35

 

$

120,792

 

 

 

 

 

 

 

 

 

 

Vested, exercisable, expected to vest

 

 

 

 

 

 

 

 

 

at June 30, 2017

5,145,696

 

$

13.69

 

7.35

 

$

120,792

Exercisable at June 30, 2017

3,010,862

 

$

10.30

 

6.90

 

$

80,809

 

 

 

 

 

 

 

 

 

 

 

Aggregate intrinsic value represents the difference between our estimated fair value of common stock and the exercise price of outstanding in‑the‑money options. The fair value per share of common stock was $37.14 as of June 30, 2017 based upon the closing price of our common stock on the NYSE. The total intrinsic value of stock options exercised was $8,409 and $41,891 for the three and six months ended June 30, 2017, respectively, and insignificant for each of the three and six months ended June 30, 2016. 

 

Restricted Stock Units

 

The following is a summary of RSU activity under the 2016 Plan:

 

 

 

 

 

 

 

 

 

 

    

 

    

 

 

Weighted

 

 

 

 

 

 

average

 

 

 

 

 

 

grant date fair value

 

 

Number of Awards

 

 

 

per share

Outstanding at December 31, 2016

 

67,295

 

 

 

$

25.88

Granted

 

271,637

 

 

 

 

34.96

Forfeited

 

(7,191)

 

 

 

 

29.17

Vested and converted to shares

 

(37,655)

 

 

 

 

29.96

Outstanding at June 30, 2017

 

294,086

 

 

 

$

33.66

Expected to vest at June 30, 2017

 

294,086

 

 

 

$

33.66

 

 

 

 

 

 

 

 

 

Employee Stock Purchase Plan

 

We have an ESPP, which became effective January 1, 2017, for US and non-US employees (collectively, “ESPP”), both of which have a series of six month offering periods, with a new offering period beginning on the first day of January and July each year. The ESPP was adopted by our Board of Directors in May 2016 and approved by shareholders in May 2017. Employees may contribute up to 10% of their pay towards the purchase of common stock via payroll deductions to a maximum of $10 per year, or $5 per offering period. Purchase dates occur on the last business day of June and December of each year and shares are purchased at a 10% discount off the closing price on the NYSE on the date of purchase. On June 30,

13


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

2017, 29,668 shares were purchased at a price of $33.43. Employees must hold the shares purchased for a minimum of 90 days.

 

Stock Compensation Expense

 

We used the following weighted average assumptions to estimate the fair value of stock options granted for the periods presented as follows:

 

 

 

 

 

 

 

 

 

 

 

Six Months Ended June 30, 

 

    

2017

    

2016

    

Expected term (years)

 

 

6.25

 

 

6.25

 

Expected volatility

 

 

40.00

%  

 

50.00

%  

Expected dividend yield

 

 

0.00

%  

 

0.00

%  

Weighted average risk-free interest rate

 

 

1.92

%  

 

1.35

%  

Weighted average grant date fair value

 

$

14.60

 

$

9.32

 

 

We recorded total stock‑based compensation expense of $2,455 and $3,428 for the three months ended June 30, 2017 and 2016, respectively, and $4,538 and $4,502 for the six months ended June 30, 2017 and 2016, respectively.  Stock-based compensation expense for the three and six months ended June 30, 2016 includes $2,257 related to the accelerated vesting of certain stock options as a result of our IPO. As of June 30, 2017, we had total unrecognized compensation cost related to 2,428,920 unvested stock options and RSUs under the Plans of $24,338 which we expect to recognize over the next 2.7 years.

 

Note 14. Segment Information

 

We conduct our business through two reportable business segments: Healthcare and Global Retail and Other. Through our Healthcare segment, we offer prospective and retrospective claims accuracy solutions to healthcare payers in the United States. We also provide analytics-based solutions unrelated to our healthcare payment accuracy solutions, on a limited basis in the United States. Through our Global Retail and Other segment, we provide retrospective claims accuracy solutions to retailers primarily in the United States, Canada and the United Kingdom, as well as solutions that improve efficiency and effectiveness of payment networks for a limited number of clients.

 

We evaluate the performance of each segment based on segment net revenue and segment operating income. Operating income is calculated as net revenue less operating expenses and is not affected by other expense (income) or by income taxes. Indirect costs are generally allocated to the segments based on the segments’ proportionate share of revenue and expenses directly related to the operation of the segment. We do not allocate interest expense, other non-operating (income) expense or the provision for income taxes, since these items are not considered in evaluating the segment’s overall operating performance. Our Chief Operating Decision Maker does not receive or utilize asset information to evaluate performance of operating segments. Accordingly, asset-related information has not been presented.

 

14


 

Table of Contents

Cotiviti Holdings, Inc.

Notes to the Financial Statements (continued)

(In thousands, except shares and per share amounts)

(Unaudited)

 

Our operating segment results for the periods presented were as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

    

2016

    

2017

    

2016

    

 

 

(unaudited)

 

(unaudited)

 

Net Revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthcare

 

$

151,559

 

$

141,043

 

$

291,362

 

$

265,173

 

Global Retail and Other

 

 

16,052

 

 

17,248

 

 

36,382

 

 

35,836

 

Consolidated net revenue

 

$

167,611

 

$

158,291

 

$

327,744

 

$

301,009

 

Operating Income

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthcare

 

$

38,689

 

$

36,713

 

$

69,850

 

$

63,335

 

Global Retail and Other

 

 

1,307

 

 

2,225

 

 

4,228

 

 

4,841

 

Consolidated operating income

 

$

39,996

 

$

38,938

 

$

74,078

 

$

68,176

 

 

Operating segment net revenue by product type for the periods presented was as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended June 30, 

 

Six Months Ended June 30, 

 

 

    

2017

    

%

    

2016

    

%

    

2017

    

%

    

2016

    

%

    

 

 

(unaudited)

 

 

 

(unaudited)

 

Healthcare

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retrospective claims accuracy

 

$

86,627

 

51.7

 

$

80,932

 

51.1

 

$

164,143

 

50.1

 

$

146,202

 

48.6

 

Prospective claims accuracy

 

 

62,020

 

37.0

 

 

56,989

 

36.0

 

 

121,737

 

37.1

 

 

112,399

 

37.3

 

Transaction services

 

 

2,912

 

1.7

 

 

3,122

 

2.0

 

 

5,482

 

1.7

 

 

6,572

 

2.2

 

Total Healthcare

 

 

151,559

 

90.4

 

 

141,043

 

89.1

 

 

291,362

 

88.9

 

 

265,173

 

88.1

 

Global Retail and Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retrospective claims accuracy

 

 

15,385

 

9.2

 

 

16,701

 

10.6

 

 

35,059

 

10.7

 

 

34,691

 

11.5

 

Other

 

 

667

 

0.4

 

 

547

 

0.3

 

 

1,323

 

0.4

 

 

1,145

 

0.4

 

Total Global Retail and Other

 

 

16,052

 

9.6

 

 

17,248

 

10.9

 

 

36,382

 

11.1

 

 

35,836

 

11.9

 

Consolidated net revenue

 

$

167,611

 

100.0

 

$

158,291

 

100.0

 

$

327,744

 

100.0

 

$

301,009

 

100.0

 

 

 

 

 

 

 

Note 15. Subsequent Event

 

Effective July 14, 2017, we completed the acquisition of RowdMap, Inc. (“RowdMap”). Based in Louisville, Kentucky, RowdMap is a payer-provider, value-based analytics company that helps health plans and providers identify and reduce low-value care from inefficient and unnecessary services. We paid approximately $70,000 in cash, subject to certain adjustments and funded entirely with available liquidity.  We also issued an aggregate of  768,021 shares of restricted common stock to certain employees of RowdMap as a material inducement to their employment with us. Half of these shares are subject to performance-based vesting requirements. The other half are subject to continued employment with us, with one-third vesting on each of the first three anniversaries of the closing of the acquisition. We are in the process of completing the accounting for business combinations and will provide additional disclosures in future filings. 

 

 

 

 

15


 

ITEM 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations

 

The following discussion and analysis of the financial condition and results of our operations should be read together with the financial statements and the related notes of Cotiviti Holdings, Inc. included in Item 1 of this Quarterly Report on Form 10-Q and with our audited financial statements and the related notes included in our Annual Report on Form 10-K, filed with the SEC.

 

This discussion and analysis contains forward-looking statements regarding the industry outlook, our expectations for the performance of our business, our liquidity and capital resources and other non-historical statements. These forward-looking statements are subject to numerous risks and uncertainties, including but not limited to the risks and uncertainties described in “—Cautionary Note Regarding Forward-Looking Statements” and “Risk Factors.” Our actual results may differ materially from those contained in or implied by these forward-looking statements.

 

Overview

 

We are a leading provider of analytics-driven payment accuracy solutions, focused primarily on the healthcare sector. Our integrated solutions help clients enhance payment accuracy in an increasingly complex healthcare environment. We leverage our robust technology platform, configurable analytics, proprietary information assets and expertise in healthcare reimbursement to help our clients enhance their claims payment accuracy. We help our healthcare clients identify and correct payment inaccuracies, which resulted in approximately $3.3 billion in savings in 2016. We work with over 60 healthcare organizations, including more than 20 of the 25 largest U.S. commercial, Medicare and Medicaid managed health plans, as well CMS. We are also a leading provider of payment accuracy solutions to approximately 35 retail clients, including eight of the ten largest retailers in the United States. We operate in two segments, Healthcare and Global Retail and Other.

 

Our growth strategy for healthcare includes:

 

·

expand within our existing client base by increasing the volume of claims we review with our solutions; expanding utilization across the depth and breadth of our solutions; and cross-selling our prospective and retrospective solutions.

 

·

expand our client base;

 

·

innovate to improve and develop new solutions to expand the scope of our services; and

 

·

pursue opportunistic acquisitions and strategic partnerships in payment accuracy and adjacent markets.

 

As a result of the meaningful savings we deliver to our clients, we have increased our client base and strengthened our long-standing relationships with many of the leading healthcare payers in the United States. In 2016, we added four new clients and two cross-sell clients which we believe will drive revenue growth in 2017 and beyond. In the first half of 2017, we added four new clients and two cross-sell clients. The average length of our relationships with our ten largest healthcare clients is over ten years. We have also substantially increased the annual savings captured by our healthcare clients over time. As a result, we believe our revenue is highly recurring and we have strong visibility into future revenue.

 

We are also a leading provider of payment accuracy solutions to the retail market. Retailers process and validate extremely high volumes of transactions with disparate suppliers on varying terms. We work with retail clients in the United States, Canada and the United Kingdom to realize their negotiated allowances, concessions, rebates and other incentives associated with merchandise procurement, logistics and other service transactions. In 2016, we generated over $500 million in savings for our retail clients.

 

For a further discussion of our two operating segments, (i) Healthcare and (ii) Global Retail and Other, refer to “—Our Segments” and Note 14 to the consolidated financial statements.

 

16


 

Factors Affecting Our Results of Operations

 

Recent Developments – 2017 Highlights

 

·

We continued to execute on our strategy, increasing volume and expanding the adoption of our solutions within our existing healthcare clients which contributed to healthcare revenue growth of 10% during the six months ended June 30, 2017.

 

·

Growth in our healthcare business also continues to benefit from the addition of new clients and our successful cross-sell efforts. During the six months ended June 30, 2017, we generated $10.5 million in revenue from eight new clients added within the past year and from an additional four existing clients who have adopted either prospective or retrospective solutions.

 

·

In March 2017, we began auditing under our two new Medicare RAC contracts awarded in October 2016 and expect to generate approximately 1-2% of total revenue from these contracts in 2017.

 

·

During the six months ended June 30, 2017, approximately 1.4 million shares of common stock were issued upon the exercise of stock options. The stock option exercises resulted in a $13.0 million tax benefit and an effective tax rate of 12.5% for the six months ended June 30, 2017.

 

·

In April 2017, we entered into and executed the First Amendment Agreement to the then outstanding Restated Credit Agreement, which, among other things, provided for a 25 basis point reduction in applicable interest rate spread over LIBOR associated with the First Lien Term B Loan. As a result, we recognized a loss on extinguishment of debt of $3.2 million, during the three months ended June 30, 2017.

 

·

In July 2017, we completed our acquisition of RowdMap, Inc., a payer-provider, value-based analytics company that helps health plans and providers identify and reduce low-value care from inefficient and unnecessary services. We paid $70.0 million in cash, subject to certain adjustments and funded entirely with available liquidity. We also issued an aggregate of 768,021 shares of restricted common stock to certain employees of RowdMap as a material inducement to their employment with us. Half of these shares are subject to performance-based vesting requirements. The other half are subject to continued employment with us, with one-third vesting on each of the first three anniversaries of the closing of the acquisition. 

 

Dollar Amount of Claims Reviewed

 

Revenue in our Healthcare segment in a given period is impacted by the dollar amount of claims we review for our clients, which impacts inaccurate payments that we identify for our clients and the amount of revenue we receive under our performance fee-based contracts. The dollar amount of claims that we review is driven by the scope of claims submitted to us by our clients. The dollar amount of inaccurate payments we identify is also dependent upon the type and number of our solutions used by our clients.

 

In our Global Retail and Other segment, our revenue is dependent on (i) the amount of payments that we review for our retail clients and (ii) the timing of our payment reviews, which typically are completed on a batch processing basis following the lapse of a period of time after payment.

 

Healthcare Industry and General Economic Conditions

 

A majority of our business is directly related to the healthcare industry and is affected by healthcare spending and complexity in the healthcare industry, as follows:

 

·

Healthcare Spending by Payers. Changing demographics, the shift to managed care plans within government healthcare and increased healthcare coverage may lead to an increase in healthcare spending by our payer clients. From 2004 to 2014, healthcare costs in the United States grew at a 4.8% CAGR to $3.0 trillion and increased 5.8% in 2015 to $3.2 trillion. According to CMS, healthcare costs are expected to continue to grow at an average annual rate of 5.6% through 2025. Our revenue is impacted by the expansion or contraction of healthcare coverage and spending, which directly affects the number of payments available for our review.

17


 

 

·

Complexity in the Healthcare Industry. We believe reimbursement models will continue to become more complex as healthcare payers accommodate new markets and lines of business and as advancements in medical care increase the number of testing and treatment options available. The adoption of the ICD-10 coding framework in October 2015 has resulted in a nearly five times increase of possible diagnosis codes to approximately 68,000, further complicating the claims process. As reimbursement models grow more complex and healthcare coverage increases, the complexity and number of claims may also increase, which could impact the demand for our payment accuracy solutions. In addition, lawmakers in Washington, D.C. continue to consider proposals to repeal and replace all or parts of the Affordable Care Act.

 

In addition, our Global Retail and Other segment is impacted by general economic conditions. For example, in a difficult economy, consumers may be willing to spend less and retailers may reduce their purchasing accordingly, thereby reducing their overall payments available for review. Alternatively, in an expanding economy, retailers may increase their purchasing to meet expected increasing demand resulting in increased payments subject to review using our solutions.

 

 

Components of Results of Operations

 

Net revenue

 

Our net revenue is generated from contracts with our clients. Our client contracts generally provide for performance fees that are based on a percentage of the inaccurate payments that we prevent through our prospective claims accuracy solutions or the payment recoveries received by our clients that use our retrospective claims accuracy solutions. We derive less than 3% of our revenue on a “fee-for-service” basis whereby billing is based upon a flat fee or a fee per hour. Our clients may request a refund or offset if their providers or vendors ultimately reject the payment inaccuracies we find or if our clients determine not to pursue reimbursement from their providers or vendors even though we may have collected fees. We record an estimate for refund liabilities at any given time based on actual historical refund data by client type. In such cases, we record any such refund as a reduction of revenue.

 

Historically, there has been a seasonal pattern to our healthcare revenue with the revenues in the first quarter generally lower than the other quarters and revenues in the fourth quarter generally being higher than the other quarters. Accordingly, the comparison of revenue from quarter to quarter may fluctuate and is dependent on various factors, including, but not limited to, reset of member liability, timing of conversions and implementations, timing of special projects and timing of inaccurate payments being prevented or recovered as well as the aforementioned seasonal considerations. Consequently, you should not rely on our revenue for any one quarter as an indication of our future performance. Additionally, we record an estimated liability for refunds and appeals which is subject to managements assumptions. These assumptions may change from time to time and result in adjustments to revenue. Historically, our adjustments of these estimates on a quarterly basis, to reflect actual results or updated expectations, have not been material to our overall business, and have resulted in either a net increase or a net decrease in revenues.

 

Cost of revenue

 

Our cost of revenue is comprised of:

 

·

Compensation, which includes the total compensation and benefit-related expenses, including stock-based compensation expense, for employees who provide direct revenue generating services to clients; and

 

·

Other costs of revenue, which primarily include expenses related to the use of subcontractors and professional services firms, costs associated with the retrieval of medical records and facilities-related costs associated with locations that are used strictly for revenue generating activities. Cost of revenue does not include depreciation and amortization, which is stated separately in our consolidated statement of comprehensive income.

 

18


 

Selling, general and administrative expenses

 

Our selling, general and administrative expenses are comprised of:

 

·

Compensation, which includes total compensation and benefit-related expenses, including stock-based compensation expense, for our employees who are not directly involved in revenue generating activities including those involved with developing new service offerings; and

 

·

Other selling, general and administrative expenses, which include all of our general operating costs. These costs include, but are not limited to, rent and occupancy costs for facilities associated with locations that are used for employees not serving in revenue generating roles, telecommunications costs, information technology infrastructure costs, software licensing costs, advertising and marketing expenses, costs associated with developing new service offerings and expenses related to the use of certain subcontractors and professional services firms. Selling, general and administrative expenses do not include depreciation and amortization, which is stated separately in our consolidated statement of comprehensive income.

 

Depreciation and amortization of property and equipment

 

Depreciation and amortization of property and equipment consists of depreciation related to our investments in property and equipment, including claims accuracy solutions software, as well as amortization of capitalized internal-use software and software development costs.

 

Amortization of intangible assets

 

Amortization of intangible assets includes amortization of customer relationships and acquired software.

 

Transaction-related expenses

 

Transaction-related expenses consist primarily of professional services and other expenses associated with our IPO and other offerings as well as certain expenses associated with corporate development activity, including our acquisition of RowdMap, Inc.

 

Interest expense

 

Interest expense consists of accrued interest and related payments on our outstanding long-term debt as well as the amortization of debt issuance costs. Additionally, interest expense includes any effective portion of realized interest rate hedging derivative gains and losses previously recorded in accumulated other comprehensive (loss) income when the actual interest payments are made on our variable rate debt and the related derivative contract settles.

 

Loss on extinguishment of debt

 

Loss on extinguishment of debt consists of fees paid and write-offs of unamortized debt issuance costs and original issue discount in connection with the 2017 repricing of our First Lien Term B Loan and the 2016 early repayment of a portion of our long-term debt.

 

Other non-operating (income) expense

 

Other non-operating (income) expense primarily consists of foreign exchange gains and losses. In addition, income received for certain sub-leases, interest income and realized gains and losses are included in other non-operating (income) expense.

 

Income tax expense

 

Income tax expense consists of federal, state, local and foreign taxes based on earnings in multiple jurisdictions. Our income tax expense is impacted by the pre-tax earnings in jurisdictions with varying tax rates and any related foreign tax credits or deductions that may be available to us. Our current and future provision for income taxes will vary from statutory

19


 

rates due to the impact of income tax incentives and holidays, certain non-deductible expenses, valuation allowances in certain countries, withholding taxes, excess tax benefits on the exercise of stock options and other discrete items.

 

Stock-based compensation expense

 

We grant equity incentive awards to certain employees, officers and non-employee directors as long-term incentive compensation. We recognize the related expense for these awards ratably over the applicable vesting period. Such expense is recognized in either cost of revenue or selling, general and administrative expenses based upon the function of the optionee. The following table shows the allocation of stock-based compensation expense between our expense line items for the periods presented (in thousands):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

    

2016

    

2017

    

2016

    

 

 

 

(unaudited)

 

(unaudited)

 

 

Cost of revenue

 

$

494

 

$

296

 

$

960

 

$

585

 

 

Selling, general and administrative expenses

 

 

1,961

 

 

3,132

 

 

3,578

 

 

3,917

 

 

Total

 

$

2,455

 

$

3,428

 

$

4,538

 

$

4,502

 

 

 

As of June 30, 2017, we had total unrecognized stock-based compensation expense related to unvested stock options and RSUs of $24.3 million, which we expect to recognize over the next 2.7 years. Stock-based compensation expense included in selling, general and administrative expenses for the three and six months ended June 30, 2016 includes $2.3 million related to the accelerated vesting of certain stock options as a result of our IPO.

 

Foreign currency translation adjustments

 

The assets and liabilities of our foreign subsidiaries with a functional currency other than the U.S. Dollar are translated into U.S. Dollars using applicable exchange rates at the balance sheet date. Revenue and expenses are translated at average exchange rates effective during the year. The resulting foreign currency translation gains and losses are included as a component of other comprehensive (loss) income. We had upward foreign currency translation adjustments of $0.5 million for the three months ended June 30, 2017 compared to downward foreign currency translation adjustments of $0.6 million for the three months ended June 30, 2016. We had upward foreign currency translation adjustments of $0.5 million for the six months ended June 30, 2017 and downward foreign currency translation adjustments of $0.7 million for the six months ended June 30, 2016. The translation adjustments were the result of the strengthening of the U.S. Dollar against the Canadian Dollar and British Pound over the corresponding period.

 

Change in fair value of derivative instruments, net of related taxes

 

We are a party to interest rate cap agreements that hedge the potential impact fluctuations in interest rates may have on payments we make pursuant to our long-term debt. We had a upward net change in fair value of derivative instruments, net of related taxes, of approximately $0.2 million and a downward net change in fair value of derivative instruments, net of related taxes, of approximately $0.1 million for the three months ended June 30, 2017 and 2016, respectively. We had a upward net change in fair value of derivative instruments, net of related taxes, of approximately $0.1 million and a downward net change in fair value of derivative instruments, net of related taxes, of approximately $0.6 million for the six months ended June 30, 2017 and 2016, respectively. The changes were the result of fluctuations in three-month LIBOR.

 

How We Assess Our Performance

 

Adjusted EBITDA

 

We believe Adjusted EBITDA (a non-GAAP measure) is useful to investors as a supplemental measure to evaluate our overall operating performance. Management uses Adjusted EBITDA as a measurement to compare our operating performance to our peers and competitors. We define Adjusted EBITDA as net income before depreciation and amortization, interest expense, other non-operating (income) expense such as foreign currency translation, income tax expense, transaction-related expenses and other and stock-based compensation. See the notes to our consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional information regarding these adjustments. Management believes Adjusted EBITDA is useful because it provides meaningful supplemental information

20


 

about our operating performance and facilitates period-to-period comparisons without regard to our financing methods, capital structure or other items that we believe are not indicative of our ongoing operating performance. By providing this non-GAAP financial measure, management believes we are enhancing investors’ understanding of our business and our results of operations, as well as assisting investors in evaluating how well we are executing our strategic initiatives. Management believes that Adjusted EBITDA is frequently used by securities analysts, investors and other interested parties as a supplemental measure of financial performance within our industry. In addition, the determination of Adjusted EBITDA is consistent with the definition of a similar measure in our First Lien Credit Facilities.

 

Adjusted EBITDA has important limitations as an analytical tool and you should not consider it in isolation or as a substitute for analysis of our results as reported under GAAP. Some of these limitations are:

 

·

Adjusted EBITDA does not reflect our cash expenditures or future requirements for capital expenditures or contractual commitments;

 

·

Adjusted EBITDA does not reflect changes in, or cash requirements for, our working capital needs;

 

·

Although depreciation is a non-cash charge, the assets being depreciated will often have to be replaced in the future, and Adjusted EBITDA does not reflect any cash requirements for such replacements;

 

·

Adjusted EBITDA does not reflect the impact of stock-based compensation upon our results of operations;

 

·

Adjusted EBITDA does not reflect the significant interest expense, or the cash requirements necessary to service interest or principal payments on our debt;

 

·

Adjusted EBITDA does not reflect our income tax expense or the cash requirements to pay our income taxes; and

 

·

Other companies in our industry may calculate Adjusted EBITDA differently than we do, limiting its usefulness as a comparative measure.

 

In evaluating Adjusted EBITDA, you should be aware that in the future we may incur expenses similar to those eliminated in this presentation.

 

The following table presents a reconciliation of Adjusted EBITDA to net income, the most directly comparable GAAP measure, for the periods presented:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

   

2016

   

2017

   

2016

 

(in thousands)

 

(unaudited)

 

(unaudited)

 

Net income

 

$

21,088

 

$

10,893

 

$

48,063

 

$

18,977

 

Depreciation and amortization

 

 

21,097

 

 

20,019

 

 

41,871

 

 

40,061

 

Interest expense

 

 

8,538

 

 

14,660

 

 

16,959

 

 

30,720

 

Other non-operating (income) expense(a)

 

 

(556)

 

 

(359)

 

 

(1,009)

 

 

(658)

 

Income tax expense

 

 

7,743

 

 

6,676

 

 

6,882

 

 

12,069

 

Transaction-related expenses and other(b)

 

 

661

 

 

653

 

 

1,392

 

 

893

 

Stock-based compensation(c)

 

 

2,455

 

 

3,428

 

 

4,538

 

 

4,502

 

Loss on extinguishment of debt(d)

 

 

3,183

 

 

7,068

 

 

3,183

 

 

7,068

 

Adjusted EBITDA

 

$

64,209

 

$

63,038

 

$

121,879

 

$

113,632

 


(a)

Represents other non‑operating (income) expense that consists primarily of gains and losses on transactions settled in foreign currencies. Income received for certain sub‑leases is included herein.

 

(b)

Represents transaction‑related expenses that consist primarily of certain expenses associated with our secondary offering and our IPO and other offering costs in 2016 as well as certain corporate development activity, including the acquisition of RowdMap.

 

21


 

(c)

Represents expense related to equity incentive awards granted to certain employees, officers and non‑employee directors as long‑term incentive compensation. We recognize the related expense for these awards ratably over the vesting period.

 

(d)

Represents loss on extinguishment of debt that consists primarily of fees paid and write-offs of unamortized debt issuance costs and original issue discount in connection with the repricing of our First Lien Term B Loan in 2017 and the early repayment of a portion of our long-term debt in 2016.

 

Dollar Amount of Inaccurate Payments Prevented or Recovered

 

The majority of our net revenue consists of performance fees earned under our client contracts. Our performance fees generally represent a specified percentage of inaccurate payments that are either prevented prior to payment using our prospective claims accuracy solutions or recovered by our clients after they are identified using our retrospective claims accuracy solutions. For those clients where we identify any payment inaccuracies in advance of payment to the providers, the clients reduce the amount paid to the providers based upon the inaccuracies that we have identified. For those clients where we identify payment inaccuracies using our retrospective claims accuracy solutions after the client has made payment, clients generally recover claims either by taking credits against outstanding payables to healthcare providers or retail vendors, or future purchases from the related retail vendors, or receiving refund checks directly from those healthcare providers or retail vendors.

 

The dollar amount of inaccurate payments prevented or recovered in a given period is impacted by the dollar amount of claims or payments reviewed, the scope of claims or payments that we review, the success of our cross-selling efforts, our ability to retain existing clients and obtain new clients and our ability to enhance our existing solutions or create new solutions.

 

We believe the dollar amount of inaccurate payments prevented or recovered is useful to measure our overall operating performance and how well we are executing on our client contracts.

 

Factors Affecting the Comparability of our Results of Operations

 

As a result of a number of factors, our historical results of operations may not be comparable to our results of operations in future periods and our results of operations may not be directly comparable from period to period. Set forth below is a brief discussion of the key factors impacting the comparability of our results of operations.

 

Debt Refinancings, Repayments and Repricing

 

In connection with our various debt refinancings, we incurred significant debt issuance costs, primarily associated with the new indebtedness. These debt issuance costs are amortized utilizing the effective interest method over the associated life of the related indebtedness and recorded as interest expense. Unamortized debt issuance costs were $8.2 million as of June 30, 2017.

 

In June 2016, we repaid $223.0 million in outstanding principal under our then outstanding second lien credit facility using proceeds from our IPO. We also made a voluntary prepayment of $13.1 million of outstanding principal under the second lien credit facility. As a result of these repayments, we recognized a loss on extinguishment of debt totaling $7.1 million during the three months ended June 30, 2016 primarily related to the accelerated recognition of the unamortized portion of debt issuance costs and original issue discount.

 

In September 2016, we completed a refinancing of our then existing first and second lien credit facilities and entered into the Restated Credit Agreement, which provides for the First Lien Credit Facilities consisting of a (a) Term Loan A in the amount of $250.0 million, (b) Term Loan B in the amount of $550.0 million and (c) Revolver in the amount of up to $100.0 million, reducing our total debt principal outstanding by $22.7 million and reducing the interest rates. As a result of this refinancing, we recognized a loss on extinguishment of debt of $9.3 million during the three months ended September 30, 2016, primarily related to the payment of certain fees and the accelerated recognition of the unamortized portion of debt issuance costs and original issue discount related to indebtedness that was repaid to certain lenders.

 

In April 2017, we entered into the First Amendment Agreement to the then outstanding Restated Credit Agreement, which, among other things, provided for lower applicable interest rates associated with the First Lien Term B Loan. As a result, we recognized a loss on extinguishment of $3.2 million during the three months ended June 30, 2017.

22


 

 

Our Segments

 

We report our results of operations in two segments, (i) Healthcare and (ii) Global Retail and Other. Through our Healthcare segment, we offer prospective and retrospective claims accuracy solutions to healthcare payers in the United States. We also provide analytics-based solutions unrelated to our healthcare payment accuracy solutions, on a limited basis in the United States. Through our Global Retail and Other segment, we provide retrospective claims accuracy solutions to retailers primarily in the United States, Canada and the United Kingdom, as well as solutions that improve efficiency and effectiveness of payment networks for a limited number of clients.

 

We evaluate the performance of each segment based on segment net revenue and segment operating income. The cost of revenue for each segment is based on direct expenses associated with revenue generating activities of each segment. We allocate selling, general and administrative expenses to each segment based on the segments’ proportionate share of revenue and expenses directly related to the operation of the segment as determined by management. The following table sets forth the net revenue and operating income for our Healthcare and Global Retail and Other segments for the periods presented (in thousands).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30, 

 

June 30, 

 

 

    

2017

   

2016

   

2017

   

2016

   

 

 

(unaudited)

 

(unaudited)

 

Net Revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthcare

 

$

151,559

 

$

141,043

 

$

291,362

 

$

265,173

 

Global Retail and Other

 

 

16,052

 

 

17,248

 

 

36,382

 

 

35,836

 

Consolidated net revenue

 

$

167,611

 

$

158,291

 

$

327,744

 

$

301,009

 

Operating Income

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthcare

 

$

38,689

 

$

36,713

 

$

69,850

 

$

63,335

 

Global Retail and Other

 

 

1,307

 

 

2,225

 

 

4,228

 

 

4,841

 

Consolidated operating income

 

$

39,996

 

$

38,938

 

$

74,078

 

$

68,176

 

 

The following table sets forth our segment net revenue and percentage of consolidated net revenue by product type for the periods presented (in thousands):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended June 30, 

 

Six Months Ended June 30, 

 

 

    

2017

    

%

    

2016

    

%

    

2017

    

%

    

2016

    

%

    

 

 

(unaudited)

 

 

 

(unaudited)

 

Healthcare

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retrospective claims accuracy

 

$

86,627

 

51.7

 

$

80,932

 

51.1

 

$

164,143

 

50.1

 

$

146,202

 

48.6

 

Prospective claims accuracy

 

 

62,020

 

37.0

 

 

56,989

 

36.0

 

 

121,737

 

37.1

 

 

112,399

 

37.3

 

Transaction services

 

 

2,912

 

1.7

 

 

3,122

 

2.0

 

 

5,482

 

1.7

 

 

6,572

 

2.2

 

Total Healthcare

 

 

151,559

 

90.4

 

 

141,043

 

89.1

 

 

291,362

 

88.9

 

 

265,173

 

88.1

 

Global Retail and Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retrospective claims accuracy

 

 

15,385

 

9.2

 

 

16,701

 

10.6

 

 

35,059

 

10.7

 

 

34,691

 

11.5

 

Other

 

 

667

 

0.4

 

 

547

 

0.3

 

 

1,323

 

0.4

 

 

1,145

 

0.4

 

Total Global Retail and Other

 

 

16,052

 

9.6

 

 

17,248

 

10.9

 

 

36,382

 

11.1

 

 

35,836

 

11.9

 

Consolidated net revenue

 

$

167,611

 

100.0

 

$

158,291

 

100.0

 

$

327,744

 

100.0

 

$

301,009

 

100.0

 

 

23


 

Results of Operations

 

Three Months Ended June 30, 2017 Compared to Three Months Ended June 30, 2016

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended June 30, 

 

Percentage

 

 

    

 

 

    

Percentage of 

    

 

 

    

Percentage of 

    

Change

 

 

 

 

 

 

Net Revenue

 

 

 

 

Net Revenue

 

Period to

 

 

 

2017

 

 (%)

 

2016

 

 (%)

 

Period (%)

 

Net revenue

 

$

167,611

 

100.0

 

$

158,291

 

100.0

 

5.9

 

Cost of revenue (exclusive of depreciation and amortization, stated separately below):

 

 

 

 

 

 

 

 

 

 

 

 

 

Compensation

 

 

58,870

 

35.1

 

 

55,285

 

34.9

 

6.5

 

Other costs of revenue

 

 

6,123

 

3.7

 

 

5,275

 

3.3

 

16.1

 

Total cost of revenue

 

 

64,993

 

38.8

 

 

60,560

 

38.3

 

7.3

 

Selling, general and administrative expenses (exclusive of depreciation and amortization, stated separately below):

 

 

 

 

 

 

 

 

 

 

 

 

 

Compensation

 

 

25,564

 

15.3

 

 

23,176

 

14.6

 

10.3

 

Other selling, general and administrative expenses

 

 

15,300

 

9.1

 

 

14,945

 

9.4

 

2.4

 

Total selling, general and administrative expenses

 

 

40,864

 

24.4

 

 

38,121

 

24.1

 

7.2

 

Depreciation and amortization of property and equipment

 

 

5,896

 

3.5

 

 

4,811

 

3.0

 

22.6

 

Amortization of intangible assets

 

 

15,201

 

9.1

 

 

15,208

 

9.5

 

(0.0)

 

Transaction-related expenses

 

 

661

 

0.4

 

 

653

 

0.4

 

1.2

 

Total operating expenses

 

 

127,615

 

76.1

 

 

119,353

 

75.4

 

6.9

 

Operating income

 

 

39,996

 

23.9

 

 

38,938

 

24.6

 

2.7

 

Other expense (income):

 

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense

 

 

8,538

 

5.1

 

 

14,660

 

9.3

 

(41.8)

 

Loss on extinguishment of debt

 

 

3,183

 

1.9

 

 

7,068

 

4.5

 

(55.0)

 

Other non-operating (income) expense

 

 

(556)

 

(0.3)

 

 

(359)

 

(0.2)

 

54.8

 

Total other expense (income)

 

 

11,165

 

6.7

 

 

21,369

 

13.5

 

(47.8)

 

Income before income taxes

 

 

28,831

 

17.2

 

 

17,569

 

11.1

 

64.1

 

Income tax expense

 

 

7,743

 

4.6

 

 

6,676

 

4.2

 

16.0

 

Net income

 

$

21,088

 

12.6

 

$

10,893

 

6.9

 

93.6

 

 

Net revenue

 

Net revenue was $167.6 million for the three months ended June 30, 2017 as compared to $158.3 million for the three months ended June 30, 2016. The increase of $9.3 million was the result of increased Healthcare segment revenue of $10.6 million and decreased Global Retail and Other segment revenue of $1.1 million. See “−Segment net revenue and operating income.”

 

Cost of revenue

 

Cost of revenue related to compensation was $58.9 million for the three months ended June 30, 2017 as compared to $55.3 million for the three months ended June 30, 2016. The increase of $3.6 million was primarily the result of approximately $2.8 million in additional payroll related expenses due to increased headcount and growth of our Healthcare segment. Employee benefit costs increased approximately $0.6 million due to rising healthcare coverage costs and an increase in the number of our employees. Stock-based compensation increased by approximately $0.2 million due to additional equity incentive awards.

 

Other costs of revenue were $6.1 million for the three months ended June 30, 2017 as compared to $5.3 million for the three months ended June 30, 2016. The increase of $0.8 million was primarily the result of an increase of approximately $0.4 million in personnel-related costs due to an increase in the number of employees. Professional and consulting fees increased $0.3 million as we have leveraged external resources and expertise. Rent and occupancy increased approximately $0.1 million as a result of new and expanded locations.

 

24


 

Selling, general and administrative expenses

 

Selling, general and administrative expenses related to compensation were $25.6 million for the three months ended June 30, 2017 as compared to $23.2 million for the three months ended June 30, 2016. The increase of $2.4 million was primarily related to a $3.2 million increase in compensation related expenses due to an increase in the number of employees to support our growing operations, particularly as we continue to invest in technology, analytics and go-to-market. Employee benefit costs increased approximately $0.4 million due to rising healthcare coverage costs and the increase in number of employees. The increase was partially offset by a $1.2 million decrease in stock-based compensation due to accelerated vesting of certain stock options during the second quarter of 2016 as a result of the IPO as well as additional stock option grants.

 

Other selling, general and administrative expenses were $15.3 million for the three months ended June 30, 2017 as compared to $14.9 million for the three months ended June 30, 2016. The increase of $0.4 million was primarily due to an increase of $0.6 million in IT infrastructure and telecommunications. Professional and consulting fees increased $0.5 million as we have leveraged external resources and expertise. The increase was partially offset by a $0.7 million decrease in certain variable costs.

 

Depreciation and amortization of property and equipment

 

Depreciation and amortization of property and equipment was $5.9 million for the three months ended June 30, 2017 as compared to $4.8 million for the three months ended June 30, 2016. The increase of $1.1 million was due to continued investments in capital expenditures over the past year.

 

Amortization of intangible assets

 

Amortization of intangible assets was $15.2 million for each of the three months ended June 30, 2017 and 2016 as there have been no changes in our intangible assets.

 

Transaction-related expenses

 

Transaction-related expenses were $0.7 million for the three months ended June 30, 2017 primarily related to expenses incurred in connection with our secondary offering as well as certain expenses related to corporate development activity, including the acquisition of RowdMap. Transaction-related expenses were $0.7 million for the three months ended June 30, 2016 primarily related to expenses incurred in connection with our IPO.

 

Interest expense

 

Interest expense was $8.5 million for the three months ended June 30, 2017 as compared to $14.7 million for the three months ended June 30, 2016. The decrease of $6.2 million was primarily due to the significant decline in outstanding principal over the past year in connection with the use of our IPO proceeds and the September 2016 refinancing, which resulted in a $2.6 million decrease in interest expense. Additionally, interest rate reductions in connection with the September 2016 refinancing and the April 2017 repricing of our First Lien Term B Loan resulted in a $4.0 million decrease in interest expense.

 

Loss on extinguishment of debt

 

Loss on extinguishment of debt was $3.2 million for the three months ended June 30, 2017 related to the payment of fees and write-off of unamortized debt issuance costs and original issue discount as a result of the repricing of our First Lien Term B Loan. Loss on extinguishment of debt was $7.1 million for the three months ended June 30, 2016 related to the payment on our outstanding borrowings under our Second Lien Credit Facility.

 

Other non-operating income

 

We had other non-operating income of $0.6 million for the three months ended June 30, 2017 as compared to $0.4 million for the three months ended June 30, 2016. The increase of $0.2 million was primarily the result of additional interest income as a result of our growing cash balance.

 

25


 

Income tax expense

 

We had total income tax expense of $7.7 million for the three months ended June 30, 2017 as compared to $6.7 million for the three months ended June 30, 2016. The increase of $1.0 million was primarily the result of an increase in pre-tax book income for the three months ended June 30, 2017. The effective tax rate for the three months ended June  30, 2017 was 26.9% compared to 38.0% for the three months ended June  30, 2016. The decrease in the effective tax rate is primarily due to a $2.6 million tax benefit related to stock option exercises, as well as a $0.7 million tax benefit related to the filing of amended state tax returns as a result of certain tax planning. Excluding the impact of discrete items, our effective income tax rate was 37.7% for the three months ended June 30, 2017.

 

Segment net revenue and operating income

 

Healthcare segment net revenue was $151.6 million for the three months ended June 30, 2017 as compared to $141.0 million for the three months ended June 30, 2016. The increase of $10.6 million was primarily the result of a net increase of $3.3 million due to increased penetration and extended scope of services provided to our existing client base and a $7.3 million increase due to the addition of new clients and the success of our cross-sell efforts.

 

Global Retail and Other segment net revenue was $16.1 million for the three months ended June 30, 2017 as compared to $17.2 million for the three months ended June 30, 2016. The decrease of $1.1 million was primarily the result of the timing, nature and size of the claims reviewed.

 

Healthcare segment operating income was $38.7 million for the three months ended June 30, 2017 as compared to $36.7 million for the three months ended June 30, 2016. The increase in operating income of $2.0 million was the result of an increase in net revenue noted above. This was partially offset by an increase in compensation expense of $7.0 million related to an increase in the number of employees in our growing Healthcare segment. Our ongoing investment in strategic initiatives contributed an additional $0.6 million in expense primarily related to an increase in IT infrastructure costs. Rent and occupancy related costs increased $0.3 million as a result of new and expanded locations. Personnel-related expenses increased $0.3 million due to the increase in number of employees. Professional and consulting fees increased $0.3 million as we have leveraged external resources and expertise. Depreciation and amortization expenses increased $1.2 million due to our continued investments in capital expenditures. These increases in expenses were partially offset by a $0.9 million decrease in stock-based compensation expense due to accelerated vesting of certain stock options during the second quarter of 2016 as a result of the IPO as well as additional stock option grants and a $0.3 million decrease in certain variable costs.

 

Global Retail and Other segment operating income was $1.3 million for the three months ended June 30, 2017 as compared to $2.2 million for the three months ended June 30, 2016. The decrease in operating income of $0.9 million was the result of a decrease in net revenue noted above and a $0.2 million increase in personnel-related expenses due to an increase in number of employees. This increase in expenses was partially offset by a $0.4 million decrease in the allocation of selling, general and administrative expenses as a result of the reduction in the segments proportionate share of the business.

 

26


 

Six Months Ended June 30, 2017 Compared to Six Months Ended June 30, 2016

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Six Months Ended June 30, 

 

Percentage

 

 

 

 

 

 

Percentage of

 

 

 

 

Percentage of

 

Change

 

 

 

 

 

 

 Net Revenue

 

 

 

 

 Net Revenue

 

Period to

 

 

    

2017

    

 (%)

    

2016

    

 (%)

    

Period (%)

 

Net revenue

 

$

327,744

 

100.0

 

$

301,009

 

100.0

 

8.9

 

Cost of revenue (exclusive of depreciation and amortization, stated separately below):

 

 

 

 

 

 

 

 

 

 

 

 

 

Compensation

 

 

115,158

 

35.0

 

 

108,746

 

36.1

 

5.9

 

Other costs of revenue

 

 

12,809

 

3.9

 

 

10,673

 

3.5

 

20.0

 

Total cost of revenue

 

 

127,967

 

39.0

 

 

119,419

 

39.7

 

7.2

 

Selling, general and administrative expenses (exclusive of depreciation and amortization, stated separately below):

 

 

 

 

 

 

 

 

 

 

 

 

 

Compensation

 

 

50,257

 

15.3

 

 

42,286

 

14.0

 

18.9

 

Other selling, general and administrative expenses

 

 

32,179

 

9.9

 

 

30,174

 

10.0

 

6.6

 

Total selling, general and administrative expenses

 

 

82,436

 

25.2

 

 

72,460

 

24.1

 

13.8

 

Depreciation and amortization of property and equipment

 

 

11,471

 

3.5

 

 

9,646

 

3.2

 

18.9

 

Amortization of intangible assets

 

 

30,400

 

9.3

 

 

30,415

 

10.1

 

(0.0)

 

Transaction-related expenses

 

 

1,392

 

0.4

 

 

893

 

0.3

 

55.9

 

Total operating expenses

 

 

253,666

 

77.4

 

 

232,833

 

77.4

 

8.9

 

Operating income

 

 

74,078

 

22.6

 

 

68,176

 

22.6

 

8.7

 

Other expense (income):

 

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense

 

 

16,959

 

5.2

 

 

30,720

 

10.2

 

(44.8)

 

Loss on extinguishment of debt

 

 

3,183

 

1.0

 

 

7,068

 

2.3

 

(55.0)

 

Other non-operating (income) expense

 

 

(1,009)

 

(0.3)

 

 

(658)

 

(0.2)

 

53.3

 

Total other expense (income)

 

 

19,133

 

5.8

 

 

37,130

 

12.3

 

(48.5)

 

Income before income taxes

 

 

54,945

 

16.8

 

 

31,046

 

10.3

 

77.0

 

Income tax expense

 

 

6,882

 

2.1

 

 

12,069

 

4.0

 

(43.0)

 

Net income

 

$

48,063

 

14.7

 

$

18,977

 

6.3

 

153.3

 

 

Net revenue

 

Net revenue was $327.7 million for the six months ended June 30, 2017 as compared to $301.0 million for the six months ended June 30, 2016. The increase of $26.7 million was the result of increased Healthcare segment revenue of $26.2 million and increased Global Retail and Other segment revenue of $0.6 million. See “−Segment net revenue and operating income.”

 

Cost of revenue

 

Cost of revenue related to compensation was $115.2 million for the six months ended June 30, 2017 as compared to $108.7 million for the six months ended June 30, 2016. The increase of $6.5 million was primarily the result of approximately $4.8 million in additional payroll related expenses due to increased headcount and growth of our Healthcare segment. Employee benefit costs increased approximately $1.3 million due to rising healthcare coverage costs and the increase in the number of our employees. Stock-based compensation increased by approximately $0.4 million due to additional equity incentive awards.  

 

Other costs of revenue were $12.8 million for the six months ended June 30, 2017 as compared to $10.7 million for the six months ended June 30, 2016. The increase of $2.1 million was primarily the result of an increase of approximately $0.9 million in professional and consulting fees as we have leveraged external resources and expertise. Personnel-related costs increased approximately $0.8 million due to an increase in the number of employees. Rent and occupancy increased approximately $0.4 million as a result of new and expanded locations.

27


 

Selling, general and administrative expenses

 

Selling, general and administrative expenses related to compensation were $50.3 million for the six months ended June 30, 2017 as compared to $42.3 million for the six months ended June 30, 2016. The increase of $8.0 million was primarily related to a $7.8 million increase in compensation related expenses due to an increase in the number of employees to support our growing operations, particularly as we continue to invest in technology, analytics and go-to-market. Employee benefit costs increased approximately $0.5 million due to rising healthcare coverage costs and the increase in number of employees. This was partially offset by a decrease in stock-based compensation of $0.3 million due to accelerated vesting of certain stock options during the second quarter of 2016 as a result of the IPO as well as additional stock option grants.

 

Other selling, general and administrative expenses were $32.2 million for the six months ended June 30, 2017 as compared to $30.2 million for the six months ended June 30, 2016. The increase of $2.0 million was primarily due to an increase of $1.7 million in IT infrastructure and telecommunications. Personnel-related expenses increased approximately $0.8 million due to an increased number of employees. Professional and consulting fees increased $0.2 million as we have leveraged external resources and expertise. The increase was partially offset by a $0.7 million decrease in certain variable costs.

 

Depreciation and amortization of property and equipment

 

Depreciation and amortization of property and equipment was $11.5 million for the six months ended June 30, 2017 as compared to $9.6 million for the six months ended June 30, 2016. The increase of $1.9 million was due to continued investments in capital expenditures over the past year.

 

Amortization of intangible assets

 

Amortization of intangible assets was $30.4 million for each of the six months ended June 30, 2017 and 2016 as there have been no changes in our intangible assets.

 

Transaction-related expenses

 

Transaction-related expenses were $1.4 million for the six months ended June 30, 2017 primarily related to expenses incurred in connection with our secondary offering as well as certain expenses related to corporate development activity, including the acquisition of RowdMap. Transaction-related expenses were $0.9 million for the six months ended June 30, 2016 primarily related to expenses incurred in connection with our IPO.

 

Interest expense

 

Interest expense was $17.0 million for the six months ended June 30, 2017 as compared to $30.7 million for the six months ended June 30, 2016. The decrease of $13.7 million was primarily due to the significant decline in outstanding principal over the past year in connection with the use of our IPO proceeds and the September 2016 refinancing, which resulted in a  $6.2 million decrease in interest expense. Additionally, interest rate reductions in connection with the September 2016 refinancing and the April 2017 repricing of our First Lien Term B Loan resulted in an  $8.2 million decrease in interest expense.

 

Loss on extinguishment of debt

 

Loss on extinguishment of debt was $3.2 million for the six months ended June 30, 2017 related to the payment of fees and write-off of unamortized debt issuance costs and original issue discount as a result of the repricing of our First Lien Term B Loan. Loss on extinguishment of debt was $7.1 million for the six months ended June 30, 2016 related to the payment on our outstanding borrowings under our Second Lien Credit Facility.

 

Other non-operating income

 

We had other non-operating income of $1.0 million for the six months ended June 30, 2017 as compared to $0.7 million for the six months ended June 30, 2016. The increase of $0.3 million was primarily the result of foreign exchange gains related to our operations in India.

28


 

 

Income tax expense

 

We had total income tax expense of $6.9 million for the six months ended June 30, 2017 as compared to $12.1 million for the six months ended June 30, 2016. The decrease of $5.2 million was primarily the result of a $13.0 million tax benefit relating to stock option exercises, a tax benefit of $0.3 million related to the settlement of an uncertain tax position due to the closure of our audit with the Internal Revenue Service as well as a tax benefit of $0.7 million related to the filing of amended state tax returns as a result of certain tax planning during the six months ended June 30, 2017. The effective tax rate for the six months ended June 30, 2017 was 12.5% compared to 38.9% for the six months ended June 30, 2016. The decrease in the effective tax rate is primarily due to these same tax benefits. Excluding the impact of discrete items, our effective income tax rate was 38.1% for the six months ended June 30, 2017.

 

Segment net revenue and operating income

 

Healthcare segment net revenue was $291.4 million for the six months ended June 30, 2017 as compared to $265.2 million for the six months ended June 30, 2016. The increase of $26.2 million was primarily the result of a net increase of $15.7 million due to increased penetration and extended scope of services provided to our existing client base and a $10.5 million increase due to the addition of new clients and the success of our cross-sell efforts.

 

Global Retail and Other segment net revenue was $36.4 million for the six months ended June 30, 2017 as compared to $35.8 million for the six months ended June 30, 2016. The increase of $0.6 million was primarily the result of the timing, nature and size of the claims reviewed.

 

Healthcare segment operating income was $69.9 million for the six months ended June 30, 2017 as compared to $63.3 million for the six months ended June 30, 2016. The increase in operating income of $6.6 million was the result of an increase in net revenue noted above. This was partially offset by an increase in compensation expense of $13.4 million related to an increase in the number of employees in our growing Healthcare segment. Our ongoing investment in strategic initiatives contributed an additional $1.5 million in expense primarily related to an increase in IT infrastructure costs. Rent and occupancy related costs increased $0.6 million as a result of new and expanded locations. Depreciation and amortization expenses increased by $1.9 million due to our continued investments in capital expenditures. Personnel-related expenses increased $1.3 million due to an increase in the number of employees. Transaction-related expenses increased $0.5 million primarily related to our secondary offering and the acquisition of RowdMap. Additionally, professional and consulting fees increased $0.4 million as we have leveraged external resources and expertise. 

 

Global Retail and Other segment operating income was $4.2 million for the six months ended June 30, 2017 as compared to $4.8 million for the six months ended June 30, 2016. The decrease in operating income of $0.6 million was the result of an increase of $0.9 million in compensation related expenses. Our ongoing investment in strategic initiatives contributed an additional $0.1 million in IT infrastructure costs. Additionally, certain variable costs increased approximately $0.2 million. This was partially offset by the increase in net revenue noted above.

 

Liquidity and Capital Resources

 

Overview

 

Our primary sources of liquidity are our existing cash and cash equivalents, cash provided by operating activities and borrowings under our credit facilities. As of June 30, 2017, we had cash and cash equivalents of $137.4 million and availability under the Revolver of $99.5 million. Our total debt principal outstanding was $786.5 million as of June 30, 2017. 

 

In April 2017, we successfully repriced our First Lien Term B Loan, reducing the interest rate by 25 basis points.

 

Our principal liquidity needs have been, and we expect them to continue to be, debt service, capital expenditures, working capital and potential mergers and acquisitions. Our capital expenditures support investments in our underlying infrastructure to enhance our solutions and technology for future growth. Our capital expenditures were $16.6 million and $14.0 million for the six months ended June 30, 2017 and 2016, respectively. The increase is primarily due to expenditures associated with enhancing our IT platform. We do not expect our capital expenditures to continue to increase. However, our strategy includes the expansion of our existing solutions and the development of new solutions, which will require cash expenditures over the next few years and will be funded primarily with cash provided by operating activities.

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We believe that our cash flow from operations, availability under our First Lien Credit Facilities and available cash and cash equivalents will be sufficient to meet our liquidity needs for at least the foreseeable future. We anticipate that to the extent that we require additional liquidity, it will be funded through the incurrence of additional indebtedness, the issuance of equity financings, or a combination thereof. We cannot assure you that we will be able to obtain this additional liquidity on reasonable terms, or at all. Additionally, our liquidity and our ability to meet our obligations and fund our capital requirements are also dependent on our future financial performance, which is subject to general economic, financial and other factors that are beyond our control. Accordingly, we cannot assure you that our business will generate sufficient cash flow from operations or that future borrowings will be available from additional indebtedness or otherwise to meet our liquidity needs. If we decide to pursue one or more significant acquisitions, we may incur additional debt or sell additional equity to finance such acquisitions, which could possibly result in additional expenses or dilution.

 

Summary of Cash Flows

 

The following table provides a summary of cash flows from operating, investing and financing activities for the periods presented (in thousands):

 

 

 

 

 

 

 

 

 

 

 

Six Months Ended

 

 

 

June 30, 

 

 

    

2017

    

2016

 

 

 

(unaudited)

 

Net cash provided by operating activities

 

$

42,300

 

$

72,574

 

Net cash used in investing activities

 

 

(16,593)

 

 

(12,838)

 

Net cash provided by (used in) financing activities

 

 

885

 

 

(163,165)

 

 

Operating Activities

 

Net cash provided by operating activities was $42.3 million and $72.6 million for the six months ended June 30, 2017 and 2016, respectively. The decrease in cash provided by operating activities for the six months ended June 30, 2017 as compared to the six months ended June 30, 2016 primarily was due to a $38.6 million increase in net income adjusted for the exclusion of non-cash expenses, offset by approximately a $68.9 million decrease related to the effect of changes in operating assets and liabilities.

 

Net income adjusted for the exclusion of non-cash expenses was approximately $101.6 million for the six months ended June 30, 2017 as compared to $63.0 million for the six months ended June 30, 2016. The increase was primarily due to the growth in our Healthcare operations and the reduction in interest expense.

 

The effect of changes in operating assets and liabilities was a decrease of $59.3 million for the six months ended June 30, 2017 compared to an increase of $9.6 million for the six months ended June 30, 2016. The most significant drivers contributing to this decrease relate to the following:

 

·

Changes in accounts receivable primarily driven by increased revenue and timing of collections. Accounts receivable, net of the allowance for doubtful accounts, increased $19.5 million during the six months ended June 30, 2017 as compared to a decrease of $4.2 million during the six months ended June 30, 2016; 

 

·

Changes in accrued compensation primarily driven by timing of payments and an increase in the number of employees. Accrued compensation decreased $20.6 million during the six months ended June 30, 2017 as compared to a decrease of $5.1 million during the six months ended June 30, 2016; and

 

·

Timing of income tax payments including the impact of approximately $12.1 million prepaid toward our 2017 tax liabilities as of June 30, 2017. This compares to lower tax payments during the six months ended June 30, 2016 due to the application of approximately $10.0 million in payments made during the year ended December 31, 2015 toward our 2016 tax liabilities. 

 

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Investing Activities

 

Net cash used in investing activities was $16.6 million and $12.8 million for the six months ended June 30, 2017 and 2016, respectively. The increase in cash used in investing activities during the six months ended June 30, 2017 as compared to the six months ended June 30, 2016 was due to an increase in capital expenditures due to our ongoing investments, particularly as it relates to enhancing our information technology infrastructure and platforms to support our growing operations.

 

Financing Activities

 

Net cash provided by financing activities was $0.9 million for the six months ended June 30, 2017 compared to net cash used of $163.2 million for the six months ended June 30, 2016. The increase in cash provided by financing activities during the six months ended June 30, 2017 as compared to the six months ended June 30, 2016 was primarily due to $10.5 million in proceeds from the exercise of stock options, partially offset by scheduled debt principal payments of $9.0 million during the six months ended June 30, 2017 as compared to $4.0 million during the six months ended June 30, 2016. Additionally, the use of cash during the six months ended June 30, 2016 was driven by the payment of a special cash dividend of $150.0 million and the repayment of $236.1 million of outstanding borrowings under our Second Lien Credit Facility was partially offset by net cash proceeds from our IPO of $226.9 million.

 

Off-Balance Sheet Arrangements

 

Except for operating leases and certain letters of credit entered into in the normal course of business, we do not have any off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on our financial condition, changes in financial condition, revenue or expenses, results of operations, liquidity, capital expenditures or capital resources that is material to investors.

 

Contractual Obligations

 

Except as set forth below, there have been no material changes to our contractual obligations as described in the Annual Report on Form 10-K for the year ended December 31, 2016.

 

In April 2017, we repriced our First Lien Term B Loan reducing the interest rate by 25 basis points.

 

Critical Accounting Policies and Estimates

 

The preparation of financial statements in conformity with GAAP requires us to make estimates and assumptions that affect reported amounts and disclosure of contingent assets and liabilities. There have been no significant changes in the critical accounting policies and estimates described in our Annual Report on Form 10-K for the year ended December 31, 2016.

 

Jumpstart Our Business Act of 2012

 

We are an “emerging growth company” as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”). We will remain an emerging growth company until the earlier of (1) the last day of our fiscal year (a) following the fifth anniversary of the completion of our IPO, (b) in which we have total annual gross revenue of at least $1.0 billion, or (c) in which we are deemed to be a large accelerated filer, which means the market value of our Common Stock that is held by non-affiliates exceeds $700.0 million as of the last business day of our most recently completed second fiscal quarter, and (2) the date on which we have issued more than $1.0 billion in non-convertible debt securities during the prior three-year period. An emerging growth company may take advantage of specified reduced reporting and other burdens that are otherwise applicable generally to public companies.

 

At the end of our second fiscal quarter ending on June 30, 2017, our aggregate worldwide market value of voting and non-voting common equity held by non-affiliates was over the $700 million threshold. As such, as of December 31, 2017, we will be considered a large accelerated filer and therefore will lose our status as an emerging growth company. 

 

31


 

Recently Issued Accounting Pronouncements

 

See “Recently Issued Accounting Pronouncements” in Note 2 of the unaudited consolidated financial statements.

 

Cautionary Note Regarding Forward-Looking Statements

 

This Quarterly Report on Form 10-Q contains forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements can be identified by words such as “anticipates,” “intends,” “plans,” “seeks,” “believes,” “estimates,” “expects” and similar references to future periods, or by the inclusion of forecasts or projections. Examples of forward-looking statements include, but are not limited to, statements we make regarding the outlook for our future business and financial performance.

 

Forward-looking statements are based on our current expectations and assumptions regarding our business, the economy and other future conditions. Because forward-looking statements relate to the future, by their nature, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict. As a result, our actual results may differ materially from those contemplated by the forward-looking statements. Important factors that could cause actual results to differ materially from those in the forward-looking statements include regional, national or global political, economic, business, competitive, market and regulatory conditions and the following: our inability to successfully leverage our existing client base by expanding the volume of claims reviewed and cross-selling additional solutions; improvements to healthcare claims and retail billing processes reducing the demand for our solutions or rendering our solutions unnecessary; healthcare spending fluctuations; our clients declining to renew their agreements with us or renewing at lower performance fee levels; inability to develop new clients; delays in implementing our solutions; system interruptions or failures, including cyber-security breaches, identity theft or other disruptions that could compromise our information; our failure to innovate and develop new solutions for our clients; our failure to comply with applicable privacy, security and data laws, regulations and standards; changes in regulations governing healthcare administration and policies, including governmental restrictions on the outsourcing of functions such as those that we provide; loss of a large client; consolidation among healthcare payers or retailers; slow development of the healthcare payment accuracy market; negative publicity concerning the healthcare payment industry or patient confidentiality and privacy; significant competition for our solutions; our inability to protect our intellectual property rights, proprietary technology, information, processes and know-how; compliance with current and future regulatory requirements; declines in contracts awarded through competitive bidding or our inability to re-procure contracts through the competitive bidding process; our failure to accurately estimate the factors upon which we base our contract pricing; our inability to manage our growth; our inability to successfully integrate and realize synergies from any future acquisitions or strategic partnerships including our acquisition of RowdMap; our failure to maintain or upgrade our operational platforms; our failure to renew our Medicare Recovery Audit Contractor program contracts or if the terms of the Medicare RAC program contracts are substantially changed; litigation, regulatory or dispute resolution proceedings, including claims or proceedings related to intellectual property infringements; our inability to expand our retail business; our inability to manage our relationships with information suppliers, software vendors or utility providers; fluctuations in our results of operations; changes in tax rules; risks associated with international operations; our inability to realize the book value of intangible assets; our success in attracting and retaining qualified employees and key personnel; general economic, political and market forces and dislocations beyond our control; risks related to our substantial indebtedness and holding company structure; volatility in bank and capital markets; our status as a controlled company and as an emerging growth company; and provisions in our amended and restated certificate of incorporation.

 

For the reasons described above, as well as factors identified in the section of the Annual Report on Form 10-K entitled “Risk Factors,” we caution you against relying on any forward-looking statements. Any forward-looking statement made by us in this Quarterly Report on Form 10-Q speaks only as of the date on which it is made. Factors or events that could cause our actual results to differ may emerge from time to time, and it is not possible for us to predict all of them. Given these uncertainties, you should not place undue reliance on these forward-looking statements. We undertake no obligation to publicly update or revise any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by law.

 

ITEM 3.   Quantitative and Qualitative Disclosures About Market Risk

 

Except as set forth below, there have been no material changes to our quantitative and qualitative disclosures about market risk compared to the quantitative and qualitative disclosure about market risk described in the Annual Report on Form 10-K for the year ended December 31, 2016.

 

32


 

We are exposed to interest rate risk on our First Lien Credit Facilities, which bear interest at variable rates. As of June 30, 2017, we had $786.5 million outstanding principal under our long-term debt and $540.0 million notional debt outstanding related to interest rate cap agreements. Based on our outstanding debt as of June 30, 2017, and assuming that our mix of debt instruments, interest rate caps and other variables remain the same, the annualized effect of a one percentage point change in variable interest rates would have an annualized pre-tax impact on our earnings and cash flows of approximately $7.5 million.

 

ITEM 4.   Controls and Procedures

 

Evaluation of Disclosure Controls and Procedures

 

Our management has evaluated, with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of our disclosure controls and procedures, as defined in Rule 13(a)-15(e) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), as of the end of the period covered by this Quarterly Report on Form 10-Q pursuant to Rule 13a-15(b) of the Exchange Act. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer have concluded that our disclosure controls and procedures as of the end of the period covered by this Quarterly Report on Form 10-Q are effective at a reasonable assurance level in ensuring that information required to be disclosed in our Exchange Act reports is (1) recorded, processed, summarized and reported in a timely manner and (2) accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions regarding required disclosure. While our disclosure controls and procedures are designed to provide reasonable assurance of their effectiveness, because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, within the Company have been detected.

 

Changes in Internal Control over Financial Reporting

 

There were no changes to our internal control over financial reporting during the six months ended June 30, 2017 that have materially affected, or that are reasonably likely to materially affect, our internal control over financial reporting.

 

An audit of our internal control over financial reporting as of any balance sheet date or for any period reported in our financial statements has not been required through June 30, 2017. Our independent public registered accounting firm will first be required to attest to the effectiveness of our internal controls over financial reporting for our Annual Report on Form 10-K for the year ended December 31, 2017 as we will no longer be an “emerging growth company.” In addition, as a newly public company, our management will be required to perform an annual assessment of the effectiveness of our internal controls over financial reporting in our second Annual Report on Form 10-K which is for the year ending December 31, 2017.

33


 

PART II - OTHER INFORMATION

 

ITEM 1.   Legal Proceedings

 

None.

 

ITEM 1A.   Risk Factors

 

For a discussion of potential risks and uncertainties related to our Company and our business see the information in Part I, Item 1A “Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2016. There have been no material changes to the risk factors previously disclosed in our Annual Report on Form 10-K for the year ended December 31, 2016. 

 

 

ITEM 2.   Unregistered Sales of Equity Securities and Use of Proceeds

 

None.

 

ITEM 3.   Defaults Upon Senior Securities

 

Not applicable.

 

ITEM 4.   Mine Safety Disclosures

 

Not applicable.

 

ITEM 5.   Other Information

 

None.

 

34


 

ITEM 6.   Exhibits

 

 

 

 

Exhibit No.

  

Description of Exhibits

31.1*

 

Certification of Chief Executive Officer pursuant to Rule 13a-14(a) or 15d-14(a) of the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

 

 

 

31.2*

 

Certification of Chief Financial Officer pursuant to Rule 13a-14(a) or 15d-14(a) of the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

 

 

 

32.1*

 

Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

 

 

 

32.2*

 

Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

 

 

 

**101.INS

 

XBRL Instance Document.

 

 

 

**101.SCH

 

XBRL Taxonomy Extension Schema Document.

 

 

 

**101.CAL

 

XBRL Taxonomy Extension Calculation Linkbase Document.

 

 

 

**101.DEF

 

XBRL Taxonomy Extension Definition Linkbase Document.

 

 

 

**101.LAB

 

XBRL Taxonomy Extension Label Linkbase Document.

 

 

 

**101.PRE

 

XBRL Taxonomy Extension Presentation Linkbase Document.

 


*  Filed herewith.

 

** Submitted electronically with this Report.

 

 

 

35


 

SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

 

 

 

 

 

 

COTIVITI HOLDINGS, INC.

 

 

 

Date: August 2, 2017

By:

/S/ STEVE SENNEFF

 

 

Name:

Steve Senneff

 

 

Title:

Senior Vice President and Chief Financial Officer (Principal Financial Officer and Principal Accounting Officer)

 

 

 

 

 

 

 

 

 

36