TruBridge (TBRG) Q4 2024 earnings summary

Executive summary

• 2024 saw a rebrand, global workforce expansion, and divestiture of American Health Tech, with full-year revenue at $339.2M and Q4 revenue at $87.4M, both ahead of expectations.

• Adjusted EBITDA for 2024 was $53.1M, up 12% YoY, and Q4 adjusted EBITDA was $17.2M, with margins improving from 11.4% in Q1 to 20% in Q4.

• Net loss for 2024 was $23.1M, with Q4 net loss at $5.7M; cash flow from operations grew to $32.1M from just over $1M last year.

• Integration of the Viewgol acquisition progressed, and bookings for the year were $82M, with Q4 bookings at $14.3M, impacted by deal timing.

• Strategic focus for 2025 includes customer satisfaction, retention, profitability, operational optimization, and 4% core business growth.

Financial highlights

• Q4 cash flow from operations was $10.3M, a $23M YoY improvement; free cash flow for 2024 was $15.5M, up $38M YoY.

• Net leverage ratio improved to 3x from over 4x YoY; $23M in debt repaid during the year.

• Q4 gross margin was 53% (up 390 bps YoY); financial health gross margin rose 545 bps YoY to 49.1%.

• Recurring revenue comprised 94.4% of total revenue for 2024.

• Ended Q4 with $12.3M in cash and $159M in net debt.

Outlook and guidance

• 2025 revenue guidance: $345M–$360M; adjusted EBITDA: $59M–$66M, implying 4% revenue growth and 200 bps margin expansion.

• Q1 2025 guidance: revenue $85M–$88M, adjusted EBITDA $14M–$16M.

• Expect mid-single-digit revenue growth and EBITDA margins in the mid-20s over the next few years.

• Financial health expected to drive higher growth than patient care, which should see low single-digit growth.

• Focus for 2025 includes sales pipeline expansion.