CareCloud, Inc. Q3 FY2025 Earnings Call

Greetings, and welcome to the CareCloud, Inc. Third Quarter 2025 Results Conference Call. As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Kristen Rothe. You may begin.

Good morning, everyone. Welcome to CareCloud's Third Quarter 2025 Conference Call. On today's call are Mahmud Haq, our Founder and Executive Chairman; Co-Chief Executive Officer, Stephen Snyder and Hadi Chaudhry; and Norman Roth, our Interim Chief Financial Officer and Corporate Controller. Before we begin, I would like to remind you that certain statements made during this conference call are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 as amended and Section 21E of the Securities Exchange Act of 1934 as amended. All statements other than statements of historical fact made during this conference are forward-looking statements, including, without limitation, statements regarding our expectations and guidance for future financial and operational performance, expected growth, business outlook and potential organic growth and acquisitions. Forward-looking statements may sometimes be identified with words such as will, may, expect, plan, anticipate, approximately, upcoming, belief, estimate or similar terminology and the negative of these terms. Forward-looking statements are not promises or guarantees of future performance and are subject to a variety of risks and uncertainties, many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. These statements reflect our opinions only as to the date of this presentation, and we undertake no obligation to revise these forward-looking statements in light of new information or future events. Please refer to our press release and our reports filed with the Securities and Exchange Commission, where you will find a more comprehensive discussion of our performance and factors that could cause actual results to differ materially from these forward-looking statements. For anyone who dialed into this call by telephone, you may want to download our third quarter 2025 earnings presentation. Please visit our Investor Relations site, ir.carecloud.com, click on News and Events, then click IR calendar, click on Third Quarter 2025 Results Conference Call and download the earnings presentation. Finally, on today's call, we may refer to certain non-GAAP financial measures. Please refer to today's press release announcing our third quarter results and for a reconciliation of these non-GAAP performance measures to our GAAP financial results. With that said, I'll now turn the call over to our Co-CEO, Stephen Snyder.

Thank you, Kristen, and good morning, everyone. We appreciate you joining us as we discuss our year-to-date performance and progress against our strategic objectives. Q3 was a truly transformational quarter for CareCloud. We delivered strong results and hit important AI milestones while simultaneously closing 2 strategic acquisitions that expanded our reach into the hospital market and deepened our analytics and benchmarking capabilities. I'm excited about what this means for our overall trajectory and for the value we can create for providers in today's market. Also, we are pleased to be raising full year revenue guidance to $117 million to $119 million, up from the $111 million to $114 million we set at the beginning of the year. And we are reaffirming adjusted EBITDA guidance of $26 million to $28 million and GAAP EPS guidance of $0.10 to $0.13, reflecting the momentum we are seeing and disciplined execution. Turning to the quarter. CareCloud delivered another period of profitable growth with revenue of $31.1 million, an increase of 9% from the same period last year. Further, growth is converting to earnings power. GAAP EPS improved by $0.08 year-over-year to $0.04 and adjusted EBITDA increased 13% to $7.7 million, demonstrating operating leverage in our model. I'll come back to guidance in a moment. But first, I want to go deeper on the 2 strategic acquisitions that are reshaping the company, namely Medsphere and Map App. First, on August 22, we completed the acquisition of the assets of the Medsphere Systems Corporation. This transaction represents a significant expansion of CareCloud into the inpatient market. Historically, CareCloud has been known primarily for its ambulatory solutions, revenue cycle and technology-enabled services. Medsphere immediately broadens that profile. We can now serve community hospitals, regional systems and critical access hospitals with a full stack that includes Care View, an integrated inpatient EHR, RCM Cloud, which extends our revenue cycle capabilities into hospital billing and collections; Wellsoft, a class-recognized emergency department information system, HealthLine for hospital supply chain management, ChartLogic, our ambulatory EHR and practice management suite, which has a particular strength in the surgical subspecialties such as orthopedics; Marketware, which provides physician relationship management and referral analytics to grow service lines and reduce referral leakage; and managed IT services for implementation, interface management, infrastructure support and a 24/7 help desk. Put simply, we've evolved from an ambulatory-first company to serving the entire care continuum. We can now support the full patient clinician journey from the doctor's office or outpatient clinic to the emergency department into the inpatient bed through the revenue cycle and even into the supply chain. That is a fundamentally different and stronger posture for CareCloud. Scale matters here as well. Medsphere brings a national network of hospitals and gives us immediate hospital reach and credibility with buyers who are often priced out of large enterprise suites, but still need AI-enabled capabilities to operate. Consistent with our playbook, we were disciplined in how we financed it. We acquired Medsphere for $16.5 million, funding roughly half with cash on hand and the balance under our new credit facility. Since closing in late August, we rapidly deleveraged and have already reduced the finance portion by nearly half. And today, the outstanding balance on the line of credit is under $5 million. In other words, approximately 70% of the purchase price has been funded from our internally generated cash, and we expect to pay off the remaining balance to 0 over the upcoming months. Further, we executed this plan with no dilution to common shareholders. That is what we mean by disciplined capital allocation. We added an at-scale hospital IT platform and client base while strengthening the balance sheet and driving positive cash flow. Our near-term integration priorities are straightforward. First, cross-sell and upsell. We are beginning to introduce AI-driven revenue cycle services, analytics and automation across the Medsphere hospital footprint to help facilities collect cash faster and at higher levels, address staffing constraints and gain access to integrated AI solutions that were previously out of their reach. Second, infrastructure leverage. We are aligning Medsphere's support implementation and managed services with CareCloud's operating model to accelerate go-lives and lower support cost per client, supporting margin expansion over time. Medsphere is not just more revenue; it is strategic positioning, placing us firmly inside the hospital IT stack with deployed assets and creating a national cross-sell channel for our AI and RCM automation. The second transaction since our last earnings call was our acquisition of Map App from the Healthcare Financial Management Association, which closed on October 1, alongside a long-term joint marketing agreement. Map App is a hospital benchmarking and performance analytics platform used by leading hospitals and integrated delivery networks to measure and compare revenue cycle metrics such as cash collections efficiency, denial performance and cost to collect, exactly the levers CFOs and revenue cycle leaders are focused on right now. HFMA built this tool to show with clarity where an organization is underperforming and what best-in-class looks like. That matters for us for multiple reasons. First, we move up the decision stack. We can now walk into a CFO conversation leading with benchmarking insights and tie gaps directly to our solutions. Second, we create an analytics-led plan of action. Map App can identify the problems and CareCloud's RCM capabilities and AI automation can then in turn provide the solutions. Third, through our joint marketing agreement with HFMA, we further extend our reach and credibility in the hospital finance leadership. From a near-term revenue standpoint, Map App is about improving win rates and expansions into 2026 and beyond, particularly on top of the Medsphere base. And there is a tight product fit with our AI center of excellence. We intend to enrich map benchmarks with AI-driven recommendations where a provider, for instance, is underperforming, the expected dollar impact of closing that gap and the automation to prioritize first. That is where the market is going, and we intend to lead it. Let me close with how we see the path forward. Again, we are increasing our full year 2025 revenue guidance to a range of $117 million to $119 million and reaffirming adjusted EBITDA guidance of $26 million to $28 million with $0.10 to $0.13 of GAAP EPS. More importantly, we believe the combination of Medsphere and Map App positions CareCloud very differently from a year ago. We now have a credible hospital presence covering inpatient EHR, ED systems, RCM technology, analytics, supply chain and managed IT already deployed in facilities across the country. And we have a benchmarking engine that allows us to start commercial conversations with data, not just a pitch. And we have an AI center of excellence that sits on top of both, driving targeted automation, measurable financial benefits and operating leverage. We're doing all this while remaining profitable, generating cash and preserving flexibility. Said simply, we are building an integrated AI-enabled ambulatory and hospital platform that's designed to meet and exceed the needs of providers in today's market. With that, I'll turn the floor over to Hadi to discuss how we are productizing AI inside clinical and revenue cycle workflows and then to Norm for additional financial details.

Thank you, Steve, and good morning, everyone. I would like to start by echoing Steve's comments and thanking all of you for joining us today. Artificial intelligence remains at the center of CareCloud's transformation strategy, driving both operational efficiency and long-term growth. Over the past year, we have made measurable progress embedding AI across our platform, improving clinical documentation, accelerating revenue cycle performance and modernizing patient engagement. Through our AI center of excellence, we are rapidly converting innovation into results, enhancing client productivity, reducing costs and positioning CareCloud as a scalable differentiated player in the health care technology landscape. One of the most exciting developments from our AI center of excellence is our upcoming Agentic AI front desk solution, which is currently in advanced pilot testing and scheduled for formal launch in mid-December. This next-generation multilingual voice-driven digital assistant autonomously manages patient calls, handling appointment scheduling, rescheduling and cancellations, new patient registrations, prescription refills, lab result inquiries, preventive care reminders, billing questions and referral requests, all through natural conversational interactions. Operating 24/7 with no hold times, it can securely access, process and, where needed, update real-time clinical and financial data to deliver accurate contextual responses. The system is fully integrated with CareCloud's EHR and practice management platforms and can also interface with other leading systems across the industry. To the best of my knowledge, none of our direct competitors are offering this level of proprietary AI capabilities or depth. In our pilot deployments, the Agentic AI front desk solution has already delivered strong results, successfully handling over 70% of incoming patient calls end-to-end without human intervention and achieving over 80% success in appointment scheduling and related tasks. The pilot included calls in multiple languages, roughly 90% English and 10% Spanish, demonstrating the system's ability to serve diverse patient populations. By reducing administrative burden, eliminating wait times, improving patient access and removing language barriers, this solution creates measurable efficiency gains and represents a major growth opportunity for CareCloud as we scale its deployment. Looking across both our client base and the broader market, the opportunity for this technology is significant. As a fully integrated and highly scalable solution, the Agentic AI front desk is positioned to transform patient communication across both ambulatory and hospital settings. We see strong potential to deepen relationships with existing clients while expanding adoption among new health care organizations, unlocking meaningful recurring revenue opportunities as this solution scales. At the end of my remarks, we will play a brief recording of a real patient call that highlights the depth and capability of our Agentic AI solution. We have chosen a more complex interaction rather than a routine scheduling call to show the system's sophistication and versatility. This recording was shared with patient consent and all protected health information has been removed in full compliance with HIPAA. Following our recent acquisition of Medsphere, we are making steady progress on the integration and modernization of their platform portfolio. Our roadmap is centered on merging Medsphere's Care View inpatient system with CareCloud's ONC-certified CAH platform, creating a unified next-generation solution tailored for community and critical access hospitals. A major focus is on reestablishing Care View as an industry-leading mobile-friendly platform designed to simplify workflows for physicians and nurses while improving speed, usability and access across devices. In addition, ChartLogic customers will gain access to CareCloud's proprietary EHR, practice management and AI-enabled capabilities, expanding the value of our combined portfolio. We are also working on plans to advance the recently acquired HFMA Map App, a benchmarking tool that helps providers compare key operational and financial metrics. Our goal is to enhance it with AI-driven analytics and predictive insights, transforming static benchmarks into actionable intelligence and further extending our AI footprint to help health care leaders optimize performance in real time. Together, these initiatives reflect how CareCloud is evolving into a unified AI-driven health care technology company, now serving both the hospital and ambulatory segments. By connecting front office automation, clinical intelligence and financial performance within a single platform, we are expanding our reach, strengthening our product portfolio and positioning CareCloud to deliver stronger growth, improved margins and sustained value creation heading into 2026. Before I hand the call over to Norm Roth, our Interim CFO and Controller, let's listen to the patient call I mentioned earlier, demonstrating the depth and capability of our Agentic AI front desk solution.

Thank you, Hadi. That was a very interesting demonstration of our AI capabilities, and thanks, everyone, for joining our call today. We delivered another strong quarter, reflecting the strength of our business model and the disciplined execution of our strategic priorities. Positive earnings per share and strong cash flow underscore our continued operational efficiency and financial health. During the 9 months ended September 30, 2025, we generated $19.9 million of cash flow from operations compared to $15.4 million in the same period last year. In the third quarter, we reported revenue of $31.1 million, an increase of $2.5 million compared to the same period last year. CareCloud Wellness generated approximately $900,000 in revenue for the quarter and approximately $2.6 million for the first 9 months of this year. There was approximately $3.4 million in revenue related to the Medsphere acquisition, which was completed towards the end of this past August. In the third quarter, we reported GAAP operating income of $3.2 million and GAAP net income of $3.1 million. This is consistent with the GAAP operating income of $3.3 million and GAAP net income of $3.1 million during Q3 2024. The GAAP net income per share for the quarter was $0.04 based on the net income attributable to common shareholders, which takes into account the preferred stock dividends. There was a loss of $0.04 per share in the third quarter of 2024. Non-GAAP adjusted net income for the third quarter of 2025 was $4.4 million or $0.10 per share, calculated using the end-of-period common shares outstanding. We reported adjusted EBITDA of $7.7 million in the third quarter compared to $6.8 million in the same period last year. Revenue for the 9 months of 2025 was $86.1 million compared to $82.6 million for the same period in 2024. For the first 9 months of 2025, the company's GAAP net income was $7.9 million compared to GAAP net income of $4.6 million for the first 9 months of 2024. This equates to income of $0.07 per share after subtracting the preferred stock dividends. This compares to a $0.28 loss for the same period last year. Non-GAAP adjusted net income for the 9 months was $10 million or $0.24 per share. Year-to-date, the adjusted EBITDA was $19.9 million, an increase of $3 million from $16.9 million in the same period last year. As of September 30, 2025, the company had approximately $4.3 million of cash, net of restricted cash of $815,000. Net working capital was approximately $6.1 million. We have a new $10 million line of credit with Provident Bank. And as of September 30, 2025, the line of credit balance was $6.5 million. Since then, we have made $1.6 million of additional payments on the line of credit, bringing the balance today to $4.9 million. Our intention is to fully pay the balance on the line of credit as soon as possible. We remain focused on profitability and cash flow and delivering long-term shareholder value. We look forward to updating you at year-end. With that, I'll now turn the call over to Mahmud for his closing remarks.

Thank you, Norm. As we look ahead to 2026, we remain focused on driving innovation, improving patient experience and creating lasting value for our shareholders. I want to thank our employees for their dedication, our clients for their continued trust and our shareholders for their confidence and support. Thank you. Operator, you can open the call for questions.

Our first question comes from the line of Allen Klee with Maxim Group.

Great quarter. Starting out with your push into the hospital space. Can you talk about your plan to try to win new customers and grow sales? What's your go-to-market strategy on that?

Allen, certainly. So if we step back for a minute and we think about what has transpired since our last earnings call, we would really focus in on 2 primary things. One would be the acquisition of Medsphere. The second would be Map App. If we think about Medsphere, Medsphere truly brings us from the position we were in a year ago roughly, where we were an ambulatory-centric provider to one that will serve the full care continuum. And this brings with it immediate credibility in community hospitals, acute care facilities, critical access hospitals and the like. And then the second would be Map App. So Map App brings with it the analytics engine and the credibility to be able to extend the throughput of the overall Medsphere operations and cross-selling within that same hospital segment. So if we think about the more immediate opportunities, our near-term opportunities candidly, will really be more so focused on cross-selling and upselling into that installed base. So we are now working with hundreds of hospitals throughout the country. And we have the opportunity to cross-sell our AI solutions to implement the AI solutions to embed them more fully in existing platforms, to cross-sell and upsell our RCM solutions into those existing relationships. That would be really the first order of priority. Our second order of priority will really be more focused on extending the same benefits that we're able to deliver to these existing customers to the broader hospital community with a focus initially on critical access hospitals. There are more than 1,400 critical access hospitals throughout the country. They are underserved in terms of their technology opportunities from a platform perspective and also in terms of the opportunity to avail themselves of RCM and AI platforms. So we see a significant opportunity to be able to sell into these critical access facilities. But that will really come in the order of second priority in relationship to the significant upsell and cross-selling opportunities we have in the existing base.

My next question and after that, I'll go back in the queue and ask more after other people. For AI, how are you thinking about the rollout of your new offerings?

Allen, thanks for your question. I think before even getting into the more specific products like this FTE Agentic AI product, let's take note of how this whole AI landscape is changing and evolving, especially in health care. If you think about it in the first 6 months of 2025 alone, nearly $6 billion of venture funds were invested into digital health, and about 60% of that was captured by AI startups. That level of investment is transforming the AI landscape, especially in clinical, financial and operational workflows. If you think about CareCloud, we have spent years building the infrastructure and certification to make this possible. While voice AI companies are great at natural conversation, we believe CareCloud's advantages lie in operational execution within the health care workflows. Our AI front desk solution isn't just a voice tool; it's natively built into our EHR and practice management platforms, enabling secure, real-time access to highly regulated clinical and financial data. This is fundamentally different and advantageous.

Our next question comes from the line of Michael Kim with Zacks Small-Cap Research.

First, I guess, just in terms of M&A, I know you recently closed Medsphere and Map App. But just wondering, maybe taking a step back, what you're seeing from a competitive standpoint, particularly as it relates to buyer and seller expectations around valuations. And then related to that, I know you plan to pay down the credit facility balance in the coming months, but just curious how you're thinking about capacity from a funding standpoint going forward.

Thanks, Michael. AI is absolutely driving conversations in the M&A space. Companies looking to exit are understanding that if they are not actively and rapidly deploying AI throughout their service offering, their expected valuation is negatively impacted. The valuations of the two companies we acquired reflect this reality. We continue to be open to opportunities where we can proceed with an asset purchase without dilution to common shareholders and maintain balance sheet flexibility. We aim for attractive valuations in any opportunistic acquisition.

Got it. That's super helpful. Appreciate that. And maybe just to follow up on your comments regarding Medsphere and Map App. Just curious how the structures of those transactions may have differed from prior deals in the past and how you think about structuring going forward?

Certainly. At a high level, all four acquisitions we closed this year really follow the same disciplined playbook for our accretive well-priced acquisitions. They were asset purchases, non-dilutive and maintained balance sheet flexibility, with valuations around 1x or less. For instance, Medsphere was acquired for $16.5 million, with roughly half paid in cash and the balance through a new credit facility that had practical covenants and lower effective interest rates. As of now, we've paid off nearly half of the facility. This positions us well for further transactions in the future.

Our next question comes from the line of Allen Klee with Maxim Group.

I was just wondering, do you think for the acquisitions, if you're able to do the cross-selling, upselling synergies that they have the potential to get to the type of margins that your company has overall?

Certainly. Our playbook regarding acquisitions aims to reach an operating cash flow margin of about 30% or greater within approximately 3 quarters. With the four acquisitions this year, we believe we're making good progress towards those targets. Yes, we can upsell and cross-sell RCM solutions and AI solutions at extremely attractive margins, so I am optimistic.

This now concludes our question-and-answer session. I would like to turn the floor back over to Norman Roth for closing comments.

Thank you, everyone, for joining our call. Enjoy your day.

Ladies and gentlemen, thank you for your participation. This does conclude today's teleconference. You may disconnect your lines and have a wonderful day.