Quarterly report pursuant to Section 13 or 15(d)


9 Months Ended
Sep. 30, 2022
Business Combination and Asset Acquisition [Abstract]  



2021 Acquisition


On June 1, 2021, CAC entered into an Asset and Stock Purchase Agreement (“Purchase Agreement”) with MedMatica and its sole shareholder. Pursuant to the Purchase Agreement, CAC acquired (i) all of the issued and outstanding capital stock of SRS, a Delaware corporation, and (ii) all of the MedMatica assets that were used in MedMatica’s and SRS’ business. Certain MedMatica liabilities were also assumed under the Purchase Agreement. The total cash consideration was $10 million plus a working capital adjustment of approximately $3.8 million. The Purchase Agreement also provides that if during the 18-month period commencing on June 1, 2021 (the “Earn-Out Period”), certain EBITDA and revenue targets with respect to the assets and capital stock purchased under the Purchase Agreement are achieved, then CAC shall pay MedMatica an earn-out up to a maximum of $8 million. Further, if during the Earn-Out Period, certain additional and increased EBITDA and revenue targets with respect to the assets and capital stock purchased under the Purchase Agreement are achieved, then CAC shall pay MedMatica an additional earn-out, up to a maximum of $5 million.


MedMatica and SRS were in the business of providing a broad range of specialty consulting services to hospitals and large healthcare groups, including certain consulting services related to healthcare IT application services and implementations, medical practice management, and revenue cycle management. The acquisition has been accounted for as a business combination.


A summary of the total consideration is as follows:


medSR Purchase Price      
      ($ in thousands)  
Cash   $ 12,261  
Amounts held in escrow     1,571  
Contingent consideration     5,605  
Total purchase price   $ 19,437  


The Company engaged a third party valuation specialist to assist the Company in valuing the assets acquired and liabilities assumed from MedMatica. The following table summarizes the purchase price allocation.


    ($ in thousands)  
Accounts receivable   $ 2,696  
Receivable from seller     227  
Prepaid expenses     102  
Unbilled receivables     2,491  
Property and equipment     84  
Customer relationships     3,100  
Acquired backlog     490  
Goodwill     11,931  
Accounts payable     (539 )
Accrued expenses & compensation     (1,125 )
Deferred revenue     (20 )
Total purchase price allocation   $ 19,437  


The acquired accounts receivable is recorded at fair value, which represents amounts that have subsequently been paid or were expected to be paid by clients. The fair value of customer relationships was based on the estimated discounted cash flows generated by these intangibles. The goodwill represents the Company’s ability to have an expanded local presence in additional markets and operational synergies that we expect to achieve that would not be available to other market participants. The goodwill from this acquisition is deductible ratably for income tax purposes over fifteen years. The purchase agreement provides that if revenue and EBITDA over the next 18 months exceeds certain specified amounts, there will be an earn-out payment to the seller equal to such excess, up to $13 million. It was estimated that the probable payment will be approximately $5.6 million and this amount was recorded as part of the purchase price allocation as contingent consideration. At September 30, 2022 and December 31, 2021, the Company determined that the fair value of the contingent consideration was approximately $200,000 and $3.1 million, respectively, based in part on the actual operating results since the acquisition. The difference in the contingent consideration between December 31, 2021 and September 30, 2022 has been recorded as a change in contingent consideration in the consolidated statements of operations.



As part of the acquisition, $1.5 million of the purchase price was held in escrow, which represented $500,000 to be paid upon the achievement of agreed-upon revenue and backlog milestones, and the balance to be held for up to 18 months to satisfy certain indemnification obligations. During the third quarter of 2021, the initial portion of the escrow was settled whereby $250,000 was paid to the seller and $250,000 was offset against the working capital adjustment. An additional $71,000 that was held in escrow was also paid. The balance of the $1.0 million escrow is included in consideration payable and restricted cash in the consolidated balance sheets at December 31, 2021 and September 30, 2022. Approximately $12.3 million in cash was paid at closing.


The weighted-average amortization period of the acquired intangible assets is approximately three years.


Revenue earned from the clients obtained from the medSR acquisition was approximately $6.4 million and $22.2 million for the three and nine months ended September 30, 2022, respectively.


The medSR acquisition added additional clients to the Company’s customer base and, similar to previous acquisitions, broadened the Company’s presence in the healthcare information technology industry through expansion of its customer base and by increasing available customer relationship resources and specialized trained staff.


Pro forma financial information (Unaudited)


The unaudited pro forma information below represents the consolidated results of operations as if the medSR acquisition occurred on January 1, 2021. The pro forma information has been included for comparative purposes and is not indicative of results of operations that the Company would have had if the acquisition occurred on the above date, nor is it necessarily indicative of future results. The unaudited pro forma information reflects material, non-recurring pro forma adjustments directly attributable to the business combination. The difference between the actual revenue and the pro forma revenue is approximately $17.8 million of additional revenue recorded by medSR for the nine months ended September 30, 2021. Other differences arise from amortizing purchased intangibles using the double declining balance method.


    2022     2021     2022     2021  

Three Months Ended

September 30,


Nine Months Ended

September 30,

    2022     2021     2022     2021  
    ($ in thousands, except per share amounts)  
Total revenue   $ 33,723     $ 38,304     $ 106,292     $ 119,929  
Net income   $ 1,128     $ 1,682     $ 5,195     $ 59  
Net loss attributable to common shareholders   $ (2,721 )   $ (1,960 )   $ (6,467 )   $ (10,349 )
Net loss per common share   $ (0.18 )   $ (0.13 )   $ (0.43 )   $ (0.72 )