About Computer Programs and Systems

TruBridge, Inc. (TruBridge) provides healthcare solutions and services for community hospitals, their clinics and other healthcare systems. TruBridge is a trusted partner to more than 1,500 healthcare organizations with a broad range of technology-first solutions that address the unique needs and challenges of diverse communities, promoting equitable access to quality care and fostering positive outcomes. TruBridge has over four decades of experience in connecting providers, patients and communities with innovative data-driven solutions that create real value by supporting both the financial and clinical side of healthcare delivery. The company’s industry leading HFMA Peer Reviewed suite of revenue cycle management (RCM) offerings combine unparalleled visibility and transparency to enhance productivity and support the financial health of healthcare organizations across all care settings. The company supports efficient patient care with electronic health record (EHR) product offerings that successfully integrate data between care settings. The company’s legal structure includes TruBridge, Inc., the parent company, with Viewgol, LLC (‘Viewgol’), iNetXperts, Corp. d/b/a Get Real Health, Healthcare Resource Group, Inc. (‘HRG’), and Healthland Holding Inc. as its wholly-owned subsidiaries. The company operates its business in three operating segments, which are also the company’s reportable segments: RCM, EHR, and Patient Engagement. These segments contribute towards the combined focus of improving the health of the communities the company serves as follows: The RCM reporting segment focuses on providing a complete RCM solution for all care settings, regardless of their primary healthcare information solutions provider along with business management, consulting, managed IT services, analytics and business intelligence. The EHR segment provides comprehensive acute care solutions and related services for community hospitals, and their physician clinics. The Patient Engagement segment offers comprehensive patient engagement and empowerment technology solutions to improve patient outcomes and engagement strategies with care providers. The company supports community hospitals and other healthcare systems with a geographically diverse patient mix within the domestic community healthcare market. The company’s target market for its RCM, EHR, and Patient Engagement solutions includes community hospitals with fewer than 400 acute care beds, and their clinics, as well as independent or small to medium sized chains of skilled nursing facilities. Approximately 98% of the company’s acute care hospital EHR customer base is consisted of hospitals with fewer than 100 beds. As of January 16, 2024, the company had divested its post-acute care EHR business, American HealthTech, Inc., to PointClickCare Technologies USA Corp. In October 2023, the company closed its acquisition of Viewgol, LLC (‘Viewgol’), a provider of ambulatory RCM analytics and complementary outsourcing services. Strategy The key components of the company’s strategy include: Core Growth: The company’s core growth initiatives include cross-selling RCM solutions and services into the company’s existing sizeable EHR client base and expanding the company’s RCM market share with sales to new community hospitals and larger health systems. Digital Innovation: The company focuses on identifying new innovation and larger adjacency opportunities, driven by demand for patient engagement, industry insights, reporting and analytics technology. The company’s strategy to grow its patient engagement business is centered around leveraging the company’s established customer relationships within the company’s substantial partner ecosystem for continued sales around licensing and professional services. In addition, the company targets hospitals that use competitor EHRs, including upmarket larger hospitals and health systems that support multiple EHRs and data sources around affiliated providers and practices. Products and Services RCM The company offers RCM services which can be grouped into the following categories: Revenue Cycle Management Products. The company’s RCM solutions empower providers and caregivers in hospitals, healthcare systems, clinics and skilled nursing organizations to accelerate their revenue cycle through a suite of comprehensive, web-based solutions designed to improve financial operations and staff productivity and increase reimbursement. The company’s RCM products include the following offerings: Patient Liability Estimates. Improve patient satisfaction, maximize point-of-service collections, and equip staff with the ability to provide transparent pricing with the Patient Liability Estimate module. Eligibility Verification. Reduce claim denials and carrier rejections by performing on-demand eligibility look-ups, assuring the care provided is covered. Claim Scrubbing and Submission. A powerful claim management solution for submitting, validating, and processing a healthcare facility’s claims with ease and with a high quality of edits. Remittance Management. Remittance advice can be effortlessly gathered and managed with the Electronic Remittance Advice Retrieval and Remittance Management modules, simplifying workflow and involvement. Denial/Audit Management. Equips healthcare facilities with the tools necessary to combat denied and audited claims, assisting organizations in recovering lost revenue. Contract Management. Allows healthcare facilities to take control over complex healthcare contracts by prospectively pricing every claim submitted to payers, retrospectively pricing every remittance to ensure proper payment was received, and modeling proposed contract terms during payer negotiations. Revenue Cycle Management Services. The company’s RCM services span a healthcare enterprise’s revenue cycle and provide clients with a strong alternative to in-house operations. These services leverage the company’s deep service and technology experience and are designed to allow clients to streamline their administrative staffing while improving operational efficiencies. The company’s RCM services include the following service offerings: Accounts Receivable Management, Private Pay Service, Medical Coding, Revenue Cycle Consulting, and other additional Insurance and Patient Billing Services. Consulting and Business Management Services. The company’s consulting and business management services are designed to help healthcare organizations by assessing their needs, setting goals, and creating an action plan to achieve those goals, and if needed, implementing the action plan. Many of the company’s professional consultants have decades of experience and all are skilled in adopting new technologies, redesigning processes, educating staff, and providing interim or on-going management services. The company’s consulting and business management services include the following service offerings: Consulting, Business Intelligence, Staffing, and Administrative. Managed IT Services. The company’s managed IT services provide a range of services designed to meet the IT needs of community healthcare enterprises. The pace of technological change can be overwhelming. The company’s services allow clients to affordably maintain an advanced IT infrastructure, meet regulatory requirements, and reduce risk. The company’s managed IT services include the following service offerings: Cloud Services, Backup and Recovery, Collaboration and Connectivity, Security Services, Systems Management, and Help Desk. Encoder Solutions. The company’s encoder technology and services support the hospital, consulting and payer markets. The company’s encoder solution is known for its knowledge-based coding methodology, which presents coding guidance and references at the point of coding, helping to improve coding accuracy and productivity. EHR Acute Care Software Systems The company offers healthcare IT solutions designed to cater to the specific needs of community hospital organizations under the software solution platform TruBridge EHR. TruBridge EHR Within TruBridge EHR, the company offers a full array of software applications using one fully integrated system designed to streamline the flow of information to the primary functional areas of community hospitals. The company intends to continue to enhance its existing software applications and develop new applications as required by evolving industry standards and the changing needs of the company’s clients. Pursuant to the company’s client support agreements, the company provides its clients with software enhancements and upgrades periodically on a when-and-if-available basis. See ‘Acute Care Support and Maintenance Services.’ These enhancements enable each client, regardless of its original installation date, to have the benefit of the company’s most advanced products available. The company’s software applications within TruBridge HER provide automated processes that improve clinical workflow and support clinical decision-making; allow healthcare providers to efficiently input and easily access the most current patient medical data in order to improve quality of care and patient safety; integrate clinical, financial and patient information to promote efficient use of time and resources, while eliminating dependence on paper medical records; provide tools that permit healthcare organizations to analyze past performance, model new plans for the future and measure and monitor the effectiveness of those plans; provide for rapid and cost-effective implementation, whether through the installation of an in-house system or through the company’s Software as a Service (‘SaaS’) services; and increase the flow of information by replacing centralized data over which there is limited control with broad-based, secure access by clinical and administrative personnel to data relevant to their functional areas. The company’s software applications within Trubridge EHR are grouped for support purposes according to the following general functional categories described below: Patient Management. The company’s patient management software enables a hospital to identify a patient at any point in the healthcare delivery system and to collect and maintain patient information throughout the entire process of patient care on an enterprise-wide basis. The TruBridge EHR single database structure permits authorized hospital personnel to simultaneously access appropriate portions of a patient’s record from any point on the system. The company’s patient management software applications include Registration, Patient Accounting, Health Information Management, Patient Index, Enterprise Wide Scheduling, Contract Management, and Quality Improvement. Financial Accounting. The company’s financial accounting software provides a variety of business office applications designed to efficiently track and coordinate information needed for managerial decision-making. The company’s financial accounting software applications include: Executive Information System, General Ledger, Accounts Payable, Payroll/Personnel, Time and Attendance, Electronic Direct Deposits, Human Resources, Budgeting, Fixed Assets, and Materials Management. Clinical. The company’s clinical software automates record keeping and reporting for many clinical functions, including laboratory, radiology, physical therapy, respiratory care and pharmacy. These products eliminate tedious paperwork, calculations and written documentation while allowing for easy retrieval of patient data and statistics. The company’s clinical software applications include Laboratory Information Systems, Laboratory Instrument Interfaces, Radiology Information Systems, ImageLink Picture Archiving and Communication System (PACS), Physical Therapy and Respiratory Care, and Pharmacy. Patient Care. The company’s patient care applications allow hospitals to create computerized ‘patient files’ in place of the traditional paper file systems. This software enables physicians, nurses and other hospital staff to improve the quality of patient care through increased access to patient information, assistance with projected care requirements and feedback regarding patient needs. The company’s software also addresses current safety initiatives in the healthcare industry such as the transition from written prescriptions and physician orders to computerized physician order entry. The company’s patient care software applications include Order Entry/Results Reporting, Point-of-Care System, Patient Acuity, ChartLink, Computerized Physician Order Entry (CPOE), Medication Verification, Resident Assessment Instruments, Thrive Provider EHR, Outreach Client Access, Electronic Forms, Physician Documentation, and Emergency Department System. Enterprise Applications. The company provides software applications that support the products described above and are useful to all areas of the hospital. These applications include ad hoc reporting, automatic batch and real-time system backups, an integrated fax system, archival data repository, document scanning and Microsoft Office integration, and an Application Portal. Centriq Centriq is a web-based acute-care EHR platform. The company was discontinuing support and services of the Centriq platform as of December 31, 2024. A large number of clients that used Centriq have already migrated to the TruBridge EHR platform. Acute Care Support and Maintenance Services After EHR installation, the company provides software application support, hardware maintenance, continuing education and related services pursuant to a support agreement using the company’s collaborative support model. The following describes services provided to customers using the TruBridge EHR: Total System Support. The quality of continuing customer support is one of the most critical considerations in the selection of an information system provider. The company provides hardware, technical and software support for all aspects of the company’s system, which gives the company the flexibility to take the necessary course of action to resolve any issue. Unlike the company’s competitors who use third-party services for hardware and software support, the company provides a single, convenient and efficient resource for all of the company’s customers’ system support needs. In order to minimize the impact of a system problem, the company trains its customer service personnel to be technically proficient, courteous and prompt. Because a properly functioning information system is crucial to a hospital’s operations, the company’s support teams are available 24 hours per day to assist customers with any problem that may arise. Customers can also use the Internet to directly access the company’s support system. National Client Conference. All of the company’s customers have the opportunity to attend the company’s annual National Client Conference. TruBridge hosts this conference to provide educational sessions, product demonstrations, and one-on-one time with application experts. The conference also allows important time for networking among customers and TruBridge staff across all business platforms. The in-person conference was held in Orlando, Florida from April 30 to May 3, 2023. The 2024 in-person conference will be held during April in Las Vegas, Nevada. Continuing Education. Effective learning tools are a key factor in successful EHR adoption and allowing clients to get the most out of a software investment. Therefore, ongoing learning and training is a cornerstone to the company’s ‘total solution’ and a key competitive differentiator. The company’s ongoing learning and training offerings also address some of the unique needs of community hospitals - limited resources and staff with cross-department responsibilities and budget and time constraints - all of which require a customized approach to learning and training. To meet these needs, the company offers customers online content that can be accessed at any time, scheduled online interactive classroom presentations, on-campus training at the company’s facilities, educational sessions during user group conferences, and scheduled regional training sessions. Software Releases. The company is committed to providing its customers with software and technology solutions that will continue to meet their information system needs. To accomplish this purpose, the company continually works to enhance and improve its application programs. As part of this effort, for each customer covered under the company’s general support agreement, the company provides software updates as they become available at no additional cost. The company designs these enhancements to be seamlessly integrated into each customer’s existing system. The benefit of these enhancements is that each customer, regardless of its original installation date, uses the most advanced software available. Through this process, the company can keep its customers up-to-date with the latest operational innovations in the healthcare industry, as well as with changing governmental regulatory requirements. Another benefit of this ‘one system’ concept is that the company’s customer service teams can be more effective in responding to customer needs because they maintain a complete understanding of and familiarity with the one system that all customers use. Purchasing a new information technology system requires the expenditure of a substantial amount of capital and other resources, and many customers are concerned that these systems will become obsolete as technology changes. The company’s periodic product updates eliminate its customers’ concerns about system obsolescence. Hardware Replacement. As part of the company’s general support agreements, the company is also committed to promptly replacing malfunctioning system hardware in order to minimize the effect of operational interruptions. By offering replacements of all hardware used in the company’s system, the company is better able to meet and address all of the information technology needs of the company’s customers. Cloud Electronic Health Record (Cloud EHR). The company offers Cloud EHR services to customers via remote access telecommunications. Cloud EHR is a SaaS configuration and is a monthly subscription to access and use application software maintained by TruBridge in a cloud environment. Under this configuration, a customer is able to obtain access to an advanced EHR without a significant initial capital outlay. The company stores and maintains all Cloud EHR customers’ critical patient and administrative data. These customers access this information remotely through direct telecommunications connections. Forms and Supplies. In addition to the company’s support services, the company offers its customers the standard and customized forms that they need for their patient and financial records, as well as the supplies necessary to support the operation of their server and peripheral equipment. Furnishing these forms and supplies helps the company to achieve its objective of being a one-source solution for a hospital’s complete healthcare information system requirements. Public Cloud Infrastructure – In 2021, the company formed a strategic partnership with Microsoft for Azure cloud hosting and infrastructure services, with the end-goal of migrating all existing internal and client data to Azure’s public cloud and utilizing the related infrastructure solutions to enhance both internal and client-facing processes and services. The eventual migration to Azure, which began during 2022 and continued through 2023, will benefit customers by removing the burden of maintaining their own on-premise infrastructure while the underlying applications will operate with higher availability and stability, reducing unexpected downtime. This modernized infrastructure will open the door to future innovations and data access as well. Post-acute Care Software Systems, Support and Maintenance Services The company entered into the post-acute care market with the acquisition of American HealthTech, Inc. (‘AHT’) in January 2016. The company’s comprehensive, long-term care management solutions in 2023 included care management and financial and enterprise management, backed by ongoing training and support to ensure that clients can maximize their software investment. The company’s post-acute care EHR business line was solely consisted of AHT and was disposed of in January 2024. Patient Engagement The company’s patient engagement offering is a comprehensive digital front door platform that both improves outcomes and promotes patient engagement through the following tools: InstantPHR. The company’s interactive portal is designed to serve all patient populations and health organizations' needs. Ideal for chronic disease management, maintaining wellness goals, and meeting federal mandates, this solution is flexible enough to grow and change as industry trends dictate. InstantPHR can be integrated into nearly any existing EHR system to improve care and outcomes for individuals and professionals alike. CHBase. This powerful tool funnels data from multiple sources into one platform. Patients have the ability to contribute data from their favorite apps and home health devices and combine it with clinical data from providers. This combined data can then be pulled into patient-oriented health applications or population health management and customer analytics. This process makes data comprehensive and relevant, thus maximizing its value to the entire care circle. Additionally, innovators have the capability to create, develop and connect other systems and applications through the CHBase APIs. Software Development Total product development expenses included in the company’s consolidated results of operations were approximately $37.2 million during the year ended December 31, 2023. The company capitalized software development costs of approximately $23.1 million during the year ended December 31, 2023. Clients, Sales and Marketing Target Markets The target market for the company’s RCM product and services extends beyond hospitals of less than 100 beds, where the company has historically focused its EHR efforts. The company is acutely focused on its vision of selling the company’s RCM solution to both its existing customer base, as well as to hospitals of 400 beds or under in the United States. There are approximately 4,600 of these hospitals with fewer than 400 beds. The company’s strategy to grow its RCM business is centered around leveraging the company’s established sales relationships within the company’s substantial EHR customer base in order to cross sell RCM services. In addition, the company targets hospitals that use competitor EHRs and upmarket larger hospitals and health systems that manage their RCM operations in-house. A core initiative to the company’s growth plan is to maintain a strong retention rate across the company’s EHR base and pursue conservative growth of new EHR clients, as they are critical to driving cross-sales of the company’s RCM solutions. The company targets hospitals under 100 beds in the United States that are using a vendor that the company has determined is vulnerable based on a variety of factors. The company’s intention in the ambulatory market is to aggressively target physician practices in those communities where the local hospital is a current TruBridge client. The target market for the company’s acute care EHR systems consists of community hospitals with fewer than 200 acute care beds, with a primary focus on hospitals with fewer than 100 acute care beds. In the United States, there are approximately 3,800 community hospitals with fewer than 200 acute care beds, with approximately 2,900 having fewer than 100 acute care beds. In addition, the company markets its products to small specialty hospitals in the United States that focus on discrete medical areas, such as behavioral health, surgery, rehabilitation and long-term acute care. Approximately 98% of the company’s existing acute care clients are hospitals with fewer than 100 acute care beds. The company’s patient engagement efforts continue to focus on growing the number of registered patient users with existing clients in the international market while also initiating penetration of the domestic market. The company targets hospitals in the U.S. that use competitor EHRs, including upmarket larger hospitals and health systems that support multiple EHRs and data sources around affiliated providers and practices. The target market for the company’s domestic launch is acute care EHR systems of community hospitals that are part of a hospital system. In the United States, there are approximately 3,400 community hospitals that fall into this category. The target market for the company’s engagement solution also includes government healthcare and health information exchanges focused on leveraging technology to drive efficient care delivery in addition to citizen portal initiatives. Sales Staff The company has dedicated sales organizations in all three business units: RCM, EHR, and patient engagement. The company’s sales organizations are generally divided into four areas: sales management, new client sales, existing client sales and sales support staff. The company’s sales representatives who sell to existing clients have assigned clients within their territory, which is also geographically based. Some sales representatives in the company’s services areas are assigned specifically to cross-sell services into the company’s acute care EHR client base. Health Information Security and Privacy Practices Health Insurance Portability and Accountability Act (HIPAA) and the standards promulgated by the Department of Health and Human Services (DHHS) apply to certain health plans, healthcare clearinghouses and healthcare providers (referred to as ‘covered entities’), which includes the company’s hospital and post-acute care clients. Intellectual Property The company endeavors to protect its intellectual property rights and maintain certain trademarks, trade names, service marks and other intellectual property rights, including Clear the Way for Care, TruBridge, MyCareCorner, and others. Material Government Regulations The company’s business operations are subject to various federal, state and international laws, and the company’s products and services are governed by a number of rules and regulations. For example, the company is affected by the following regulations: As discussed above, the HIPAA security and privacy standards affect the company’s claims transmission services, since those services must be structured and provided in a way that supports the company’s clients’ HIPAA compliance obligations, and GDPR is applicable to certain of the company’s activities conducted from an establishment in the EU and the company’s operations that are targeting clients and activities within the EU. The United States Food and Drug Administration (the ‘FDA’) has determined that certain of the company’s solutions, such as the company’s ImageLink and Blood Administration products, are medical devices that are actively regulated under the Federal Food, Drug and Cosmetic Act, as amended. The use of the company’s solutions by physicians for electronic prescribing and electronic routing of prescriptions via the Surescripts network to pharmacies is governed by federal and state laws. States have differing regulations that govern the electronic transmission of certain prescriptions and prescription requirements. The federal Anti-Kickback Statute (‘AKS’) (See 42 U.S.C. § 1320a-7b) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs. The CMS has stated that kickbacks have led to overutilization and increased costs of healthcare services, corruption of medical decision making, steering patients away from valid services or therapies and unfair, non-competitive service delivery. Competition The company’s principal competitors for RCM solutions include RelayHealth Corp, SSI Group, LLC, Quadax Inc., Change Healthcare Holdings, Inc., Availity, LLC, Waystar Technologies, Inc., and Navicure, Inc. The company’s principal competitors in the business management, consulting and managed IT services market are Resolution Health, Inc., The Outsource Group Inc., Patient Focus, Inc., Xtend Healthcare Inc., Ensemble Health Partners, and nThrive, Inc. Secondary competitors in the RCM space include ARx LLC, Citadel Outsource Group LLC, Patient Matters, LLC, KIWI-TEK, LLC, and Aviacode Inc. The primary competitors for the company’s encoder solutions include 3M, Nuance and Optum. The company’s principal competitors in the acute care EHR market are Oracle Cerner Corporation, Medical Information Technology, Inc. (‘Meditech’), and MEDHOST, Inc. The company’s secondary competitors in the acute care EHR market include N. Harris Computer Corporation and Epic Systems Corporation. The company’s principal competitors in the patient engagement market include Relay Health, Get Well Network/Healthloop, Apollo Care Connect, Bridge Patient Portal, eClinicalWorks Patient Portal, Influence Health, and InteliChart. History The company was founded in 1979. It was incorporated in 2002. The company was formerly known as Computer Programs and Systems, Inc. and changed its name to TruBridge, Inc. in March 2024.