About NextGen Healthcare

NextGen Healthcare, Inc. (NextGen Healthcare) operates as a provider of cloud-based, healthcare technology solutions that empower ambulatory healthcare providers to manage the risk and complexity of delivering care in the United States healthcare system. The company’s combination of technological breadth, depth, and domain expertise positions it as a preferred solution provider and trusted advisor for its clients. In addition to highly configurable core clinical and financial capabilities, the company’s portfolio includes tightly integrated solutions that deliver on ambulatory healthcare imperatives, including consumerism, digitization, risk allocation, regulatory influence, and integrated care and health equity. The company serves clients across all 50 states. Over 100,000 providers use NextGen Healthcare solutions to deliver care in nearly every medical specialty in a wide variety of practice models, including accountable care organizations (ACOs), independent physician associations (IPAs), managed service organizations (MSOs), veterans service organizations (VSOs), and dental service organizations (DSOs). The company’s clients range from some of the largest and most progressive multi-specialty groups in the country to sole practitioners with a wide variety of business models. With the addition of behavioral health to its medical and oral health capabilities, the company continues to extend its share not only in federally qualified health centers (FQHCs) but also in the growing integrated care market. Strategy The company’s long-term strategy is to position NextGen Healthcare as both the essential, integrated, delivery platform and the most trusted advisor for the ambulatory practices of the future. The company plans to invest in its capabilities, as well as build and/or acquire new capabilities. Acquisitions In November 2022, the company acquired TSI Healthcare, LLC (TSI) for its purpose-built clinical content and differentiated service offerings, which expands the addressable market served by its Enterprise domain, including new specialties, such as rheumatology, pulmonology, and cardiology. Dispositions In August 2022, the company divested its commercial dental assets, further emphasizing the company’s focus on serving ambulatory care. Value Proposition NextGen Healthcare’s value proposition to the company’s clients can be summarized by the four ‘I’s’ as follows: Integration – Delivering a broad and highly integrated set of solutions and end-user experiences. NextGen Healthcare, a top ranked platform solution provider, is driving greater levels of efficiency and engagement for practices. The company’s clients value the full breadth of its solution offering and seamless integration into their clinical workflows. This integration is an important determinant of the company’s success. Interoperability – Building seamlessly connected data and human networks across ambulatory healthcare. NextGen Healthcare’s Interoperability solutions help create a frictionless environment where those that need important healthcare data can rapidly find and utilize it. For example, NextGen Healthcare powers over a third of all United States state-based Health Information Exchanges (HIE’s), with over 170 million patient records passing over its network of almost 2.8 million directory addresses. Insights – Providing intelligence at the point of care to enable better health and financial decision-making. The company is helping its clients move from being data rich to insight rich. By providing intelligence, through innovative solutions that take data out of electronic health records (EHRs), normalize, cleanse, and present it back as usable data pipelines, NextGen Healthcare can help optimize prescription guidance, care gap reviews, billing quality, practice variance, etc. and insert it directly into clinician’s workflows in order to facilitate sound clinical and financial decisions when serving patients. Impact – Delivering and shaping outcomes in all aspects of the company’s solutions and service. NextGen Healthcare is pivoting towards becoming a true performance partner for the company’s clients and is evidenced by proactively helping manage performance and outcomes for its clients. The company delivers value to its clients in several ways. The company’s solutions enable its clients to address needs while preparing for the needs of the future, including expanding access to health services, enhancing the coordination and management of care, and optimizing patient outcomes while also ensuring the sustainability of their practices. Specifically, the company offers a range of solutions to allow clinicians to practice anywhere and work in new and innovative collaboration models. The company provides integrated cloud-based solutions and services that align with its client’s strategic imperatives. Ultimately, this value is reflected in the overall insights and impact delivered to the client. The foundation for its integrated ambulatory care platform is a core of the company’s industry-leading electronic health records (EHR) and practice management (PM) systems that support clinical, financial and patient engagement activities. The company optimizes the core with an automation and workflow layer that gives its clients control over how platform capabilities are implemented to drive their desired outcomes. The workflow layer includes mobile and voice-enabled capabilities proven to reduce physician burden. Recognizing that engaged patients are key to positive outcomes, the company’s patient experience platform enables its clients to create personalized care experiences that enhance trust and drive patient loyalty. Further, the company supports the advances in integrated care that focus on the whole person with solutions supporting behavioral and oral health. The company’s cloud-based population health and analytics engine allows its clients to improve results in both fee-for-service and fee-for-value environments. In the support of extensibility, the company surrounds the core with open, web-based application programming interfaces (APIs) to drive the secure exchange of health and patient data with connected health solutions. The company’s commitment to interoperability, defragmenting care and its experience powering many of the nation’s HIE’s places it in a unique position to enable its clients to leverage this technology to improve the patient and provider experience by providing an integrated community patient record. Finally, to ensure the company’s clients get maximum value from its solutions, the company has augmented its technology with key services aligned with their needs, helping to ensure they reach their organizational goals. The company partners with its clients to optimize their information technology (IT) operations, enhance revenue cycle processes across fee-for-service and fee-for-value models, service line expansion and operations, as well as advise on long-term strategy. Additional commentary on the company’s collection of solutions within the three broad domains are described in further detail below. Enterprise Clinical Care Solutions improve the quality and efficiency of care delivery, as well as the patient and provider experience. They significantly ease the administrative burden and enable the delivery of high quality, personalized care. Providers can automate patient intake, streamline clinical workflows, and leverage vendor-agnostic interoperability to achieve quality measures and qualify for incentives. An example of the company’s clinical care solutions is: NextGen Enterprise EHR– The company’s electronic health records solution stores and maintains clinical patient information and offers a workflow module, prescription management, automatic document and letter generation, patient education, referral tracking, interfaces to billing and lab systems, physician alerts and reminders, and reporting and data analysis tools. Financial Solutions provides key analytics that allow clients to drive healthy, predictable financial outcomes. More than just billing and collection services, financial management involves all functions that effectively capture revenue at the lowest cost, while providing an efficient experience for the patient. Financial management solutions help practices improve performance and correct operational inefficiencies, while enhancing the practice’s financial outcomes throughout the revenue cycle. An example of the company’s financial management solutions is: NextGen Enterprise PM– The company’s practice management offering is a seamlessly integrated, scalable, multi-module solution that includes a master patient index, enterprise-wide appointment scheduling with referral tracking, and clinical support. Patient Engagement Solutions boost loyalty and improve outcomes by engaging patients in their own care. The company’s patient engagement tools enable patients to better manage their own health through direct patient-provider messaging, online scheduling, automated reminders, easy payment options, and virtual visits. The ability of patients to handle their own scheduling and billing frees provider staff, restoring valuable time. An example of the company’s patient engagement solutions is: NextGen Virtual Visits– Delivers a tightly integrated, bi-directional telehealth experience that allows patients to have a virtual visit with their own personal doctor and their own provider’s care team. The solution allows for screen-sharing, document passing, in-visit chat, one-touch access to interpretive services, and a ‘no-login’ experience for patients. Office Integrated Clinical Care and Financial Solutions provide a comprehensive set of software and services specifically targeted to improve the clinical and financial performance of small and independent practices across a broad set of clinical specialties. An example of the company’s solution in this space is: NextGen Office– A cloud-based EHR and PM solution for physicians and medical billing services designed to meet the specific needs of smaller practices. Insights Interoperability Solutions enable different information technology systems to communicate and exchange usable data thereby allowing caregivers to more effectively work together within and across care teams and organizational boundaries, and equipping patients to collaborate on their own care. The company’s integration and interoperability offerings enable providers to leverage their technology for better outcomes and truly connected patient care. Examples of the company’s interoperability solutions are: NextGen Share – A broad and expanding suite of plug-and-play interoperability solutions which help NextGen Enterprise EHR users safely and securely exchange clinical content with external providers and organizations. The platform includes support for secure direct messaging with more than 2.8 million providers and organizations, and care quality integration to enable automated data exchange of over 250 million records as of March 31, 2023. Mirth Connect – Enables patient data from disparate systems to be easily and securely shared, aggregated, and put to work, regardless of EHR, PM, or other healthcare information technology (IT) platform or location. This offering optimizes interoperability capabilities with advanced administration tools that help drive affordable and effective health data exchange and supports client’s ability to control resources and elevate performance. Data and Analytics Solutions help NextGen Healthcare’s customers to unlock the value of their information assets and deliver actionable insight and decision support at the point of care. The company does this by aggregating and normalizing data assets across multiple sources of truth, enriching those data sets as needed with proprietary and 3rd party information assets and applying sophisticated analytics to develop a broad set of clinical, operational, financial, and experiential insights. An example of the company’s data and analytics solutions is: NextGen Health Data Hub (HDH) – A fully redesigned data aggregation platform to meet the expanding market demand for robust data sharing, aggregation, and community access. HDH was built from the ground-up to provide comprehensive, continuous access to aggregated patient health data on a robust, reliable, platform that will enable system-wide connectivity, and support the growing enterprise data management needs for HIEs, hospitals and large ambulatory practices. Value Based Care Solutions provide the company’s customers the ability to enhance care quality and optimize the total cost of delivering care to patient populations across risk strata. As the incidence of chronic conditions rises across patient populations, providers are increasingly seeking turnkey chronic condition management, remote patient monitoring and care program adherence solutions that can improve clinical outcomes. The company’s solutions also give practices the ability to share risk with payors under alternative payment models and sustainably navigate the transition from fee-for-service to fee-for-value. An example of the company’s value based care solutions is: NextGen Population Health Solutions – Delivers robust capabilities for core population health insights using integrated clinical and claims data to support both broad and deep analysis for populations of interest (attribute visualization, risk stratification, gaps in care, etc.). Services Applicable across all three domains, NextGen Healthcare provides additional value to clients in the form of services that help clients achieve their strategic objectives. Through these services, the company enables clients to effectively address core operational and financial needs so they can focus on their primary mission of providing efficient and high-quality patient care. The company’s three categories of services include: Managed Services include the company’s scalable, cloud hosting services that reduce the burden of information technology expertise from its clients and speed implementations, simplify upgrades, cut technology costs significantly and provide 24/7 monitoring and support by a broad team of technical experts. In addition, the company offers Revenue Cycle Management (RCM) Services that includes billing and collections, electronic claims submission and denials management, electronic remittance and payment posting and accounts receivable follow-up. The company’s dedicated account management model helps make NextGen Healthcare a top-performing provider of RCMS as reported in the 2020 KLAS Ambulatory RCM Services Report. Professional Services include training, project management, installation services, and application managed services. The company’s consulting services, which include physician, professional, and technical consulting, assisting clients to optimize their staffing and software solutions, enhance financial and clinical outcomes, achieve regulatory requirements in the drive to value-based care, and meet the evolving requirements of healthcare reform. Client Service and Support in which the company’s technical services staff provides support for the dependable and timely resolution of technical inquiries from clients. Such inquiries are made via telephone, email and the internet. The company offers several levels of support, with the most comprehensive service covering 24 hours a day, seven days a week. Competition The company’s traditional full-suite competitors in the healthcare information systems and services market include: athenahealth, Inc.; Oracle Corporation; eClinicalWorks; Epic Systems Corporation; Greenway Health, LLC; Veradigm Inc.; and Modernizing Medicine, Inc. Sales and Marketing The company sells and markets its products primarily through a direct sales force and to a significantly lesser extent, through a reseller channel. The company also provides solutions to networks of practices, such as MSOs, IPAs, ACOs, ambulatory care centers (ACCs), and community health centers (CHCs). The company’s direct sales force consists of sales executives and account executives, who seek to understand the client strategy and build a multistage roadmap to reach the desired end state. For large clients, the company uses both inside and outside sales where efforts are a mix of on-site and virtual based. For smaller clients, efforts are all inside sales via web and phone, all of whom deliver presentations to potential clients by demonstrating the company’s systems and capabilities either on prospective client’s premises or through video meeting and web-based presentations. The company’s sales and marketing employees identify prospective clients through a variety of means, including a healthcare data and analytics platform, search engine optimization and value exchange content on nextgen.com; digital advertising; direct mail and email campaigns; referrals from existing clients and industry consultants; contacts at professional society meetings and trade shows (online and in person); webinars; public relations and social media campaigns; and telemarketing. The company’s sales cycle can vary significantly and typically ranges from six to 18 months from initial contact to contract execution. Smaller practices on NextGen Office tend to have significantly shorter sales cycles ranging in weeks. The company continues to concentrate its direct sales and marketing efforts on the ambulatory market from large multi-specialty organizations to small-single specialty practices in high-opportunity specialty segments. Privacy and Security The company’s comprehensive Information Security Management Program (ISMP) is designed to help safeguard the confidentiality, integrity and availability of its clients’ data through use of testing for assurances and outlining processes for appropriate response and reporting of security incidents. The company utilizes the industry’s most well-respected certifications starting with Health Information Trust Alliance (HITRUST) Common Security Framework (CSF), which provides a process to standardize requirements of Health Insurance Portability and Accountability Act (HIPAA) and coordinate it with other national and international data security frameworks and many state laws. The company maintains Payment Card Industry Data Security Standard (PCI-DSS) Level 1 Service Provider, which allows it to minimize its clients’ PCI scope. In addition, the company is a DirectTrust Health Information Service Provider (HISP), helping to maintain compliance with Security Organization Control 2, or SOC 2 Type II, across the domains of privacy, security, confidentiality, and availability. These certifications and pertinent audits help with the company’s client’s third-party assurance programs to ensure it is meeting or exceeding HIPAA and other regulatory requirements. Regulatory Environment The company’s business is subject to rules, particularly Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH). History The company was founded in 1974. It was incorporated in California in 1974. The company was formerly known as Quality Systems, Inc. and changed its name to NextGen Healthcare, Inc. in 2018.