Specialist
Former executive director at Athenahealth Inc
Agenda
- Recent trends and developments in the EHR (electronic health record) and EMR (electronic medical record) industries
- Ambulatory EMR offerings, data interoperability pain points and ability to improve technological integration, including athenaOne product and Insights Dashboard analysis
- Contract dynamics and ability to defend ambulatory position against eClinicalWorks, Greenway Health and encroachment by larger players
- Consolidation dynamics, including Oracle's (NYSE: ORCL) Cerner (NASDAQ: CERN) acquisition and Athenahealth's recent sale to PE
- 2022 post-sale outlook, including growth expectations and strategic assessments
Questions
1.
What are the most important trends or developments in the EHR [electronic health record] or EMR [electronic medical record] market over the past 12 months related to Athenahealth?
2.
Could you expound on the cloud adoption as it relates to EMR customers and the tailwind this could pose for AthenaHealth? What inning are we in for cloud adoption and are there notable migration costs transitioning data to the cloud?
3.
What are your thoughts on increasing consolidation of large health systems and academic centres continuing to acquire physician groups in the US? How detrimental could this be to Athena, given its positioning in the ambulatory market? Why would a consolidated health system opt to keep a service-provider such as Athena if it is acquired by a larger system running on Epic or Cerner?
4.
Have you been monitoring any recent developments from CMS [Centers for Medicare and Medicaid Services] or HIPAA [Health Insurance Portability and Accountability Act] that could materially affect the operating environment for Athena and other EHRs? There has been a renewed focus on patient privacy concerns and the collection of sensitive healthcare data.
5.
What do you think of the shift to value-based care from fee-for-service as it relates to EMR vendors? Are there any notable hurdles in adapting the platforms to process value-based payment models? How is Athena preparing itself for the shift to outcomes-based payment arrangements?
6.
How do you assess the general customer stickiness and retention rates for Athenahealth's athenaOne product? How entrenched have these contracts been historically? How do Athenahealth’s retention rates compare to players such as Epic, Cerner and Allscripts?
7.
How much pricing flexibility does Athena have on contracts? How much does its differentiated portfolio and long-standing customer relationships contribute to pricing power? How is the company balancing revenue maximisation vs retention considerations as contracts come up for renewal?
8.
Athena’s Insights Dashboard allows customers to explore revenue cycle performance by visualising key metrics in one location. How much of a game changer could this offering be in terms of improving customer performance and contract retention?
9.
How expensive are Athena’s software development costs? Is there any concern around underinvestment in its tech infrastructure given the company’s relatively high existing leverage of 10x total debt/EBITDA?
10.
What’s your assessment of Athena’s efforts to augment its telehealth capabilities? Would you expect a greater focus on telehealth given accelerating clinician burnout? What’s important to understand about the company’s value proposition in digital care?
11.
What ancillary service lines should Athena focus on to diversify revenue streams and expand margins? Where is the most opportunity, considering patient engagement, pop health management, RCM [revenue cycle management], etc??
12.
How is Athenahealth tackling data interoperability challenges and pain points in the data integration process? How would you assess its interoperability and integration capabilities vs the broader market?
13.
What are your takeaways from the recently announced leveraged buyout of Athena by a consortium of private investors for USD 17bn? How might the strategic direction of the company change under new ownership and what should be the top priorities for the new sponsors?
14.
Could you discuss some of Athena’s cost-cutting initiatives to become more operationally lean and deleverage the business? What further low-hanging fruit could be targeted for further optimisation?
15.
What do you make of newer upstarts entering the EMR/EHR market such as Medallion? How high are the barriers to entry for newer players? How much of a competitive moat do EHR incumbents enjoy from prospective entrants?
16.
What are your thoughts on Oracle’s announced acquisition of Cerner in late 2021 and general encroachment from big tech companies into the EHR sector? How much of a stronger player does this make Cerner and how defensible are the market positions of Athena and Epic?
17.
How important is customising or tailoring solutions to carving out a market share niche in smaller outpatient settings? How is Athena approaching its ambulatory strategy to maximise penetration and cross-sell opportunity?
18.
How do you think Athena’s capital deployment strategy will evolve post-leveraged buyout? To what extent could its current leverage position temper capital spend? Where do you think the company will deploy capital, considering R&D, tech infrastructure investment, or M&A?
19.
What’s your 12-18-month outlook for Athenahealth? Can the company attain low double-digit revenue growth in 2022? What factors should we monitor closely to assess whether this benchmark is achievable?
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