Medpace Holdings, Inc.

and gentlemen, and welcome to the MedPay's first quarter 2021 earnings conference call. At this time, all participants are in a listen-only mode. Later, we will conduct question and answer session, and instructions will follow at that time. If anyone should require operator assistance, please press star, then zero on your touchstone telephone. As a reminder, this call may be recorded. I would now like to introduce your host for today's conference call, Kevin Braney, MedPace Executive Director of Finance. You may begin.

Good morning, and thank you for joining MedPace's first quarter 2021 earnings conference call. Also on the call today is our President and CEO, August Trundle, and our CFO and COO of Laboratory Operations, Jesse Geiger. Before we begin, I would like to remind you that our remarks and responses to your questions during this teleconference may include forward-looking statements within the meaning of the Private Security Litigation Reform Act of 1995. These statements involve inherent assumptions with known and unknown risk and uncertainties, as well as other important factors that could cause actual results to differ materially from our current expectations. These factors, including the ongoing impact of COVID-19 on our business, are discussed in our Form 10-K and other filings with the SEC. Please note that we assume no obligation to update forward-looking statements, even if estimates change. Accordingly, you should not rely on any of today's forward-looking statements as representing our views as of any date after today. During this call, we will also be referring to certain non-GAAP financial measures. These non-GAAP measures are not superior to or a replacement for the comparable GAAP measures, but we believe these measures help investors gain a more complete understanding of results. A reconciliation of such non-GAAP financial measures to the most directly comparable GAAP measures is available in the earnings press release and earnings call presentation slides provided in connection with today's call. The slides are available in our investor relations section of our website at investor.medpace.com. With that, I would now like to turn the call over to Jesse Geiger to discuss our financial results and guidance.

Thank you, Kevin, and good morning, everyone. Net new business awards entering backlog in the first quarter increased 44.2% from the prior year to $356.2 million, resulting in a 1.37 net book to bill. Ending backlog as of March 31st was $1.6 billion, an increase of 26.1% from the prior year. Revenue was $260 million in the first quarter of 2021, which represents a year-over-year increase of 12.6% on a reported basis and 11.6% on a constant currency organic basis. EBITDA of $53.6 million increased 32.1% compared to $40.6 million in the first quarter of 2020. On a constant currency basis, first quarter EBITDA increased 34.1% compared to the prior year. EBITDA margin for the first quarter was 20.6% compared to 17.6% in the prior year period. The higher margin was primarily attributable to lower reimbursed out-of-pocket expenses as a percentage of revenue. In the first quarter of 2021, net income was $43.3 million compared to net income of $29 million in the prior year period. Net income growth was primarily driven by higher EBITDA as well as a lower effective tax rate. Net income per diluted share for the quarter was $1.14, compared to 76 cents in the prior year period. Regarding customer concentration, our top five and top 10 customers represent roughly 16% and 24% respectively of our first quarter revenue. In the first quarter, we generated 57.3 million in cash flow from operating activities and our net day sales outstanding decreased compared to the fourth quarter from negative 33.6 days to negative 40.8 days. We ended the first quarter with $332.9 million of cash, no outstanding debt, and $50 million of undrawn capacity on our revolving line of credit. Moving now to our guidance for 2021. We are now forecasting total revenue in the range of 1.09 billion to 1.15 billion for the full year 2021. representing growth of 17.7% to 24.2% over 2020 total revenue of $925.9 million. This reflects our current view of a slightly slower return of reimbursed out-of-pocket costs and the associated revenue related to investigator site payments. Our 2021 EBITDA is expected in the range of $205 million to $215 million representing growth of 9.2% to 14.5%, compared to EBITDA of $187.8 million in 2020. This updated EBITDA guidance reflects increased cost expectations related to our strong hiring in the first quarter and anticipated continued robust headcount growth. We anticipate our 2021 effective tax rate to be in the range of 12% to 13%. We have assumed 37.9 million fully diluted shares for 2021, and there are no share repurchases in our guidance. We forecast 2021 net income in the range of 160.6 million to 167.6 million, and earnings per diluted share in the range of $4.24 to $4.42, with the increased expectations for net income and earnings per diluted share driven by the anticipated lower tax rate. With that, I will turn the call back over to the operator so we can take your questions.