Streamline Health Solutions, Inc.

Greetings. Welcome to the Streamlined Health Solutions Incorporated fourth quarter and fiscal year 2024 earnings conference call. At this time, all participants are in the listen-only mode. A question and answer session will follow the formal presentation. If anyone should require operator assistance, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce Jacob Goldberger, Vice President of Finance. Thank you. You may begin.

Thank you for joining us for the Corporate Update and Financial Results Review of Streamlined Health Solutions for the 12 and three months ended January 31st, 2025. As the conference call operator indicated, my name is Jacob Goldberger. Joining me on the call today are Ben Stilwell, President and Chief Executive Officer, and BJ Reeves, Chief Financial Officer. At the conclusion of today's paired remarks, we will open the call for a question and answer session. If anyone participating on today's call does not have a full text copy of our press release announcing these results, You can retrieve it from the company's website at www.streamlinehealth.net or from numerous financial websites. Before we begin with prepared remarks, we want to be sure we are clear for everyone on the record how certain information which may be provided today as with all of our earnings calls should be viewed. We therefore submit for the record the following statement. Statements made on this conference call that are not historical facts are considered to be forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These are subject to risks, uncertainties, assumptions, and other factors that could cause actual results to differ materially from those we may discuss. Please refer to the company's press releases and filings made with the U.S. Securities and Exchange Commission, including our most recent Form 10-K Annual Report, which is on file with the SEC for more information about these risks, uncertainties, and assumptions and other factors. As always, we are presenting management's current analysis of these items as of today. Participants on this call should take into account these risks when evaluating the topics we will discuss. Please note, Streamline is not undertaking any commitment or obligation to publicly revise any such forward-looking statements made today. On today's call, we will discuss non-GAAP financial measures such as adjusted EBITDA and booked SAS ACV. Management uses these measures to help provide better insight into our financial performance. However, certain items of income and expense are not included in these measures, so these calculations may differ from those which another entity may utilize in calculating their own non-GAAP measures. To help you compare these amounts on consistent terms, please refer to our website at www.streamonthehealth.net and our earnings release for reconciliation of such non-GAAP measures to the most comparable GAAP measures. I would now like to turn the call over to Ben Stilwell, CEO.

Thanks, Jacob, and thank you all for joining this morning. In fiscal 2024, we furthered our mission to ensure our health system clients be paid accurately for the care they provided. As of January 31st, 2025, our solutions are delivering an annualized financial impact of more than $210 million across our client base. That impact is the result of our partnership with revenue cycle departments who leverage our solutions to maintain control over the financial outcomes of their health systems. And thanks to our solutions, our team and our client partnerships, U.S. health systems now have $210 million to care for their communities in 2025. As of the end of fiscal 2024, we had booked SAS ACV of $14 million. And as of April 30th, 2025, booked SAS ACV total 14.6 million, 13.1 million of which was implemented. Since we last reported our October 31st, 2024 results, we booked an additional $1.4 million in new SAS ACV. And this was offset by $700,000 of churn, the majority of which was the result of two clients lost to an acquisition of those health systems. $350,000 of our new bookings were the result of our Oracle channel for Rev ID, including a new Community Works client. And we expect continued wins from this channel as our relationship with Oracle remains strong. The remaining new bookings represent significant new evaluator clients, which were sold through our direct channel and influenced by their peers and our talented sales team. We recently made the proactive decision to discontinue selling our quality module as an independent unit. While the module reflected an interesting market opportunity, it did not meet our bookings expectation, and the call point was too distinct from Evaluator and RevID. So rather than invest further in a solution that would not deliver the returns we demand, we chose to redirect resources to initiatives that allow us to expand the impact of our solution's core value proposition. So in particular, we have focused on our resources towards denial prevention functionality. So speaking of, as of last night, we're excited to debut our new denial prevention functionality within the Evaluator platform, a major step forward in how we help clients protect revenue in real time. These new rules will enable Evaluator users to proactively identify and prevent both outright denials and coding DRG downgrades before a claim is submitted. This capability is the result of a deep collaboration across our rules team, client partners, and our data science efforts, incorporating the insights from client feedback and machine learning trained on 835 remittance data we've received from select users. By leveraging real-world denial patterns, we've built rules that are not only clinically sound, but directly aligned with payer behavior. And based on extensive backtesting, we expect these new rules to expand the inpatient financial impact of Evaluator by more than 15%, and potentially double the financial impact on outpatient cases. That's particularly important given the surge in denial activity we're seeing across the industry the last couple of years, especially from commercial payers, which tend to represent higher dollar patient populations for our clients. These denials are placing an unsustainable burden on providers, and we believe our denial prevention functionality is launching at exactly the right time to provide much needed relief and measurable value. Our client success team has been sharing this new functionality with our clients over the last couple months, and they're universally excited, and we'll be quickly translating those client results into a data story and narrative to armor direct sellers. Our Rev ID clients are more excited than ever to talk about their partnerships with Streamline. Last week, one of our Rev ID users, Chris Regional, presented to a packed room at a user conference how they leveraged our solution to develop a charge reconciliation program and the impact of adding this tool and workflow to the revenue cycle. Many of these community works type systems have not historically had the resources to attack charge capture, but many sorely need it. And as I've noted, we had a successful new booking from community works user recently and have been receiving significant inbound interest from that cohort. We're leaning into those user stories in a bigger way with webinars and finding ways to encourage further peer to peer marketing from our clients. We expect the enhanced value offered by new features like denials prevention and improving client referenceability to translate to an increased rate of bookings in fiscal 25. Our implementation teams continue to make strides in their ability to execute projects across both solutions. Our most recent evaluator go-live was completed 42 days after contract signature, and our most recent client win wants to go live by July 1st. We expect to maintain this rapid pace on the evaluator side and our RevID implementation time continues to accelerate. Our new future push, pipeline, and improved implementation execution mean we maintain our expectation related to achieving an EBITDA profitable run rate as we exit the second quarter of fiscal 2025. Healthcare systems need to be able to succeed in the revenue cycle so that they can get paid for the care they provide. We believe it is our duty to develop the products and provide the insights so they can succeed. With that, I'd like to turn the call over to our CFO, BJ Reeves. BJ?