Item
1. Financial Statements
Report
of Independent Registered Public Accounting Firm
To
the
Board of Directors and Stockholders of I-trax, Inc.
We
have
reviewed the accompanying condensed consolidated balance sheet of I-trax, Inc.
(a Delaware corporation) and Subsidiaries as of September 30, 2007, and the
related condensed consolidated statements of operations for the three and nine
month periods ended September 30, 2007 and 2006, and the related condensed
consolidated statements of cash flows for the nine month periods ended September
30, 2007 and 2006. These interim financial statements are the
responsibility of the company’s management.
We
conducted our reviews in accordance with the standards of the Public Company
Accounting Oversight Board (United States). A review of interim
financial information consists principally of applying analytical procedures
and
making inquiries of persons responsible for financial and accounting
matters. It is substantially less in scope than an audit conducted in
accordance with standards of the Public Company Accounting Oversight Board,
the
objective of which is the expression of an opinion regarding the consolidated
financial statements taken as a whole. Accordingly, we do not express
such an opinion.
Based
on
our reviews, we are not aware of any material modifications that should be
made
to the condensed consolidated financial statements referred to above for them
to
be in conformity with United States generally accepted accounting
principles.
We
have
previously audited, in accordance with standards of the Public Company
Accounting Oversight Board (United States), the consolidated balance sheet
as of
December 31, 2006, and the related consolidated statements of operations,
stockholders’ equity and cash flows, for the year then ended (not presented
herein); and in our report dated March 10, 2007, we expressed an unqualified
opinion on those consolidated financial statements. In our opinion,
the information set forth in the accompanying condensed consolidated balance
sheet as of December 31, 2006, is fairly stated, in all material respects,
in
relation to the consolidated balance sheet from which it has been
derived.
GOLDSTEIN
GOLUB KESSLER LLP
New
York,
New York
November
8, 2007
I-TRAX
,
INC. AND SUBSIDIARIES
CONDENSED
CONSOLIDATED BALANCE SHEET
(in
thousands, except share data)
ASSETS
|
|
|
|
September
30, 2007 (Unaudited)
|
|
|
December
31, 2006
|
|
Current
assets
|
|
|
|
|
|
|
Cash
and cash
equivalents
|
|
$
|
8,708
|
|
|
$
|
6,558
|
|
Accounts
receivable,
net
|
|
|
24,863
|
|
|
|
21,704
|
|
Other
current
assets
|
|
|
1,278
|
|
|
|
1,526
|
|
Total
current
assets
|
|
|
34,849
|
|
|
|
29,788
|
|
|
|
|
|
|
|
|
|
|
Property
and equipment, net
|
|
|
4,736
|
|
|
|
3,377
|
|
Goodwill
|
|
|
51,620
|
|
|
|
51,620
|
|
Customer
list, net
|
|
|
17,047
|
|
|
|
18,159
|
|
Other
intangible assets, net
|
|
|
198
|
|
|
|
402
|
|
Other
long term assets
|
|
|
36
|
|
|
|
41
|
|
|
|
|
|
|
|
|
|
|
Total
assets
|
|
$
|
108,486
|
|
|
$
|
103,387
|
|
|
|
|
|
|
|
|
|
|
LIABILITIES
AND STOCKHOLDERS’ EQUITY
|
|
|
|
|
|
|
|
|
|
|
Current
liabilities
|
|
|
|
|
|
|
|
|
Accounts
payable
|
|
$
|
7,730
|
|
|
$
|
10,376
|
|
Accrued
payroll and
benefits
|
|
|
4,388
|
|
|
|
4,444
|
|
Accrued
restructuring
charges
|
|
|
--
|
|
|
|
118
|
|
Other
current
liabilities
|
|
|
9,868
|
|
|
|
11,627
|
|
Total
current
liabilities
|
|
|
21,986
|
|
|
|
26,565
|
|
|
|
|
|
|
|
|
|
|
Senior
secured credit facility
|
|
|
13,370
|
|
|
|
9,057
|
|
Note
payable
|
|
|
902
|
|
|
|
129
|
|
Other
long term liabilities
|
|
|
3,905
|
|
|
|
1,945
|
|
|
|
|
|
|
|
|
|
|
Total
liabilities
|
|
|
40,163
|
|
|
|
37,696
|
|
|
|
|
|
|
|
|
|
|
Commitments
and contingencies
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Stockholders’
equity
|
|
|
|
|
|
|
|
|
Preferred
stock - $.001 par
value, 2,000,000 shares authorized,
219,126
and 559,101 issued and outstanding, respectively;
Liquidation
preference: $5,478,000 and $13,978,000 at September
30,
2007 and December 31, 2006, respectively
|
|
|
--
|
|
|
|
1
|
|
Common
stock - $.001 par value,
100,000,000 shares authorized
41,230,123
and 36,613,707 shares issued and outstanding,
respectively
|
|
|
41
|
|
|
|
35
|
|
Additional
paid in
capital
|
|
|
140,138
|
|
|
|
136,623
|
|
Accumulated
deficit
|
|
|
(71,856
|
)
|
|
|
(70,968
|
)
|
Total
stockholders’
equity
|
|
|
68,323
|
|
|
|
65,691
|
|
|
|
|
|
|
|
|
|
|
Total
liabilities and stockholders’ equity
|
|
$
|
108,486
|
|
|
$
|
103,387
|
|
The
accompanying notes are an integral
part of these financial statements.
I-TRAX
,
INC. AND SUBSIDIARIES
CONDENSED
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(in
thousands, except share data)
|
|
Three
months ended
September
30
|
|
|
Nine
months ended
September
30
|
|
|
|
2007
|
|
|
2006
|
|
|
2007
|
|
|
2006
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net
revenue
|
|
$
|
35,148
|
|
|
$
|
30,495
|
|
|
$
|
103,234
|
|
|
$
|
91,061
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Costs
and expenses
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating
expenses
|
|
|
26,618
|
|
|
|
22,622
|
|
|
|
78,280
|
|
|
|
68,849
|
|
General
and administrative
expenses
|
|
|
7,118
|
|
|
|
6,437
|
|
|
|
21,793
|
|
|
|
18,356
|
|
Lease
termination expense (Note
10)
|
|
|
780
|
|
|
|
--
|
|
|
|
780
|
|
|
|
--
|
|
Depreciation
and
amortization
|
|
|
1,155
|
|
|
|
826
|
|
|
|
3,004
|
|
|
|
2,513
|
|
Total
costs and expenses
|
|
|
35,671
|
|
|
|
29,885
|
|
|
|
103,857
|
|
|
|
89,718
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating
income (loss)
|
|
|
(523
|
)
|
|
|
610
|
|
|
|
(623
|
)
|
|
|
1,343
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other
expenses (income)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other
expense
(income)
|
|
|
(2
|
)
|
|
|
--
|
|
|
|
(1,421
|
)
|
|
|
--
|
|
Interest
expense
|
|
|
116
|
|
|
|
113
|
|
|
|
424
|
|
|
|
342
|
|
Amortization
of financing
costs
|
|
|
14
|
|
|
|
59
|
|
|
|
72
|
|
|
|
172
|
|
Total
other expenses (income)
|
|
|
128
|
|
|
|
172
|
|
|
|
(925
|
)
|
|
|
514
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income
(loss) before provision for income taxes
|
|
|
(651
|
)
|
|
|
438
|
|
|
|
302
|
|
|
|
829
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Provision
for income taxes
|
|
|
149
|
|
|
|
234
|
|
|
|
428
|
|
|
|
414
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net
income (loss)
|
|
|
(800
|
)
|
|
|
204
|
|
|
|
(126
|
)
|
|
|
415
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Less
preferred stock dividend
|
|
|
121
|
|
|
|
282
|
|
|
|
467
|
|
|
|
902
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net
loss applicable to common stockholders
|
|
$
|
(921
|
)
|
|
$
|
(78
|
)
|
|
$
|
(593
|
)
|
|
$
|
(487
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Earnings
(loss) per common share:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
and Diluted
|
|
$
|
(0.02
|
)
|
|
$
|
0.00
|
|
|
$
|
(0.01
|
)
|
|
$
|
(0.01
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted
average number of shares outstanding:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
and Diluted
|
|
|
40,949,053
|
|
|
|
36,462,797
|
|
|
|
39,938,780
|
|
|
|
35,875,461
|
|
The
accompanying notes are an integral part of these financial
statements.
I-TRAX
,
INC. AND SUBSIDIARIES
CONDENSED
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
(in
thousands)
|
|
Nine
months ended
September
30
|
|
|
|
2007
|
|
|
2006
|
|
Operating
activities:
|
|
|
|
|
|
|
Net
income
(loss)
|
|
$
|
(126
|
)
|
|
$
|
415
|
|
Adjustments
to reconcile net
income (loss) to net cash provided by (used in) operating
activities:
|
|
|
|
|
|
|
|
|
Stock
issued as bonus
compensation
|
|
|
31
|
|
|
|
--
|
|
Stock
based
compensation
|
|
|
1,238
|
|
|
|
961
|
|
FIN
48
Liability
|
|
|
235
|
|
|
|
--
|
|
Accrued
loss on
contracts
|
|
|
--
|
|
|
|
(419
|
)
|
Depreciation
and
amortization
|
|
|
3,004
|
|
|
|
2,513
|
|
Modification
of
warrants
|
|
|
--
|
|
|
|
57
|
|
Issuance
of stock below market
value
|
|
|
--
|
|
|
|
130
|
|
Issuance
of warrants for
services
|
|
|
47
|
|
|
|
72
|
|
Amortization
of financing
costs
|
|
|
72
|
|
|
|
172
|
|
Loss
on disposal of
assets
|
|
|
--
|
|
|
|
390
|
|
Changes
in operating assets and
liabilities:
|
|
|
|
|
|
|
|
|
Accounts
receivable
|
|
|
(3,159
|
)
|
|
|
(1,466
|
)
|
Other
current
assets
|
|
|
248
|
|
|
|
(227
|
)
|
Other
long term
assets
|
|
|
5
|
|
|
|
--
|
|
Accounts
payable
|
|
|
(2,646
|
)
|
|
|
(485
|
)
|
Accrued
payroll and
benefits
|
|
|
(57
|
)
|
|
|
(52
|
)
|
Accrued
restructuring
charges
|
|
|
(118
|
)
|
|
|
(197
|
)
|
Other
current
liabilities
|
|
|
(496
|
)
|
|
|
642
|
|
Other
long term
liabilities
|
|
|
964
|
|
|
|
(7
|
)
|
Net
cash provided by (used in) operating activities
|
|
|
(758
|
)
|
|
|
2,499
|
|
Investing
activities:
|
|
|
|
|
|
|
|
|
Purchases
of property and
equipment
|
|
|
(1,840
|
)
|
|
|
(1,152
|
)
|
Acquisition
of intangible
assets
|
|
|
(61
|
)
|
|
|
(4
|
)
|
Net
cash used in investing activities
|
|
|
(1,901
|
)
|
|
|
(1,156
|
)
|
Financing
activities:
|
|
|
|
|
|
|
|
|
Proceeds
from option
exercises
|
|
|
536
|
|
|
|
132
|
|
Proceeds
from stock
issuance
|
|
|
--
|
|
|
|
107
|
|
Issuance
of (repayment of) note
payable
|
|
|
(40
|
)
|
|
|
143
|
|
Proceeds
from exercise of
warrants
|
|
|
--
|
|
|
|
22
|
|
Proceeds
from bank credit
facility
|
|
|
4,313
|
|
|
|
1,776
|
|
Net
cash provided by financing activities
|
|
|
4,809
|
|
|
|
2,180
|
|
Net
increase in cash and cash equivalents
|
|
|
2,150
|
|
|
|
3,523
|
|
Cash
and cash equivalents at beginning of period
|
|
|
6,558
|
|
|
|
5,386
|
|
Cash
and cash equivalents at end of period
|
|
$
|
8,708
|
|
|
$
|
8,909
|
|
|
|
|
|
|
|
|
|
|
Schedule
of non-cash investing and financing activities:
|
|
|
|
|
|
|
|
|
Software
acquired under a capital
lease
|
|
$
|
1,219
|
|
|
$
|
--
|
|
Modification
of
warrants
|
|
$
|
--
|
|
|
$
|
57
|
|
Stock
issuance below market
value
|
|
$
|
--
|
|
|
$
|
130
|
|
Issuance
of warrants for
services
|
|
$
|
47
|
|
|
$
|
72
|
|
Preferred
stock
dividend
|
|
$
|
467
|
|
|
$
|
902
|
|
Conversion
of accrued dividends
to common stock
|
|
$
|
2,034
|
|
|
$
|
1,115
|
|
The
accompanying notes are an integral part of these financial
statements.
I-TRAX
,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
1. Organization
I-trax,
Inc. offers integrated workplace health and productivity management
solutions. We operate on-site health centers which deliver primary
care, pharmacy care management, acute care corporate health, and occupational
health as well as disease, wellness and lifestyle management
programs. We enhance the services we offer at our on-site centers
with larger scale disease management and wellness programs that use telephonic
and e-health tools and which benefit from the trusted relationships established
with patients by our clinicians at the worksite. We are focused on
helping our customers achieve employer-of-choice status, making the workplace
safer, and improving the quality of care and productivity of the workforce
while
mitigating healthcare costs.
We
conduct on-site services through CHD Meridian Healthcare, LLC, a Delaware
limited liability company (
“CHD Meridian LLC”
), and its
subsidiary companies, and our disease management and wellness programs through
Continuum Health Management Solutions, LLC, a Delaware limited liability
company, and I-trax Health Management Solutions, Inc., a Delaware
corporation.
Physician
services at our on-site locations are provided under management agreements
with
affiliated physician associations, which are organized professional corporations
that hire licensed physicians who provide medical services (the
“Physician Groups”
). The Physician Groups provide
all medical aspects of our on-site services, including the development of
professional standards, policies, and procedures. We provide a wide
array of business services to the Physician Groups, including administrative
services, support personnel, facilities, marketing, insurance, and other
non-medical services.
2. Basis
of Presentation and Interim Results
The
condensed consolidated financial statements include the accounts of I-trax,
Inc.
and its subsidiaries. We have prepared these statements without
audit, pursuant to the rules and regulations of the Securities and Exchange
Commission.
Certain
information and footnote disclosures normally included in annual financial
statements prepared in accordance with generally accepted accounting principles
have been condensed or omitted pursuant to such rules and
regulations. We believe that the disclosures are adequate to make the
financial information presented not misleading. These condensed
consolidated financial statements should be read in conjunction with the audited
consolidated financial statements and the notes thereto included in the our
Annual Report on Form 10-K for the year ended December 31, 2006, filed with
the
Securities and Exchange Commission on March 16, 2007 (“
2006 Annual
Report
”). All adjustments were of a normal recurring nature
unless otherwise disclosed. In the opinion of management, all
adjustments necessary for a fair statement of the results of operations for
the
interim periods have been included. The results of operations for
such interim periods are not necessarily indicative of the results for the
full
year.
All
material intercompany accounts and transactions have been
eliminated. The financial statements of the Physician Groups are
consolidated with CHD Meridian LLC in accordance with the nominee shareholder
model of Emerging Issues Task Force (“
EITF
”) Issue No. 97-2,
Application of FASB Statement No. 94 and APB Opinion
No. 16 to Physician
Practice Management Entities and Certain Other Entities with Contractual
Management Arrangements
. CHD Meridian LLC has unilateral control
over the assets and operations of the Physician Groups.
I-TRAX,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
Consolidation
of the Physician Groups with CHD Meridian LLC, and consequently, with I-trax,
Inc. is necessary to present fairly the financial position and results of our
operations. Control of the Physician Groups is perpetual and other
than temporary because of the nominee shareholder model and the management
agreements between the entities. The net tangible assets of the
Physician Groups were not material at September 30, 2007 or December 31,
2006.
We
record
pass-through pharmaceutical purchases on a net basis in compliance with EITF
Issue No. 99-19,
Reporting Gross Revenue as a Principal vs. Net as an
Agent
. The amounts of pass-through pharmaceuticals purchased by
us for the three month period ended September 30, 2007 and 2006 were $37,357
and
$37,888, respectively, and for the nine months ended September 30, 2007 and
2006
were $114,160 and $113,113, respectively.
3.
Initial Adoption of FIN 48
We
adopted the provisions of Financial Accounting Standards Board
(
“FASB”
) Interpretation No. 48,
Accounting for Uncertainty
in Income Taxes – an interpretation of FASB Statement No. 109
(
“FIN
48”
), on January 1, 2007. FIN 48 increases the relevancy and
comparability of financial reporting by clarifying the way companies account
for
uncertainty in income taxes. FIN 48 prescribes a consistent recognition
threshold and measurement attribute, as well as clear criteria for subsequently
recognizing, derecognizing and measuring such tax positions for financial
statement purposes. FIN 48 also requires expanded disclosure with respect
to the uncertainty in income taxes. As a result of the implementation of
FIN 48, we recognized approximately $761 as a liability for unrecognized tax
benefits, including estimated interest and penalties of $135. This amount
was included in other long-term liabilities on our condensed consolidated
balance sheet as of March 31, 2007. We recorded a corresponding
increase in our
opening
accumulated deficit of $761.
During
the nine months ended September 30, 2007, we recorded an additional $235 of
FIN
48 expense which increased our total unrecognized tax benefits to $996, all
of
which would, if recognized, affect the effective tax rate. The increase is
the result of additional uncertainties identified subsequent to the adoption
date. Cumulative potential interest and penalties accrued related to
unrecognized tax benefits at September 30, 2007 totaled $198 which is included
in the $996 figure mentioned above.
We
file income tax
returns in the U.S. federal jurisdiction and
numerous state and local
jurisdictions
. With
few exceptions, we are no longer subject to U.S. federal examinations by tax
authorities for years before 2003 and state and local income tax examinations
by
tax authorities for years before 2001.
The New York Department
of Revenue is currently examining state income tax returns for one of our
subsidiaries for years 2003 through 2005. The results of this
examination are not expected to have a material impact on our financial position
or results of operations.
We
do not
currently anticipate that the total amount of unrecognized tax benefits will
significantly increase or decrease by the end of 2007.
4.
Net
Loss Per Share
We
present both basic and diluted loss per share on the face of the consolidated
statements of operations. As provided by Statement of Financial
Accounting Standards (
“SFAS”
) No. 128,
Earnings per
Share
, basic loss per share is calculated as income available to common
stockholders divided by the weighted average number of shares outstanding during
the period. Diluted loss per share reflects the potential
I-TRAX,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
dilution
that could occur from common shares issuable through stock options, warrants
and
convertible preferred stock.
The
following shares issuable upon exercise of options, warrants, and convertible
securities were excluded from the diluted loss per share computation because
their effect would be anti-dilutive for the three and nine months ended
September 30:
|
|
2007
|
|
|
2006
|
|
Series
A Convertible Preferred Stock
|
|
|
2,191,260
|
|
|
|
5,591,600
|
|
Warrants
|
|
|
1,765,561
|
|
|
|
2,813,603
|
|
Stock
options
|
|
|
4,552,625
|
|
|
|
4,309,100
|
|
Anti-dilutive
shares
|
|
|
8,509,466
|
|
|
|
12,714,303
|
|
5. Long
Term Debt
We
use
our senior credit facility with Bank of America, N.A. to finance operations,
which include the purchase of pharmaceuticals on a pass-through basis for the
benefit of our pharmacy clients. Borrowings under the facility are
secured by substantially all of our tangible assets and bear interest at rates
specified in the credit agreement.
At
September 30, 2007 and December 31, 2006, we had $10,870 and $9,057,
respectively, of debt outstanding under the revolving loan
facility. We also had $2,500 outstanding under our Swingline
Commitment at September 30, 2007. At September 30, 2007, the interest
rate applicable under the revolving loan facility was 7.1%. In
addition, at September 30, 2007, $1,700 of the facility was outstanding to
secure a standby letter of credit, which reduces the amount available under
the
facility for borrowings. Availability under the revolving loan
facility was $2,430 and $4,943 at September 30, 2007 and December 31, 2006,
respectively. Availability under the Swingline Commitment at
September 30, 2007 was $2,500. As of September 30, 2007, we were in
compliance with our facility covenants, including covenants measuring: (1)
our
fixed charges coverage ratio, (2) our ratio of funded indebtedness to earnings
before income, taxes, depreciation and amortization, (3) our funded indebtedness
to capitalization, and (4) minimum stockholders’ equity amounts.
6. Stockholders’
Equity
Preferred
Stock
During
the third quarter of 2007, stockholders converted 22,159 shares of Series A
Convertible Preferred Stock into 221,591 shares of common stock, and 42,643
shares of common stock were issued to satisfy the dividends accrued on the
converted shares. As of September 30, 2007, 219,126 shares of Series
A Convertible Preferred Stock were issued and outstanding. Accrued
dividends relating to our preferred stock at September 30, 2007 and December
31,
2006 were $1,549 and $3,116, respectively, which amounts are included in other
current liabilities on the condensed consolidated balance sheet.
Common
Stock
On
August
13, 2007, we granted options to acquire 473,166 shares of common stock to
certain employees with an exercise price of $3.60 per share, which approximated
the market value at the date of grant. The options vest over a three
year period.
I-TRAX,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
On
August
13, 2007, we granted 105,000 shares of restricted stock to certain
employees. The restricted shares were valued at $3.60 per share,
which approximated the market value at the date of grant, and vest over a three
year period.
On
September 10, 2007, we granted options to acquire 146,000 shares of common
stock
to certain employees with an exercise price of $3.25 per share, which
approximated the market value at the date of grant. The options vest
over a three year period.
On
September 10, 2007, we granted 6,000 shares of restricted stock to certain
employees. The restricted shares were valued at $3.25 per share,
which approximated the market value at the date of grant, and vest over a three
year period.
Share
Based Compensation
During
the three months ended September 30, 2007, we recognized $418 of share
compensation expense which is included in general and administrative expense
on
our condensed consolidated statement of operations.
8. Commitments
and Contingencies
Litigation
We
are
involved in legal disputes on a variety of matters in the ordinary course of
business. After reasonable diligence, we expect these matters will be
resolved without a material adverse effect on our consolidated financial
position or results of operations. Further, after reasonable
diligence, we believe that our estimated losses from such matters have been
adequately reserved in other current and other long term liabilities to the
extent probable and reasonably estimable. Nonetheless, it is possible
that our future results of operations for any particular quarterly or annual
period may be materially affected by changes in such matters. See
Note 9,
Professional Liability and Related Reserves
, for further
details.
Compliance
with Healthcare Regulations
Because
we operate in the healthcare industry, we are subject to numerous laws and
regulations of Federal, state, and local governments. These laws and
regulations include, but are not limited to, matters regarding licensure,
accreditation, government healthcare program participation requirements,
reimbursement for patient services, and Medicare and Medicaid fraud and
abuse. Government activity remains high with respect to
investigations and allegations concerning possible violations of fraud and
abuse
laws and regulations by healthcare providers. Violations of these
laws and regulations could result in, among other things, expulsion from
government healthcare programs, fines, penalties, and restitution for billed
services.
We
believe we are in compliance with laws and regulations applicable to our
business. Further, compliance with such laws and regulations in the
future is subject to further government review, changing interpretations and
other regulatory actions. Accordingly, major changes in healthcare
laws, regulations or regulatory interpretations may have an adverse effect
on
our future results of operations.
I-TRAX,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
Significant
Customers
One
customer represented 26% and 27% of our trade accounts receivable at September
30, 2007 and 2006, respectively. This customer also represented 12% and 13%
of our net revenue for the three and nine month periods ended September 30,
2007, respectively.
For
both
the three and nine month periods ended September 30, 2007, a different customer
represented 12% of our net revenue. This same customer accounted for
13% of our net revenue for both the three and nine month periods ended September
30, 2006.
9. Professional
Liability and Related Reserves
Since
2004, we have secured professional and general liability insurance for certain
of our direct and indirect subsidiaries through Green Hills Insurance Company,
a
Risk Retention Group (
“GHIC”
), incorporated as a subsidiary of
CHD Meridian LLC under the laws of the State of Vermont. GHIC
provides professional and general liability insurance to I-trax, Inc., its
subsidiaries, and the Physician Groups and professional liability insurance
to
our medical professionals. The professional liability insurance is a
claims-made policy, which covers claims made during a given period of time
regardless of when the causable event occurred. We purchase excess
insurance to mitigate risk in excess of GHIC’s policy limits. In
years prior to 2004, we secured similar insurance in the commercial
market.
The
operations of GHIC are reflected in our consolidated financial
statements. We maintain professional liability reserves as
follows:
|
|
Total
|
|
Reserves
at December 31, 2006
|
|
$
|
5,759
|
|
Payments
|
|
|
(777
|
)
|
Charged
to operating expenses
|
|
|
404
|
|
Adjustment
(1)
|
|
|
(253
|
)
|
Reserves
at March 31, 2007
|
|
|
5,133
|
|
Payments
|
|
|
(87
|
)
|
Charged
to operating expenses
|
|
|
404
|
|
Adjustment
(1)
|
|
|
(42
|
)
|
Reserves
at June 30, 2007
|
|
|
5,408
|
|
Payments
|
|
|
(50
|
)
|
Charged
to operating expenses
|
|
|
400
|
|
Adjustment
(1)
|
|
|
4
|
|
Reserves
at September 30, 2007
|
|
$
|
5,762
|
|
_______________________
(1)
Represents
changes in estimates of outstanding reported claims and unreported
claims.
Reported
Claims
Our
reported claims reserves include our estimated exposure for claims pre-dating
GHIC as well as claims that have been reported under GHIC’s
policies. These reserves are included in other current liabilities on
our consolidated balance sheet. These reserves are estimated using
individual case-basis valuations, statistical analyses, and independent third
party valuations. These reserves represent our best estimate of the
cost of satisfying all obligations associated with the claims. Our
estimates are reviewed and adjusted as experience develops or new information
becomes known. We also record loss and loss
I-TRAX,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
adjustment
expenses, which include changes in exposure estimates related to reported claims
on a monthly basis. Any changes in estimates are reflected in
operating expenses. At September 30, 2007 and December 31, 2006, the
reserves for reported claims included in other current liabilities on our
consolidated balance sheet were $1,189 and $1,745, respectively.
Unreported
Claims
We
maintain additional reserves for potential claims that may be reported in the
future. On an annual basis, we use independent actuaries to estimate
our exposure for unreported claims. Our estimates are subject to the
effects of trends in claim severity and frequency. Although
considerable variability is inherent in such estimates, management believes
the
reserves for losses and loss adjustment expenses are adequate. The
estimates are reviewed and adjusted as experience develops or new information
becomes known and such adjustments are included in current
operations. Reserves for unreported claims that have been transferred
to GHIC or relate to current operations are recorded as current
liabilities. Unreported claims reserves that have not yet been transferred
to GHIC are included in other long-term liabilities.
At
September 30, 2007 and December 31, 2006, unreported claims reserves were $4,573
and $4,014, respectively. Of these amounts, unreported claims
exposure not transferred to GHIC of $1,638 was included in other long-term
liabilities on our consolidated balance sheet. The remaining amount
is classified as other current liabilities.
10. Lease
Amendment
Under
the
terms of a Lease Agreement dated January 25, 2002, as amended on May 17, 2005,
we lease from Burton Hills IV Investments, Inc. approximately 31,000 square
feet
of office space in Nashville, Tennessee for use as executive, administrative
and
sales offices.
On
August
9, 2007, we executed an Amended and Restated Second Amendment to the Lease
Agreement with Burton Hills IV Investments. Under the terms of the
Amended and Restated Second Amendment, we agreed to relinquish the majority
of
the office space on May 1, 2008 in consideration of an early termination payment
of $964.
On
August
9, 2007, CHD Meridian, LLC executed an Office Facility Lease with First
Industrial Development Services, Inc. Under the terms of this Office
Facility Lease:
·
|
First
Industrial paid Burton Hills IV Investments on our behalf the early
termination payment of $964 required under the Amended and Restated
Second
Amendment.
|
·
|
First
Industrial will build for us an office building in Franklin, Tennessee
of
approximately 50,000 square feet, which we expect to occupy on or
about
May 1, 2008.
|
·
|
The
total value of contractual lease payments related to this facility
is
approximately $9,409.
|
·
|
Thefacility
lease is for a term of 11
years.
|
We
account for lease expenses in accordance with FASB Technical Bulletin 85-3,
Accounting for Operating Leases with Scheduled Rent Increases
, which
stipulates that rent expense for operating leases with rent-free periods or
scheduled increases must be accounted for on a straight-line basis over the
lease
I-TRAX,
INC. AND SUBSIDIARIES
NOTES
TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
($
in thousands, except per share amounts)
term. In
connection with the termination of the Burton Hills IV Investments lease, $184
of deferred rent related to our lease with Burton Hills IV Investments was
offset against the termination payment of $964 resulting in a net lease
termination charge of $780.
At
September 30, 2007, other long term liabilities on our condensed consolidated
balance sheet included deferred rent of $964 related to our new lease
agreement. Our scheduled lease payments to First Industrial include
the repayment of deferred rent.
Item
2
. Management’s Discussion and Analysis of
Financial Condition and Results of Operation
We
believe the primary goals of successful financial reporting are transparency
and
understandability. We are committed to providing our stockholders
with informative financial disclosures and presenting an accurate view of our
financial position and operating results.
Forward
Looking Statements
The
following discussion contains forward-looking statements. All
statements, other than statements of historical facts, included in this
quarterly report regarding our strategy, future operations, financial position,
future revenues, projected costs, prospects, plans and objectives of management
are forward-looking statements. The words “anticipates,” “believes,”
“estimates,” “expects,” “intends,” “may,” “plans,” “projects,” “will,” “would”
and similar expressions are intended to identify forward-looking statements,
although not all forward-looking statements contain these identifying
words. We cannot guarantee that we actually will achieve the plans,
intentions or expectations disclosed in our forward-looking statements, and
readers of this report should not place undue reliance on our forward-looking
statements. Actual results or events could differ, possibly
materially, from the plans, intentions and expectations disclosed in our
forward-looking statements. We have identified important factors in
the cautionary statements below and in our Annual Report on Form 10-K for the
year ended December 31, 2006, filed with the Securities and Exchange Commission
on March 16, 2007 (“
2006 Annual Report
”) that we believe could
cause actual results or events to differ, possibly materially, from our
forward-looking statements. Our forward-looking statements do not
reflect the potential impact of any future acquisitions, mergers, dispositions,
joint ventures or investments we may make. We undertake no duty to
update these forward-looking statements, even though our situation may change
in
the future.
Risk
Considerations
You
are
cautioned not to place undue reliance on the statements and other discussion
set
forth in this quarterly report. These statements and other discussion
speak only as of the date this quarterly report is filed with the Securities
and
Exchange Commission, and these statements are based on management’s current
expectations and are subject to uncertainty and changes in
circumstances. Factors that may cause actual results to differ
materially from management expectations include, but are not limited
to:
·
|
effects
of increasing competition for contracts to establish and manage
employer-dedicated pharmacies and
clinics;
|
·
|
loss
of advantageous pharmaceutical
pricing;
|
·
|
inability
to meet covenants and financial tests under the terms of our senior
secured credit facility;
|
·
|
long
and complex sales cycles;
|
·
|
loss
of a major client;
|
·
|
cost
pressures in the healthcare
industry;
|
·
|
exposure
to professional liability claims and a failure to manage effectively
our
professional liability risks;
|
·
|
economic
uncertainty; and
|
·
|
each
of the factors discussed under “Item 1A. – Risk Factors” in our 2006
Annual Report.
|
Basis
of Presentation
The
accompanying unaudited condensed consolidated financial statements have been
prepared in accordance with generally accepted accounting principles in the
United States of America for interim financial information, the instructions
to
Form 10-Q, and Regulation S-X. In our opinion, the unaudited
condensed consolidated financial statements have been prepared on the same
basis
as the annual financial statements and reflect all adjustments necessary to
present fairly our financial position as of September 30, 2007 and the results
of the operations and cash flows for the three and nine month periods ended
September 30, 2007. The preparation of these financial statements
requires us to make estimates and judgments that affect the reported amounts
of
assets and liabilities and the reported amounts of revenue and expenses during
the covered periods. We base our estimates and judgments on our
historical experience and on various other factors that we believe are
reasonable under the circumstances. We evaluate our estimates and
judgments, including those related to revenue recognition, bad debts, and
goodwill and other intangible assets on an ongoing
basis. Notwithstanding these efforts, there can be no assurance that
actual results will not differ from the respective amount of those
estimates.
This
Management’s Discussion and Analysis of Financial Condition and Results of
Operations (
“MD&A”
), is designed to provide a reader of our
financial statements with a narrative from the perspective of our management
on
our financial condition, results of operations, liquidity and certain other
factors that may affect our future results. Our MD&A is presented in the
following sections:
·
|
Critical
Accounting Policies
|
·
|
Liquidity
and Capital Resources
|
·
|
Material
Equity Transactions
|
Overview
I-trax,
Inc. provides integrated workplace medical, pharmacy, wellness, and disease
management services to enhance the health and productivity of the employees,
dependents, and retirees of our clients. We deliver these services at
or near the client’s worksite by opening, staffing and managing health centers
and pharmacies dedicated to our clients and their eligible
populations. We enhance our on-site services with larger scale
disease management and wellness programs through the use of telephonic and
e-health tools and pharmaceutical benefits management programs. We
believe our clinicians deliver excellent care in part because of the trusted
relationship they establish with their patients at the worksite.
We
believe our services improve the health status of client populations and
mitigate the upward cost trend experienced by employers, employees, and
government agencies with respect to healthcare. By proactively
managing the healthcare needs of our clients’ eligible populations, we believe
our programs improve health, increase productivity, reduce absenteeism, reduce
the need for future critical care, and
manage
overall costs. We also believe the breadth of our services allows our
clients the flexibility to meet many of their needs in a cost-effective and
professional manner.
As
of
September 30, 2007, we were providing services to over 105 clients, including
large financial institutions, consumer products manufacturers, automotive and
automotive parts manufacturers, diversified industrial companies, and a variety
of other employers. As of September 30, 2007, we were operating 234
on-site facilities in 35 states. Our client retention rate is high
due to strong client relationships that are supported by the critical nature
of
our services, the benefits achieved by employer and employee constituents,
and
the utilization of multi-year service contracts.
Historically,
our on-site services separated into four general categories: occupational
health, primary care, and corporate health centers, and
pharmacies. Traditional lines among the occupational health, primary
care, and corporate health categories are blurring, however, as employers seek
unique combinations of services to challenge rising healthcare
costs. Accordingly, although we continue to use the general
categories to emphasize the primary purpose of a specific facility, we do so
with the recognition that many components of excellent care are uniform across
all of our facilities.
Critical
Accounting Policies
A
summary
of significant accounting policies is disclosed in Note 2 to the consolidated
financial statements included in our 2006 Annual Report. Our critical
accounting policies are further described under the caption “Critical Accounting
Policies” in Management’s Discussion and Analysis of Financial Condition and
Results of Operations in our 2006 Annual Report.
Results
of Operations
During
the quarter ended September 30, 2007, we:
·
|
Accelerated
revenue growth to 15.3% over the prior-year quarter and achieved
the
highest quarterly revenue in our company’s history, $35.1
million;
|
·
|
Opened
9 net new sites, which brings total sites under management to
234;
|
·
|
Recorded
$0.8 million of expense related to the early termination of our lease
as
discussed below;
|
·
|
Reported
diluted loss per share of $(0.02) (which includes the effect of $0.8
million of lease termination expense) compared to prior-year quarter
of
$0.00;
|
·
|
Reduced
the preferred stock dividend to a run rate of $0.1 million per
quarter;
|
·
|
Increased
discretionary spending on selling, marketing and new product development
efforts by $0.3 million from prior-year;
and
|
·
|
Reported
share-based compensation expense of $0.4
million.
|
Consolidated
Results
The
following table presents selected consolidated financial data for the three
and
nine month periods ended September 30:
$
in thousands, except per share
amounts
|
|
Three
Months Ended
September
30
|
|
|
Nine
Months Ended
September
30
|
|
Consolidated Performance Summary
|
|
2007
|
|
|
2006
|
|
|
2007
|
|
|
2006
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net
revenue
|
|
$
|
35,148
|
|
|
$
|
30,495
|
|
|
$
|
103,234
|
|
|
$
|
91,061
|
|
Gross
profit as % of net revenue
|
|
|
24.3
|
%
|
|
|
25.8
|
%
|
|
|
24.2
|
%
|
|
|
24.4
|
%
|
General
and administrative expense as % of net revenue
|
|
|
20.3
|
%
|
|
|
21.1
|
%
|
|
|
21.1
|
%
|
|
|
20.2
|
%
|
Operating
income (loss)
|
|
$
|
(523
|
)
|
|
$
|
610
|
|
|
$
|
(623
|
)
|
|
$
|
1,343
|
|
Operating
income (loss) as % of net revenue
|
|
|
(1.5
|
)%
|
|
|
2.0
|
%
|
|
|
(0.6
|
)%
|
|
|
1.5
|
%
|
Lease
termination expense
|
|
$
|
780
|
|
|
$
|
--
|
|
|
$
|
780
|
|
|
$
|
--
|
|
Net
income (loss)
|
|
$
|
(800
|
)
|
|
$
|
204
|
|
|
$
|
(126
|
)
|
|
$
|
415
|
|
Net
loss applicable to common stockholders
|
|
$
|
(921
|
)
|
|
$
|
(78
|
)
|
|
$
|
(593
|
)
|
|
$
|
(487
|
)
|
Diluted
loss per common share
|
|
$
|
(0.02
|
)
|
|
$
|
0.00
|
|
|
$
|
(0.01
|
)
|
|
$
|
(0.01
|
)
|
Three
Months Ended September 30, 2007 Compared to Three Months Ended September 30,
2006
Net
revenue for the three months ended September 30, 2007 increased by $4.6 million
to $35.1 million, or by 15.3%, from $30.5 million for the three months ended
September 30, 2006. The increase in revenue is primarily attributable
to the increase in the number of sites we operated. At September 30,
2007, we operated 234 sites compared to 211 sites at September 30,
2006. In the three months ended September 30, 2007, same site net
revenue growth for sites in operation for more than one year was 2.7% compared
to net revenue for the three months ended September 30, 2006.
Our
operating expenses, that is our direct costs associated with the operation
of
our on-site and health management services, increased by $4.0 million to $26.6
million for the three months ended September 30, 2007 from $22.6 million for
the
three months ended September 30, 2006. This increase of 17.7%
reflects the greater number of facilities under management and the growth of
services provided to existing clients. In addition, the year-ago
quarter included a reduction of operating expenses by $0.3 million due to a
health insurance reserve true-up.
Operating
expenses as a percent of revenue were 75.7% for the third quarter of 2007,
which
is slightly higher than 74.2% recorded in the third quarter of
2006. Consequently, our third quarter gross margin (net revenue minus
operating expenses) decreased to 24.3% of net revenue from 25.8% of net revenue
in the prior-year quarter. Excluding the health insurance true-up
from the year-ago quarter, gross margin would have been 24.8% of net
revenue. Our ratio of new site gross margin to existing site gross
margin at the end of the third quarter was 1.17. For purposes of this
ratio, we define new sites as sites that have been in operation for less than
two full fiscal years.
General
and administrative (“
G&A
”) expense increased to $7.1
million for the three months ended September 30, 2007 from $6.4 million for
the
three months ended September 30, 2006, an increase of $0.7 million or
10.6%. Discretionary spending in sales and marketing and research and
development
accounted
for approximately $1.0 million of G&A expense for the third quarter of 2007
or $0.3 million of the increase from the prior year’s comparable
period. Non-cash stock compensation expenses required by Statement of
Financial Accounting Standards No.123 (revised 2004),
Share-Based
Payment
, (“
SFAS 123R
”) totaled approximately $0.4 million
in both the current year and prior year quarters. The balance of the
increase in G&A expense was approximately $0.4 million. This
increase is the result of upgrades in our operating systems and information
technology infrastructure which will help provide scalable operations, lower
maintenance costs, better client reporting, and improved overall
efficiency.
The
following table shows details our G&A expenditures in functional
categories:
$
in
thousands
|
|
Three
Months Ended
|
|
|
|
September
30,
2007
|
|
|
%
of Net
Revenue
|
|
|
September
30,
2006
|
|
|
%
of Net
Revenue
|
|
Net
revenue
|
|
$
|
35,148
|
|
|
|
100%
|
|
|
$
|
30,495
|
|
|
|
100%
|
|
Total
G&A expenses
|
|
|
7,118
|
|
|
|
20.3%
|
|
|
|
6,437
|
|
|
|
21.1%
|
|
Less:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Sales
and marketing and research
and development
|
|
|
993
|
|
|
|
2.8%
|
|
|
|
708
|
|
|
|
2.3%
|
|
SFAS
123R expense
|
|
|
418
|
|
|
|
1.2%
|
|
|
|
405
|
|
|
|
1.3%
|
|
“Core”
G&A
(1)
|
|
|
5,707
|
|
|
|
16.2%
|
|
|
|
5,324
|
|
|
|
17.5%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Information
technology expenditures
included
in “core” G&A
|
|
|
1,193
|
|
|
|
3.4%
|
|
|
|
741
|
|
|
|
2.4%
|
|
___________________
(1)
Excludes
SFAS 123R stock based compensation expense, new product development, and sales
and marketing.
We
monitor our general and administrative expenses as a percentage of
revenue. We define our “core” G&A expense to be all G&A
expenditures necessary to maintain current operations. This excludes
sales and marketing and new product development, which we view as investments
made to grow the business. Core G&A also excludes SFAS 123R
expense. The significant reduction in core G&A as a percentage of
revenue for the third quarter of 2007 is due to operating leverage gained from
consciously monitoring and controlling core G&A expenditures while
substantially increasing revenue.
Lease
termination expense in the third quarter of 2007 relates to an early termination
penalty under the lease for our current Nashville corporate operations
facility. An early termination penalty of $1 million, offset by a
reduction in deferred rent on our current facility of $0.2 million, resulted
in
net charge of $0.8 million. We concurrently signed a new lease for
more space at less cost per square foot, which management believes will better
accommodate our anticipated growth. The early termination penalty was
paid by our new landlord and will be spread over the term of our new
lease.
Our
depreciation and amortization expense was $1.2 million for the three months
ended September 30, 2007, an increase of $0.3 million as compared to $0.8
million for the three months ended September 30, 2006. An amortization
expense of $0.4 million for the third quarter of 2007 is primarily related
to
amortization of our customer list. Our depreciation expense of $0.7
million has increased from $0.4 million for the year-ago quarter due to
investments in operating systems and information technology
infrastructure. Our fixed asset investment for the third quarter of
2007 was approximately $1.9 million compared to $0.4 million for the year-ago
period. Current year fixed asset investments include cash investments
of $0.7 million and software licenses which are treated as a capital lease
of
$1.2 million.
Our
interest expense for the three months ended September 30, 2007 and September
30,
2006 was $0.1 million. Interest expense is primarily attributable to
our senior secured credit facility.
The
provision for income taxes for the three months ended September 30, 2007 was
$0.1 million compared to $0.2 million for the three months ended September
30,
2006. This decrease is related to prior period expense adjustment and
book income variances.
For
the
three months ended September 30, 2007, our net loss was $(0.8) million compared
to net income $0.2 in the year-ago period. Net loss applicable to
common stockholders was $(0.9) million for the three months ended September
30,
2007 and $(0.1) million for the year-ago period. Current year results
were largely affected adversely by $0.8 million of early lease termination
expense recorded during the third quarter. We continued to expand
services to both new and existing clients while investing in sales, marketing
and research and development to take advantage of what management believes
will
be future market opportunities and also to invest in revenue growth and
profitability in the future.
Nine
Months Ended September 30, 2007 Compared to Nine Months Ended September 30,
2006
Net
revenue for the nine months ended September 30, 2007 increased by $12.1 million
to $103.2 million from $91.1 million for the nine months ended September 30,
2006, an increase of approximately 13.4%. This increase is primarily
attributable to the addition of 22 net new sites since December 31,
2006. In the first nine months of 2007, same site net revenue growth
for sites in operation for more than one year was 1.7% compared to net revenue
for the three months ended September 30, 2006.
Our
operating expenses, that is our direct costs associated with the operation
of
our on-site and health management services, increased by $9.5 million to $78.3
million for the nine months ended September 30, 2007 from $68.8 million for
the
nine months ended September 30, 2006, an increase of 13.7%. The
increase reflects the greater number of facilities under management and the
growth of services provided to existing clients.
Operating
expenses as a percent of revenue were 75.8% for the first nine months of 2007,
a
slight increase of 0.2% from the 75.6% achieved in the year ago
period. Consequently, gross margin (net revenue minus operating
expenses) for the nine months ended September 30, 2007 decreased to 24.2% of
net
revenue from 24.4% of net revenue in the year ago period. Our ratio of new
site gross margin to existing site gross margin at the end of the third quarter
was 1.18. For purposes of this ratio, we define new sites as sites
that have been in operation for less than two full fiscal years.
G&A
expense increased to $21.8 million for the nine months ended September 30,
2007
from $18.4 million for the nine months ended September 30, 2006, an increase
of
$3.4 million, or 18.7%. Discretionary spending in sales and marketing
and research and development accounted for approximately $3.1 million of G&A
expense for the first three quarters of 2007, or $1.4 million of the increase
from the prior year period. An additional increase of $0.3 million is
attributable to increased SFAS 123R non-cash stock compensation expenses, which
totaled approximately $1.2 million for the nine months ended September 30,
2007. The balance of the increase in G&A expense was $1.4
million, of which $1.2 million represents the increase in information
technology spend over the year-ago period. We believe these
investments enhance our client delivery infrastructure, increase customer
awareness, and accelerated growth in revenue and operating margins, and prove
our concept and significant competitive advantage in the
marketplace.
The
following table shows details our G&A expenditures in functional
categories:
$
in
thousands
|
|
Three
Months Ended
|
|
|
|
September
30,
2007
|
|
|
%
of Net Revenue
|
|
|
September
30,
2006
|
|
|
%
of Net Revenue
|
|
Net
revenue
|
|
$
|
103,234
|
|
|
|
100%
|
|
|
$
|
91,061
|
|
|
|
100%
|
|
Total
G&A expenses
|
|
|
21,793
|
|
|
|
21.1%
|
|
|
|
18,356
|
|
|
|
20.2%
|
|
Less:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Sales
and marketing and research
and development
|
|
|
3,089
|
|
|
|
3.0%
|
|
|
|
1,706
|
|
|
|
1.9%
|
|
SFAS
123R expense
|
|
|
1,238
|
|
|
|
1.2%
|
|
|
|
961
|
|
|
|
1.1%
|
|
“Core”
G&A
(1)
|
|
|
17,466
|
|
|
|
16.9%
|
|
|
|
15,689
|
|
|
|
17.2%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Information
technology expenditures
included
in “core” G&A
|
|
|
3,285
|
|
|
|
3.2%
|
|
|
|
2,086
|
|
|
|
2.3%
|
|
______________
(1)
Excludes
SFAS 123R stock based compensation expense, new product development, and sales
and marketing.
We
monitor our general and administrative expenses as a percentage of
revenue. We define our “core” G&A expense to be all G&A
expenditures necessary to maintain current operations. This excludes
sales and marketing and new product development, which we view as investments
made to grow the business. Core G&A also excludes SFAS 123R
expense. The reduction in core G&A as a percentage of revenue for
the nine months ended September 31, 2007, is due to operating leverage gained
from consciously monitoring and controlling core G&A expenditures while
substantially increasing revenue.
Lease
termination expense in the third quarter of 2007 relates to an early termination
penalty under the lease for our current Nashville corporate operations
facility. An early termination penalty of $1 million, offset by a
reduction in deferred rent on our current facility of $0.2 million, resulted
in
net charge of $0.8 million. We concurrently signed a new lease for
more space at less cost per square foot, which management believes will better
accommodate our anticipated growth. The early termination penalty was
paid by our new landlord and will be spread over the term of our new
lease.
Our
depreciation and amortization expense was $3.0 million for the nine months
ended
September 30, 2007, an increase of $0.5 million as compared to $2.5 million
for
the nine months ended September 30, 2006. An amortization expense of
$1.4 million for the nine months ended September 30, 2007 is primarily related
to amortization of our customer list. Our depreciation expense of
$1.6 million is an increase of $0.5 million over the year-ago period related
to
increased purchases of software and information technology equipment over the
past year.
Our
interest expense for the nine months ended September 30, 2007 was $0.4 million,
an increase of $0.1 million from that for the nine months ended September 30,
2006 of $0.3 million. Interest expense is primarily attributable to
our senior secured credit facility.
Amortization
of financing costs for the nine months ended September 30, 2007 were $0.1
million, a decrease of $0.1 million from the year ago period.
The
provision for income taxes for both the nine months ended September 30, 2007
and
2006 was $0.4 million. 2007 results include $0.2 million of expense
related to the increase in FIN 48 liability recorded during 2007.
During
the second quarter of 2007, we received a premium refund of $1.4 million in
accordance with the terms of our terminated excess liability insurance
policy. This amount is included in other expense (income) on the face
of our consolidated income statement.
For
the
nine months ended September 30, 2007, our net loss was $(0.1) million compared
to net income of $0.4 million for the year-ago period. Net loss
applicable to common stockholders was $(0.6) million for the first nine months
of 2007 compared to $(0.5) million for the year-ago period. Current
year results were affected by two non-recurring events:
·
|
During
the second quarter of 2007, we secured a new excess insurance
policy. We also allowed our old excess policy to
expire. The terms of our old excess policy allowed us to
receive a refund of a portion of the premiums we paid during the
policy
period. This absolutely and unconditionally released and
discharged the insurer from and against any and all obligations to
us for
claims covered during the policy’s three year period. Consequently, we
recorded a premium refund of $1.4
million.
|
·
|
We
made a decision to relocate our Nashville operations to accommodate
our
significant anticipated growth over the next several years. As
a result of this decision, we recognized a loss of $0.8 million during
the
third quarter of 2007 related to the buy out of our existing
lease.
|
The
increase in gross profit was used to fund the business of the future through
discretionary expenditures for sales and marketing, research and development,
and information technology infrastructure.
Liquidity
and Capital Resources
Summary
We
use
our credit facility to finance operations, which includes the purchase of
pharmaceuticals. Borrowings under the facility are secured by
substantially all of our tangible assets and bear interest at rates specified
in
the credit agreement. At September 30, 2007, $1,700 of the facility
was outstanding to secure a standby letter of credit, which reduces the amount
available under the facility for borrowings.
Cash
recorded on our consolidated balance sheet consists primarily of cash held
by
our insurance subsidiary. We utilize a revolving senior secured
credit facility and our swingline commitment to manage our working capital
needs
during the year. Our accounts payable and cash outlays are driven
primarily by pass-through pharmaceutical purchases averaging $6 million every
two weeks. During the third quarter of 2007, our weighted-average
balance outstanding under our revolving credit facility was
$9.1 million. As of September 30, 2007, $2.4 million was
available under the revolving credit facility and $2.5 million was outstanding
under our swingline commitment. Total borrowings under the credit
facility (revolving and swingline) at September 30, 2007 and December 31, 2006
were $13.4 million and $9.1 million, respectively.
We
ended
the third quarter with $8.7 million of cash and cash equivalents, an increase
of
$2.2 million from the end of 2006, of which $8.3 million is held in our
insurance subsidiary. Our current ratio, the ratio of current assets
to current liabilities, was 1.59 at September 30, 2007, as compared to 1.12
at
December 31, 2006 and 1.26 at September 30, 2006. We believe that
these ratios demonstrate improving financial liquidity. We believe
that availability under our credit facility and our cash and cash equivalents
will be sufficient to meet our anticipated cash needs for the next 12
months.
The
following table summarizes our cash flows from operating, investing and
financing activities for the nine months ended September 30:
$
in
thousands
|
|
2007
|
|
|
2006
|
|
Total
cash provided by (used in):
|
|
|
|
|
|
|
Operating
activities
|
|
$
|
(758
|
)
|
|
$
|
2,499
|
|
Investing
activities
|
|
|
(1,901
|
)
|
|
|
(1,156
|
)
|
Financing
activities
|
|
|
4,809
|
|
|
|
2,180
|
|
Increase
in cash and cash equivalents
|
|
$
|
2,150
|
|
|
$
|
3,523
|
|
Operating
Activities
Cash
used
in operating activities was $0.8 million for the first nine months of 2007,
compared with cash provided by operations of $2.5 million for the first nine
months of 2006. This decrease is primarily attributable to the increase in
accounts receivable and the decrease in accounts payable and other current
liabilities, offset in part by the increase in other long term
liabilities. The increase in accounts receivable is due to our growth
in sites and a longer average collection period. We do not believe
that this constitutes an increased risk of uncollectible accounts, however,
as
we continue to have a strong history of collecting outstanding accounts
receivable balances.
Investing
Activities
Cash
used
in investing activities was $1.9 million for the first nine months of 2007
compared with $1.2 million for the first nine months of 2006. We
entered into a licensing arrangement with a vendor resulting in non-cash
investment in software licenses of $1.2 million during the third quarter of
2007. The primary purpose of our cash investment activities was to
support our clinicians at site locations, improve our operational efficiency
and
create scalability for future service offerings.
Financing
Activities
Cash
provided by financing activities was $4.8 million for the first nine months
of
2007, compared with $2.2 million for the first nine months of
2006. Financing activity in each period primarily constituted
additional draws under our credit facility.
Generally,
we rely on three principal sources of cash for liquidity: (1) funds
generated by operating activities; (2) cash and cash equivalents in excess
of
the amounts necessary to meet reserve requirements in our insurance subsidiary;
and (3) borrowings under our revolving credit facility. During the
first nine months of 2007, however, we used $0.8 million of funds in operating
activities principally as a result of the $3.2 million increase in accounts
receivable and the $3.1 million decrease in other current liabilities and
accounts payable, offset in part by the increase in other long term
liabilities. Moreover, we carry very little cash in excess of amounts
necessary to meet our insurance reserves. As a result, during the
period ended September 30, 2007, we have relied exclusively on draws under
our
credit facility for liquidity. To fund operations since December 31,
2006, we have increased the balance owed on our credit facility by approximately
$4.3 million, of which $1.8 million represents an increase in
borrowing
under the revolving line and $2.5 million represents a borrowing under the
newly-available swingline commitment.
The
increase in our accounts receivable balance is due to a combination of our
revenue growth and an increase in the average days our accounts receivable
are
outstanding. We do not anticipate that our average collection period
will continue to increase. As most of our outstanding accounts
receivable balances are current, we do not believe there are any ultimate
collection issues or that these outstanding balances will adversely affect
our
credit facility borrowing base.
We
believe funds available under our credit facility and generated from operations
will be sufficient to finance continuing operations and strategic initiatives
for the next year. As of September 30, 2007, $2.4 million was
available under the revolving facility and $2.5 million was available under
the
swingline commitment. Nonetheless, our ability to access our credit
facility is subject to compliance with the terms and conditions of the credit
facility, including financial covenants that require us to maintain certain
financial ratios. At September 30, 2007, we were in compliance with
all such covenants.
We
will,
from time to time, consider the acquisition of, or investment in, complementary
businesses, products, services and technologies, which would most likely affect
our liquidity requirements or cause us to issue additional equity or debt
securities.
If
sources of liquidity are not available or if we cannot generate sufficient
cash
flow from operations during the next 12 months, we might be required to obtain
additional sources of funds through additional operating improvements, capital
market transactions (including the sale of common stock), asset sales or
financing from third parties, or a combination of these options. We
cannot provide assurance that these additional sources of funds will be
available or, if available, would have reasonable terms.
Contractual
Obligations and Commitments
We
have
various contractual obligations that are recorded as liabilities in our
condensed consolidated financial statements. Other items, such as
operating lease obligations are not recognized as liabilities in our condensed
consolidated financial statements but are required to be disclosed.
As
discussed earlier, we made a decision to relocate our Nashville operations
to
accommodate our significant anticipated growth over the next several
years. We also entered into a software licensing agreement which is
classified as a capital lease in accordance with SFAS No. 13,
Accounting for
Leases
. The contractual cash outlays related to these agreements
are as follows:
|
|
Payments
due by period
|
|
Contractual
obligations
|
|
Total
|
|
|
<
1 Year
|
|
|
1
– 3 Years
|
|
|
3
– 5 Years
|
|
|
>
5 Years
|
|
Office
lease obligation
|
|
$
|
9,409
|
|
|
$
|
66
|
|
|
$
|
1,619
|
|
|
$
|
1,685
|
|
|
$
|
6,039
|
|
Capital
lease obligation
|
|
$
|
1,219
|
|
|
$
|
406
|
|
|
$
|
813
|
|
|
$
|
--
|
|
|
$
|
--
|
|
Material
Equity Transactions
Series
A Convertible Preferred Stock shares converted
|
|
|
22,159
|
|
Common
shares issued upon conversion
|
|
|
221,591
|
|
Common
shares issued in satisfaction of dividends accrued
|
|
|
42,643
|
|
Total
common shares issued upon Series A Convertible Preferred Stock
conversions
|
|
|
264,234
|
|