HMS Reports Fourth Quarter and Full Year 2020 Financial Results

• FY’20 Total Revenue of $673.3 Million, +7.5% vs. FY’19
• FY’20 Net Income of $70.1 Million, -19.6% vs. FY’19
• FY’20 GAAP EPS of $0.78 per Diluted Share vs. $0.98 per Diluted Share in FY’19
• FY’20 Adjusted EPS of $1.33 per Diluted Share vs. $1.12 per Diluted Share in FY’19 (excluding net benefit of 2Q-19 Reserve Release, 3Q-19 Gain on Investment and discrete tax benefits)
• FY’20 Adjusted EBITDA of $184.3 Million, +12.6% vs. FY’19 (excluding net benefit of 2Q-19 Reserve Release and 3Q-19 Gain on Investment)

IRVING, Texas, Feb. 26, 2021 (GLOBE NEWSWIRE) — HMS Holdings Corp. (Nasdaq: HMSY) today announced financial results for the fourth quarter and full year ended December 31, 2020.

Fourth Quarter
Total revenue in the fourth quarter of 2020 was $194.0 million, compared to total revenue of $163.4 million in the fourth quarter of 2019 (+18.7%). Revenue in the fourth quarter of 2020 from the Accent business, which was acquired at the end of 2019, was $10.9 million. Organic revenue in the fourth quarter of 2020, excluding Accent, increased 13.2%.

Coordination of Benefits (COB) revenue was $130.5 million in the fourth quarter of 2020 compared to $98.6 million in the fourth quarter of 2019 (+32.4%). Organic COB revenue, excluding Accent, was $119.7 million (+23.5%).

Payment Integrity (PI) revenue was $50.3 million in the fourth quarter of 2020, compared to $48.4 million in the fourth quarter of 2019 (+4.1%). Population Health Management (PHM) revenue was $13.1 million in the fourth quarter of 2020, compared to $16.6 million in the prior year fourth quarter (-20.6%).

Net income in the fourth quarter of 2020 was $32.8 million, or $0.36 per diluted share, compared to net income of $17.3 million, or $0.20 per diluted share, in the fourth quarter of 2019.

Adjusted EBITDA in the fourth quarter of 2020 was $64.9 million, compared to $42.3 million in the fourth quarter of 2019 (+53.4%).

Adjusted EPS in the fourth quarter of 2020 was $0.51 per diluted share, compared to adjusted EPS of $0.27 per diluted share in the fourth quarter of 2019 (+88.9%).

Full Year
Total revenue for the twelve months ended December 31, 2020 was $673.3 million, compared to $626.4 million in the prior year (+7.5%). For the twelve months ended December 31, 2019, total revenue included $10.5 million in revenue from the second quarter of 2019 related to the Company’s release of its remaining contract-related balance under its original Medicare RAC Contract (the “2Q 2019 Reserve Release”). Revenue in the twelve months ended December 31, 2020 from the Accent business was $43.3 million. Excluding the 2Q 2019 Reserve Release and revenue from the Accent business, total revenue increased 2.6% compared to the prior year.

COB revenue for the twelve months ended December 31, 2020 was $469.2 million, compared to $404.1 million in the prior year (+16.1%). Organic COB revenue for the twelve months ended December 31, 2020, excluding Accent, was $425.9 million (+5.8%).

PI revenue for the twelve months ended December 31, 2020 was $152.0 million, compared to $162.2 million in the prior year (-6.3%). Excluding the 2Q 2019 Reserve Release, PI revenue increased 0.2% compared to the prior year. PHM revenue for the twelve months ended December 31, 2020 was $52.1 million, compared to $60.1 million in the prior year (-13.3%).

Net income for the twelve months ended December 31, 2020 was $70.1 million, or $0.78 per diluted share, compared to $87.2 million, or $0.98 per diluted share, in the prior year. For the twelve months ended December 31, 2019, net income included $0.07 per diluted share related to the 2Q 2019 Reserve Release, a net benefit of $0.06 per diluted share related to a gain on the sale of an investment in the third quarter of 2019 (the “3Q 2019 Gain on Investment”), and discrete tax benefits recorded in the first quarter of 2019 totaling $0.07 per diluted share.

Adjusted EBITDA for the twelve months ended December 31, 2020 was $184.3 million, compared to $179.6 million in the prior year (+2.6%), which included a net benefit of $8.2 million related to the 2Q 2019 Reserve Release and $7.7 million related to the 3Q 2019 Gain on Investment. Excluding those benefits, Adjusted EBITDA increased 12.6% compared to the prior year.

Adjusted EPS for the twelve months ended December 31, 2020 was $1.33 per diluted share. Adjusted EPS was $1.32 per diluted share in the prior year, including $0.07 per diluted share related to the 2Q 2019 Reserve Release, $0.06 per diluted share related to the 3Q 2019 Gain on Investment and discrete tax benefits recorded in the first quarter of 2019 totaling $0.07 per diluted share. Excluding the 2Q 2019 Reserve Release, the 3Q 2019 Gain on Investment and discrete tax benefits in 2019, adjusted EPS for the twelve months ended December 31, 2020 was $1.33 per diluted share, compared to $1.12 per diluted share in the prior year period (+18.8%).

Cash Flow and Capital Resources
Net cash provided by operating activities for the twelve months ended December 31, 2020 was $99.0 million compared to $133.2 million in the prior year. Capital expenditures were $27.9 million for the twelve months ended December 31, 2020, compared to $21.6 million in the prior year.

The Company’s balance sheet at December 31, 2020 included $207.1 million of cash and cash equivalents and $240.0 million in outstanding bank debt, compared to cash and cash equivalents of $139.3 million and outstanding bank debt of $240.0 million at December 31, 2019.

About HMS
HMS advances healthcare by helping organizations reduce costs and improve health outcomes. Through our industry-leading technology, analytics and engagement solutions, we save billions of dollars annually while helping consumers lead healthier lives. HMS provides a broad range of payment accuracy and population health management solutions that help move healthcare forward. Visit us at www.hms.com.

Trademarks
HMS and the HMS logo are registered trademarks of HMS Holdings Corp. and/or its affiliates. Other names may be trademarks of their respective owners.

Non-GAAP Financial Measures
The Company reports and discusses its operating results using financial measures consistent with accounting principles generally accepted in the United States (“GAAP”). From time to time, in press releases, financial presentations, earnings conference calls or otherwise, the Company may disclose certain non-GAAP financial measures. The non-GAAP financial measures presented in this press release should not be viewed as alternatives or substitutes for the Company’s reported GAAP results. A reconciliation to the most directly comparable GAAP financial measure is set forth in the tables that accompany this release.

The Company believes that the non-GAAP financial measures presented in this press release are relevant and provide useful information to the Company’s management, investors, and other interested parties about the Company’s operating performance because the measures allow them to understand and compare the Company’s actual and expected operating results during the prior, current and future periods in a more consistent manner. The non-GAAP measures presented in this press release may not be comparable to similarly titled measures used by other companies. These non-GAAP financial measures are used in addition to and in conjunction with results presented in accordance with GAAP and reflect an additional way of viewing aspects of the Company’s operations that, when viewed with GAAP results and the accompanying reconciliations to corresponding GAAP financial measures, provides a more complete understanding of the results of operations and trends affecting the Company’s business. These non-GAAP financial measures should be considered as a supplement to, and not as a substitute for, or superior to financial measures calculated in accordance with GAAP.

Safe Harbor Statement
The financial results in this press release reflect preliminary, unaudited results, which are not final until the Company’s Annual Report on Form 10-K for the year ended December 31, 2020 is filed. This press release, and other written or oral statements made by management from time to time, may contain “forward-looking statements” within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Such statements relate to our current expectations, projections and assumptions about our business, the economy and future events or conditions. They do not relate strictly to historical or current facts. Forward-looking statements can be identified by words such as “aims,” “anticipates,” “assumes,” “believes,” “estimates,” “expects,” “forecasts,” “future,” “intends,” “likely,” “may,” “outlook,” “plans,” “potential,” “projects,” “seeks,” “strategy,” “targets,” “trends,” “will,” “would,” “could,” “should,” variations of such terms and similar expressions and references to guidance, although some forward-looking statements may be expressed differently. Factors or events that could cause actual results to differ may emerge from time to time and are difficult to predict. Should known or unknown risks or uncertainties materialize, or should underlying assumptions prove inaccurate, actual results may differ materially from past results and those anticipated, estimated or projected. We caution you not to place undue reliance upon any of these forward-looking statements. 

Factors that could cause or contribute to such differences, include, but are not limited to: the occurrence of any event, change, or other circumstances that could delay or prevent closing of the proposed acquisition of HMS by Gainwell Acquisition Corp. (“Gainwell”), or give rise to the termination of that certain Agreement and Plan of Merger, dated December 20, 2020, by and among HMS, Gainwell, Mustang MergerCo Inc. and Gainwell Intermediate Holding Corp.; the course of the COVID-19 pandemic and the responses to the pandemic, and their effects on our business and operations, including those of our customers and partners, and general economic, business and market conditions; our ability to execute our business plans or growth strategy; our ability to innovate, develop, implement and deliver new or enhanced solutions or services; the nature of any strategic acquisition, investment, partnership and divestiture opportunities we are pursuing, and our ability to successfully execute on such opportunities; our ability to successfully integrate or merge acquired businesses and realize synergies; significant and increased competition for our solutions and services; changes in the healthcare environment or healthcare financing system, including regulatory, budgetary or political actions that affect healthcare spending or the practices and operations of healthcare organizations; our ability to protect our systems from damage, interruption or breach, and to maintain effective information and technology systems and networks, including during a catastrophic or extraordinary event, such as the COVID-19 pandemic; our failure to maintain a high level of customer retention or the unexpected reduction in scope or termination of key contracts with major customers; customer dissatisfaction or our non-compliance with contractual provisions or regulatory requirements; our failure to meet performance standards triggering significant costs or liabilities under our contracts; our inability to manage our relationships with data and IT suppliers; our reliance on subcontractors and other third party providers and parties to perform services; our ability to secure future contracts and favorable contract terms through the competitive bidding process; our success in attracting and retaining qualified employees and members of our management team; risks relating to our international operations, including political, regulatory, economic, foreign exchange, cybersecurity, tax compliance and other risks; variations in our results of operations; our ability to accurately forecast the revenue under our contracts and solutions; our ability to generate sufficient cash to cover our interest and principal payments under our credit facility; changes in tax laws, regulations or guidance or unexpected changes in our effective tax rate; unanticipated increases in the number or amount of claims for which we are self-insured; accounting changes or revisions; our ability to protect our intellectual property rights, proprietary technology, information processes, and know-how; our failure to comply with applicable laws and regulations governing individual privacy and information security, domestically and internationally, or to protect such information from theft and misuse; our ability to comply with current and future legal and regulatory requirements; negative results of government or customer reviews, audits or investigations; pending or threatened litigation; unfavorable outcomes in legal proceedings; state or federal limitations related to outsourcing of certain government programs or functions; restrictions on bidding or performing certain work due to perceived conflicts of interests; the market price of our common stock and lack of dividend payments; anti-takeover provisions in our corporate governance documents; and other factors, risks and uncertainties described in our most recent Annual Report on Form 10-K and in our other filings with the Securities and Exchange Commission. Any forward-looking statements herein speak only as of the date such statements are first made. Except as may be required by law, we disclaim any obligation to publicly update forward-looking statements, whether as a result of new information, future events or otherwise.

HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(in thousands, except per share amounts)
(unaudited)

HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(in thousands, except share and per share amounts)
(unaudited)

HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands, unaudited)

HMS HOLDINGS CORP. AND SUBSIDIARIES
(unaudited)

Reconciliation of Net Income to EBITDA and Adjusted EBITDA

HMS HOLDINGS CORP. AND SUBSIDIARIES
(unaudited)

Reconciliation of Net Income to GAAP EPS (Diluted) and Adjusted EPS (Diluted)

(1) Tax effect of adjustments is computed as the pre-tax effect of the adjustments multiplied by the adjusted annual effective tax rate at period end.

(2) Diluted GAAP EPS and Diluted adjusted EPS for the twelve months ended December 31, 2019 included (i) discrete tax benefits of $0.07 per diluted share primarily related to the exercise of employee stock options, (ii) $0.07 per diluted share related to the 2Q 2019 Reserve Release benefit and (iii) a $0.06 per diluted share benefit related to the 3Q 2019 Gain on Investment.

(3) The 2Q 2019 Reserve Release benefit of $0.07 per diluted share for the twelve months ended December 31, 2019 is net of income tax of approximately $0.03 per diluted share. The 3Q 2019 Gain on Investment benefit of $0.06 per diluted share for the twelve months ended December 31, 2019 is net of income tax of approximately $0.02 per diluted share.

HMS HOLDINGS CORP. AND SUBSIDIARIES
(unaudited)

Reconciliation of Total Debt to Net Leverage Ratio

(4) Total Debt consists of the outstanding principal under our senior secured revolving credit facility
(5) Trailing twelve months Net income
(6) Trailing twelve months Adjusted EBITDA
(7) The Company’s net leverage ratio is calculated by dividing total net debt by trailing twelve months’ Adjusted EBITDA

Reconciliation of Net Cash Provided by Operating Activities to Free Cash Flow

The Company believes that the non-GAAP free cash flow financial measures presented in this press release provide useful information regarding how much cash flow is available, after purchases of property and equipment and investment in capitalized software, to be used for working capital needs or for other opportunities. It should not be inferred that the entire non-GAAP free cash flow amount is available for discretionary expenditures. These non-GAAP measures may not be comparable to similarly titled measures used by other companies.