Welcome everyone to the sort of Q3 reporting for Nordhealth. We wanted to just briefly introduce myself for those that haven't met me before. I'm Charles MacBain. I'm the CEO of Nordhealth, and I'm here with my colleague, Mari.
Hello, everyone.
For this quarter, we've decided to give a little bit more information and break down by business unit. We'll start off with a company update, general company update similar to the previous quarters, and then we'll dive a little bit deeper onto the two separate business unit, the veterinary business unit and therapy business units. Thereafter, Mari will go through our financial updates, and then we'll be able to answer any questions that you may have. Starting with the company updates. Our mission at Nordhealth is still the same, right?
It's to acquire and build great vertical SaaS businesses in select healthcare markets. How do we translate that today to our current to-be use is we wanna be able to build great software, right? That empowers either veterinary or therapy professionals to save time so they can focus on delivering great care, right? Delighting pet parents in one case, or patients and growing their business. In terms of strategy, I think that with the change in market situation, we are focusing quite a bit more on profitability and balancing profitability and growth. Let me tell you about a couple different levers that we're going forward to be able to achieve those goals. One is similar to before, right? We are developing one product per vertical, right? In veterinary, we've got Provet Cloud, and in therapy, we're developing a product based upon the EasyPractice platform.
Second, focus on ensuring that the people or users on legacy or hosted solutions are migrated over to our flagship cloud solutions, right? To be able to have those product and development efficiencies. Third is looking to improve our sort of customer acquisition cost and new ARR ratio through, A, centralization of the sales functions, and B, improvements in the onboarding efficiency, specifically on the veterinary business units. Four is very lean corporate G&A, right? We're not looking to add any additional headcount, right? We've got the team in place that we need in order to scale, right? All other functions are on the BU level. Lastly, similarly, the G&A, right, we're not looking for any significant net increase in headcounts in order to achieve the three-year plan.
On the growth side, right, we wanna make sure that we're growing, in a profitable way, right? Focus is key on that side, right? Focusing on key growth markets. In therapy, right, we're not gonna go after any new markets in 2023 in a major way, right? We're gonna focus on migrations, right? Second, on veterinary, we're gonna focus our growth efforts on the U.S., U.K., and Spain. In addition, right, to continuously grow with the markets that we're already in as the market is also growing. Second point is we'll continue to expand our product, offering, right? We can continue to upsell our customers, right?
Starting with building the great PMS, then onboarding people on our payment solution, and then at some point, right, going into a booking portal that enables us to capture some of the B2C revenue. Providing a little bit more meat on what are the business segments, right? What products are on those. On the veterinary side, right, we've got two sort of products that we include in our cloud segment. One is Provet Cloud, the second is Provet Pay, which is our payment solution. That accounted for roughly 22% of the ARR. Second, you've got the veterinary hosted solutions, which is Provet legacy products in Finland, Sanimalis in Norway and Sweden, Vetserve in Norway, Vetvision in Denmark, and the recently acquired Vetera in the DACH region. That accounts for roughly 27%.
We have big focus this year and in the next few years on migrating those all over to Provet Cloud. On the therapy side, we've got a couple different cloud products, right? EasyPractice, which we acquired earlier this year, right? Which will be the base upon which we built the new therapy platform, right? Which is a fully product-led self-service platform. Diarium, which is the current cloud solution in Finland. Nordhealth Connect, which is our solution for the end patients, right? To be able to communicate, help the clinic communicate directly with the patients in a secure way. There's AG Flex, which is our courses solution. On the hosted side, we had acquired last year Aspit, right? Aspit over time will be migrated to this new therapy platform. Diving a little bit more into the KPIs for Q3.
We grew 33% over the last 12 months, ending Q3 2022. Breaking that down, 16% came from organic growth from, of which 8% of that came from organic new customer recruitments, and the 180% was from the net retention rates. At the end of the quarter, we stood at EUR 30.7 million in signed ARR and EUR 29.3 million in implement ARR. The metric that we were always focusing on is this ARR per share rates is now EUR 0.38 per share. One of the most impressive and the real differentiator in this business is the churn rate. Our churn rate remains very, very low at 2.4%, right? That's probably the main differentiating factor of our business. Looking now at how we've progressed over the last 12 months.
We started at EUR 23.1 million of ARR in Q3 of 2021. We've added EUR 1.9 million of new ARR from new customers. We've also upsold our current customers that we had prior to Q3 in 2021 by EUR 1.8 million. We had some price increases, right? Which were based, which were spread out throughout the year of EUR 0.6 million. We had some churn of EUR 0.5 million. Looking, we also made acquisitions, right? We bought EasyPractice and Vetera in the last 12 months, right? Which in the beginning of Q3 of 2021 were at an ARR around EUR 3 million. They've also been growing by 36% and 13.5% for EasyPractice and Vetera respectively. Looking quarter-over-quarter, right?
We've been able to grow our ARR at 3.3% this last quarter. Price increases were only of 0.2 within that, and that was driven by the price increase that happened in EasyPractice. What's interesting to note is of the EUR 0.9 million of ARR that we were able to get from new customers, right? 70% of that came from our cloud customers. One interesting thing to note is that if you look at the churn rate, you can see that the annualized churn for the whole business is 3.6%. It's slightly higher than the organic one because the fact that EasyPractice, through its product-led approach, right, has a slightly higher churn rate, but also very low customer acquisition cost.
Now, taking a little bit of a step back to look at how we've grown historically, right? We started when I purchased the company in 2018, what was November 20, almost four years from now, ago, we had an ARR of EUR 3.4 million. We've grown this quite significantly, over 80% CAGR, per year if we account for both acquisitions and organic growth. Quite a, the business has changed quite a bit over the period. What you can see is that, 70% of the growth in Therapy Cloud in the third quarter of 2022 was, driven by EasyPractice. That's one thing to note. On the people front, right, we made some significant recruitments over the last few months. One is that we recruited Hanna Miettinen, right, as our new Chief People Officer.
She joined us from BC Platforms. Second is we recruited Szymon Olko , who is the Engineering Director for Provet Cloud. He joined us from Opera, the browser. Also we were promoted Fabio Carneiro, right, who as VP of Product and Design for Provet Cloud. Previously, he had worked in engineering, in design, and also in product management at Booking.com and Mailchimp. Diving a little bit deeper into the financials and what the drivers of those results are, I try to provide a picture of the different drivers by product. I'm not gonna go through the whole slide, but I want to highlight a couple interesting points in this slide. One is that excluding migration, right, our veterinary cloud products have been growing by 56.7%.
Our Therapy Cloud products have been growing by 23.2%. Overall, right, we're roughly excluding migration impact. We're growing those cloud products at around 37.7%. Right, we are also have acquired hosted products, which historically were not growing, and they're still, very high, to a very high degree. Our veterinary hosted ones are growing by 1.4%, excluding migration, right? The therapy ones are actually growing still quite nicely at 11.2%. There was no migrations yet in therapy business units. That's how we can break down the 17.5% growth rates. It's always good to highlight the churn, right, to really understand this business. We looked at churn for the veterinary cloud, was -1.5%, right?
For the hosted solutions was -1.6%. On the therapy side, the cloud one was 7.4%, but if we exclude EasyPractice, right, the therapy churn rate was at 2%. As I said before, right, the EasyPractice churn rate is higher because of the fact that they have a product-led growth approach, right? On the hosted side, we see, which is mostly Aspit, it's -3.3%. Overall, we have a -3.3% churn rate, right? Which is quite low. Going into a bit more detail on the veterinary business unit. Over the last few years, right? The veterinary business has grown spectacularly, right? Through a combination of acquisition, but also organically. You can see the huge growth in Provet Cloud specifically, right?
Which has been driven by our expansion to new markets and our upsell of new products to current customers. Looking now, at year-over-year, the veterinary business unit has been growing at 20% organically and 34% if we include the acquisitions. Similarly, right of the last 12 months, our organic ARR gross churn was 1.8%. Interesting to note here as well is that Vetera has been growing at 14%, so even though it's a hosted platform, right, we're still seeing some growth in the DACH region, which is sort of lagging slightly on the cloud adoption versus other regions. Now, we've been asked a lot about breaking down the information by country. Provet Cloud is the main platform that we use to go internationally, right?
It's the flagship platform that all other users will migrate to at some point in time. If we compare Q3 2021 versus Q3 2022 per market, we can see we've had strong growth in the Nordics still as we continue to conquer new markets, right? At 38%. Our expansion in the U.S., we've been growing by 165%. We're roughly at EUR 400,000 of ARR now. The U.K. is at, has been growing 85%, and we're roughly at EUR 700,000 ARR. Interesting to note on this one is that the full rollouts of CVS is not included in that number. We just added the sign item. We also have Spain, which has been a very strong performer.
We've had some great new opportunities, and we're working on some very interesting opportunities in Spain. We've got other markets, which is basically markets that do not require significant additional localizations that we serve from an international team. That's been growing just over 100% per year. Diving a little bit more into therapy. The therapy ARR also has been growing quite significantly, right? You can see DR, Navisec, and Nordhealth Connect has been capturing market share in Finland, right? We're at EUR 3.5 million of ARR. Aspit, which we acquired last year, is growing quite nicely still. We can see the impact in Q3 2022 of the acquisition of EasyPractice, which has added EUR 2.2 million.
An interesting thing to note here is that DR new customer recruits accounted for 30% of the growth in year-to-date Q3 2022. That EasyPractice new customer recruitments account for 51% of the growth in year-to-date Q3 2022. Looking at the same view as we did for veterinary, the therapy business unit organically is growing slower at 13%, as we're not adding too many new countries currently. We're focusing on the migration. However, with acquisitions, right, of EasyPractice, we've been growing just over 30%. Interesting to note that there's very strong growth in EasyPractice. Over the last 12 months, they've been able to grow ARR by 36%, right? That only includes a price increase of 0.2. Looking at EasyPractice specifically, right?
I think it's really good to understand the dynamics of that business 'cause they are slightly different from the dynamics of our other businesses. They're able to acquire new customers at scale, fully self-service, which is a wonderful thing that we're trying to also adopt in the other therapy countries by localizing the platform for those countries. They're also able to upsell their customers quite significantly through their app store model, where depending on the complexity of the operation, you can self-select to add functionality, fully self-service. They do have a churn, as we said, which is quite higher or quite a bit higher than our current products. That's mostly driven by two reasons.
One is there's a very, very low barrier to entry, given the self-service, for people to start using it, given the self-service model. Second is they deal with slightly smaller types of clients. I think this is a huge opportunity for us to be able to learn from how EasyPractice does things, because if we can bring this self-service model to our current therapy customers and also, partly in veterinary, right, we can reduce our customer acquisition costs quite dramatically and making it much easier for people to onboard. Now financial update from Mari.
Thank you, Charles. If you take us to the next slide, please. Thank you. If you first looking at our recurring revenues, our third quarter recurring revenues, they grew by 36% amounting to EUR 7.2 million. On a year-to-date basis, our recurring revenues have grown by 66%, they were EUR 20.8 million. Recurring revenues, they represent 92% of the total revenues or EUR 22.6 million, that is on a year-to-date basis. EBITDA minus CapEx, that was negative EUR 2.7 million in the third quarter. On a year-to-date basis, it has been negative EUR 8.4 million. We have made significant investments in our core platforms in all of our markets, especially we've been investing to expand our business in our veterinary growth markets.
We've also made significant recruitments in key positions during the year. As already mentioned, we do not anticipate making any new recruitments in the large scale like we have done during this year. Instead, we believe that our organization is now at the right size to continue on the growth path. Our year-to-date revenues, they grew by 62% and amounted to EUR 22.6 million. Our third quarter revenues, they were up by 39% year-on-year. Organic growth in recurring revenue quarter-on-quarter was 19%. At the high level of the talent acquisition activity, that has significantly increased our cost base during the year. Our third quarter EBITDA was negative EUR 1.3 million, and our year-to-date EBITDA was negative EUR 4.4 million.
The net increase in our headcount during the year has been 161 employees, which is quite an impressive number, and that has significantly increased our employee cost base, by over 140% year-on-year basis, which is about EUR 3 million a quarter. On the balance sheet. Well, the changes on the balance sheet, they are mainly driven by the acquisitions of EasyPractice and Vetera, which were completed already during the first half of the year. Despite of the acquisitions and other investments into especially our product development, our cash position still remains strong at EUR 42.1 million. That is, comprising, cash and money market funds. The acquisitions which were completed in 2022, they were mainly paid in cash. As a result of these acquisitions, our goodwill has increased to EUR 59 million.
Minority share in PetLeo that was acquired as part of Vetera, that is reported under other shares. The increase in other current liabilities, that is mainly due to EasyPractice earnout debt, that amounts to EUR 4 million. We had an earnout debt relating to Sanimalis acquisition that dates back to 2019. That was in fact classified as other non-current liability at the end of last year, but that was already paid out in the first quarter. On to the cash flow statement. Operative cash flow this year has been heavily impacted by the growth investments and the recruitment activities, especially in product development, which has been in accordance with our growth strategy. Our cash flow from investing activities, that includes the cash payments related to EasyPractice and Vetera acquisitions that were financed through proceed from the money market funds.
The capitalized R&D expenses are shown here as investments in intangible assets. Cash flow from financing activities in the third quarter, that consists of a repayment of long-term debt of Vetera, which they had at the time of the acquisition when we acquired them, plus the repayment of the earlier mentioned Sanimalis earnout debt. That was in the first quarter. In the second quarter, we made a repayment of a short-term debt of Vetera of about EUR 5.2 million.
Thanks, Mari. On the financial calendar meeting?
Sure. The fourth quarter results, they will be presented, on March 7th and the 2022 annual financial statements release will be on April 14th .
Just to summarize a bit and to provide some insights on going forward for the year, right? We started the year at EUR 24 million of ARR, right? We've acquired roughly EUR 3 million of ARR, and then we've been able to grow that combined base by EUR 5.5 million organically. We are looking to land the lower end of the range, right? Roughly around EUR 32.5, the initial range that we had suggested. On concluding remarks, just the three things that I think we'll be focused on going forward. One is we're all focused on improving profitability, right? The three main levers for that are migration, right? Which brings a lot of operational efficiencies that you don't have to support many different products, right?
Second is focus on key markets, not going after too many markets at the same time, right? To make sure that our CAC to AR payback remains low. Third is we built a team. We've had spent the last sort of 18 months recruiting, now it's time to stabilize and make sure that those teams that have recruited people can focus on sort of delivering value. We don't foresee any significant net new hires in the next few quarters and the next few years. Second is new customer acquisitions in current markets, right? As well as the U.S. and U.K. Third is just continuously improving the value proposition that we have for our customers that we can upsell, right?
Building a great PMS, making sure that we're the best in the world in our individual verticals in providing that solution. Second, upselling payments, right? It's a great thing for our customers as they want an all-in-one solution, right? They don't want. And second, it's a great thing for us in that with our scale, we can negotiate quite good rates. Third is over time, right? Not in the next quarters, but we will be looking to also expand it to sort of the B2C area with the booking portal to be able to help customers find steps. Now it's on to Q&A. If anyone has questions, please feel free to raise your hand or add them to the chat. All right. It seems that we don't have any questions.
Thank you very much everyone for your time and, we'll see you next quarter. Bye.
Thank you. Bye-bye.