All right. Thanks, everyone, for joining. Jack Slevin, Research Analyst here at Jefferies. Pleased to kick off our final presentation in this track of the conference. We're here with Veradigm, and I've got CEO Don Trigg and CFO Greyenbuh l. Don, Christian, thanks so much for joining. Really appreciate it.
Thanks, Jack. Thanks for having us.
Yeah. Thanks for having us.
I'd be remiss without forgetting Steven Halper of IR, also in the crowd. If anyone feels they need to connect with Steve, he's here. To kick off, I know you guys have a disclaimer, a slide you guys want to go over, and then we're going to get into a little bit of Q&A.
Absolutely. So one, thanks so much for having us. Two, I do want to just note we are going to be making some forward-looking statements. Encourage folks to take a look at the specifics around that on our website, or to your earlier point, they can reach out to Steven Halper, our head of IR.
Excellent. All right.
Fantastic.
Yeah, go ahead. Go ahead.
Well, look, it's really nice to be here and have an opportunity to talk a little bit about where we're at with the business. Jack, we talked a little bit earlier. I think I'll just do a little bit of a thumbnail sketch of the business itself, but also talk a little bit about why and how it brought me to the company-
Yep
-In the role of CEO. This is a really interesting, and I think, highly differentiated business. I think the first thing that excites me about it is the quality level and the depth of our independent practice footprint. If we just think about the opportunity to work with 20,000 small and medium-sized practices and be core to their infrastructure and how they think about practice operations, the inefficiency of venture capital and assembling that asset, the inability of a large player like an Oracle or a Microsoft to manage that install base, I think just creates this really interesting and strategically differentiated business at a time when there's never been a greater need for more independent provider capacity tied to complexities around cost and cost trend. It's a really interesting business. We love the provider practice component of what we're doing.
The second thing that I think is super interesting about it is at a time when the market following meaningful use was really buying integrated clinicals and financials, our level of revenue cycle penetration is comparatively low. On the Practice Fusion side of our client base, our smallest clients use Practice Fusion for their EMR. There was no historic billing solution. On the Veradigm EHR side, for our larger practices, we're meaningfully under-penetrated relative to that installed client base. As a proxy for that, we think from a revenue cycle services perspective, there's about $350 million of white space opportunity in our install base alone. We think if we looked more like our industry peers who offer revenue cycle services, there's a $100 million incremental revenue opportunity just inside our install base.
What I have a lot of conviction on, having grown up in this space, is that if we can do revenue cycle well, we become more operationally relevant to these clients and more core to their strategy and their focus going forward. The first big thing that I got excited about, and that I think is core to understanding Veradigm, is our focus on keeping independent practices independent and thinking about that through both a clinical and financial lens. Beyond the core provider business, then, we have really two other businesses that are important to how we think about the total profile of the organization as a whole.
In the payer space, we had a business that was mostly focused on risk analytics and submissions, but there's significant momentum in that space around chart retrieval, but also now increasingly around how we engage with independent practices to do gaps in care closure in workflow. Again, the opportunity for payers to think about that space, how do I get more aligned with independent practices, move beyond the scope of dominant health system presence in a zip code? We create a vehicle or opportunity for them to tech enable a strategy with those practices.
Finally, really derivative of how the Practice Fusion business grew up, there's a very relatively small, $50 million Life Sciences business that we think can be potentially super strategic to where we're taking the company from here, leveraging the real-world data that's coming out of that practice environment, and helping pharmaceutical companies think through how they can leverage it, both pre-approval and post-approval from a commercialization perspective. That's sort of a five-minute snapshot about the business and a little bit of what got me so excited about the idea of coming in and taking on the day-to-day responsibilities.
Awesome. Super, super helpful, Don. I appreciate the overview. Maybe to start to drill down, right?
Yep.
I think you touched on it a little bit, but provider segment's obviously 70% of the revenue base for 2025. You talked about some of the opportunities, larger numbers and things that come out of it, but as you look at maybe core growth drivers in the business and then layer over some of those opportunities, how do you think about what those key things you're looking at are, and what some of the challenges you might be facing right now to unlock those things are? Yeah.
Well, it's a great question. I think, one, part of what I try to bring into the business is a level of strategic clarity. What you would hear me say if I were talking to clients or I were talking to my internal teams is our number one focus, our growth strategy starts and is anchored to that core EMR and practice management infrastructure implied in those practice settings. We had real work to do to get beyond sort of the legacy solution stead and really reenergize the product roadmap and get focused on feature function capabilities that were important to those practices, and how we drive provider productivity and overall practice economics. So that's been a big focus for us over the first 180 to now almost three quarters of 2026. For sure that's been an emphasis and a focus for us.
I think the second thing that's interesting to me is, and attracted me to the company is, do we have an opportunity to do something differentiated relative to the generational trends that are playing out around AI? I think a lot of the early experimentation, I'll call it, around AI was very point solution driven, shiny object driven. But what I liked about the Veradigm business was, as I looked at it, I said, "I think this business is incredibly AI moded, first and foremost, because it's verticalized, because it's small and medium practices, and I think critically because we are the system of record." So we're part of the enterprise risk strategy for these practices. We're also increasingly core to how they think about reimbursement.
When I talk to our clients, they do not say, "Hey, we have been experimenting on the weekends with Quadcode, and we have created our own ONC-certified EMR." They say, "You are our AI strategy. Now, how can you use it to help advance my practice operations and performance?" I like the moded nature of it, and then I think there is a real opportunity for us to be disproportionately more innovative with a set of smaller practices that are more nimble and that can move much more quickly.
What we have tried to do is really prioritize early use cases around the pre-visit process to really think through member engagement through to intake, as well as then to start to work our way into what we call the system of work above the system of record, to start thinking about what does it look like for us to agentic or AI enable how we think about diagnostics, plan creation, prescribing, and management of the patient with the claim generated as a secondary dimension of how that workflow advances. Again, within the last mile workflow of the provider.
That has a chance to be a huge differentiator for us, and I think if we do that well from a practice transformation perspective and we marry it with a revenue cycle strategy, we become very strategically relevant to these practices, and positively impact the growth of that piece of our business.
Mm-hmm. Okay. You feel like you have AI moding, you are making headway from a product deliverable standpoint on-
100%
-Some AI things you just talked about. I guess, what's the feedback been at this point as you're bringing some of that stuff forward when you think about key clients you have and the market broadly?
Well, one of the things that we did very early was think about what does it look like to get more engaged with our core install base. We think about, there's 102 clients that represent about 15% of total revenue. I've been disproportionately focused on those 102 clients and what it looks like for us to drive impact there. Then within that, we did some specific sub-segmentation to really say, let's focus on GI and neurology, let's focus on MSK and ortho, and let's focus on family medicine where we have high density of practices. We can drive an impact and a roadmap for these clients that we know that will have second-order impacts for the install base as a whole. The feedback's been very positive. Again, I feel like we're aligned from a product roadmap perspective.
I think there's excitement around where we're going from an AI perspective. I also think there's excitement around where we're going from a data platform perspective and what we call Health Network Architecture.
Okay. Super, super interesting. Maybe to just, on a similar vein in this provider business, just taking a step back.
Yep
To say, when you look across the broader market for technology services within the space, how do you feel like you're differentiated? I'm hearing maybe segmentation and specialization with some of the types of clients you're working with and the profile of who your customer is. But would love to hear you more specifically talk about what gives you competitive advantage in the space versus peers or others that are out there.
Yeah. I think it's a great question. So, one, as I've stepped into this role, I think a lot of people tend to focus on my experience at Cerner and my role as president there, part of the sale to Oracle. But after I did my stint at Cerner, I ran an advanced primary care business. And so we were operationally running a set of practices, but also partnering with independent providers, and it really afforded me a chance to think through the data platform strategy and how you actually meaningfully impact progression of the pre-visit, visit, and post-visit workflow in that context to lower total cost to serve.
I think part of what happened in the EMR space is we really got an orientation around meaningful use, and milestone-based use of the technology as opposed to focusing on what it looks like to use the technology and tooling to drive practice operations and performance. I think the opportunity for us is these organizations have made an investment in their core EMR and PM infrastructure. They know that it's massively disruptive to rip and replace it, and they're looking for significant leverage in that technology asset, including of how they think about it from a go-forward innovation perspective around areas like AI. I think we have to get really good at the compulsories around what it looks like to understand practice operations and drive performance. I think when we do that well, good things happen. That is our focus.
The early returns from clients have been exceptionally good.
Awesome. Okay. I think enough on the provider segment here.
Yeah, for sure.
But before we jump across to talk a little bit on that payer business, I know there's a data event of sorts that occurred between yourself and a counterparty, RevSpring. Maybe just giving you an opportunity to set the record straight on your take of that.
Yeah. So thanks for asking me that. I appreciate it. We did file an 8-K on it on Tuesday afternoon, which probably is part of what spurred the question. The first thing I would just say is, cyber is an area of significant focus for us, and something that I think we do well as an organization, Mike Sneeringer and his team. It's part of the expectation that our clients have for us when we are part of the core infrastructure at the intersection of healthcare and IT. So it's very important. We take it super seriously. The second thing I would say is, we have a product partner ecosystem. In this case, we had a cyber incident with one of our product partners named RevSpring. They are a very good size, very reputable, great partner and company.
We work with them to provide intelligent payment capabilities tied to creating a better customer experience. They had a set of compromised credentials tied to a vendor API that we were leveraging for enabling those intelligent payment solutions. As a result of that, we had a very small number of clients that were impacted as a result of that. We have notified all those clients. We have reached out to the relevant oversight organizations, importantly, we are also collaborating with RevSpring to make sure that they are able to do what they need to do from a cyber perspective to deal with the larger set of events, but also specifically around the small group of clients that were impacted by what occurred.
Okay. Super helpful.
That is probably a good place to stop and to frame. Again, I will end where I started, which is, it is a space we care a lot about. We are super focused on it. Any time any set of our clients is impacted, in this case, a very small subset of clients, we take it super serious. We do everything we can to support what needs to happen for them to manage those patient interactions and to deal with the breach.
Got it. Really helpful answer. I guess now doing that pivot to talk a little on the payer side, can you just talk about some of the underlying drivers and strong trends you are seeing in that business? Perhaps it helps to go a click deeper on exactly the things you are executing there beyond the little preamble you gave at the start. I know from my experience in the risk-bearing provider space, even beyond payer services, there is a lot of interest and a lot of the key things you are looking at. So I would love to hear you sort of talk about what those drivers are and why you are excited about it.
Yep. The first thing I would just say is that when I looked at this piece of the business, it is relatively small in terms of our total revenue today. It is about a $75 million business. But the thing I got excited about it is that there are 84 payer clients that are using at least one of our solutions today. As you know, it is a very long lead time sales cycle business. To have the benefit of working with organizations like that, with a contractual MSA in place and a chance to go do more with them seemed like a huge strategic advantage and opportunity to me as I sort of looked at the business and thought about the overall growth case. The second thing I would say is kind of what I framed up earlier, which is we have very good risk analytics, quality, and submissions capabilities.
That is sort of where the business started. But the piece that I am excited about, and you know a lot about, is I am excited about what payers are thinking through from a provider network management perspective and rethink perspective, and saying, "What would it look like for us to get better and more engaged with independent practices as a strategy for tackling MLR and cost trend?" We have a business that does chart retrieval, that is tiptoeing into in-workflow gaps and care closure, and it goes beyond just Veradigm and Practice Fusion EMR. It actually extends out to multiple EMRs. It really becomes an enabling strategy for non-Epic long-tail EMR strategies to really begin to activate alternative network strategies and designs. When I look at that, I say there is a huge opportunity for us.
My providers that are taking a significant full and delegated risk are saying, "Look, we need a better all-payer strategy." We have an ability to build out those MSO capabilities on the provider side. We also then have an ability to think about connecting that into those payer relationships that exist and are contractually in place today and say, what would it look like for us to be part of provisioning that technology, showing up in a way that is a third party as opposed to the payer themselves, and creating something that is in workflow and impactful to the practice on an all-payer basis.
I think there is a real shared value proposition on both sides in a way that creates a really interesting opportunity for us to build out a set of MSO and collaboration tools that can be very impactful, very differentiated, and it is a big part of what gets me excited about that payer business and allows us to begin to think about it beyond the scope of what it does today.
Okay. Really interesting. Maybe taking now the third sort of branch of the tree here, right, to say similar question for life sciences. What's differentiated about that business? What are the drivers that sort of get you excited or make you think about where that business can go on a multi-year basis?
Well, as you know, the business that is the Life Sciences business today, again, it's about a $50 million business, really came out of the legacy Practice Fusion part of this business, and that was really the original design, which is we'll provision the EMR, but with a really enhanced data use agreement that allows us then to do secondary monetization in the pharma space. So we've been in this space for some period of time. I think what I'm interested in imagining in that space really is about backing out and asking: Where are the more focused and differentiated therapeutic areas sitting inside those independent practice footprints? So as opposed to a very wide business, with relatively modest growth, what does it look like for us to get focused on a very defined set of therapeutic areas? The example I always use is cardiometabolic.
Like if you were wanting to do something around obesity, around diabetes, around cardiovascular disease, our install base on the provider side is creating really rich, high-quality clinical data against that TA. I think what we imagine doing on a prospective basis is building out a clinical evidence platform, selling subscription-based evidence products that are highly anchored to a defined set of therapeutic areas like cardiometabolic that have significant secular tailwinds, and where we know our data is significantly differentiated. By the way, from a marketing call point perspective inside pharma, which is very complex on a relative basis, we think there's a chance to do that, not only around things like HEOR and med affairs, but really to play in multiple parts of top 30 pharma and be strategically relevant to multiple parts of the organization and some of the key things they're trying to advance.
It's a big opportunity for us. Approximately, we're very focused on getting aligned with our installed clients and our provider clients. Revenue cycle is a big focus. It is a very easy move into the adjacency around payer. But life sciences is a big innovation opportunity for us, too, and on a five-year basis, I think it could be a big part of how we talk about the business and investors think about the value proposition.
Got it. Really interesting. I guess, going to backtrack to some of the stuff you talked about at the beginning, and maybe it is just to hit it on again for importance, but you mentioned Health Network Architecture, in some of the discussion we have had already. Can you maybe just explain what that is for everyone in the room and why an investor should care about that? I know it is oftentimes hard to access that sort of level of importance when you are just looking at numbers, but how should we go
Well, look, when I think about all three of the end markets that we operate in, data is a critical dimension of how we think about value proposition and performance. Our practices are absolutely looking for better clinical, financial, and operational data to drive change and to drive performance. Payers are absolutely looking for better and more data for how they engage with those providers to manage their provider network strategies. And we sort of just articulated what that looks like from a clinical evidence platform, both in terms of how pharma thinks about FDA and regulatory approval, but also how they think about activating commercial strategies around new therapeutics. Data is a central dimension of what we think about on a day-to-day basis across all the businesses. Health Network Architecture is a really intentional term.
Again, we did not use the term provider network management or provider network architecture. We used Health Network Architecture because we think it is part of the mission of the company and the value proposition of the data platform that we are advancing. The first thing that we are doing is building out Health Network Architecture for practice operations. So how do we give our practices consistent access to the right clinical, operational, and financial data to drive practice operations? That data layer, importantly, also becomes the enabling data for how we think about the agentic capabilities, pre-visit, visit, and post-visit. So that is its starting point. Then we start to think about Health Network Architecture from a provider perspective.
They want to be able to think about it at the practice level, but if they are a super regional or a national, they want to be able to think about it at a state level, and they also want to be able to think about it on a multi-state basis in terms of how they think at the health economy level about how MA or Medicaid is performing across multiple states, multiple geographies. And then finally, and I think similarly, if you are doing something around the pharma space, you are also thinking about it in a very similar way, which is: Where can I get access to pockets of patients that will fulfill requirements pre or post-approval that are part of what I am trying to get accomplished around a new therapeutic, either for approval or for commercialization?
This concept of Health Network Architecture is about how do we create a systems view of U.S. healthcare, and how does our data infrastructure play an active role in enabling that? Why should I care about that as an investor? Because what we think over time is that we're going to have an ability to build things in the provider business. Think about something like ambient documentation, where I can think about something that's creating a meaningful value proposition for the provider and his or her practice. But also is creating the right fidelity of unstructured and structured data for me to think through value-based care use cases for the payer and payer provider collaboration. Or is about how I create a high-fidelity data asset that pharma wants to leverage for strategies around a new therapeutic.
The ability to build once and monetize multiple times across three end markets gives us an opportunity to think about a high-end growth case and an EBITDA profile for this business that looks better and different than our peers. That's why investors should care about it.
Okay. Really thoughtful, really interesting. Christian, maybe to jump to you. You joined in May, right, as CFO. Just would love to hear a little bit about thoughts and observations of the company since joining and in your time over the summer.
Sure. Appreciate the question. So no real surprises, which is a good thing. Don and I spent a lot of time together before I joined. Just a renewed conviction in the transformation journey that the company has undertaken and the strategy that we're deploying. So if I think about that from a tactical and more high-level perspective, get current, stay current is top of mind for us. For us, we've said this before, which is we're aiming to get that 2025 10-K out the door by the end of this year. Then we'll pivot all the efforts onto the 2026 10-K in 2027. So that is top of mind.
But with that said, in terms of threading the needle with regards to all the things that Don said, it's balancing that effort on the more administrative side of things, which I don't want to diminish the amount of time and resources that it takes to get through that process, but with re-energizing the business around driving that long-term growth profile and creating sustainable shareholder value. One of the things that we spent a lot of time on in the summer was around our go-to-market strategies. In particular, we've observed and we know that it's sometimes hard for our clients to do business with us. We don't really make it that easy for them in terms of the way that we approach, the number of SKUs that we have, the systems ourselves that we use, how long it takes to quote certain things.
We can do a better job at that. One of the things that we've been focused on before getting through the full re-list process is a market study around our client needs, buyer behaviors, and really re-imagining that go-to-market bundle approach and how you price it. Versus coming to someone and saying, "I can sell you this, and this," and there's 10 lists of things, and you lose them along the way. It's making it a much simpler experience. We've already done some of that. I don't want to diminish the work that we've already done beforehand, which is simplifying the SKUs and simplifying our contracts. But we know that that's an area that we need to spend time on. We're in that it's a multi-tiered approach. We're in the third or the fourth zone of getting that launched.
We really think that that's going to be something that'll help re-energize and drive the top-line growth of the business. You have to supplement those kinds of things with not just the how do I change and restructure my go-to-market motions, but also the systems side of things, and then the processes that underpin that, and getting the company into a position where when we're re-listed and we're public, how do we reorient everyone's thinking to the mentality of we are a performance-driven organization. So putting in QBRs, putting in systems in place, which takes time.
But testing those systems and making sure that they operate the way that you need them to in order for people to not be there to question the numbers, but to actually leverage that information to actually create and drive better decision support with ourselves internally, but also with our customers when we're engaging with them. Overall, the observations, I would say, we're on the right track. When I think about the standpoint from our associates, we also look at how they're reacting to the messaging as well, and our clients. NPS scores are up over this period of time that I've been here, and also, not to do with me, by the way, but from the transformation journey that the company's been on. But also in terms of the associate messaging.
We saw a 20% increase in the associates' understanding and their backing of the company's strategy. We know that it's working on both sides of the equation.
Okay. Got it. Really helpful. Don, maybe to close out here. Let's just say a year from now, 2027, we're here in Nashville. What do you think Veradigm looks like from an operating and financial standpoint compared to how it stands today?
Yeah. Well, I think we're driving multiple transformation journeys, and they're embedded in some of our discussions. Historically, you really had three businesses that were run separately as a holding company. As I was articulating to you, one big motion is us becoming a single operating company. Christian's describing what that looks like, and it's central to how we think about get current and stay current on our underlying financial reportings, and the path to relisting the business. That's the first thing that I think you will see have played out in a meaningful way, and I think it will reinforce that client sentiment and client narrative that Christian's describing. That's the first thing. The second thing is that the company, on a five-year basis, had a pretty heavy orientation around partnering and buying assets inorganically.
What we're really doing is getting very focused on building a set of capabilities to retain our EHR install base, drive our revenue cycle management solution set, and to start to create differentiated capabilities in the payer and life sciences space. You will see that product set moving out into our client base and into greenfield clients in a much more meaningful way on a 12-month basis, and it will be a big part of what we think momentum around this business looks like on a FY 2027 basis. Then finally, because of the really hard work that Christian's doing around get current and stay current, I think you'll see us begin to be able to talk with confidence and conviction around the financial performance and operating performance of the business.
And start to articulate not only what that performance has been on a year-over-year basis, but also importantly, how we think about a longer-term growth case for this business out into 2028 and beyond. I think this is a big year for us in 2027, and I think as Christian Greyenbuhl said, we're super excited, not only about the progress, but how we're going to close out the next 107 days of 2026 and into 2027.
Awesome. Well, Don Trigg, Christian Greyenbuhl, thanks so much. Really appreciate having you here.
Thank you.
Thank you.
Appreciate it.