Good morning, everyone. Hopefully, it's good. We've got an early start. It's a short presentation today. It's only been 25 minutes. I think we're around for the rest of the week, so whatever we can cover off would be great. We're around for questions either at the end of today or feel free to come by where we're hanging out, but we'll be hanging around for the next little while. Who are we? VitalHub is, we've been around since about the 2010 place, but really got started in 2016, 2017. We're a healthcare IT software solution that has accumulated over 50 different hospital solutions over the last little while. We're focused on government-based, funded-based healthcare systems. Those would be mostly those areas outside of the United States. We have operations in Canada, the U.K., Australia, and the Middle East are our primary area.
We've ramped up through both an M&A strategy and through organic growth to about over $70 million of ARR. We've completed over 20 acquisitions or actually 21, and we just announced our 22nd acquisition since its inception. We really are focused on our numbers. Our financial numbers are extremely important to us. We feel we're very strong in both operations and capital allocation. Our goal, and we're well on our goal, is to be a self-contained compounder, producing our own revenue and producing our own margins and our ability to get discipline, scale, growth, and profitability in our organization. You'll see that through our numbers as we move along. The marketplace, in presenting to the U.S. marketplace, the biggest question is, why aren't you in the U.S.? My first 10 years of my career were actually spent in healthcare IT in the U.S. marketplace.
It's not that we don't know. We actually do know the U.S. marketplace, and maybe eventually we will move in there. The marketplace outside of the U.S. for healthcare IT software is really made up of smaller, niche-based vendors that have built solutions that have serviced those marketplaces. As one of those vendors in a predecessor life before this in a company called MedWorxx, which was a successful venture, which we sold off to Vista Equity Partners, we really came to the conclusion that these organizations would form stronger as a cohesive unit than they would individually so o ff we went on our consolidation-based run. Really, it's a $10 billion opportunity for healthcare IT spending outside of the U.S. marketplace and really focused on our Canadian, U.K., Australian, Middle East marketplace with some work in the U.S.
Again, a lot of money being spent in healthcare IT. D igitization is moving in those markets pretty aggressively, and we're right in the middle of that base marketplace. What do we do? We really have concentrated on three main marketplaces with our patient flow and operational visibility market being our primary base market. Those are solutions that help healthcare organizations really help with the movement of patients throughout their organization. Capacity is really a strong driver within healthcare. Moving patients effectively through the healthcare organizations is what's talked about every day within a boardroom of every healthcare-based organization. We have two different areas where we have healthcare, where we have applications in patient flow. One is what we call Operational Visibility solutions.
Those are data analytic solutions that help healthcare organizations, be it the government itself or the acute care or a division within a hospital, get insights into what the patient movement is within those organizations and really to help them define those processes that it could do that. We have patient engagement solutions. Those are solutions that we as patients use as we navigate through the healthcare system to help us navigate those systems, be it a preoperative-based assessment and appointment scheduling or aftercare-based questionnaires or aftercare-based solutions. We have accumulated over 40 different products in those arenas, and we're continuously looking to add more. The second area we have is electronic records for social services or care coordination. We have about 20 different solutions. It is primarily based in the Canadian marketplace, but it is social-based services-based software.
That would not be an electronic health record for physicians, nor would it be an acute care setting within a hospital-based setting. It would be those environments that would do that. It would still be B2B. Typically, there are organizations over 500 employees, generally between 500 employees to 2,500 employees. We also have some really big base deals in that system where we do the entire jail populations for an entire province in Canada, or we have entire provinces that would use those systems. We have a product called TREAT that has done extremely well in there, and we have accumulated other base modules over the years with it.
The third area that we just entered is in workforce automation-based solutions, smaller part of our business, primarily U.K.-based, but we ask for solutions that help employees of healthcare organizations in terms of compliance, recruiting, certification, et cetera, that go along with it. Just a few case studies to show where patient flow would be. Patient flow journeys would be those systems that help us, such as kiosk, web-based applications, entries, appointment management, et cetera. We have accumulated a whole gamut base of solutions that would drive those markets. Operational visibility, we run that from both a countrywide level in the case of the U.K. with a product called SHREWD, through to hospital-based levels or departmental-based levels with patient tracking lists and patient tracking boards that you would see across hospitals in many of those regions. We have accumulated a significant amount of assets in those areas.
In case management, it's a full-blown ERP-ish type system, complete from registration, integrated care, billing, facility management, a full-blown patient care system that would drive those models with our product called TREAT. It went the wrong way. We also have, we've built a strong merger and acquisition-based strategy. As I said, we've done 22-ish, 21, 22 that we've just announced. We have an effective-based strategy that really is focused on consolidation and really cost-based reduction once we acquire those entries and cross-selling of our assets. If you look at our revenue base, we've had strong organic growth, and we've been established, we've been doing about, on average, about $1.5 million of new organic ARR. That's not purchased ARR on a per quarterly basis because we have an effective strategy where we've been cross-selling our assets into our strong customer base that we've established.
We look at that strategy as we do that. As we work through it, we consolidate our G&A functions and put everybody under operations. We have a cost-effective R&D channel. We have about 500 of our employees, 200 of those are based in our Sri Lankan-based operation. We have built this operation for 20 something. We started in 2016, well over 200 people in 2025. A big part of our strategy is moving our resources offshore into those environments and getting real effective R&D off of that at a really cost-effective price. It has allowed us to get the margins that we feel we needed. We strategize on how these products work together. We put those strategic directions in place, which really affects us for our cross-selling. That is optimizing a sales and marketing-based strategy off of these small vendors to do that.
We grow together, we sell, we build strong organic growth, and those have been proven in our numbers that you can see in our financials. Our merger and acquisition model, we've been buying our assets at about between one and 2.5x module, revenue model. We paid some, well, over three, but primarily it's been in that range. We target companies between $2 million and $20 million in revenue as being our base that we do that. There are some larger acquisitions in play that are north of that. Usually, these businesses are making a little bit or losing a little bit, break even, or profitable. We have work to do when we acquire them to get them into our deal. There's about 400 companies in our pipeline, and we have our own team that sources these acquisitions, and we make them.
We model our companies on a five-year to seven-year payback. We are looking on a cash-by-cash basis. Whatever cash we do, we're looking. We model very non-aggressively in terms of our organic growth-based model. It is really based on our cost-based model to do that. We will not touch a company if it does not have at least 60% recurring revenue to do that. Our goal is to get it to 20% adjusted EBITDA on a pretty fast basis. I think the company is reporting 28% adjusted EBITDA on a regular basis, 25% and 28% on a regular basis. We do have the ability to offer stock and cash as part of our transitions. In the early days, we used stock, but for the most part, it has been cash-based, and we are pretty cash-based cash structure in terms of what we have.
Those are the acquisitions that you've seen. As you can see, we've been pretty active in the U.K. and the Canadian marketplaces, some based in Australia and nothing in the Middle East, but we do have operations in the Middle East. We've been pretty aggressive in our strategy in terms of we built up. Most of these products that we've acquired have been bought for a reason in terms of building up our portfolio and building up our strategy as we go into the marketplace and really working at cross-selling our solutions into our market. As you can see, we've been pretty busy in those markets, and we continue to be busy on our M&A front. We're doing between two to four transactions on an annual basis. Again, the secret to what we said, I think I mentioned this, is our Sri Lankan-based organization.
Again, 200-plus people that work there. It really helps on our innovation, very in tune with our domain, very in tune with our groups, and do an effective job of us being able to do cost-effective solutions on an offshore type of basis. Financial performance, we're north of $71 million of annual recurring revenue. I think it represents about 85% of our revenue to date. If you look at our revenue, most of it's recurring in nature. Total revenue has been $20.6 million on last year's quarter, and we continue to see that being up. We're 100% net revenue retention, 3% to 6% churn on annual basis that we offer. 81% to 85% gross margin that you've seen on a regular basis. Very high gross margin every time we add another $1.5 million of recurring. We like to see that. In our ARRs, it's been pretty strong.
It's been about 15% organic ARR. When I say organic ARR, it's important to mention we are a consolidator. That's on top of the ARR that we purchase. We've done an effective job of growing our ARR on top of our acquisitions in terms of what we've done. Overall, it's been 51% total revenue growth used.
Good morning. Now presenting Dan Matlow with VitalHub.
Good morning, everyone. Hopefully, it's good. We've got an early start. It's a short presentation today. It's only been 25 minutes. I think we're around for the rest of the week. Whatever we can cover off would be great. We're around for questions either at the end of today or feel free to come by where we're hanging out, but we'll be hanging around for the next little while. Who are we?
VitalHub, we've been around since about the 2010 place, but really got started in 2016, 2017. We're a healthcare IT software solution that has accumulated over 50 different hospital solutions over the last little while. We're focused on government-based, funded-based healthcare systems. Those would be mostly those areas outside of the United States. We have operations in Canada, the U.K., Australia, and the Mideast are our primary area. We've ramped up through both an M&A strategy and through organic growth to about over $70 million of ARR. We've completed over 20 acquisitions or actually 21, and we just announced our 22nd acquisition since its inception. We really are focused on our numbers. Our financial numbers are extremely important to us. We feel we're very strong in both operations and capital allocation.
Our goal, and we're well in our goal, is to be a self-contained compounder, producing our own revenue and producing our own margins and our ability to get discipline, scale, growth, and profitability in our organization. You'll see that through our numbers as we move along. The marketplace, in presenting to the U.S. marketplace, the biggest question is, why aren't you in the U.S.? My first 10 years of my career were actually spent in healthcare IT in the U.S. marketplace. It's not that we don't know. We actually do know the U.S. marketplace, and maybe eventually we will move in there. The marketplace outside of the U.S. for healthcare IT software is really made up of smaller, niche-based vendors that have built solutions that have serviced those marketplaces.
As one of those vendors in a predecessor life before this in a company called MedWorxx, which was a successful venture, which we sold off to Vista Equity Partners, we really came to the conclusion that these organizations would form stronger as a cohesive unit than they would individually so o ff we went on our consolidation-based run. Really, it's a $10 billion opportunity for healthcare IT spending outside of the U.S. marketplace and really focused on our Canadian, U.K., Australian, Mideast marketplace with some work in the U.S. Again, a lot of money being spent in healthcare IT. D igitization is moving in those markets pretty aggressively, and we're right in the middle of that base marketplace. What do we do? We really have concentrated on three main marketplaces with our patient flow and operational visibility market being our primary base market.
Those are solutions that help healthcare organizations really help with the movement of patients throughout their organization. Capacity is really a strong driver within healthcare. Moving patients effectively through the healthcare organizations is what's talked about every day within a boardroom of every healthcare-based organization. We have two different areas where we have healthcare, where we have applications in patient flow. One is what we call operation and visibility solutions. Those are data analytic solutions that help healthcare organizations, be it the government itself or the acute care or aid division within a hospital, get insights into what the patient movement is within those organizations and really to help them define those processes that it can do that. Then we have patient engagement solutions.
Those are solutions that we as patients use as we navigate through the healthcare system to help us navigate those systems, be it a pre-operative-based assessment and appointment scheduling or aftercare-based questionnaires or aftercare-based solutions. We have accumulated over 40 different products in those arenas, and we are continuously looking to add more. The second area we have is electronic records for social services or care coordination. We have about 20 different solutions. It is primarily based in the Canadian marketplace, but it is social-based services-based software. That would not be an electronic health record for physicians, nor would it be an acute care setting within a hospital-based setting. It would be those environments that would do that. It would still be B2B. Typically, there are organizations over 500 employees, generally between 500 employees to 2,500 employees.
We also have some really big base deals in that system where we do the entire jail populations for an entire province in Canada, or we have entire provinces that would use those systems. We have a product called TREAT that has done extremely well in there, and we've accumulated other base modules over the years with it. The third area that we just entered is in workforce automation-based solutions, smaller part of our business, primarily U.K.-based, but as for solutions that help employees of healthcare organizations in terms of compliance, recruiting, certification, etc., that go along with it. Just a few case studies to show where patient flow would be. Patient flow journeys would be those systems that help us, such as kiosk, web-based applications, entries, appointment management, etc. We've accumulated a whole gamut base of solutions that would drive those markets.
Then operational visibility, we'd run that from both a countrywide level, in the case of the U.K., with a product called SHREWD, through to hospital-based levels or departmental-based levels with patient tracking lists and patient tracking boards that you would see across hospitals in many of those regions. We've accumulated a significant amount of assets in those areas. In case management, it's a full-blown ERP-ish type system, complete from registration, integrated care, billing, facility management, a full-blown patient care system that would drive those models with a product called TREAT. Went the wrong way. We also have, we've built a strong merger and acquisition-based strategy. As I said, we've done 22-ish, 21, 22 that we've just announced. We have an effective-based strategy that really is focused on consolidation and really cost-based reduction once we acquire those entries and cross-selling of our assets.
If you look at our revenue-based, we've had strong organic growth, and we've been established, we've been doing about, on average, about $1.5 million of new organic ARR. That's not purchased ARR on a per quarterly basis because we have an effective strategy where we've been cross-selling our assets into our strong customer base that we've established. We look at that strategy as we do that. As we work through it, we consolidate our G&A functions and put everybody under operations. We have a cost-effective R&D channel. About 500 of our employees, 200 of those are based in our Sri Lankan-based operation. We've built this operation for 20-something. We started in 2016, well over 200 people in 2025. A big part of our strategy is moving our resources offshore into those environments and getting real effective R&D off of that at a really cost-effective price.
It has allowed us to get the margins that we feel we needed. We strategize on how these products work together. We put those strategic directions in place, which really affects us for our cross-selling. That is optimizing a sales and marketing-based strategy off of these small vendors to do that. We grow together. We sell. We build strong organic growth. Those have been proven in our numbers that you can see in our financials. Our merger and acquisition model, we have been buying our assets at about between one and two and a half times module revenue model. We paid some well over three, but primarily it has been in that range. We target companies between $2 million and $20 million in revenue. That has been our base that we do that. There are some larger acquisitions in play that are north of that.
Usually, these businesses are making a little bit or losing a little bit, break even, or profitable. We have work to do when we acquire them to get them into our deal. There are about 400 companies in our pipeline, and we have our own team that sources these acquisitions, and we make them. We model our companies on a five-year to seven-year payback. We are looking on a cash-by-cash basis. Whatever cash we do, we're looking. We model very non-aggressively in terms of our organic growth-based model. It is really based on our cost-based model to do that. We will not touch a company if it does not have at least 60% recurring revenue to do that. Our goal is to get it to 20% adjusted EBITDA on a pretty fast basis.
I think the company is reporting 28% adjusted EBITDA on a regular basis to 25% and 28% on a regular basis. We do have the ability to offer stock and cash as part of our transitions. In the early days, we used stock, but for the most part, it's been cash-based. We're a pretty cash-based cash structure in terms of what we have. Those are the acquisitions that you've seen. As you can see, we've been pretty active in the U.K. and the Canadian marketplaces. Some base in Australia and nothing in the Middle East, but we do have operations in the Middle East. We've been pretty aggressive in our strategy in terms of we built up.
Most of these products that we've acquired have been bought for a reason in terms of building up our portfolio and building up our strategy as we go into the marketplace and really working at cross-selling our solutions into our market. As you can see, we've been pretty busy in those markets, and we continue to be busy on our M&A front. We're doing in between two to four transactions on an annual basis. Again, the secret to what we said, I think I mentioned this, is our Sri Lankan-based organization. Again, 200-plus people that work there. It really helps our innovation, very in tune with our domain, very in tune with our groups, and do an effective job of us being able to do cost-effective solutions on an offshore type of basis. Financial performance, we're north of $71 million of annual.
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