UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-Q

(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2019March 31, 2020
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ______ to ______
Commission File NumberNumber: 000-55039
logo1a13.jpg
BIOTELEMETRY, INC.BioTelemetry, Inc.
(Exact Name of Registrant as Specified in its Charter)
Delaware 46-2568498
(State or other jurisdiction of incorporation or organization) (I.R.S. Employer Identification No.)
1000 Cedar Hollow Road  
Malvern,Pennsylvania 19355
(Address of principal executive offices) (Zip Code)
(610) 729-7000
(Registrant’s Telephone Number, including Area Code)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $0.001 par value $0.001 per shareBEATNASDAQ Global Select Market
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes    No 
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes    No 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company, or an emerging growth company.  See the definitions of “large accelerated filer,” “accelerated filer”filer,” “smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act.  (Check one):
Large accelerated filerAccelerated filerEmerging growth company
Non-accelerated filerSmaller reporting company  
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes    No  
As of October 28, 2019, 33,991,107April 30, 2020, 34,144,802 shares of the registrant’s common stock were outstanding.
 




BIOTELEMETRY, INC.BioTelemetry, Inc.
QUARTERLY REPORT ON FORMQuarterly Report on Form 10-Q
FOR THE PERIOD ENDED SEPTEMBER 30, 2019For the Period Ended March 31, 2020

TABLE OF CONTENTS
  Page
PART I
 
Financial Statements (unaudited)
Management’s Discussion and Analysis of Financial Condition and Results of Operations
   
PART II
 
   
Unless the context otherwise indicates or requires, the terms “we,” “our,” “us,” “BioTelemetry” and the “Company,” as used in this Quarterly Report on Form 10-Q, refer to BioTelemetry, Inc. and its directly and indirectly owned subsidiaries as a combined entity, except where otherwise stated or where it is clear that the terms mean only BioTelemetry, Inc. exclusive of its subsidiaries. We do not use the ® or ™ symbol in each instance in which one of our registered or common law trademarks appears in this Quarterly Report on Form 10-Q, but this should not be construed as any indication that we will not assert our rights thereto to the fullest extent permissible under applicable law.


CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This document includes certain forward-looking statements within the meaning of the “Safe Harbor” provisions of the Private Securities Litigation Reform Act of 1995 regarding, among other things, our growth prospects, the prospects for our products and our confidence in our future. These statements may be identified by words such as “expect,” “anticipate,” “estimate,” “intend,” “plan,” “believe,” “promises” and other words and terms of similar meaning. Examples of forward-looking statements include statements we make regarding our ability to increase demand for our products and services, to leverage our Mobile Cardiac Outpatient Telemetry platform, to expand into new markets, to grow our market share, our expectations regarding revenue trends in our segments and the achievement of cost efficiencies through process improvement. Such forward-looking statements are based on current expectations and involve inherent risks and uncertainties, including important factors that could delay, divert or change any of these expectations, and could cause actual outcomes and results to differ materially from current expectations. These factors include, among other things:
our ability to identify acquisition candidates, acquire them on attractive terms and integrate their operations into our business;
our ability to educate physicians and continue to obtain prescriptions for our products and services;
changes to insurance coverage and reimbursement levels by Medicare and commercial payors for our products and services;
our ability to attract and retain talented executive management and sales personnel;
the commercialization of new competitive products;
acceptance of our new products and services, such as our mobile cardiac telemetry (“MCT”) patch;
the outcome of our pending and ongoing incident investigation (as detailed in “Part I; Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations” of this report), including our discovery of additional information relating to the incident and our customers’ and other stakeholders’ reactions to that additional information;
costs related the incident investigation and resulting liabilities;impact of the COVID-19 pandemic;
the impact of the October 2019 information technology incident;
our ability to obtain and maintain required regulatory approvals for our products, services and manufacturing facilities;
changes in governmental regulations and legislation;
adverse regulatory action;
our ability to obtain and maintain adequate protection of our intellectual property;
interruptions or delays in the telecommunications systems and/or information technology systems that we use;
our ability to successfully resolve outstanding legal proceedings; and
the other factors that are described in “Part I; Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2018,2019, as well as the factors that are described


in “Part II; Item 1A. Risk Factors” of this Quarterly Report on Form 10-Q.
We undertake no obligation to publicly update any forward-looking statement, whether as a result


of new information, future events, or otherwise, except as may be required by law.

PART I — FINANCIAL INFORMATION


Item 1.  Financial Statements
BIOTELEMETRY, INC.
CONSOLIDATED BALANCE SHEETS
(in thousands, except share and par value data)
(Unaudited)
September 30,
2019
 December 31,
2018
(Unaudited)
March 31,
2020
 December 31,
2019
ASSETS      
Current assets:      
Cash and cash equivalents$61,573
 $80,889
$106,845
 $68,614
Healthcare accounts receivable, net of allowance for doubtful accounts of $26,504 and $25,345, at September 30, 2019 and December 31, 2018, respectively56,832
 37,754
Other accounts receivable, net of allowance for doubtful accounts of $92 and $268, at September 30, 2019 and December 31, 2018, respectively15,637
 14,874
Healthcare accounts receivable, net of allowance for credit losses of $37,980 and $31,780, at March 31, 2020 and December 31, 2019, respectively74,864
 71,851
Other accounts receivable, net of allowance for credit losses of $548 and $201, at March 31, 2020 and December 31, 2019, respectively18,727
 15,625
Inventory6,389
 7,323
7,612
 5,738
Prepaid expenses and other current assets9,712
 5,820
5,026
 6,505
Total current assets150,143
 146,660
213,074
 168,333
Property and equipment, net of accumulated depreciation of $74,241 and $67,202, at September 30, 2019 and December 31, 2018, respectively55,608
 48,377
Property and equipment, net of accumulated depreciation of $75,103 and $76,095, at March 31, 2020 and December 31, 2019, respectively58,330
 56,380
Intangible assets, net133,593
 129,653
125,816
 129,596
Goodwill304,101
 238,814
301,150
 301,321
Deferred tax assets12,828
 19,975
8,547
 12,626
Other assets19,891
 3,322
33,509
 17,464
Total assets$676,164
 $586,801
$740,426
 $685,720
LIABILITIES AND EQUITY      
Current liabilities:      
Accounts payable$19,287
 $18,157
$25,339
 $24,198
Accrued liabilities28,487
 24,689
23,379
 27,318
Current portion of finance lease obligations490
 1,652
373
 394
Current portion of long-term debt12,813
 5,125

 3,844
Total current liabilities61,077
 49,623
49,091
 55,754
Long-term portion of finance lease obligations348
 117
272
 289
Long-term debt182,825
 193,424
227,425
 190,823
Other long-term liabilities71,007
 33,152
86,640
 71,937
Total liabilities315,257
 276,316
363,428
 318,803
Stockholders’ equity:      
Common stock—$0.001 par value as of September 30, 2019 and December 31, 2018; 200,000,000 shares authorized as of September 30, 2019 and December 31, 2018; 33,991,107 and 33,406,364 shares issued and outstanding at September 30, 2019 and December 31, 2018, respectively34
 33
Common stock—$0.001 par value as of March 31, 2020 and December 31, 2019; 200,000,000 shares authorized as of March 31, 2020 and December 31, 2019; 34,138,516 and 34,023,053 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively34
 34
Paid-in capital449,087
 426,054
457,000
 453,366
Accumulated other comprehensive (loss)/income(624) 256
Accumulated other comprehensive loss(784) (469)
Accumulated deficit(87,590) (115,858)(79,252) (86,014)
Total equity360,907
 310,485
376,998
 366,917
Total liabilities and equity$676,164
 $586,801
$740,426
 $685,720
See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
 Three Months Ended Nine Months Ended
 September 30, September 30,
(in thousands, except per share data)2019 2018 2019 2018
Revenue$111,291

$100,013
 $327,073
 $295,869
Cost of revenue41,952
 37,276
 122,716
 109,329
Gross profit69,339
 62,737
 204,357
 186,540
Operating expenses:       
General and administrative29,651
 26,325
 87,845
 81,785
Sales and marketing12,572
 10,120
 37,807
 32,535
Bad debt expense5,858
 5,157
 16,385
 16,911
Research and development3,661
 2,429
 10,526
 8,451
Other charges2,598
 1,330
 7,902
 11,623
Total operating expenses54,340
 45,361
 160,465
 151,305
Income from operations14,999
 17,376
 43,892
 35,235
Other expense:       
Interest expense(2,338) (2,408) (7,358) (6,982)
Loss on equity method investments(65) (54) (251) (238)
Other non-operating (expense)/income, net(845) (194) (1,813) 543
Total other expense, net(3,248) (2,656) (9,422) (6,677)
Income before income taxes11,751
 14,720
 34,470
 28,558
(Provision for)/benefit from income taxes(3,468) 1,281
 (6,202) 2,923
Net income8,283
 16,001
 28,268
 31,481
Net loss attributable to noncontrolling interest
 
 
 (946)
Net income attributable to BioTelemetry, Inc.$8,283
 $16,001
 $28,268
 $32,427
        
Net income per common share attributable to BioTelemetry, Inc.:       
Basic$0.24
 $0.48
 $0.83
 $1.00
Diluted$0.23
 $0.45
 $0.78
 $0.91
Weighted average number of common shares outstanding:       
Basic33,908
 33,003
 33,885
 32,488
Dilutive common stock equivalents2,360
 2,915
 2,560
 3,078
Diluted36,268
 35,918
 36,445
 35,566

 Three Months Ended
 March 31,
(in thousands, except per share data)2020 2019
Revenue$113,031

$103,979
Cost of revenue42,523
 39,201
Gross profit70,508
 64,778
Operating expenses:   
General and administrative31,881
 27,607
Sales and marketing13,446
 12,440
Credit loss expense6,020
 5,148
Research and development3,568
 3,333
Other charges2,084
 3,070
Total operating expenses56,999
 51,598
Income from operations13,509
 13,180
Other expense:   
Interest expense(2,107) (2,482)
Loss on equity method investments
 (32)
Other non-operating income/(expense), net931
 (1,054)
Total other expense, net(1,176) (3,568)
Income before income taxes12,333
 9,612
(Provision for)/benefit from income taxes(5,224) 2,073
Net income$7,109
 $11,685
    
Net income per common share:   
Basic$0.21
 $0.35
Diluted$0.19
 $0.32
Weighted average number of common shares outstanding:   
Basic34,186
 33,654
Dilutive common stock equivalents2,403
 2,752
Diluted36,589
 36,406
See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited)

Three Months Ended Nine Months EndedThree Months Ended
September 30, September 30,March 31,
(in thousands)2019 2018 2019 20182020 2019
Net income attributable to BioTelemetry, Inc.$8,283
 $16,001
 $28,268
 $32,427
Net income$7,109
 $11,685
Other comprehensive loss:          
Foreign currency translation loss(167) (27) (880) (194)(315) (2)
Comprehensive income attributable to BioTelemetry, Inc.$8,116
 $15,974
 $27,388
 $32,233
Comprehensive income$6,794
 $11,683
See accompanying Notes to Consolidated Financial Statements.

BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)


Nine Months EndedThree Months Ended
September 30,March 31,
(in thousands)2019 20182020 2019
OPERATING ACTIVITIES      
Net income$28,268
 $31,481
$7,109
 $11,685
Adjustments to reconcile net income to net cash provided by operating activities:      
Bad debt expense16,385
 16,911
Credit loss expense6,020
 5,148
Depreciation and amortization30,508
 30,231
10,485
 10,021
Stock-based compensation9,662
 6,278
3,382
 2,549
Accretion of debt discount932
 932
261
 311
Deferred income taxes5,021
 (4,149)4,079
 (1,416)
Change in fair value of acquisition-related contingent consideration(1,720) (700)(290) 
Other non-cash items(105) 279
1,201
 32
Changes in operating assets and liabilities:      
Healthcare and other accounts receivable(34,637) (28,826)(12,135) (11,397)
Inventory934
 (3,454)(1,874) (1,633)
Prepaid expenses and other assets(3,493) 1,932
3,007
 (588)
Accounts payable640
 1,105
1,141
 8,026
Accrued and other liabilities207
 (7,733)(9,683) (5,194)
Net cash provided by operating activities52,602
 44,287
12,703
 17,544
INVESTING ACTIVITIES      
Acquisition of businesses, net of cash acquired(44,766) 
Acquisition of business, net of cash acquired
 (44,566)
Purchases of property and equipment and investment in internally developed software(23,686) (17,498)(6,984) (5,334)
Net cash used in investing activities(68,452) (17,498)(6,984) (49,900)
FINANCING ACTIVITIES      
Proceeds related to the exercising of stock options and employee stock purchase plan7,045
 10,818
1,719
 4,311
Payments of tax withholdings related to vesting of share-based awards(4,955) (2,890)(1,467) (4,911)
Principal payments on long-term debt(3,844) (1,538)(197,825) (1,281)
Proceeds from borrowings on revolving credit facility232,000
 
Payment of debt issuance costs(1,678) 
Principal payments on finance lease obligations(1,735) (3,005)(179) (1,163)
Acquisition of noncontrolling interests
 (2,885)
Net cash (used in)/provided by financing activities(3,489) 500
Net cash provided by/(used in) financing activities32,570
 (3,044)
Effect of exchange rate changes on cash23
 (193)(58) (2)
Net (decrease)/increase in cash and cash equivalents(19,316) 27,096
Net increase/(decrease) in cash and cash equivalents38,231
 (35,402)
Cash and cash equivalents - beginning of period80,889
 36,022
68,614
 80,889
Cash and cash equivalents - end of period$61,573
 $63,118
$106,845
 $45,487
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION      
Non-cash purchases of property and equipment$1,721
 $1,056
$5,045
 $2,584
Non-cash fair value of equity issued for acquisition of business2,142
 
Non-cash fair value of equity issued for acquisition of noncontrolling interests
 3,972
Cash paid for interest6,301
 5,830
1,960
 2,106
Cash paid for taxes$617
 $1,120
$50
 $
See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF EQUITY
(Unaudited)




BioTelemetry, Inc. EquityBioTelemetry, Inc. Equity
Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Total EquityCommon Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Total Equity
(in thousands, except shares)Shares Amount Shares Amount 
Balance at June 30, 201933,888,920
 $34
 $443,135
 $(457) $(95,873) $346,839
Balance at December 31, 201934,023,053
 $34
 $453,366
 $(469) $(86,014) $366,917
Cumulative effect of change in accounting principle
 
 
 
 (347) (347)
Share issuances related to stock compensation plans102,187
 
 2,316
 
 
 2,316
143,180
 
 1,719
 
 
 1,719
Stock-based compensation
 
 3,636
 
 
 3,636

 
 3,382
 
 
 3,382
Shares withheld to cover taxes on vesting of share-based awards(27,717) 
 (1,467) 
 
 (1,467)
Currency translation adjustment
 
 
 (167) 
 (167)
 
 
 (315) 
 (315)
Net income
 
 
 
 8,283
 8,283

 
 
 
 7,109
 7,109
Balance at September 30, 201933,991,107
 $34
 $449,087
 $(624) $(87,590) $360,907
Balance at March 31, 202034,138,516
 $34
 $457,000
 $(784) $(79,252) $376,998


BioTelemetry, Inc. EquityBioTelemetry, Inc. Equity
Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Total EquityCommon Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Income
 Accumulated Deficit Total Equity
(in thousands, except shares)Shares Amount Shares Amount 
Balance at June 30, 201832,715,190
 $33
 $415,701
 $(281) $(142,252) $273,201
Balance at December 31, 201833,406,364
 $33
 $426,054
 $256
 $(115,858) $310,485
Share issuances related to stock compensation plans496,868
 
 4,985
 
 
 4,985
460,952
 1
 4,310
 
 
 4,311
Stock-based compensation
 
 1,355
 
 
 1,355

 
 2,549
 
 
 2,549
Shares withheld to cover taxes on vesting of share-based awards(63,580) 
 (4,911) 
 
 (4,911)
Deferred purchase price consideration - equity portion
 
 8,890
 
 
 8,890
Currency translation adjustment
 
 
 (27) 
 (27)
 
 
 (2) 
 (2)
Net income
 
 
 
 16,001
 16,001

 
 
 
 11,685
 11,685
Balance at September 30, 201833,212,058
 $33
 $422,041
 $(308) $(126,251) $295,515
Balance at March 31, 201933,803,736
 $34
 $436,892
 $254
 $(104,173) $333,007



See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
CONSOLIDATED STATEMENTS OF EQUITY
(Unaudited)




 BioTelemetry, Inc. Equity
 Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Income/(Loss)
 Accumulated Deficit Total Equity
(in thousands, except shares)Shares Amount    
Balance at December 31, 201833,406,364
 $33
 $426,054
 $256
 $(115,858) $310,485
Share issuances related to stock compensation plans599,161
 1
 7,044
 
 
 7,045
Stock-based compensation
 
 9,662
 
 
 9,662
Shares withheld to cover taxes on vesting of share-based awards(64,418) 
 (4,955) 
 
 (4,955)
Issuance of stock related to business combination50,000
 
 2,142
 
 
 2,142
Deferred purchase price consideration - equity portion
 
 9,140
 
 
 9,140
Currency translation adjustment
 
 
 (880) 
 (880)
Net income
 
 
 
 28,268
 28,268
Balance at September 30, 201933,991,107
 $34
 $449,087
 $(624) $(87,590) $360,907


 BioTelemetry, Inc. Equity    
 Common Stock Paid-in Capital 
Accumulated
Other
Comprehensive
Loss
 Accumulated Deficit Noncontrolling Interest Total Equity
(in thousands, except shares)Shares Amount     
Balance at December 31, 201731,906,195
 $32
 $409,517
 $(114) $(158,678) $(1,054) $249,703
Share issuances related to stock compensation plans1,332,254
 1
 11,136
 
 
 
 11,137
Stock-based compensation
 
 6,278
 
 
 
 6,278
Shares withheld to cover taxes on vesting of share-based awards(85,177) 
 (2,890) 
 
 
 (2,890)
Acquisition of noncontrolling interest58,786
 
 (2,000) 
 
 2,000
 
Currency translation adjustment
 
 
 (194) 
 
 (194)
Net income/(loss)
 
 
 
 32,427
 (946) 31,481
Balance at September 30, 201833,212,058
 $33
 $422,041
 $(308) $(126,251) $
 $295,515



See accompanying Notes to Consolidated Financial Statements.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)



1. Summary of Significant Accounting Policies
a) Principles of Consolidation & Reclassifications
The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information, the instructions to Form 10-Q, and Rule 10-01 of Regulation S-X and include the accounts of BioTelemetry, Inc. and its controlledwholly owned subsidiaries (“BioTelemetry,” the “Company,” “we,” “our” or “us”). In the opinion of management, all adjustments (which are of a normal and recurring nature) considered necessary to present fairly the financial position as of March 31, 2020 and December 31, 2019 and the results of operations, and statements of comprehensive income, cash flows, and equity for the interim periods ended September 30,March 31, 2020 and 2019 and 2018 have been included. All intercompany transactions and balances have been eliminated in consolidation. The results of operations for any interim period are not indicative of the results of the full year. Certain information and footnote disclosures normally included in consolidated financial statements presented in accordance with U.S. GAAP, but which are not required for interim reporting purposes, have been omitted. The accompanying unaudited consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.2019.
Certain reclassifications have been made to prior period statements to conform to the current period presentation. These consist of combining our non-cash depreciation and amortization expenses into one line on our consolidated statements of cash flows and separating the non-cash operating item of change in fair value of acquistion-relatedacquisition-related contingent consideration from other non-cash items on our consolidated statements of cash flows. These reclassifications had no impact on previously reported working capital, consolidated results of operations, cash flows or accumulated deficit.
b) Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. GAAP requires that we make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results may differ from those estimates.
c) Fair Value of Financial Instruments
Fair value is defined as the exit price, the price that would be received to sell an asset or transfer a liability in an orderly transaction between market participants at the measurement date. The fair value hierarchy prioritizes the inputs to valuation techniques used to measure fair value into three broad levels, as defined below. Observable inputs are inputs a market participant would use in valuing an asset or liability based on market data obtained from sources independent of us. Unobservable inputs are inputs that reflect our own assumptions about the factors a market participant would use in valuing an asset or liability developed using the best information available in the circumstances. The classification of an asset’s or liability’s level within the fair value hierarchy is determined based on the lowest level input that is significant to the fair value measurement.
Level 1 -Quoted prices in active markets for an identical asset or liability.
Level 2 -Inputs that are observable for the asset or liability, either directly or indirectly through market corroboration, for substantially the full term of the asset or liability.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Level 3 -Inputs that are unobservable for the asset or liability, based on our own assumptions about the assumptions a market participant would use in pricing the asset or liability.
Our financial instruments consist primarily of cash and cash equivalents, Healthcare accounts receivable, other accounts receivable, accounts payable, acquisition-related contingent consideration, short-termcurrent portion of long-term debt and long-term debt. With the exception of acquisition-related contingent consideration and long-term debt, the carrying value of these financial instruments approximates their fair value because of their short-term nature (classified as Level 1).
Our long-term debt (classified as Level 2) is measured using market prices for similar instruments, inputs such as the borrowing rates currently available, benchmark yields, actual trade data, broker/dealer quotes and other similar data obtained from quoted market prices or independent pricing vendors.
The fair value of acquisition-related contingent consideration (classified as Level 3) is measured on a recurring basis using a Monte Carlo simulation. This model uses assumptions, including estimated projected revenues, estimated stock price volatility in future periods, estimated discount rates and discounts for the lack of marketability of common stock. In addition to the recurring fair value measurements, the fair value of certain assets acquired and liabilities assumed in connection with a business combination are recorded at fair value, primarily using a discounted cash flow model (classified as Level 3). This valuation technique requires us to make certain assumptions, including future operating performance, cash flows and revenue growth rates, royalty rates and other such variables, which are discounted to present value using a discount rate that reflects the risk factors associated with future cash flow, the characteristics of the assets acquired and liabilities assumed and the experience of the acquired business. Non-financial assets such as goodwill, intangible assets, and property and equipment and right-of-use (“ROU”) assets are subsequently measured at fair value when there is an indicator of impairment and recorded at fair value only when an impairment is recognized. We assess the impairment of goodwill, intangible assets, property and intangibleequipment and ROU assets annually or whenever events or changes in circumstances indicate that the carrying amount of an intangible asset may not be recoverable.
d) Accounts Receivable and Allowance for Doubtful AccountsCredit Losses
Healthcare accounts receivable, isincluding contract assets, are recorded at the time Healthcare segment revenue is recognized and is presented on the consolidated balance sheet net of an allowance for doubtful accounts.credit losses. For our contracted payors, we determine revenue based on negotiated prices for the services provided. Based on our history, we have experience collecting substantially all of the negotiated contracted rates and are therefore not providing an implicit price concession. As a result, an allowance for doubtful accounts is recorded based on historical collection trends to account for the risk of patient default. Because of continuing changes in the health care industry and third-party reimbursement, it is possible that our estimates of collectability could change, which could have a material impact on our operations and cash flows.
Other accounts receivable isare related to the Research segment and Corporate and Other category and isare recorded at the time revenue is recognized, when products are shipped or services are performed. We estimate
When calculating an allowance for doubtful accountscredit losses, we calculate the expected credit loss based on a specific account basispast events, current conditions, and consider several factors inreasonable and supportable forecasts that affect the collectability of our analysis, including customer specific information.receivables, even if we believe that no loss has been incurred as of the measurement date. This includes, but is not limited to, historical collection trends, the current state of the healthcare market, and current and projected future industry trends.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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We write off receivables when the likelihood for collection is remote, we believe collection efforts have been fully exhausted and we do not intend to devote additional resources in attempting to collect. We performassess write-offs on a monthly basis.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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e) Acquisition-Related Contingent Consideration
Acquisition-related contingent consideration is our obligation, arising from a business combination, to transfer additional assets and/or equity interests to the seller if certain future events occur or conditions are met. The fair value of the contingency is estimated as of the acquisition date using certain unobservable inputs (and therefore classified as Level 3 in the fair value hierarchy) and is recorded as a liability. We re-measure the estimated fair value of acquisition-related contingent consideration classified as a liability at each reporting date. Adjustments subsequent to the acquisition measurement period are recorded in other charges in the consolidated statements of operations. Changes to the inputs used in the measurement of acquisition-related contingent consideration include but are not limited to: changesestimated projected revenues, estimated stock price volatility in the assumptions regarding probabilities of successful achievement of future events or conditions;periods, estimated revenue projections;discount rates and discounts for the lack of marketability of our common stock; estimated stock price volatility; and the discount rate used to estimate the fair value of the liability.stock. Acquisition-related contingent consideration may change significantly as our inputs and assumptions noted above evolve and additional data is obtained. The inputs and assumptions used in estimating fair value require significant judgment. The use of different assumptions and judgments could result in different fair value estimates that may have a material impact on our results from operations and financial position.
f) Concentrations of Credit Risk
Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, Healthcare accounts receivable, including contract assets related to our cardiac monitoring services and other accounts receivable. We maintain our cash and cash equivalents with high quality financial institutions to mitigate this risk. We perform ongoing credit evaluations of our customers and generally do not require collateral. We record an allowance for doubtful accountscredit losses in accordance with the procedures described above. Past-due amounts are written off against the allowance for doubtful accountscredit losses when collections are believed to be unlikely and all collection efforts have ceased.
At September 30, 2019March 31, 2020 and December 31, 2018,2019, 1 payor, Medicare, accounted for 21% and 15%22%, respectively, of our gross Healthcare accounts receivable.
g) Noncontrolling Interest
The consolidated financial statements reflect the application of Accounting Standards Codification (“ASC”) 810 - Consolidations, which establishes accounting and reporting standards that require: (i) the ownership interest in subsidiaries held by parties other than the parent to be clearly identified and presented in the consolidated balance sheet within stockholders’ equity but separate from the parent’s equity; (ii) the amount of consolidated net income/(loss) attributable to the parent and the noncontrolling interest to be clearly identified and presented in the consolidated statements of operations; and (iii) changes in a parent’s ownership interest while the parent retains its controlling financial interest in its subsidiary to be accounted for consistently.
h) Leases
We lease our administrative and service facilities, as well as certain office equipment, monitoring devices and information technology equipment under arrangements classified as leases under Accounting Standards Codification (“ASC”) 842 - Leases (“ASC 842”). We adopted ASC 842 using the optional modified retrospective transition method as of January 1, 2019, therefore prior period amounts are not restated.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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We recognize right-of-use (“ROU”) assets at the inception of the arrangement as the present value of the lease payments plus our initial direct costs (if any), less any lease incentives. The corresponding liability is computed as the present value of the lease payments at inception. Assets are classified as either operating or finance ROU assets according to the classification criteria in ASC 842. Upon the adoption of ASC 842, we elected the transition practical expedients to not reassess lease identification, lease classification and initial indirect costs related to those leases entered into prior to adoption of ASC 842 and to not separate lease and non-lease components where we are the lessor when the requisite criteria is met to be treated as such. The present value of the lease payments is computed using the rate implicit in the lease (if known) or our incremental borrowing rate.rate, which is the rate incurred to borrow on a collateralized basis of a similar term at an amount equal to the lease payments.
Operating lease costs are charged to operations on a straight-line basis over the lease term. Interest
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


charged on the finance lease liabilities is charged to interest expense, while the amortization of the finance lease ROU assets is also charged to operations on a straight-line basis.
Under our policy, we do not record an ROU asset or corresponding liability for arrangements where the initial lease term is one year or less, or when the ROU asset at inception is deemed immaterial.less. Those leases are expensed on a straight-line basis over the term of the lease.
Effective January 1, 2019, forFor our operating leases, we record the ROU assets as a component of other assets, the current lease liability as a component of accrued liabilities, and the long-term lease liability as a component of other long-term liabilities on our consolidated balance sheet. For our finance leases, we record the ROU asset and the accumulated amortization for the finance ROU asset as a component of property and equipment, net, with the current and long-term portions of the finance lease obligations as separate lines within our consolidated balance sheet. We amortize the finance ROU assets over the shorter of the remaining lease term or the estimated life of the asset.
i)h) Stock-Based Compensation
ASC 718 - Compensation - Stock Compensation (“ASC 718”), addresses the accounting for share-based payment transactions in which an enterprise receives employee services in exchange for: (i) equity instruments of the enterprise or (ii) liabilities that are based on the fair value of the enterprise’s equity instruments or that may be settled by the issuance of such equity instruments. ASC 718 requires that an entity measure the cost of equity-based service awards issued to employees, such as stock options and restricted stock units (“RSUs”), based on the grant-date fair value of the award and recognize the cost of such awards over the requisite service period (generally, the vesting period of the award). The compensation expense associated with performance stock units (“PSUs”) is recognized ratably over the period between when the performance conditions are deemed probable of achievement and when the awards are vested. Performance stock options (“PSOs”) are valued and stock-based compensation expense is recorded once the performance conditions of the outstanding PSOs have achieved probability. Prior to July 1, 2018, we accounted for equity awards issued to non-employees in accordance with ASC 505-50, Equity-Based Payments to Non-Employees; see “m) Recent Accounting Pronouncements; Accounting Pronouncements Recently Adopted” for further details related to our adoption of Accounting Standards Update (“ASU”) 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting, during the three months ended June 30, 2018 and our current accounting for equity awards issued to non-employees.
We have historically recorded stock-based compensation expense based on the number of stock options or RSUsstock units we expect to vest using our historical forfeiture experience and we periodically update
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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those forfeiture rates to apply to new grants. While we early adopted ASU 2016-09, Improvements to Employee Share-Based Payment Accounting during the year ended December 31, 2016, we have elected to continue torates. We estimate forfeitures under the true-up provision of ASC 718. We record additional expense if the actual forfeiture rate is lower than estimated and record a recovery of prior expense if the actual forfeiture rate is higher than estimated.
We estimate the fair value of our stock options using the Black‑Scholes option valuation model. The Black‑Scholes option valuation model requires the use of certain subjective assumptions. The most significant of these assumptions are the estimates of the expected volatility of the market price of our stock and the expected term of the award. We base our estimates of expected volatility on the historical average of our stock price. The expected term represents the period of time that share‑based awards granted are expected to be outstanding. Other assumptions used in the Black‑Scholes option valuation model include the risk‑free interest rate and expected dividend yield. The risk‑free interest rate for periods pertaining to the expected term of each option is based on the U.S. Treasury yield of a similar duration in effect at the time of grant. We have never paid, and do not expect to pay, dividends in the foreseeable future.
We estimate the fair value of our PSUs using a Monte Carlo simulation. This model uses assumptions, including the risk free interest rate, expected volatility of our stock price and those of the performance group, dividends of the performance group members and expected life of the awards. As noted above, we continue to estimate forfeitures under the true-up provision of ASC 718. If it is deemed
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


probable that the PSU performance targets will be met, compensation expense is recorded for these awards ratably over the requisite service period. The PSUs are forfeited to the extent the performance criteria are not met within the service period.
j)i) Income Taxes
We account for income taxes under the liability method, as described in ASC 740 - Income Taxes (“ASC 740”). Deferred income taxes are recognized for the tax consequences of temporary differences between the tax and consolidated financial statement reporting bases of assets and liabilities. When we determine that we will not be able to realize our deferred tax assets, we adjust the carrying value of the deferred tax asset through the valuation allowance.
Under ASC 740, the effects of changes in tax rates and tax laws on deferred tax balances are recognized in the period in which the new legislation is enacted. The total effect of tax law changes on deferred tax balances is recorded as a component of income tax expense.
We record unrecognized tax benefits in accordance with ASC 740 on the basis of a two-step process in which (i) we determine whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the position and (ii) for those tax positions that meet the more-likely-than-not recognition threshold, we recognize the largest amount of tax benefit that is more than 50 percent likely to be realized upon ultimate settlement with the related tax authority.
k)Under ASC 740, the effects of changes in tax rates and tax laws on deferred tax balances are recognized in the period in which the new legislation is enacted. The total effect of tax law changes on deferred tax balances is recorded as a component of income tax expense.
j) Net Income/(Loss) Per Share
We compute net income/(loss) per share in accordance with ASC 260 - Earnings Per Share. Basic net income/(loss) per share is computed by dividing net income/(loss) by the weighted average number of common shares outstanding during the period. Diluted net income per share is computed by giving effect to all potential dilutive common stock equivalents, including stock options, RSUs, PSOs and PSUs, using
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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the treasury stock method and shares expected to be issued in connection with acquisition-related contingent consideration arrangements when dilutive.
Certain stock options, which are priced higher than the average market price of our shares for the periods ended September 30,March 31, 2020 and March 31, 2019 and September 30, 2018 would be anti-dilutive and therefore have been excluded from the weighted average shares used in computing diluted net income per share. These options could become dilutive in future periods. Similarly, certain recently granted RSUs and PSUs are also excluded using the treasury stock method as their impact would be anti-dilutive. The dilutive effect of weighted average shares outstanding excludes approximately 1.0 million and 0.40.7 million shares for the three and nine month periodsperiod ended September 30, 2019, respectively,March 31, 2020, and excludes approximately 0.1 million and 0.50.3 million shares for the three and nine month periodsperiod ended September 30, 2018, respectively,March 31, 2019, as their effect would have been anti-dilutive on our net income per share.
l)k) Segment Information
ASC 280 - Segment Reporting, establishes standards for reporting information regarding operating segments in annual consolidated financial statements. Operating segments are identified as components of an enterprise for which separate discrete financial information is available for evaluation by the chief operating decision maker, or decision-making group, in making decisions on how to allocate resources and assess performance.
We report our business under 2 segments: Healthcare and Research. The Healthcare segment is focused on remote cardiac monitoring to identify cardiac arrhythmias or heart rhythm disorders and to
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services. The Research segment is engaged in centralized core laboratory services providing cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. Included in the Corporate and Other category is the manufacturing, testing and marketing of cardiac and blood glucose monitoring devices to medical companies, clinics and hospitals and corporate overhead and other items not allocated to any of our reportable segments.
m)l) Recent Accounting Pronouncements
Accounting Pronouncements Recently Adopted
In March 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-03, Codification Improvements to Financial Instruments (“ASU 2020-03”). ASU 2020-03 clarifies a number of issues, including certain issues related to leases and revolving credit arrangements. Our adoption of this update upon its release did not have a material impact to our consolidated financial statements.
In August 2018, the FASB issued ASU 2018-15, Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract, to align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The updated guidance also requires an entity to expense the capitalized implementation costs of a hosting arrangement that is a service contract over the term of the hosting arrangement. Historically, our implementation costs incurred in hosting service contracts have not been material. We early adopted this standard effective April 1, 2019 on a prospective basis. Upon adoption, our cloud computing implementation costs are deferred and recorded as a component of technology within intangible assets in our consolidated balance sheet and amortized to selling, general and administrative costs over the life of the service arrangement on our statement of operations. This update did not have a material impact on our financial position, results of operations or disclosures.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


In August 2018, the U.S. Securities and Exchange Commission (“SEC”) adopted the final rule under SEC Release No. 33-10532, Disclosure Update and Simplification 2018-13, amending certain disclosure requirements that were redundant, duplicative, overlapping, outdated or superseded. Additionally, the amendments expanded the disclosure requirements on the consolidated statements of equity for interim consolidated financial statements. Under the amendments, a summary of changes in each caption of stockholders’ equity presented in the consolidated balance sheets must be provided in a note or separate statement. The consolidated statements of equity should present a reconciliation of the beginning balance to the ending balance of each period for which the consolidated statement of comprehensive income is required to be filed. This final rule was effective in the fourth quarter of 2018. The SEC provided relief on the effective date until the first quarter of 2019, and we adopted this rule in the first quarter of 2019.
In June 2018, the Financial Accounting Standards Board (“FASB”) issued ASU 2018-07, Compensation - Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting (“ASU 2018-07”). This update expands the scope of Topic 718 to include share-based payment transactions for acquiring goods and services from nonemployees. The amendments specify that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in a grantor’s own operations by issuing share-based payment awards. The amendments also clarify that Topic 718 does not apply to share-based payments used to effectively provide (1) financing to the issuer or (2) awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under ASC 606 - Revenue from Contracts with Customers (“ASC 606”). The amendments in ASU 2018-07 are effective for public business entities for fiscal years beginning after December 15, 2018, including interim periods within that fiscal year. Early adoption was permitted. We adopted this standard on July 1, 2018, effective January 1, 2018, and this standard did not have a material impact on our financial position, results of operations or disclosures.
In February 2016, the FASB issued ASU 2016-02, Leases. This standard, along with several subsequent updates, requires lessees to recognize most leases on their balance sheet, make selected changes to lessor accounting and disclose additional key information about leases. We adopted these updates on January 1, 2019, using the optional modified retrospective transition method and utilizing practical expedients available. The adoption of the new standard resulted in the recording, as of January 1, 2019, of additional ROU assets of $22.7 million as a component of other assets, current ROU liabilities of $6.2 million as a component of accrued liabilities and long-term ROU liabilities of $16.5 million, all of which relate to our operating leases. The adoption of the new standard did not materially impact our consolidated results of operations and had no impact on our cash flows.
Accounting Pronouncements Not Yet Adopted
In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement (“ASU 2018-13”). This update eliminates certain disclosures related to transfers and valuation processes, clarifies the requirement for measurement uncertainty disclosures, and requires additional disclosures for Level 3 fair value measurements, including the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. ASU 2018-13 is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, with early2019. Our adoption permitted. We are in the process of evaluating the impact of this update on January 1, 2020 did not have a material impact to our consolidated financial statements and related disclosures.statements.
In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses. This update, along with subsequent updates and amendments, introduces the current expected credit loss model, which will require
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


requires an entity to measure credit losses for certain financial instruments and financial assets, including trade receivables. Under this update, upon initial recognition and at each reporting period, an entity will beis required to recognize an allowance that reflects the entity’s current estimate of credit losses expected to be incurred over the life of the financial instrument. Our adoption of this update on January 1, 2020 resulted in an immaterial adjustment to accumulated deficit, and we have modified our disclosures in accordance with the new guidance.
Accounting Pronouncements Not Yet Adopted
In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”). ASU 2020-04 provides optional guidance for a limited period of time to ease the potential burden in accounting for (or recognizing the effects of) the transition from LIBOR and other interbank offered rates to alternative reference interest rates. This updateASU can be applied immediately; however, the guidance will only be effective for fiscal years beginning afteravailable until December 15, 2019 and interim periods within those fiscal years, with early adoption permitted.31, 2022. We are in the process of evaluating the impact of this update on our consolidated financial statements and related disclosures.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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2. Revenue Recognition
We adoptedrecognize revenue in accordance with ASC 606 on January 1, 2018,- Revenue from Contracts with Customers (“ASC 606”), which requires revenue recognized to represent the transfer of promised goods or services to customers at an amount that reflects the consideration that a company expects to receive in exchange for those goods or services.
We utilized the modified retrospective method for adoption, allowing us to not retrospectively adjust prior periods. We applied the modified retrospective method only to contracts that were not complete at January 1, 2018 and accounted for the aggregate effect of any contract modifications upon adoption. No cumulative adjustment to retained earnings was recorded.
Disaggregation of Revenue
We disaggregate revenue from contracts with customers by payor type and major service line. We determined that disaggregating revenue into these categories achieves the disclosure objective of illustrating the differences in the nature, amount, timing and uncertainty of our revenue streams. Disaggregated revenue by payor type and major service line for the three and nine months ended September 30, 2019 and 2018 werewas as follows:
Three Months Ended September 30, 2019Three Months Ended March 31, 2020
Reporting Segment   Total ConsolidatedReporting Segment   Total Consolidated
(in thousands)Healthcare Research Other Healthcare Research Other 
Payor/Service Line              
Remote cardiac monitoring services - Medicare$39,537
 $
 $
 $39,537
$40,128
 $
 $
 $40,128
Remote cardiac monitoring services - commercial payors54,336
 
 
 54,336
55,579
 
 
 55,579
Clinical trial support and related services
 14,236
 
 14,236

 13,820
 
 13,820
Technology devices, consumables and related services
 
 3,182
 3,182

 
 3,504
 3,504
Total$93,873
 $14,236
 $3,182
 $111,291
$95,707
 $13,820
 $3,504
 $113,031

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


 Three Months Ended September 30, 2018
 Reporting Segment   Total Consolidated
(in thousands)Healthcare Research Other 
Payor/Service Line       
Remote cardiac monitoring services - Medicare$34,638
 $
 $
 $34,638
Remote cardiac monitoring services - commercial payors49,558
 
 
 49,558
Clinical trial support and related services
 13,464
 
 13,464
Technology devices, consumables and related services
 
 2,353
 2,353
Total$84,196
 $13,464
 $2,353
 $100,013

 Nine Months Ended September 30, 2019
 Reporting Segment   Total Consolidated
(in thousands)Healthcare Research Other 
Payor/Service Line       
Remote cardiac monitoring services - Medicare$114,573
 $
 $
 $114,573
Remote cardiac monitoring services - commercial payors162,313
 
 
 162,313
Clinical trial support and related services
 41,079
 
 41,079
Technology devices, consumables and related services
 
 9,108
 9,108
Total$276,886
 $41,079
 $9,108
 $327,073
Nine Months Ended September 30, 2018Three Months Ended March 31, 2019
Reporting Segment   Total ConsolidatedReporting Segment   Total Consolidated
(in thousands)Healthcare Research Other Healthcare Research Other 
Payor/Service Line              
Remote cardiac monitoring services - Medicare$101,452
 $
 $
 $101,452
$33,935
 $
 $
 $33,935
Remote cardiac monitoring services - commercial payors150,018
 
 
 150,018
54,074
 
 
 54,074
Clinical trial support and related services
 37,254
 
 37,254

 12,964
 
 12,964
Technology devices, consumables and related services
 
 7,145
 7,145

 
 3,006
 3,006
Total$251,470
 $37,254
 $7,145
 $295,869
$88,009
 $12,964
 $3,006
 $103,979

Remote Cardiac Monitoring Services Revenue (Healthcare segment)
Healthcare segment revenue is generated by remote cardiac monitoring to identify cardiac arrhythmias or heart rhythm disorders and to monitormonitoring the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services.
Performance obligations are determined based on the nature of the services provided. With our remote cardiac monitoring services, the patient receives the benefits of the service over time, resulting in revenue recognition over time based on the output method. We believe that this method provides an accurate depiction of the transfer of value over the term of the performance obligation because the level of effort in providing these services is consistent during the service period.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


A summary of the payment arrangements with payors is as follows:
Contracted payors (including Medicare): We determine the transaction price based on negotiated prices for services provided, on a case rate basis, as provided for under the relevant Current Procedural Terminology (“CPT”) codes.
Non-contracted payors: Non-contracted commercial and government insurance carriers often reimburse out-of-network rates provided for under the relevant CPT codes on a case rate basis. Our transaction price includes implicit price concessions based on our historical collection experience for our non-contracted patients.
We are utilizing the portfolio approach practical expedient in ASC 606 for our patient contracts in the Healthcare segment. We account for the contracts within each portfolio as a collective group, rather than individual contracts. Based on our history with these portfolios and the similar nature and characteristics of the patients within each portfolio, we have concluded that the financial statement effects are not materially different than if accounting for revenue on a contract-by-contract basis.
For the contracted portfolio, we have historical experience of collecting substantially all of the negotiated contractual rates and determined at contract inception that these customers have the intention and ability to pay the promised consideration. We have also concluded that historical information is largely representative of forward-looking information. As such, we are not providing an implicit price concession but, rather, have chosen to accept the risk of default, and adjustments to the transaction price are recorded as bad debtcredit loss expense.
For our non-contracted portfolio, we are providing an implicit price concession because we do not have a contract with the underlying payor, the result of which requires us to estimate our transaction price based on historical cash collections utilizing the expected value method. Subsequent adjustments to the transaction price are recorded as an adjustment to Healthcare segment revenue and not as bad debtcredit loss expense.
We have not made any significant changes to judgments in applying ASC 606 to the Healthcare segment during the three and nine months ended September 30,March 31, 2020 and 2019.
Clinical Trial Support and Related Services Revenue (Research segment)
Research segment revenue is generated by providing centralized core laboratory services, including cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. These amounts are due from pharmaceutical companies and contract research organizations. We bill our customers on a fee for servicefee-for-service basis. Under a typical contract, some customers pay us a portion of our fee upon contract execution as an upfront refundable deposit. Upfront deposits are deferred and then recognized as the services are performed. If a contract is canceled prior to service being provided, the upfront deposit is refunded.
Performance obligations are determined based on the nature of the services provided by us.provided. Our core laboratory services are provided over time as the customer receives benefits resulting in revenue recognition over the term of the contract. Our research customer contracts have legally enforceable terms that are predominately thirty days due to termination for convenience clauses, which are held by the customer with no significant penalty. Given the short-term nature of these contracts and the structure of our billing practices, our billing practices approximate our performance if measured by an output method, where each output is an individual occurrence of each performance obligation. Accordingly, we utilize the invoice
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


practical expedient as defined in ASC 606, resulting in recognition of revenue in the amount that we have the right to invoice.
We have historical experience of collecting substantially all of the fees for services incurred and thus believe that no material loss has been incurred as of the measurement date. As such, we are not providing an implicit price concession but, rather, have chosen to accept the risk of default, and adjustments to the transaction price are recorded as credit loss expense.
We have not made any significant changes to judgments in applying ASC 606 to the Research segment during the three and nine months ended September 30,March 31, 2020 and 2019.
Other Revenue (Other category)
Our Other category revenue is primarily derived from the sale of non-invasive cardiac monitors to healthcare companies, wireless blood glucose meters and test strips to wholesale distributors of diabetes supplies and diabetic patients, as well as product repairs. Performance obligations are primarily the sale of devices, related goods and repairs provided by us. These contracts transfer control to a customer at a point in time based on the transfer of title for the underlying good or service. We provide standard warranty provisions.
We determine the transaction price based on fixed consideration in our contractual agreements with our customers and allocate the transaction price to each performance obligation based on the relative stand-alone selling price. We determine the relative stand-alone selling price utilizing our observable prices for the sale of the underlying goods. We have historical experience of collecting substantially all and thus believe that no material loss has been incurred as of the measurement date. As such, we are not providing an implicit price concession but, rather, have chosen to accept the risk of default, and adjustments to the transaction price are recorded as credit loss expense.
We have not made any significant changes to judgments in applying ASC 606 to the Other category during the three and nine months ended September 30,March 31, 2020 and 2019.
Contract Assets and Contract Liabilities
ASC 606 requires an entity to present a revenue contract as a contract asset when the entity performs its obligations under the contract by transferring goods or services to a customer before the customer pays consideration or before payment is due. ASC 606 also requires an entity to present a revenue contract as a contract liability in instances when a customer pays consideration, or an entity has a right to an amount of consideration that is unconditional (e.g., receivable), before the entity transfers a good or service to the customer.
As of September 30, 2019March 31, 2020 and December 31, 2018,2019, we had contract assets of $9.8$18.4 million and $2.1$15.1 million, respectively, duerelated to cardiac monitoring services.  Our contract assetsservices, which are included as a component of Healthcare accounts receivable on our consolidated balance sheets. We also had contract assets of $1.9 million and $1.7 million, respectively, related to our Other category revenue contracts, which are included as a component of other accounts receivable on our consolidated balance sheets.
As of September 30, 2019March 31, 2020 and December 31, 2018,2019, we had contract liabilities of $1.7$1.5 million and $3.1$1.6 million, respectively, primarily related to the Research segment where customers paid upfront deposits upon contract execution for future services to be performed by us. If the contract is canceled, these upfront
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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deposits are refundable if service was not yet provided. Our contract liabilities are now included as a component of accrued liabilities on our consolidated balance sheets.
For the three months ended September 30, 2019,March 31, 2020, the amount recognized as revenue from the contract liabilities balance at June 30,as of December 31, 2019 was $0.6 million, while$0.5 million. Similarly, for the ninethree months ended September 30,March 31, 2019, the amount recognized as revenue from the contract liabilities balance as of December 31, 2018 was $1.9$3.1 million. Similarly, for the three months ended September 30, 2018, the amount recognized as revenue from the contract liabilities balance at June 30, 2018 was $1.0 million, while for the nine months ended September 30, 2018, the amount recognized as revenue from the contract liabilities balance as of
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


December 31, 2017 was $2.6 million. NoThere were no significant changes or impairment losses occurredincurred related to contract balances during the ninethree months ended September 30, 2019.March 31, 2020.
Practical Expedient ElectionsAllowance For Credit Losses
We have electedrecord an allowance for credit losses based on historical collection trends, the following practical expedients in applying current state of the healthcare market and current and projected future industry trends. Disaggregated allowance by portfolio was as follows:
 Three Months Ended March 31, 2020
 Portfolio Total Consolidated
(in thousands)Healthcare Other 
Beginning balance$31,780
 $201
 $31,981
Cumulative effect of change in accounting principle
 347
 347
Current period credit loss expense*
6,020
 
 6,020
Write-offs
 
 
Recoveries collected180
 
 180
Ending Balance$37,980
 $548
 $38,528
ASC 606 across all reportable segments unless otherwise noted below.
Unsatisfied Performance Obligations:* Because all of our performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period.
Contract Costs: All incremental customer contract acquisition costs are expensed as they are incurred as the amortization period of the asset that we otherwise would have recognized is one year or less in duration.
Significant Financing Component: We do not adjust the promised amount of consideration for the effects of a significant financing component as we expect, at contract inception, that the period between when we transfer a promised good or service to a customer and when the customer pays for that good or service will be one year or less.
Sales Tax Exclusion from the Transaction Price: We exclude from the measurement of the transaction price all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected by us from the customer.
Shipping and Handling Activities: For our Other category revenue, we account for shipping and handling activities we perform after a customer obtains control of the good as activities to fulfill the promise to transfer the good.formerly bad debt expense


3. Acquisitions
ADEA Medical AB
During the second quarter of 2019, we acquired all of the remaining outstanding equity of ADEA Medical AB, now known as BioTel Europe AB (“ADEA” or “BioTel Europe”), a limited company incorporated and registered under the laws of Sweden. BioTel Europe provides cardiac monitoring in northern Europe.
Pursuant to the acquisition agreement, we agreed to issue the owners of ADEA 50,000 shares of our common stock, with a fair value of approximately $2.1 million, as well as to pay approximately $0.2 million in cash. The shares are restricted,that were issued came with restrictions: the restrictions related to 10,000 shares expiringexpired in the fourth quarter of 2019, and the restrictions on the remaining 40,000 shares, expiringwhich are currently available to satisfy indemnification obligations, are set to expire in the second quarter of 2022, and the shares are also available to satisfy indemnification obligations.2022.
Prior to the second quarter of 2019, we accounted for our 23.8% stake in ADEA as an equity method investment. We accounted for the acquisition of the remaining equity of ADEA as a step acquisition, which required us to re-measure our previous ownership interest to fair value prior to application of purchase
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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accounting, and we recognized the immaterial difference between the fair value and the carrying value of the equity method investment at that time. The total purchase price of ADEA was $3.3 million, primarily consisting of the equity and cash consideration paid in the second quarter of 2019, plus the amounts paid
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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for our initial investment in ADEA in 2018. We then allocated this purchase price to the assets acquired and liabilities assumed. The acquired net assets consisted primarily of customer relationships and non-compete agreements. The excess of the fair value of the purchase price over the fair value of the net assets acquired has been recognized as goodwill, which represents the expected future benefits arising from the assembled workforce and other synergies attributable to cost savings opportunities. We have recognized $2.6 million of goodwill as a result of the acquisition, all of which has been assigned to the Healthcare segment. NaN of this goodwill will be deductible for tax purposes.
We finalized our fair value estimates related to the BioTel EuropeADEA acquisition during the three months ended September 30, 2019. There were no changes to the total purchase price, and the measurement period adjustment related to deferred income taxes during the three months ended September 30, 2019 was not material.
We do not consider this acquisition to be significant to our results of operations. The transaction costs related to this acquisition and revenues and results of operations of BioTel EuropeADEA prior to our acquisition were all immaterial.
Geneva Healthcare, Inc.
On March 1, 2019, we acquired Geneva Healthcare, Inc., now known as Geneva Healthcare, LLC (“Geneva”), for cash consideration in the amount of $45.9 million. In addition, pursuant to the terms of the Agreement and Plan of Merger, dated January 25, 2019, by and among Geneva, BioTelemetry, Inc., Tyersall Merger Sub, Inc., and the Securityholders’ Representative (the “Geneva Agreement”), on the third anniversary date of the closing date, the Securityholders (as defined in the Geneva Agreement) are eligible to receive additional consideration in the form of cash payments, as well as shares of BioTelemetry common stock, with a total estimated present value of $32.0 million as of the March 1, 2019 acquisition date, for a total aggregate purchase price of $77.9 million. Concurrent with the closing of the acquisition, the Securityholders made elections as to the percentage mix of their total additional consideration to be settled in cash or common stock.
The estimated additional consideration of $32.0 million, as of the March 1, 2019 acquisition date, consists of the following:
The Securityholders will, subject to potential deductions pursuant to the Geneva Agreement, receive additional consideration of $20.0 million, a total of $11.1 million of which will be paid in cash, and the remaining value will be settled in shares. We will issue a total of 131,594 shares of our common stock to settle the share-related portion of the obligation, based on the elections made by the Securityholders and the formulas within the Geneva Agreement.
The estimated present value of the future cash payment of $11.1 million, which totals $9.7 million as of the acquisition date, as well as the estimated fair value of our common stock of $9.1 million, has been included within the purchase price for Geneva. The estimated present value of the future cash payment is recorded as a component of other long-term liabilities and will be accreted to its redemption value through interest expense through the payment date. The estimated fair value of the 131,594 shares our common stock has been recorded within paid-in-capital.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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The Securityholders will also be eligible to receive additional consideration, in the form of both cash and shares, based on a predetermined formula that is driven by the future revenues ofGeneva and does not have a predetermined limit. The total estimated acquisition-related contingent consideration as of the March 1, 2019 acquisition date is
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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Geneva and does not have a predetermined limit. The total estimated acquisition-related contingent consideration as of the March 1, 2019 acquisition date was $13.2 million, which is also included in the purchase price of Geneva. The $13.2 million is recorded within other long-term liabilities and will be marked to market through earnings on a quarterly basis throughout the earn-out period. The equity portion of the acquisition-related contingent consideration requires liability classification and mark-to-market accounting pursuant to the provisions of ASC 815 - Derivatives and Hedging.
We acquired Geneva as part of our business strategy to go deeper and wider into the cardiac monitoring market. Geneva has developed an innovative proprietary cloud-based platform that aggregates data from the leading cardiac device manufacturers, enabling the Company to remotely monitor a physician’s patients with implantable cardiac devices such as pacemakers, defibrillators and loop recorders. Geneva’s platform provides physicians a single portal to order patient monitoring, review monitoring results and request routine device checks, helping drive significant in-office efficiencies and patient compliance. We planhave continued to merge this functionality with that of the Healthcare segment user interface, which we believe will drive greater workflow and data management efficiencies to the clients we serve.
We accounted for the transaction as a business combination, and as such, all assets acquired and liabilities assumed were recorded at their estimated fair values. The excess of the fair value of the purchase price over the fair value of the net assets acquired has been recognized as goodwill, which represents the expected future benefits arising from the assembled workforce and other synergies attributable to cost savings opportunities. We have recognized $62.8$59.9 million of goodwill as a result of the acquisition, all of which has been assigned to the Healthcare segment. NaN of this goodwill will be deductible for tax purposes.
The amounts in the table below represent our final fair value estimates related to the Geneva acquisition as of March 1, 2019. Measurement period adjustments recorded during the second quarter of 2019 consisted primarily of decreasing additional consideration by $2.2 million and increasing net deferred tax assets by $2.9 million. We finalized our fair value estimates related to the Geneva acquisition during the three months ended September 30, 2019, during which time there were no material measurement period adjustments recorded.December 31, 2019.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


(in thousands, except years)Amount 
Weighted
Average Life
(Years)
Amount 
Weighted
Average Life
(Years)
Fair value of assets acquired:    
Cash and cash equivalents$1,376
 $1,376
 
Healthcare accounts receivable1,500
 1,500
 
Prepaid expenses and other current assets234
 234
 
Identifiable intangible assets:    
Customer relationships3,500
 123,500
 12
Technology8,900
 78,900
 7
Trade names2,500
 152,500
 15
Total identifiable intangible assets14,900
 14,900
 
Deferred tax assets1,013
 
Total assets acquired18,010
 19,023
 
Fair value of liabilities assumed:    
Accounts payable215
 215
 
Accrued liabilities872
 872
 
Deferred tax liabilities1,879
 
Total liabilities assumed2,966
 1,087
 
    
Total identifiable net assets15,044
 17,936
 
Goodwill62,836
 59,944
 
Net assets acquired$77,880
 $77,880
 

We have incurred $1.4 million of acquisition related costs associated with Geneva for the ninemonthsyear ended September 30,December 31, 2019. The costs were included in other charges in our consolidated statements of income. The revenues and income of Geneva for periods prior to our acquisition were immaterial to our consolidated operating results.
ActiveCare
On October 2, 2018, we acquired, through our subsidiary Telcare Medical Supply, LLC, certain assets of ActiveCare, Inc. (“ActiveCare”) for $3.8 million in cash. The purchase price also includes a potential earn-out payment of $2.0 million, which is contingent on the achievement of certain revenue targets by November 1, 2020. We accounted for the transaction as a business combination, and as such, all assets acquired were recorded at their estimated fair values. The excess of the fair value of the purchase price over the fair value of the net assets acquired has been recognized as goodwill, has been assigned to the Corporate and Other category and will be deductible for tax purposes. The acquired net assets primarily consisted of customer relationships and software developed by ActiveCare. The earn-out was assigned 0 value as of the acquisition date as it was and is currently not probable of achievement. We finalized our fair value estimates related to the ActiveCare acquisition during the three months ended March 31, 2019, and there were no changes to the amounts initially recorded. The transaction costs related to this acquisition and revenues and net income of ActiveCare prior to our acquisition were all immaterial.


BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


4. Inventory
Inventory consists of the following:
(in thousands)September 30,
2019
 December 31,
2018
March 31,
2020
 December 31,
2019
Raw materials and supplies$4,421
 $3,667
$5,125
 $4,429
Finished goods1,968
 3,656
2,487
 1,309
Total inventory$6,389
 $7,323
$7,612
 $5,738



5. Fair Value Measurements
We have determined that our long-term debt, classified as Level 2, has a fair value consistent with its carrying value, net of debt discount and deferred charges, of $195.6$227.4 million and $198.5$194.7 million as of September 30, 2019March 31, 2020 and December 31, 2018,2019, respectively.
Acquisition-related contingent consideration represents our contingent payment obligations related to our acquisitions and is measured at fair value, based on significant inputs not observable in the market,
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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which represents a Level 3 measurement within the fair value hierarchy. The valuation of acquisition-related contingent consideration uses assumptions we believe would be made by a market participant. We assess these estimates on an ongoing basis as additional data impacting the assumptions is obtained. The balance of the fair value of acquisition-related contingent consideration is recognized within other long-term liabilities on our consolidated balance sheet as of September 30, 2019.sheet. Changes in the fair value of the acquisition-related contingent consideration, after the final determination as of the acquistionacquisition date, resulting from changes in the variables used to compute the fair value, are recorded in other charges in the consolidated statements of operations.
The following table provides a reconciliation of the beginning and ending balances of acquisition-related contingent consideration:
Three Months Ended Nine Months EndedThree Months Ended
September 30, September 30,March 31,
(in thousands)2019 2018 2019 20182020 2019
Beginning balance$11,360
 $
 $
 $700
$12,940
 $
Acquisition-related contingent consideration
 
 13,170
 

 15,990
Changes in fair value of acquisition-related contingent consideration90
 
 (1,720) (700)
Change in fair value of acquisition-related contingent consideration(290) 
Ending balance$11,450
 $
 $11,450
 $
$12,650
 $15,990

In conjunction with the Geneva acquisition, and after a measurement period adjustment recorded in the second quarter of 2019, we recognized $13.2 million of acquisition-related contingent consideration on March 1, 2019 as a component of other long-term liabilities as the contingency will be finalized after the third anniversary of the closing date. There was 0 value assigned to the acquisition-related contingent consideration related to the ActiveCare acquisition as the achievement of the contingency was not probable as of September 30, 2019.
The estimated fair value of the acquisition-related contingent consideration related to the Geneva acquisition was determined using a Monte Carlo simulation, that considered numerous variables, including
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
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estimates for estimated projected revenues, future stock price, discount rates and discounts for lack of marketability of common stock. These estimates are subject to a significant level of judgment.
During the ninethree months ended September 30, 2019, excluding the measurement period adjustments,March 31, 2020, the acquisition-related contingent consideration related to the Geneva acquisition declined $1.7$0.3 million primarily due to changes in estimates associated with our future stock price. Duringprice, with the nine months ended September 30, 2018, the fair valuesimpact being recognized as a component of the acquisition-related contingent consideration related to our 2016 Telcare acquisition decreased $0.7 million, as it was no longer probable that any of the contingencies would be met.other charges.


6. Goodwill and Intangible Assets
Goodwill was recognized at the time of our acquisitions. The following table presents the carrying amount of goodwill allocated to our reportable segments, as well as the changes to goodwill during the ninethree months ended September 30, 2019:March 31, 2020:
 Reporting Segment Corporate and Other  
(in thousands)Healthcare Research  Total
Balance at December 31, 2018$213,507
 $16,293
 $9,014
 $238,814
Goodwill acquired65,408
 
 
 65,408
Currency translation(121) 
 
 (121)
Balance at September 30, 2019$278,794
 $16,293
 $9,014
 $304,101
 Reporting Segment Corporate and Other  
(in thousands)Healthcare Research  Total
Balance at December 31, 2019$276,014
 $16,293
 $9,014
 $301,321
Currency translation(171) 
 
 (171)
Balance at March 31, 2020$275,843
 $16,293
 $9,014
 $301,150

The goodwill acquired in the Healthcare segment is related to the Geneva and BioTel Europe acquisitions. Refer to “Note 3. Acquisitions” for details.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


The gross carrying amounts and accumulated amortization of our intangible assets are as follows:
(in thousands, except years)
Weighted
Average Life
(Years)
 September 30,
2019
 December 31,
2018
Weighted
Average Life
(Years)
 March 31,
2020
 December 31,
2019
Gross Carrying Value:��         
Customer relationships10.3 $149,380
 $146,200
10.3 $149,365
 $149,420
Technology including internally developed software6.6 21,244
 18,078
Technology, including internally developed software6.7 22,852
 21,892
Backlog3.9 3,100
 6,860
4.0 3,100
 3,100
Trade names15.0 2,500
 2,500
Covenants not to compete4.8 416
 1,040
4.7 413
 424
Trade names15.0 2,500
 
Total intangible assets, gross 176,640
 172,178
 178,230
 177,336
Accumulated Amortization:        
Customer relationships (34,626) (24,870) (41,907) (38,270)
Technology including internally developed software (5,394) (10,879)
Technology, including internally developed software (6,916) (6,153)
Backlog (2,648) (5,827) (3,035) (2,842)
Trade names (180) (138)
Covenants not to compete (282) (949) (376) (337)
Trade names (97) 
Total accumulated amortization (43,047) (42,525) (52,414) (47,740)
Total intangible assets, net $133,593
 $129,653
 $125,816
 $129,596

During the three months ended September 30, 2019, we wrote off certain fully amortized intangible assets, primarily technology and backlog, and incurred an immaterial amount of foreign currency translation impact related to the customer relationships and covenants not to compete related to the BioTel Europe acquisition.
As of September 30, 2019, theThe estimated amortization for our finite-lived intangible assets for the remainder of 2019,2020, the next four fiscal years, and thereafter, is summarized as follows:follows as of March 31, 2020:
(in thousands)(in thousands) (in thousands) 
Remainder of 2019$4,910
202018,343
Remainder of 2020Remainder of 2020$13,750
2021202117,708
202118,160
2022202216,972
202217,651
2023202316,678
202317,131
2024202416,540
ThereafterThereafter58,982
Thereafter42,584
Total estimated amortizationTotal estimated amortization$133,593
Total estimated amortization$125,816



BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


7. Equity Method InvestmentsAccrued Liabilities
Accrued liabilities consist of the following:
(in thousands)March 31,
2020
 December 31,
2019
Compensation$10,089
 $13,167
Right of use liabilities - operating leases5,484
 5,187
Professional fees3,298
 4,128
Contract liabilities1,524
 1,584
Non-income taxes665
 427
Interest
 569
Operating costs757
 637
Other1,562
 1,619
Total$23,379
 $27,318



8. Credit Agreement
2020 Credit Agreement
On October 31, 2018,January 27, 2020, we acquiredentered into an ownership interest in Amended and Restated Credit Agreement (the “ADEA2020 Credit Agreement”) with Truist Bank (successor to SunTrust Bank) as agent (the “Agent”) for the lenders (the “Lenders”), and as issuing bank and swingline lender, which amends the SunTrust Credit Agreement (as defined below) entered into by the parties on July 12, 2017.
Pursuant to the 2020 Credit Agreement, the Lenders agreed to provide us a $400.0 million senior secured revolving credit facility, which includes a $25.0 million sublimit for approximately $0.9 million. This investment was accountedthe issuance of standby letters of credit and a $40.0 million sublimit for swingline loans. The proceeds of the revolving facility were used to refinance indebtedness under the equity method. DuringSunTrust Credit Agreement (as defined below) and to fund working capital and general corporate purposes.
Our revolving credit facility bears interest, at our election, of (i) with respect to Eurodollar borrowings, LIBOR plus the second quarterapplicable Eurodollar margin and (ii) with respect to base rate borrowings, the Base Rate (the “prime rate” as published in the Wall Street Journal) plus the applicable Base Rate margin. The applicable margin for both LIBOR and Base Rate loans is determined by reference to our Consolidated Total Net Leverage Ratio, as defined in the 2020 Credit Agreement. As of 2019, we acquiredMarch 31, 2020, the applicable margin is 1.125% for Eurodollar borrowings and 0.125% for base rate borrowings.
The outstanding balance of our revolving credit facility is due on January 27, 2025. Optional prepayments may be made at any time, without premium or penalty, upon written notice as prescribed in the 2020 Credit Agreement. Interest on base rate borrowings is payable quarterly while interest on Eurodollar borrowings is generally payable monthly.
The outstanding balance of the facility is secured by substantially all of the remaining outstanding equityour assets and a pledge of ADEA. In conjunction with this step acquisition, we derecognized our equity method investment in ADEA and recognized the fair valuecapital stock, as well as a pledge of 65% of the assets acquired and liabilitiescapital stock of our first tier material foreign subsidiaries.
The carrying amount of our revolving credit facility was $227.4 million as of March 31, 2020, which is the principal amount outstanding, net of $4.6 million of unamortized deferred financing costs to
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


assumed relatedbe amortized over the remaining term of the 2020 Credit Agreement. The revolving credit facility is subject to an unused commitment fee, which is determined by reference to our Consolidated Total Net Leverage Ratio, as defined in the ADEA in our consolidated financial statements. For more information, see “Note 3. Acquisitions2020 Credit Agreement. Our unused commitment fee as of March 31, 2020 was 0.175%.
We hold an ownership interest in Well Bridge Health, Inc. (“Wellbridge”). The investmentmay increase commitments to the revolving facility or establish new incremental term loans at any time on or before the final maturity date of the revolving facility, which is accounted forJanuary 27, 2025. Incremental commitments to the revolving facility or term loans under the equity method. Our Chief Executive Officer sits on Wellbridge’s board of directors, and therefore, Wellbridge2020 Credit Agreement is considered a related party. There were no material related-party transactions between the parties during the threewill be used to fund future acquisitions, working capital and nine months ended September 30, 2019.general corporate purposes.
As of September 30, 2019, our investment in Wellbridge represented 32.2% of their outstanding stock. A summary of our investments recorded as a component of other assets is as follows:
 Three Months Ended Nine Months Ended
 September 30, September 30,
(in thousands)2019 2018 2019 2018
Beginning balance$1,112
 $1,247
 $2,044
 $1,431
Derecognition of ADEA investment
 
 (746) 
Loss on equity method investments(65) (54) (251) (238)
Ending balance$1,047
 $1,193
 $1,047
 $1,193



8. Accrued Liabilities
Accrued liabilities consist of the following:
(in thousands)September 30,
2019
 December 31,
2018
Compensation$11,307
 $13,443
Right of use liabilities - operating leases5,291
 
Professional fees4,661
 4,260
Non-income taxes2,180
 906
Contract liabilities1,650
 3,080
Operating costs776
 1,095
Interest583
 702
Other2,039
 1,203
Total$28,487
 $24,689



9.2017 SunTrust Credit Agreement
In 2017, we entered into a credit agreement with SunTrust Bank, as a lender and an agent for the lenders (the “Lenders”) (the “SunTrust Credit Agreement”). Pursuant to the SunTrust Credit Agreement, the Lenderslenders agreed to make loans to us as follows: (i) a term loan in an aggregate principal amount equal to $205.0 million; and (ii) a $50.0 million revolving credit facility for ongoing working capital purposes.
The loans bearbore interest at an annual rate, at our election, of (i) with respect to LIBOR rate loans, LIBOR plus the applicable margin and (ii) with respect to base rate loans, the Base Rate (the “prime rate” as published in the Wall Street Journal) plus the applicable margin. The applicable margin for both LIBOR
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


and Base Rate loans iswas determined by reference to our Consolidated Total Net Leverage Ratio, as defined in the SunTrust Credit Agreement. As of September 30, 2019,
Debt Modification
In connection with our 2020 Credit Agreement, we repaid the applicable margin is 1.5% for LIBOR loans and 0.5% for base rate loans.
The carrying amount ofoutstanding indebtedness under the term loan was $195.6 million as of September 30, 2019, which is the principal amount outstanding, net of $3.5 million of unamortized deferred financing costs to be amortized over the remaining term of the credit facility. The revolving credit facility is subject to an unused commitment fee, which is determined by reference to our Consolidated Total Net Leverage Ratio (as defined in the SunTrust Credit Agreement)Agreement. Our unused commitment feerefinancing via the 2020 Credit Agreement was accounted for as a debt modification pursuant to the provisions of September 30, 2019 was 0.2%,ASC 470-50 - Debt - Modifications and the revolving credit facility remains undrawn as of that date.Extinguishments.
Covenants
The SunTrust2020 Credit Agreement contains affirmative and financial covenants regarding the operations of our business and certain negative covenants that, among other things, limit our ability to incur additional indebtedness, grant certain liens, make certain investments, merge or consolidate, make certain restricted payments and engage in certain asset dispositions, including a sale of all, or substantially all, of our property. As of September 30, 2019,March 31, 2020, we were in compliance with our covenants.


10.9. Leases
We lease our administrative and service facilities, as well as certain office equipment, monitoring devices and information technology equipment under arrangements classified as leases under ASC 842. We adopted ASC 842 using the optional modified retrospective transition method as of January 1, 2019; therefore prior period amounts are not restated.
We have non-cancelable operating leases expiring at various dates through 2028.2031. Certain leases are renewable at the end of the lease term at our option, none of which are certain at this time. We have also entered into and acquired finance leases with various expiration dates through 2022,2025, which are used primarily to finance office equipment, monitoring devices and other information technology equipment.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


The components of our lease expense are as follows:
Three Months Ended Nine Months EndedThree Months Ended
September 30, September 30,March 31,
(in thousands)2019 20192020 2019
Operating lease cost:      
Operating lease cost$1,449
 $4,370
$1,579
 $1,408
Short-term lease cost83
 248
189
 146
Total operating lease cost1,532
 4,618
1,768
 1,554
      
Finance lease cost:      
Amortization of right-of-use assets181
 1,894
89
 865
Interest on lease liabilities11
 49
6
 24
Total finance lease cost192
 1,943
95
 889
      
Total lease cost$1,724
 $6,561
$1,863
 $2,443

Supplemental balance sheet information related to leases as of September 30,March 31, 2020 and December 31, 2019 is as follows:
(in thousands, except percentage and years)
Operating
Leases
 
Finance
Leases
March 31, 2020 December 31, 2019
(in thousands, except percentages and years)
Operating
Leases
 
Finance
Leases
 
Operating
Leases
 
Finance
Leases
Property and equipment, net$
 $757
$
 $481
 $
 $493
Other assets17,581
 
32,189
 
 16,400
 
Total right-of-use assets17,581
 757
32,189
 481
 16,400
 493
          
Accrued liabilities5,291
 
5,484
 
 5,187
 
Current portion of finance lease obligations
 490

 373
 
 394
Long-term portion of finance lease obligations
 348

 272
 
 289
Other long-term liabilities15,156
 
29,451
 
 14,029
 
Total lease obligations$20,447
 $838
$34,935
 $645
 $19,216
 $683
          
Weighted average remaining lease term (years)5.2
 2.0
7.9
 2.1
 5.0
 1.9
Weighted average discount rate4.4% 4.7%3.7% 4.1% 4.4% 4.5%

BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Future maturities of lease liabilities are as follows:
(in thousands)
Operating
Leases
 
Finance
Leases
Operating
Leases
 
Finance
Leases
Remainder of 2019$1,638
 $176
20205,806
 412
Remainder of 2020$5,074
 $329
20214,422
 191
6,230
 210
20223,058
 93
5,100
 109
20232,268
 
4,326
 10
20244,042
 9
Thereafter5,806
 
15,547
 1
Total minimum lease payments22,998
 872
40,319
 668
Less imputed interest(2,551) (34)(5,384) (23)
Total$20,447
 $838
Present value of lease liabilities$34,935
 $645

Supplemental cash flow information related to leases is as follows:
Three Months Ended Nine Months EndedThree Months Ended
September 30, September 30,March 31,
(in thousands)2019 20192020 2019
Cash paid for amounts included in the measurement of lease liabilities:      
Operating cash flows from operating leases$(1,559) $(4,424)$(1,558) $(1,472)
Operating cash flows from finance leases(11) (49)(6) (24)
Financing cash flows from finance leases(76) (1,735)(179) (1,163)
      
Right-of-use assets obtained in exchange for lease obligations, net of incentives:      
Operating leases(669) 21,147
17,055
 21,810
Finance leases$
 $787
$68
 $787


11.10. Other Charges
We account for expenses associated with exit or disposal activities in accordance with ASC 420 - Exit or Disposal Cost Obligations and record the expenses in other charges in our consolidated statements of operations. The related accruals are recorded in the accrued liabilities line of our consolidated balance sheets.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


We account for expenses associated with our acquisitions and activity associated with certain ongoing litigation as other charges as incurred. These expenses arewere primarily a result of activities surrounding our acquisitions and legal fees related to patent litigation in which we are the plaintiff. Integration costs are primarily due to employee-related costs. Other charges are costs that are not considered necessary to the ongoing business operations. We have reclassified the disclosure of theseour 2019 costs to more closely align with the discussion in “Part I; Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations” of this report and in our earnings release, and this reclassification did not change the total amount of other charges, which are summarized as follows:
 Three Months Ended Nine Months Ended
 September 30, September 30,
(in thousands)2019 2018 2019 2018
LifeWatch AG integration costs$212
 $661
 $590
 $7,865
Geneva integration costs122
 
 2,726
 
Reserve for note receivable
 
 
 1,793
Change in fair value of acquisition-related contingent consideration90
 
 (1,720) (700)
Patent and other litigation2,144
 339
 5,807
 1,551
Other costs30
 330
 499
 1,114
Total$2,598
 $1,330
 $7,902
 $11,623



12. Equity
Common Stock
As of September 30, 2019 and December 31, 2018, we were authorized to issue 200,000,000 shares of common stock. As of September 30, 2019 and December 31, 2018, we had 33,991,107 and 33,406,364, respectively, shares issued and outstanding.
Preferred Stock
As of September 30, 2019 and December 31, 2018, we were authorized to issue 10,000,000 shares of preferred stock. As of September 30, 2019 and December 31, 2018, there were 0 shares of preferred stock issued or outstanding.
Noncontrolling Interest
During 2018, after a formal restructuring of shareholdings approved by the board of directors of LifeWatch Turkey Holding AG (“LifeWatch Turkey”), we became the sole shareholder of LifeWatch Turkey. No cash or other consideration was exchanged to effect this transaction. As a result, we no longer reflect a noncontrolling interest on our consolidated balance sheet; however, we reflected the net loss attributable to the noncontrolling interest in our consolidated statement of operations during 2018 for the period of time where we did not own the entire entity.


BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


13.
 Three Months Ended
 March 31,
(in thousands)2020 2019
Acquisition and integration costs$163
 $1,936
Information technology incident costs, net of insurance proceeds(276) 
Change in fair value of acquisition-related contingent consideration(290) 
Patent and other litigation1,906
 1,029
Other costs581
 105
Total$2,084
 $3,070

As a result of the October 2019 information technology incident, we received $1.4 million of insurance proceeds during the first quarter of 2020.


11. Equity
Common Stock
As of March 31, 2020 and December 31, 2019, we were authorized to issue 200,000,000 shares of common stock. As of March 31, 2020 and December 31, 2019, we had 34,138,516 and 34,023,053, respectively, shares issued and outstanding.
Preferred Stock
As of March 31, 2020 and December 31, 2019, we were authorized to issue 10,000,000 shares of preferred stock. As of March 31, 2020 and December 31, 2019, there were 0 shares of preferred stock issued or outstanding.


12. Stock-Based Compensation
We have 3 stock plans: our 2017 Omnibus Incentive Plan (“OIP”), our 2008 Equity Incentive Plan (the “2008 Plan”) and our 2003 Equity Incentive Plan (the “2003 Plan”) (collectively, the “Plans”). The OIP is the only remaining stock plan actively granting new equity.stock options or units.  The purpose of these stock plans was, and the OIP is, to grant incentive stock options to employees and non-qualified stock options, RSUs, PSOs, PSUs and other stock-based incentive awards to officers, directors, employees and consultants.  The Plans are administered by our Board of Directors (the “Board”) or its delegates. The number, type, exercise price and vesting terms of awards are determined by the Board or its delegates in accordance with the terms of the Plans. The stock options granted expire on a date specified by the Board but generally not more than ten years from the grant date. Stock option grants to employees generally vest over four years while RSUs generally vest after three years.
2017 Omnibus Incentive Plan (OIP)
InOn May 11, 2017, our stockholders approved the OIP, which replaced the 2008 Plan. Stock options, RSUs, PSUs and PSOs have been granted under the OIP. Under the terms of the OIP, any cancellation, forfeiture or expiry of equity awards granted under the 2008 Plan roll into the availability under the OIP. There were 1,987,1901,611,963 shares available for grant under the OIP as of September 30, 2019.March 31, 2020.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


2008 Equity Incentive Plan
Our 2008 Plan became effective on March 18, 2008 and replaced our 2003 Plan. Under the terms of the 2008 Plan, all available shares in the 2003 Plan share reserve automatically rolled into the 2008 Plan. Any cancellations or forfeitures of granted stock options under the 2003 Plan also automatically rolled into the 2008 Plan. There are 0 shares available to grant under the 2008 Plan subsequent to the approval of the OIP.
Stock option and PSO activity is summarized as follows:
Stock Options
Number of
Shares
 
Weighted
Average
Exercise Price
 Weighted Average Remaining Contractual Term
(years)
 Aggregate Intrinsic Value
(in thousands)
Number of
Stock Options
 
Weighted
Average
Exercise
Price
 Weighted Average Remaining Contractual Term
(Years)
 Aggregate Intrinsic Value
(in thousands)
Outstanding as of December 31, 20182,661,282
 $15.94
 
 

Outstanding as of December 31, 20192,691,059
 $22.67
 
 

Granted317,142
 66.79
 
 

188,403
 51.12
 
 

Forfeited(49,168) 27.73
 
 


 
 
 

Exercised(233,885) 7.75
 
 

(6,223) 11.45
 
 

Outstanding as of September 30, 20192,695,371
 $22.42
 5.8 $60,821
Exercisable as of September 30, 20191,751,943
 $9.92
 4.5 $54,075
Expected to vest as of September 30, 2019856,160
 $45.63
 8.2 $6,122
Outstanding as of March 31, 20202,873,239
 $24.56
 5.7 $54,796
Exercisable as of March 31, 20201,981,650
 $13.52
 4.4 $52,408
Expected to vest as of March 31, 2020827,468
 $49.10
 8.6 $2,216

Performance Stock Options
Number of
PSOs
 
Weighted
Average
Exercise
Price
 Weighted Average Remaining Contractual Term
(Years)
 Aggregate Intrinsic Value
(in thousands)
Outstanding as of December 31, 201930,000
 $21.45
    
Granted
 
    
Forfeited
 
    
Exercised
 
    
Outstanding as of March 31, 202030,000
 $21.45
 6.8 $512
Exercisable as of March 31, 202030,000
 $21.45
 6.8 $512

The table below summarizes certain additional information with respect to our options:
  Three Months Ended
  March 31,
(in thousands, except per option amounts)2020 2019
Aggregate intrinsic value of options exercised$194
 $16,059
Cash received from the exercise of stock options71
 2,923
Weighted average grant date fair value per option$28.51
 $42.35

BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Performance Stock Options
Number of
Shares
 
Weighted
Average
Exercise Price
 Weighted Average Remaining Contractual Term
(years)
 Aggregate Intrinsic Value
(in thousands)
Outstanding as of December 31, 2018135,000
 $20.64
    
Granted
 
    
Forfeited
 
    
Exercised(105,000) 20.41
    
Outstanding as of September 30, 201930,000
 $21.45
 7.3 $578
Exercisable as of September 30, 201930,000
 $21.45
 7.3 $578

The table below summarizes certain additional information with respect to our options:
  Three Months Ended Nine Months Ended
  September 30, September 30,
(in thousands, except per option amounts)2019 2018 2019 2018
Aggregate intrinsic value of options exercised$1,261
 $20,398
 $18,184
 $38,277
Cash received from the exercise of stock options614
 3,493
 3,955
 8,485
Weighted average grant date fair value per option$24.00
 $33.12
 $38.64
 $20.91

The total compensation cost of options granted but not yet vested at September 30, 2019 was $21.1$22.4 million as of March 31, 2020, which is expected to be recognized over a weighted average period of approximately three years.
RSU and PSU activity is summarized as follows:
Restricted Stock Units Performance Stock UnitsRestricted Stock Units Performance Stock Units
Number
of Shares
 
Weighted Average
Grant Date Fair
Value
 
Number
of Shares
 
Weighted Average
Grant Date Fair
Value
Number
of RSUs
 
Weighted Average
Grant Date Fair
Value
 
Number
of PSUs
 
Weighted Average
Grant Date Fair
Value
Units outstanding as of December 31, 2018358,683
 $22.22
 87,109
 $37.79
Units outstanding as of December 31, 2019270,052
 $41.70
 90,020
 $55.06
Granted77,248
 65.53
 34,088
 86.29
77,214
 51.18
 51,839
 60.36
Forfeited(12,084) 30.21
 (25,000) 37.79
(1,500) 39.94
 
 
Vested(173,664) 13.73
 
 
(77,260) 26.71
 
 
Units outstanding as of September 30, 2019250,183
 $41.09
 96,197
 $54.98
Units outstanding as of March 31, 2020268,506
 $48.75
 141,859
 $57.00

Consistent with 2018,prior years, during 2019,2020, we granted awards to certain participants in the form of PSUs. These PSUs will vest at the end of a three-year performance period only if specificlong-term financial performance metrics are met, andgoals have been achieved, with the vested shares will then be modifiedincreased or decreased based on relativeour total shareholder return.return relative to the companies in the Russell 2000 Index during the same period. The 34,088 201951,839 2020 PSUs were granted at “target” levels; however, for share pool purposes, we have reserved an additional 34,08851,839 shares in the event that the combined financial performance and market conditions achieve maximum levels. For the 2018, 2019 and 20192020 PSUs combined, we have 96,197141,859 shares reserved as of September 30, 2019March 31, 2020 in the event that actual results exceed “target”achieve “maximum” levels. ForShould any PSU grant not achieve the three and nine months ended September 30, 2019, stock-based compensation expense relatedmaximum level, the excess of the maximum shares reserved over the “achieved” level will be returned to these PSUs was recognized in accordance with ASC 718 for both employees and non-employees, as amended by the adoption of ASU
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


2018-07 (see “Note 1. Summary of Significant Accounting Policies; m) Recent Accounting Pronouncements; Accounting Pronouncements Recently Adopted” for further detail regarding ASU 2018-07).share pool availability.
Additional information about our RSUs is summarized as follows:
 Three Months Ended Nine Months Ended Three Months Ended
 September 30, September 30, March 31,
(in thousands)(in thousands)2019 2018 2019 2018(in thousands)2020 2019
Aggregate market value of RSUs vestedAggregate market value of RSUs vested$
 $
 $12,833
 $7,873
Aggregate market value of RSUs vested$4,135
 $11,554

The total compensation cost of RSUs and PSUs granted but not yet vested, inclusive of the PSUs for which vesting has been deemed probable at September 30, 2019,as of March 31, 2020, was $7.5$9.9 million, which is expected to be recognized over a weighted average period of approximately two years. Additionally, there were 588,359 RSUs vested but not released at September 30, 2019.March 31, 2020.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


Employee Stock Purchase Plan
In May 2017, our stockholders approved the BioTelemetry, Inc. 2017 Employee Stock Purchase Plan (“2017 ESPP”) with 500,000 shares reserved for issuance, which replaced the 2008 Employee Stock Purchase Plan. Substantially all of our employees are eligible to participate in the 2017 ESPP. Under the 2017 ESPP, each participant may purchase option value of our shares, through payroll deductions, not to exceed $25,000 of grant date fair value in a calendar year. The purchase price per share is equal to the lower of 85% of the closing market price on the first day of the offering period, or 85% of the closing market price on the day of purchase. Proceeds received from the issuance of shares are credited to stockholders’ equity in the period that the shares are issued. Purchases under the 2017 ESPP are made in March and September. For the ninethree months ended September 30, 2019,March 31, 2020, an aggregate of 98,42559,697 shares were purchased in accordance with the 2017 ESPP. Net proceeds from the issuance of shares of common stock under the 2017 ESPP for the ninethree months ended September 30, 2019March 31, 2020 were $3.1$1.6 million. At September 30, 2019, 232,671March 31, 2020, 172,974 shares remain available for purchase under the 2017 ESPP.
Our aggregate stock-based compensation expense is summarized as follows:
Three Months Ended Nine Months EndedThree Months Ended
September 30, September 30,March 31,
(in thousands)2019 2018 2019 20182020 2019
Stock options$1,927
 $304
 $5,206
 $3,132
$2,674
 $1,459
Restricted stock units941
 832
 2,934
 2,392
1,307
 919
Performance stock units121
 
 192
 
(831) (81)
Employee stock purchase plan647
 219
 1,330
 754
232
 252
Total stock-based compensation expense$3,636
 $1,355
 $9,662
 $6,278
$3,382
 $2,549



14.13. Income Taxes
The income tax provision for interim periods is determined using an estimated annual effective tax rate adjusted for discrete items, if any, which are taken into account in the quarterly period in which they
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


occur. We review and update our estimated annual effective tax rate each quarter. We recorded an income tax provision of $3.5$5.2 million and $6.2 million for the three and nine months ended September 30, 2019, respectively,March 31, 2020, based on our estimated annual effective tax rate adjusted for discrete items.rate. We recognized an income tax benefit of $1.3 million and $2.9$2.1 million for the three and nine months ended September 30, 2018, respectively,March 31, 2019, primarily due to a discrete benefit recorded for equity compensation deductions.
At September 30, 2019March 31, 2020 and December 31, 2018,2019, we had deferred tax assets, net of deferred tax liabilities and valuation allowance, of $12.8$8.5 million and $20.0$12.6 million, respectively.
We recognize interest and penalties where applicable, related to unrecognized tax benefits within the (provision for)/benefit from income taxes line in the consolidated statements of operations. During the ninethree months ended September 30, 2019,March 31, 2020, we recognized an immaterial amount of interest expense in the consolidated statements of operations associated with our unrecognized tax benefits.
At September 30, 2019March 31, 2020 and December 31, 2018,2019, we had net reserves of $34.3$33.9 million and $31.3$34.8 million, respectively, for unrecognized tax benefits, which are recorded as a component of other long-term liabilities within our consolidated balance sheets.
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)




15.14. Segment Information
We operate under 2 reportable segments: Healthcare and Research. The Healthcare segment is focused on remote cardiac monitoring to identify cardiac arrhythmias or heart rhythm disorders and to monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of remote cardiac monitoring services. These services range from the differentiatedinclude MCT service, to, event, traditional Holter, extended Holter, Pacemaker, and International Normalized Ratio and Implantable Loop Recorder and other implantable cardiac device monitoring. The Research segment is engaged in centralized core laboratory services providing cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. Included in the Corporate and Other category is the manufacturing, testing and marketing of cardiac and blood glucose monitoring devices to medical companies, clinics and hospitals and corporate overhead and other items not allocated to any of our reportable segments.
Expenses that can be specifically identified with a segment have been included as deductions in determining pre-tax segment income/(loss). Any remaining expenses including integration restructuring and other charges, as well as the elimination of costs associated with intercompany revenue, are included in Corporate and Other. Also included in Corporate and Other is our net interest expense and other financing expenses. We do not allocate assets to the individual segments.
 Three Months Ended September 30, 2019
 Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research  Consolidated
Revenue$93,873
 $14,236
 $3,182
 $111,291
Gross profit62,780
 5,758
 801
 69,339
Income/(loss) before income taxes29,843
 1,964
 (20,056) 11,751
Depreciation and amortization8,337
 1,059
 899
 10,295
Capital expenditures6,428
 774
 392
 7,594
BIOTELEMETRY, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (continued)
(Unaudited)


 Three Months Ended March 31, 2020
 Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research  Consolidated
Revenue$95,707
 $13,820
 $3,504
 $113,031
Gross profit64,424
 5,675
 409
 70,508
Income/(loss) before income taxes29,876
 2,043
 (19,586) 12,333
Depreciation and amortization8,435
 1,066
 984
 10,485
Capital expenditures6,211
 391
 382
 6,984
 Three Months Ended September 30, 2018
 Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research  Consolidated
Revenue$84,196
 $13,464
 $2,353
 $100,013
Gross profit56,040
 5,938
 759
 62,737
Income/(loss) before income taxes28,662
 1,951
 (15,893) 14,720
Depreciation and amortization8,413
 944
 992
 10,349
Capital expenditures2,765
 472
 4,324
 7,561
 Nine Months Ended September 30, 2019
 Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research  Consolidated
Revenue$276,886
 $41,079
 $9,108
 $327,073
Gross profit187,031
 15,427
 1,899
 204,357
Income/(loss) before income taxes91,965
 3,780
 (61,275) 34,470
Depreciation and amortization24,955
 2,991
 2,562
 30,508
Capital expenditures19,950
 2,562
 1,174
 23,686
Nine Months Ended September 30, 2018Three Months Ended March 31, 2019
Reporting Segment 
Corporate
and Other
  Reporting Segment 
Corporate
and Other
  
(in thousands)Healthcare Research ConsolidatedHealthcare Research Consolidated
Revenue$251,470
 $37,254
 $7,145
 $295,869
$88,009
 $12,964
 $3,006
 $103,979
Gross profit169,891
 16,184
 465
 186,540
59,864
 4,334
 580
 64,778
Income/(loss) before income taxes81,261
 4,257
 (56,960) 28,558
29,608
 764
 (20,760) 9,612
Depreciation and amortization24,797
 2,921
 2,513
 30,231
8,291
 928
 802
 10,021
Capital expenditures14,906
 1,674
 918
 17,498
4,442
 482
 410
 5,334


Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion and analysis should be read in conjunction with our Annual Report on Form 10-K for the year ended December 31, 2018,2019, and in conjunction with the accompanying quarterly


unaudited consolidated financial statements and related notes. This discussion contains forward-looking statements reflecting our current expectations that involve risks and uncertainties. Our actual results and the timing of certain events could differ materially from those contained in these forward-looking statements due to a number of factors, including, but not limited to, those set forth herein and elsewhere in this report and in our other filings with the U.S. Securities and Exchange Commission (“SEC”). See the “Cautionary Note Regarding Forward-Looking Statements” at the beginning of this report. Unless otherwise noted, the figures in the following discussions are unaudited.
Company Background
We are the leading remote medical technology company focused on the delivery of health information to improve quality of life and reduce cost of care. We provide remote cardiac monitoring, centralized core laboratory services for clinical trials, remote blood glucose monitoring and original


equipment manufacturing that serves both healthcare and clinical research customers. We operate under two reportable segments: Healthcare
A more detailed description of our business is included in “Part I; Item 1. Business” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2019.
Executive Summary
The following is a summary of certain financial highlights and Research. Healthcare is focused on remote cardiac monitoringtrends related to identify cardiac arrhythmias or heart rhythm disorders and to monitor the functionality of implantable cardiac devices. We offer cardiologists, electrophysiologists, neurologists and primary care physicians a full spectrum of solutions, which provides them with a single source of cardiac monitoring services. These services rangequarter ended March 31, 2020:
Recognized $113.0 million in revenue, an increase of 8.7% over the prior year period. This result represents our 31st consecutive quarter of year-over-year revenue growth.
Medicare rates for 2020 did not change significantly from the differentiated remote cardiac telemetry service to event, traditional Holter, extended Holter, Pacemaker and International Normalized Ratio monitoring. Research is engaged in centralized core laboratory services providing cardiac monitoring, imaging services, scientific consulting and data management services for drug and medical device trials. Included2019 rates.
Early in the Corporatequarter, we renegotiated our credit agreement to more favorable financial terms, giving us more flexibility in the future.
In response to COVID-19’s impact on the economic environment, we have been able to scale our operations to current demand and Other category is the manufacturing, testingbelieve we have sufficient liquidity available through our operating cash flow. In addition, to further support our business, we also have access to government stimulus payments and marketing of cardiac and blood glucose monitoring devices to medical companies, clinics and hospitals and corporate overhead and other items not allocated to any of our reportable segments.credit facility.
Recent Developments
In October 2019,March 2020, the World Health Organization declared the outbreak of COVID-19 as a global pandemic, and, in the following weeks, many U.S. states and localities issued lockdown orders impacting demand for our services. We are following the mandates from public health officials and government agencies, including implementation of enhanced cleaning measures, social distancing guidelines and work from home policies. To date, we detected suspicious activityhave not seen a significant impact to our supply chain with regards to our ability to obtain supplies, inventory or materials or a significant change in prices. We continue to monitor the situation closely.
We expect the ultimate significance of the impact on our information technology network. As partfinancial condition, results of operations and cash flows will be dictated by the length of time that such circumstances continue and any further governmental and public actions taken in response, including how quickly state governments decide to lift restrictions. While these unknowns make it more challenging for us to estimate future performance, our business is flexible in terms of our comprehensiveability to adjust the cost structure to the appropriate level in response plan,to the demand for our services. As such, we immediately took certain systems offlinebelieve we will have sufficient liquidity available through our


operating cash flow. In addition, to contain the activity and engaged an outside forensics teamfurther support our business, we also have access to conduct an independent investigation. While the incident did temporarily disrupt services, substantially all systems have resumed operationgovernment stimulus payments and our technical team continuescredit facility.
On January 27, 2020, we entered into an Amended and Restated Credit Agreement with Truist Bank (successor to work closely with third-party consultants to further address this matter. AlthoughSunTrust Bank) (the “2020 Credit Agreement”), which amends the Company has insurance coverage for costs and business interruption resulting from cyber-attacks, disputes over the extent of insurance coverage for claims are not uncommon. As a result, we may incur expenditures related to addressing this incident, that may not be covered, and we anticipate fourth quarter financial results to be negatively impactedSunTrust Credit Agreement entered into by the temporary disruptionparties on July 12, 2017. The 2020 Credit Agreement provides us with a $400.0 million senior secured revolving credit facility. We used this revolving credit facility to normal operations. Atrepay the debt under the SunTrust Credit Agreement. For more details, refer to “Part I; Item 1. Financial Statements and Supplementary Data; Notes to Consolidated Financial Statements; Note 8. Credit Agreement” of this time, there is no evidence of any unauthorized transfer or misuse of customer or employee data.report.

Critical Accounting Policies and Estimates
We have prepared the consolidated financial statements and accompanying notes included in “Part I; Item 1. Financial Statements” of this report in accordance with U.S. generally accepted accounting principles. This requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. These estimates and assumptions are based on historical experience, analysis of current trends, and various other factors that we believe to be reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions.
We periodically reevaluate our accounting policies, assumptions, and estimates and make adjustments when facts and circumstances warrant. Our significant accounting policies are described in “Part II; Item 8. Financial Statements and Supplementary Data; Notes to Consolidated Financial Statements; Note 2. Summary of Significant Accounting Policies” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.2019. The accounting policies and related assumptions that we consider to be more critical to the preparation of our consolidated financial statements and accompanying notes and involve the most significant management judgments and estimates are described in “Part II; Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations; Critical Accounting Policies and Estimates” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018. Except for the implementation of Accounting Standards Codification (“ASC”) 842 - Leases and the acquisition-related contingent consideration associated with the Geneva Healthcare Inc.


(“Geneva”) acquisition,there were no material changes in, or additions to, our critical accounting policies or in the assumptions or estimates we used to prepare the financial information appearing in this report.2019.

Results of Operations
Three Months Ended September 30,March 31, 2020 and March 31, 2019 and September 30, 2018
Revenue
Three Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Healthcare$93,873
 $84,196
 $9,677
 11.5%$95,707
 $88,009
 $7,698
 8.7%
Research14,236
 13,464
 772
 5.7%13,820
 12,964
 856
 6.6%
Other3,182
 2,353
 829
 35.2%3,504
 3,006
 498
 16.6%
Total revenue$111,291
 $100,013
 $11,278
 11.3%$113,031
 $103,979
 $9,052
 8.7%
Total revenue for the three months ended September 30, 2019March 31, 2020 increased 11.3%,8.7% due to growth in revenue across all of our businesses. The increase in Healthcare revenue growth was driven by increased patient volume, primarily related tothe higher demand for our mobile cardiac telemetry (MCT)


implantable loop recorder monitoring and extended Holter services, as well as the addition of the implantable device monitoring revenue contributed by Geneva, which we acquired on March 1, 2019. The positive impact of the higher patient volume was partially offset by the reduction of MCT Medicare reimbursement, which went into effect January 1, 2019, as well as payor mix.(ePatch™) services. Research revenue continues to benefit from new cardiac studies resulting fromutilizing ePatch™ as well as the utilizationacceleration of ePatch™, our extended Holter device.certain imaging studies. Other revenue increased due to continued growth of diabetic product sales. Our year-over-year revenue growth comes despite the effects of COVID-19, which negatively impacted volume, particularly in Healthcare, in the second half of March.
Gross Profit
Three Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Gross profit$69,339
 $62,737
 $6,602
 10.5%$70,508
 $64,778
 $5,730
 8.8%
Percentage of revenue62.3% 62.7%    62.4% 62.3%    
Gross profit for the three months ended September 30, 2019March 31, 2020 increased primarily due toin line with the higher revenue. The 42 basis point decrease in gross profit percentage was due to the impact of the reduction of MCT Medicare reimbursement, which went into effect January 1, 2019, as well as increased costs to support Research studies. This was partially offset by the positive impact of Healthcare operational efficiencies.


General and Administrative Expense
Three Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
General and administrative expense$29,651
 $26,325
 $3,326
 12.6%$31,881
 $27,607
 $4,274
 15.5%
Percentage of revenue26.6% 26.3%    28.2% 26.6%    
General and administrative expense for the three months ended September 30, 2019March 31, 2020 increased primarily due to additional headcount and related costs, associated with thelargely in our information technology areas, as well as increased technology expenses. These increases are being driven by our ongoing growth and investment in our business systems and infrastructure as well as the additionfull quarter impact of the Geneva. acquisition.
Sales and Marketing Expense
Three Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Sales and marketing expense$12,572
 $10,120
 $2,452
 24.2%$13,446
 $12,440
 $1,006
 8.1%
Percentage of revenue11.3% 10.1%    11.9% 12.0%    
Sales and marketing expense for the three months ended September 30, 2019March 31, 2020 increased primarily due to increased headcount-related expenses due toheadcount and related expense associated with the ongoing investment inexpansion of our Healthcare field sales force as well asteam and the additiondevelopment of a specialized sales team focused on the deployment of our Geneva. platform.
Bad Debt

Credit Loss Expense
Three Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Bad debt expense$5,858
 $5,157
 $701
 13.6%
Credit loss expense$6,020
 $5,148
 $872
 16.9%
Percentage of revenue5.3% 5.2%    5.3% 5.0%    
BadCredit loss expense (formerly bad debt expenseexpense) for the three months ended September 30, 2019March 31, 2020 increased primarily due to the increasedhigher Healthcare revenue and the timing of Healthcare collections. Bad debtCredit loss expense for the three months ended September 30, 2019March 31, 2020 in Research and the Other category was minimal and is recorded on a specific account basis.minimal.
Research and Development Expense
Three Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Research and development expense$3,661
 $2,429
 $1,232
 50.7%$3,568
 $3,333
 $235
 7.1%
Percentage of revenue3.3% 2.4%    3.2% 3.2%    
Research and development expense for the three months ended September 30, 2019March 31, 2020 increased due to our ongoing investment inadditional headcount and related expense. Our research and development team continues to focus on bringing new products and technologies including the further incorporation of artificial intelligence and machine learning into our services.


Other Charges
 Three Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Other charges$2,598
 $1,330
 $1,268
 95.3%
Percentage of revenue2.3% 1.3%    
Other charges for the three months ended September 30, 2019 increased primarily due to a $1.8 million increase in patent litigation and other legal expense partially offset by a reduction in acquisition and integration expenses. For further details, please see “Part I; Item 1, Financial Statements; Note 11. Other Charges.”
Other Expense
 Three Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Interest expense$(2,338) $(2,408) $70
 (2.9)%
Loss on equity method investment(65) (54) (11) 20.4 %
Other non-operating expense, net(845) (194) (651) 335.6 %
Total other expense, net$(3,248) $(2,656) $(592) 22.3 %
Percentage of revenue2.9% 2.7%    
Total other expense for the three months ended September 30, 2019 increased primarily due to the effect of non-cash foreign currency transaction losses.
Income Taxes
 Three Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
(Provision for)/benefit from income taxes$(3,468) $1,281
 $(4,749) (370.7)%
Effective tax rate29.5% (8.7)%    
For the three months ended September 30, 2019, we recorded an income tax provision based on our estimated annual effective tax rate, adjusted for discrete items. For the three months ended September 30, 2018, we recorded an income tax benefit primarily due to a discrete benefit recorded for equity compensation deductions. After considering benefits from the exercise of stock options, we expect our 2019 annual effective tax rate to be in the range of 19% to 21%, absent changes in tax laws or significant changes in unrecognized tax benefits.


Nine Months Ended September 30, 2019 and September 30, 2018
Revenue
 Nine Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Healthcare$276,886
 $251,470
 $25,416
 10.1%
Research41,079
 37,254
 3,825
 10.3%
Other9,108
 7,145
 1,963
 27.5%
Total revenue$327,073
 $295,869
 $31,204
 10.5%
Total revenue for the nine months ended September 30, 2019 increased 10.5%, due to growth in revenue across all of our businesses. Healthcare revenue growth was driven by increased patient volume, primarily related to our MCT and extended Holter services, as well as the addition of the implantable device monitoring revenue contributed by Geneva, which we acquired on March 1, 2019. The positive impact of the higher patient volume was partially offset by the reduction of MCT Medicare reimbursement, which went into effect January 1, 2019, as well as payor mix. Research revenue continues to benefit from new studies resulting from the utilization of ePatch™, our extended Holter device. Other revenue increased due to continued growth of diabetic product sales.
Gross Profit
 Nine Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Gross profit$204,357
 $186,540
 $17,817
 9.6%
Percentage of revenue62.5% 63.0%    
Gross profit for the nine months ended September 30, 2019 increased primarily due to the higher revenue. The 57 basis point decrease in gross profit percentage was due to the impact of the reduction of MCT Medicare reimbursement, which went into effect January 1, 2019, as well as increased costs to support Research studies. This was partially offset by the positive impact of Healthcare operational efficiencies.
General and Administrative Expense
 Nine Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
General and administrative expense$87,845
 $81,785
 $6,060
 7.4%
Percentage of revenue26.9% 27.6%    
General and administrative expense for the nine months ended September 30, 2019 increased primarily due to costs associated with the ongoing investment in our business systems and infrastructure, increased charitable contributions to fund pediatric cardiac procedures in developing countries as well as the addition of Geneva.


Sales and Marketing Expense
 Nine Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Sales and marketing expense$37,807
 $32,535
 $5,272
 16.2%
Percentage of revenue11.6% 11.0%    
Sales and marketing expense for the nine months ended September 30, 2019 increased primarily due to increased headcount-related expenses due to the ongoing investment in our Healthcare field sales force as well as the addition of Geneva.
Bad Debt Expense
 Nine Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Bad debt expense$16,385
 $16,911
 $(526) (3.1)%
Percentage of revenue5.0% 5.7%    
Bad debt expense for the nine months ended September 30, 2019 decreased primarily due to a prior year $1.1 million specific reserve related to a customer bankruptcy in the Other category. This was partially offset by the increased Healthcare revenue and the timing of Healthcare collections. Bad debt expense for the nine months ended September 30, 2019 in Research and the Other category was minimal and is recorded on a specific account basis.
Research and Development Expense
 Nine Months Ended    
 September 30, Change
(in thousands, except percentages)2019 2018 $ %
Research and development expense$10,526
 $8,451
 $2,075
 24.6%
Percentage of revenue3.2% 2.9%    
Research and development expense for the nine months ended September 30, 2019 increased due to our ongoing investment in new products and technologies,market, including the further incorporation of artificial intelligence and machine learning into our services.
Other Charges
Nine Months Ended  Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Other charges$7,902
 $11,623
 $(3,721) (32.0)%$2,084
 $3,070
 $(986) (32.1)%
Percentage of revenue2.4% 3.9%    1.8% 3.0%    
Other charges for the ninethree months ended September 30, 2019March 31, 2020 decreased primarily due to a $7.3insurance proceeds of $1.4 million reduction of integration expense related to the LifeWatch AG (“LifeWatch”) acquisition, a $1.8 million prior year reserve for a note receivable with a bankrupt customer and the $1.0 million impact from


changes in acquisition-related contingent consideration. This decrease was partially offset by $2.7 million of costs related to our Geneva acquisition, and a $4.3 million increase in patent litigation and other legal expense.October 2019 information technology incident. For further details, please see “Part I; Item 1, Financial Statements; Note 11.10. Other Charges.”


Other Expense
Nine Months Ended    Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
Interest expense$(7,358) $(6,982) $(376) 5.4 %$(2,107) $(2,482) $375
 (15.1)%
Loss on equity method investment(251) (238) (13) 5.5 %
 (32) 32
 (100.0)%
Other non-operating (expense)/income, net(1,813) 543
 (2,356) (433.9)%
Other non-operating income/(expense), net931
 (1,054) 1,985
 (188.3)%
Total other expense, net$(9,422) $(6,677) $(2,745) 41.1 %$(1,176) $(3,568) $2,392
 (67.0)%
Percentage of revenue2.9% 2.3%    1.0% 3.4%    
Total other expense, net for the ninethree months ended September 30, 2019 increasedMarch 31, 2020 decreased primarily due to the effect of non-cash foreign currency transaction losses,gains. Additionally, as a result of the partial quarter impact of higherour 2020 Credit Agreement, which was effective from January 27, 2020, we incurred lower interest rates due to changesexpense. The 2020 Credit Agreement reduced our applicable LIBOR margin at the current Consolidated Total Net Leverage Ratio (as defined in LIBOR on our long-term debt as well as interest expense on the deferred purchase consideration for Geneva. These increases were partially offset2020 Credit Agreement) by a current year gain associated with37.5 basis points. For further details regarding the termination of a former2020 Credit Agreement, please see LifeWatch foreign pension plan as well as prior year interest expense related to a legal settlement.“Part I; Item 1, Financial Statements; Note 8. Credit Agreement.”
Income Taxes
Nine Months Ended  Three Months Ended    
September 30, ChangeMarch 31, Change
(in thousands, except percentages)2019 2018 $ %2020 2019 $ %
(Provision for)/benefit from income taxes$(6,202) $2,923
 $(9,125) (312.2)%$(5,224) $2,073
 $(7,297) (352.0)%
Effective tax rate18.0% (10.2)%    42.4% (21.6)%    
For the ninethree months ended September 30, 2019,March 31, 2020, we recorded an income tax provision based on our estimated annual effective tax rate, adjusted for a net discrete benefit primarily related to equity compensation deductions.rate. For the ninethree months ended September 30, 2018,March 31, 2019, we recorded an income tax benefit primarily due to a discrete benefit recorded for equity compensation deductions. After considering benefits from the exercise of stock options, we expect our 2019 annual effectiveThe change in income tax rate to beexpense is driven by higher equity compensation deductions in the range of 19% to 21%, absent changes in tax laws or significant changes in unrecognized tax benefits.prior year.



Liquidity and Capital Resources
The following table highlights certain information related to our liquidity and capital resources:
(in thousands, except ratios)September 30,
2019
 December 31,
2018
March 31,
2020
 December 31,
2019
Cash and cash equivalents$61,573
 $80,889
$106,845
 $68,614
Healthcare accounts receivable, net of allowance for doubtful accounts56,832
 37,754
Other accounts receivable, net of allowance for doubtful accounts15,637
 14,874
Healthcare accounts receivable, net of allowance for credit losses74,864
 71,851
Other accounts receivable, net of allowance for credit losses18,727
 15,625
Availability under revolving credit facility50,000
 50,000
168,000
 50,000
      
Working capital$89,066
 $97,037
$163,983
 $112,579
Current ratio2.5
 3.0
4.3
 3.0
      
Total operating lease obligations(1)
$20,447
 $
$34,935
 $19,216
Total finance lease obligations838
 1,769
645
 683
Total debt$195,638
 $198,549
$227,425
 $194,667
________________
(1)
We adopted ASC 842 - Leases, effective January 1, 2019, which resulted in the recognition of most of our operating leases on our balance sheet, both as a right-of-use asset and right-of-use liability. Since we adopted this standard using the optional modified retrospective method, we have not restated prior year amounts.
The following table highlights certain cash flow activities:
Nine Months EndedThree Months Ended
(in thousands)September 30,
2019
 September 30,
2018
March 31,
2020
 March 31,
2019
Net income$28,268
 $31,481
$7,109
 $11,685
Non-cash adjustments to net income60,683
 49,782
25,138
 16,645
Cash used for working capital(36,349) (36,976)(19,544) (10,786)
Cash provided by operating activities52,602
 44,287
12,703
 17,544
      
Cash used in investing activities(68,452) (17,498)(6,984) (49,900)
      
Cash (used in)/provided by financing activities$(3,489) $500
Cash provided by/(used in) financing activities$32,570
 $(3,044)
ForCash Provided By Operating Activities
The decrease in cash provided by operating activities was primarily due to the ninedecrease in net income. Non-cash adjustments to net income increased for the three months ended September 30, 2019,March 31, 2020 primarily due to the change in deferred tax expense recognized during 2020 from the usage of net operating losses, increases in other non-cash adjustments to income primarily relate to bad debt, depreciation, amortization and stock compensationexpenses, credit loss expense and deferred taxes,stock-based compensation, offset partially by the changes in acquisition-related contingent consideration. The decrease in cashCash used for working capital wasincreased primarily due to the timing of cash receipts. payments.
Cash Used In Investing Activities
During the three months ended March 31, 2019, we spent $44.6 million, net of cash acquired, related to our Geneva acquisition. We increased our purchases for equipment and internally developed software in 2020, consistent with our higher Healthcare service volumes and the continuation of the launch of our next generation products used in our monitoring services.


Cash Provided By Financing Activities
The increase in cash used in investingprovided by financing activities during the three months ended March 31, 2020 was primarily due to a $35.0 million draw on the Geneva acquisition. The change in cash flows from financing activities was due to increased payments of tax withholdings related to vesting of share-based awards, the increase in our principal payments on our long-term debt and a decrease in the proceeds received related to the exercise of stock options, offset partially by the impact of the prior year acquistion of noncontrolling interests.credit facility.
In 2017,On January 27, 2020, we established a new credit agreemententered into an Amended and Restated Credit Agreement (the “2020 Credit Agreement”) with Truist Bank (successor to SunTrust Bank and lenders named thereinBank) in the form of a $205.0revolving credit facility. The 2020 Credit Agreement provides us more favorable financial terms, giving us more flexibility in the future. As of March 31, 2020, we have $168.0 million term loan and a $50.0 millionof availability under our revolving credit facility. For further details regarding this agreement, please see “Part II;I; Item 8.1. Financial Statements and Supplementary Data;


Statements; Notes to Consolidated Financial Statements; Note 11.8. Credit Agreement” of this report.
While we have taken certain measures to enhance our Annual Reportliquidity position and provide additional financial flexibility in response to the COVID-19 situation, including drawing down additional funds on Form 10-K for the fiscal year ended December 31, 2018. As of September 30, 2019, our revolving credit facility, remains undrawn.we believe that our operating cash receipts will be sufficient to cover our operating cash needs. We will also benefit from cash receipts in the second quarter related to various COVID-related government stimulus programs.

Item 3. Quantitative and Qualitative Disclosures About Market Risk
Our cash and cash equivalents as of September 30, 2019March 31, 2020 were $61.6$106.8 million. We do not invest in any short-term or long-term securities, nor do we hold any derivative financial instruments for trading or speculative purposes.
At September 30, 2019,March 31, 2020, we had $195.6$227.4 million of variable rate debt, inclusive of debt discounts and deferred charges, at a rate of LIBOR plus the applicable margin, or the prime rate plus the applicable margin. A 1.0% change in either the LIBOR rate, prime rate, or the applicable margin would result in a change in interest expense of approximately $2.0$2.3 million. For further details regarding theour debt, rates or applicable margin, please refer to“Part I; Item 1, Financial Statements; Notes to Consolidated Financial Statements; Note 8. Credit Agreement” within this Quarterly Report on Form 10-Q and “Part II; Item 8. Financial Statements and Supplementary Data; Notes to Consolidated Financial Statements; Note 11. Credit Agreement” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.2019.



Item 4.  Controls and Procedures
Evaluation of Disclosure Controls and Procedures
We maintain disclosure controls and procedures designed to ensure information required to be disclosed in our reports filed under the Securities Exchange Act of 1934, as amended (“Exchange Act”), is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms.  Disclosure controls and procedures are designed to provide reasonable assurance that information required to be disclosed in our reports filed under the Exchange Act is accumulated and communicated to management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. It should be noted that the design of any system of controls is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions, regardless of how remote.
Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures pursuant to Rule 13a-15(b) of the Exchange Act as of the end of the period covered by this report. Based on that evaluation, our Chief Executive Officer (the Principal Executive Officer) and Chief Financial Officer (the Principal Financial Officer) have concluded that our disclosure controls and procedures were effective as of September 30, 2019.  This evaluation of the effectiveness ofMarch 31, 2020. 
Changes in Internal Control Over Financial Reporting
There were no changes in our internal control over financial reporting did not includeduring the internal controls of Geneva, which was acquired in the first quarter of 2019, nor ADEA Medical AB, which was acquired in the second quarter of 2019, dueperiod covered by this report that have materially affected, or are reasonably likely to the timing of these acquisitions. Geneva and ADEA Medical AB will be included in our evaluation of the effectiveness ofmaterially affect, our internal control over financial reporting for periods beginning after January 1, 2020.reporting.



PART II - OTHER INFORMATION
Item 1. Legal Proceedings
From time to time, in the ordinary course of business, and like others in the industry, we receive requests for information from government agencies in connection with their regulatory or investigational authority or are involved in traditional employment or business litigation.  We review such requests and notices and take appropriate action.
On April 5, 2019, a complaint filed under seal in the U.S. District Court for the Eastern District of Pennsylvania against the Company by private relators under the Federal False Claims Act, and analogous state acts, was unsealed. The U.S. Department of Justice notified the District Court of its decision not to intervene in the case at this time.time, and the case is currently stayed until May 2020 while the U.S. Department of Justice determines whether it will intervene in the case.
The relators’ complaint alleges, among other things, that the Company engaged in the offshoring of certain activities and improper performance of work at certain U.S. locations in violation of applicable law. The relators seek unspecified damages on behalf of the U.S. and various states.states and municipalities.
The Company is evaluating the complaint, but, at this point, it believes the allegations in the complaint are without merit and intends to vigorously defend the litigation. The Company also does not believe these claims will have a material impact on its business operations or strategic plans.
The final outcome of any current or future litigation or governmental or internal investigations cannot be accurately predicted, nor can we predict any resulting penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities. We record accruals for such contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be estimated.

Item 1A.  Risk Factors
In evaluating an investment in BioTelemetry common stock, investors should consider carefully, among other things, “Part I; Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2018,2019, as well as the information contained in this Quarterly Report on Form 10-Q, which could materially affect the Company’sour business, financial condition or future results. The risks described in this Quarterly Report on Form 10-Q and the Company’sour Annual Report on Form 10-K are not the only risks facing the Company.BioTelemetry. Additional risks and uncertainty not currently known to the Companyus or that the Companywe currently deemsdeem immaterial also may materially adversely affect the Company’sour business, financial condition or future results.
WeThe COVID-19 pandemic has negatively impacted our business.
The COVID-19 pandemic has disrupted the global economy and has negatively impacted large populations, including people and businesses that are increasingly dependent on sophisticated information technology systems to operate our business, and if we fail to properly maintaindirectly or indirectly involved with the integrityoperation of our data or if our products do not operate as intended or we experience a cyber-attack or other breachCompany and the manufacturing and distribution of these systems, our business could be materially affected.
We are increasingly dependent on sophisticated information technology for our products and infrastructure. We rely on information technology systemsservices. Despite these impacts, it is important to process, transmitnote that our business operations have remained operational and store electronic information in our day-to-day operations. The size and complexityavailable to service the demand of our information technology systems makes them vulnerable to increasingly sophisticated cyber-attacks, malicious intrusion, breakdown, destruction, losscustomers. The full scope and economic impact of data privacy or other significant disruption. For example,the COVID-19 pandemic is still unknown and there are many risks from COVID-19 that could generally and negatively impact economies and healthcare providers in October 2019,the area where we detected suspicious activity ondo business. At this time, we have identified the following COVID-19 related risks that we believe have a greater likelihood of negatively impacting our information technology network, which required services and systems to be takencompany, including:


offlineFederal, State and local shelter-in-place mandates and other business restrictions, which limit the ability of potential patients to see their physicians and obtain a prescription for a periodour services and our employees’ ability to conduct their jobs, including our sales force’s ability to travel and meet clients and referring physicians in person.
Localized outbreaks of time. Our information systems require an ongoing commitmentCOVID-19 in job functions at our Company that are unable to be performed remotely and are critical to providing our products and services (e.g. distribution).
The burden on hospitals and medical personnel resulting in the cancellation of significant resourcesnon-essential medical appointments, which our business relies on to maintain, protect and enhance existing systems and develop new systemsobtain prescriptions for our services.
Increased cybersecurity risks.
Increased unemployment rates, which may result in decreased insurance coverage in the locations we serve.
Erosion of the capital markets, which may make it more difficult to keep pace with continuing changes in information processing technology, evolving systems and regulatory standards, the increasingobtain financing that we may need to protect patientfund and customer informationcontinue our operations.
Demand for and changing customer patterns. As a result of technology initiatives, recently enacted regulations, changes in our system platformsability to sell and integration of new business acquisitions, wemarket our products and services have been consolidating and integratingwe expect will continue to be adversely affected by the numberCOVID-19 pandemic and responses thereto.
Restrictions on the ability to travel, social distancing policies, orders and restriction, including those described above, and recommendations regarding fears of systems we operateCOVID-19 spreading within healthcare facilities has caused both patients and have upgradedproviders to delay or cancel appointments and expandedprocedures that result in the use of our information systems capabilities.
In addition, third parties may attemptproducts and services. We are unable to hack intoaccurately predict when these policies, orders and restrictions will be relaxed or lifted, and there can be no assurances that patients or providers will restart appointments or procedures that result in the use of our products or systemsservices upon termination of these policies, orders and restrictions, particularly if there remains any continued community outbreak of COVID-19.
A prolonged economic contraction or recession may obtain data relating to patients with our products or our proprietary information. Ifalso result in employer layoffs of their employees in markets where we fail to maintain or protect our information systems and data integrity effectively, weconduct business, which could lose existing customers,result in lower demand. We have difficulty attracting new customers, have problems in determining product cost estimates and establishing appropriate pricing, have difficulty preventing, detecting and controlling fraud, have disputes with customers, physicians and other health care professionals, have regulatory sanctions or penalties imposed, have increases in operating expenses, incur expenses or lose revenuealready experienced reduced sales as a result of a data privacy breachthe effects of the COVID-19 pandemic. If our sales continue to decline, or suffer other adverse consequences. There can be no assurance thatif such lost sales are not recoverable in the future, our processbusiness and results of consolidating the number of systems we operate, upgrading and expanding our information systems capabilities, protecting and enhancing our systems and developing new systems to keep pace with continuing changes in information processing technologyoperations will be successful orsignificantly adversely affected.
Our sales and marketing personnel often rely on in-person and on site access to healthcare providers, which is currently restricted as hospitals and physicians’ offices reduce access to essential personnel only. These restrictions have harmed our sales and marketing efforts, and continued restrictions would have a negative impact on our sales and results of operations. An increase of COVID-19-related hospital admissions may overload hospitals with unexpected patients, thereby delaying further appointments and procedures that additional systems issues will not ariseresult in the future. Any significant breakdown, intrusion, interruption, corruptionuse of our products or destructionservices but that may be deemed elective by the hospital.
The global outbreak of COVID-19 continues to rapidly evolve. The ultimate impact of the COVID-19 outbreak is highly uncertain and subject to change. We do not yet know the full extent of potential delays or impacts on our business or the global economy as a whole. However, these systems, as well as any data breaches,effects have harmed our business, financial condition and results of operations in the near term and could have a continuing material adverse effectimpact on our business.operations and sales.



Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Not applicable.

Item 3.  Defaults Upon Senior Securities
Not applicable.

Item 4.  Mine Safety Disclosures
Not applicable.

Item 5.  Other Information
Not applicable.




Item 6.  Exhibits
EXHIBIT INDEX
  Incorporated by Reference Filed/Furnished Herewith  Incorporated by Reference Filed/Furnished Herewith
Exhibit
Number
 Description Form File No. Exhibit Filing Date  Description Form File No. Exhibit Filing Date 
10.1  8-K 000-558039 10.1 August 22, 2019   10-K 001-33993 10.13 February 28, 2020 
31.1    
31.2    
32  +  +
101.INS XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded withing the Inline XBRL document.  XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded withing the Inline XBRL document. 
101.DEF XBRL Taxonomy Extension Definition Linkbase Document.  XBRL Taxonomy Extension Definition Linkbase Document. 
101.SCH XBRL Taxonomy Extension Schema Document.  XBRL Taxonomy Extension Schema Document. 
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document.  XBRL Taxonomy Extension Calculation Linkbase Document. 
101.LAB XBRL Taxonomy Extension Label Linkbase Document.  XBRL Taxonomy Extension Label Linkbase Document. 
101.PRE XBRL Taxonomy Extension Presentation Linkbase Document.  XBRL Taxonomy Extension Presentation Linkbase Document. 
104 Cover Page Interactive Data File, formatted in Inline XBRL (contained in Exhibit 101).  Cover Page Interactive Data File, formatted in Inline XBRL (contained in Exhibit 101). 

Filed herewith.

+Furnished herewith.




BioTelemetry, Inc.

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
 BIOTELEMETRY, INC.
   
   
Date: November 5, 2019May 6, 2020By:/s/ Heather C. Getz
  Heather C. Getz, CPA
  Executive Vice President, Chief Financial and Administrative Officer
  (Principal Financial Officer and authorized officer of the Registrant)

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