HealthStream (HSTM) 10-Q 29 Apr 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	Apr. 29, 2019
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Trading Symbol	HSTM
Entity Registrant Name	HEALTHSTREAM INC
Entity Central Index Key	0001095565
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		32,388,307

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 110,610	$ 134,321
Marketable securities	36,322	34,497
Accounts receivable, net of allowance for doubtful accounts of $936 and $1,161 at March 31, 2019 and December 31, 2018, respectively	37,432	38,124
Accounts receivable - unbilled	3,156	2,880
Prepaid royalties, net of amortization	16,416	13,596
Other prepaid expenses and other current assets	19,806	18,016
Total current assets	223,742	241,434
Property and equipment, net of accumulated depreciation of $22,351 and $20,827 at March 31, 2019 and December 31, 2018, respectively	23,708	15,866
Capitalized software development, net of accumulated amortization of $49,223 and $46,757 at March 31, 2019 and December 31, 2018, respectively	20,425	18,352
Operating lease right of use assets, net	31,710
Goodwill	95,252	86,144
Deferred tax assets	257	145
Deferred commissions	15,731	16,470
Non-marketable equity investments	6,772	3,376
Other assets	848	783
Total assets	483,500	441,948
Current liabilities:
Accounts payable and accrued expenses	19,281	25,037
Accrued royalties	19,099	15,756
Deferred revenue	72,602	66,061
Total current liabilities	110,982	106,854
Deferred tax liabilities	11,503	11,068
Deferred revenue, noncurrent	2,868	2,868
Operating lease liability, noncurrent	32,390
Other long term liabilities	616	2,211
Commitments and contingencies
Shareholders’ equity:
Common stock, no par value, 75,000 shares authorized; 32,388 and 32,325 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively	286,785	286,597
Retained earnings	38,347	32,373
Accumulated other comprehensive income (loss)	9	(23)
Total shareholders’ equity	325,141	318,947
Total liabilities and shareholders’ equity	483,500	441,948
Customer-Related Intangible Assets [Member]
Current assets:
Intangible assets, net	57,263	53,469
Other Intangible Assets [Member]
Current assets:
Intangible assets, net	$ 7,792	$ 5,909

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Allowance for doubtful accounts, net	$ 936	$ 1,161
Accumulated depreciation on property and equipment	22,351	20,827
Accumulated amortization on capitalized software development	$ 49,223	$ 46,757
Common stock, shares authorized	75,000,000	75,000,000
Common stock, shares issued	32,388,000	32,325,000
Common stock, shares outstanding	32,388,000	32,325,000
Customer-Related Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 24,952	$ 23,245
Other Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 10,505	$ 9,663

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement [Abstract]
Revenues, net	$ 65,187	$ 54,858
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)	26,861	22,248
Product development	6,927	6,001
Sales and marketing	9,521	9,064
Other general and administrative expenses	9,970	7,742
Depreciation and amortization	6,539	6,073
Total operating costs and expenses	59,818	51,128
Operating income	5,369	3,730
Other income, net	822	313
Income from continuing operations before income tax provision	6,191	4,043
Income tax provision	1,411	414
Income from continuing operations	4,780	3,629
Loss from discontinued operations before income tax provision		(64)
Gain on sale of discontinued operations	1,620	30,991
Income tax provision	426	10,710
Income from discontinued operations	1,194	20,217
Net income	$ 5,974	$ 23,846
Net income per share - basic:
Continuing operations	$ 0.15	$ 0.11
Discontinued operations	0.03	0.63
Net income per share - basic	0.18	0.74
Net income per share - diluted:
Continuing operations	0.15	0.11
Discontinued operations	0.03	0.63
Net income per share - diluted	$ 0.18	$ 0.74
Weighted average shares of common stock outstanding:
Basic	32,337	32,097
Diluted	32,377	32,132
Dividends declared per share		$ 1

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 5,974	$ 23,846
Other comprehensive income, net of taxes:
Unrealized gain on marketable securities	32	15
Total other comprehensive income	32	15
Comprehensive income	$ 6,006	$ 23,861

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Retained Earnings (Accumulated Deficit) [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balance at Dec. 31, 2017	$ 300,170	$ 282,666	$ 17,542	$ (38)
Beginning balance, shares at Dec. 31, 2017		31,908
Cumulative effect of accounting change	15,132		15,132
Net income	23,846		23,846
Comprehensive income	15			15
Dividends declared on common stock ($1.00 per share)	(32,518)		(32,518)
Stock based compensation	328	$ 328
Common stock issued under stock plans, net of shares withheld for employee taxes	2,071	$ 2,071
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		394
Ending balance at Mar. 31, 2018	309,044	$ 285,065	24,002	(23)
Ending balance, shares at Mar. 31, 2018		32,302
Beginning balance at Dec. 31, 2018	$ 318,947	$ 286,597	32,373	(23)
Beginning balance, shares at Dec. 31, 2018	32,325	32,325
Net income	$ 5,974		5,974
Comprehensive income	32			32
Stock based compensation	516	$ 516
Common stock issued under stock plans, net of shares withheld for employee taxes	(328)	$ (328)
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		63
Ending balance at Mar. 31, 2019	$ 325,141	$ 286,785	$ 38,347	$ 9
Ending balance, shares at Mar. 31, 2019	32,388	32,388

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) (Parenthetical)	3 Months Ended
	Mar. 31, 2018$ / shares
Statement Of Stockholders Equity [Abstract]
Dividends per share common stock	$ 1

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
OPERATING ACTIVITIES:
Net income	$ 5,974	$ 23,846
Income from discontinued operations	(1,194)	(20,217)
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	6,539	6,073
Stock-based compensation	516	419
Amortization of deferred commissions	2,121	1,827
Provision for doubtful accounts	2	390
Deferred income taxes	433	608
Gain on non-marketable equity investments	(54)	(7)
Other	(28)	30
Changes in operating assets and liabilities:
Accounts and unbilled receivables	1,387	(1,864)
Prepaid royalties	(2,820)	(2,467)
Other prepaid expenses and other current assets	251	(530)
Deferred commissions	(1,382)	(1,654)
Other assets	(16)	248
Accounts payable and accrued expenses	(5,386)	(6,074)
Accrued royalties	3,342	506
Deferred revenue	6,400	8,417
Net cash provided by continuing operating activities	16,085	9,551
Net cash used in discontinued operating activities		(1,002)
Net cash provided by operating activities	16,085	8,549
INVESTING ACTIVITIES:
Business combinations, net of cash acquired	(18,002)
Proceeds from sale of discontinued operations		58,203
Proceeds from maturities of marketable securities	28,337	19,600
Purchases of marketable securities	(30,101)	(12,612)
Payments to acquire cost method investments	(3,342)
Payments associated with capitalized software development	(4,933)	(2,541)
Purchases of property and equipment	(11,338)	(1,858)
Net cash (used in) provided by continuing investing activities	(39,379)	60,792
Net cash used in discontinued investing activities		(115)
Net cash (used in) provided by investing activities	(39,379)	60,677
FINANCING ACTIVITIES:
Proceeds from exercise of stock options	31	2,368
Taxes paid related to net settlement of equity awards	(359)	(297)
Payments of earn-outs related to acquisitions	(37)	(37)
Payment of cash dividends	(52)
Net cash (used in) provided by continuing financing activities	(417)	2,034
Net cash (used in) provided by financing activities	(417)	2,034
Net (decrease) increase in cash and cash equivalents	(23,711)	71,260
Cash and cash equivalents at beginning of period	134,321	84,768
Cash and cash equivalents at end of period	$ 110,610	$ 156,028

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Basis of Presentation	1. BASIS OF PRESENTATION The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“US GAAP”) for interim financial information and with the instructions to Form 10‑Q and Article 10 of Regulation S‑X. Accordingly, condensed consolidated financial statements do not include all of the information and footnotes required by US GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. All intercompany transactions have been eliminated in consolidation. Operating results for the three months ended March 31, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. The Company receives royalties and recognizes revenues (through its Workforce Solutions business segment) from teaming agreements that are entered into on a discrete basis from time-to-time with one of its content partners. Upon review of the teaming agreements with this content partner, the Company discovered that this content partner had failed during certain prior periods to remit royalties to which the Company was entitled. The Company determined such royalties should have been recognized in prior periods as revenue in relation to amounts due and payable under this arrangement and that certain expenses were overstated in connection with this arrangement. If accounted for in these prior periods, the Company would have recognized additional revenue of approximately $689,000 and $172,000 in the years ended December 31, 2018 and 2017, respectively, and would have incurred lower operating expense of $56,000 and $63,000 in the years ended December 31, 2018 and 2017, respectively. These adjustments collectively resulted in additional revenue of $861,000, lower operating expense of $119,000 and additional income from continuing operations of $744,000 during the three months ended March 31, 2019, and additional accounts receivable of $861,000 as of March 31, 2019. The Company concluded that this error was immaterial to the Company’s consolidated financial statements for the three months ended March 31, 2019 and prior affected periods. On February 12, 2018, the Company divested its Patient Experience (“PX”) business to Press Ganey Associates, Inc. (“Press Ganey”). The sale of the PX business resulted in the divestiture of the Company’s patient experience solutions business segment. The Company has classified the results of its previously owned PX business as discontinued operations in its condensed consolidated statements of income and cash flows for all periods presented. See Note 8 for additional information. The condensed consolidated balance sheet at December 31, 2018 was derived from the audited consolidated financial statements at that date but does not include all of the information and footnotes required by US GAAP for a complete set of financial statements. For further information, refer to the consolidated financial statements and footnotes thereto for the year ended December 31, 2018 (included in the Company's Annual Report on Form 10-K, filed with the Securities and Exchange Commission on February 25, 2019).

Recent Accounting Pronouncement

Recent Accounting Pronouncements	3 Months Ended
	Mar. 31, 2019
Accounting Changes And Error Corrections [Abstract]
Recent Accounting Pronouncements	2. RECENT ACCOUNTING PRONOUNCEMENTS Accounting Standards Recently Adopted In February 2016, the FASB issued ASU 2016-02, Leases (“ASC 842”), Accounting Standards Not Yet Adopted In June 2016, the FASB issued ASU 2016-03, Financial Instruments—Credit Losses (“ASC 326”): Measurement of Credit Losses on Financial Instruments

Revenue Recognition And Sales C

Revenue Recognition And Sales Commissions	3 Months Ended
	Mar. 31, 2019
Revenue From Contract With Customer [Abstract]
Revenue Recognition And Sales Commissions	3. REVENUE RECOGNITION AND SALES COMMISSIONS Revenue Recognition Revenues are recognized when control of the promised goods or services is transferred to the customer in an amount that reflects the consideration the Company expects to be entitled in exchange for transferring those goods or services. Revenue is recognized based on the following five step model: • Identification of the contract with a customer • Identification of the performance obligations in the contract • Determination of the transaction price • Allocation of the transaction price to the performance obligations in the contract • Recognition of revenue when, or as, the Company satisfies a performance obligation The following table represents revenues included in continuing operations disaggregated by revenue source for the three months ended March 31, 2019 and 2018 (in thousands). Sales taxes are excluded from revenues. Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Business Segments Workforce Solutions Provider Solutions Consolidated Workforce Solutions Provider Solutions Consolidated Subscription/SaaS $ 52,805 $ 9,080 $ 61,885 $ 43,702 $ 9,032 $ 52,734 Professional services 1,490 1,812 3,302 1,245 879 2,124 Total revenues, net $ 54,295 $ 10,892 $ 65,187 $ 44,947 $ 9,911 $ 54,858 Subscription/SaaS services revenues primarily consist of fees in consideration of providing customers access to one or more of our SaaS-based solutions and/or courseware subscriptions, as well as fees related to licensing agreements, all of which include routine customer support and technology enhancements. Revenue is generally recognized over time during the contract term beginning when the service is made available to the customer. Subscription/SaaS contracts are generally non-cancelable, one to five years in length, and billed annually, semi-annually, quarterly, or monthly in advance. Professional services revenues primarily consist of fees for implementation services, custom courseware development, and training. The majority of our professional services contracts are billed in advance based on a fixed price basis, and revenue is recognized over time as the services are performed. For both subscription/SaaS services and professional services, t he time between billing the customer and when performance obligations are satisfied is not significant. Our contracts with customers often contain multiple performance obligations. For these contracts, the Company accounts for individual performance obligations separately if they are distinct. The contract price, which represents transaction price, is allocated to the separate performance obligations on a relative standalone selling price basis. We generally determine standalone selling prices based on the standard list price for each product, We receive payments from customers based on billing schedules established in our contracts. Accounts receivable - unbilled represent contract assets related to our conditional right to consideration for subscription/SaaS and professional services contracts where performance has occurred under the contract. Accounts receivable are primarily comprised of trade receivables that are recorded at the invoice amount, net of an allowance for doubtful accounts, when the right to consideration becomes unconditional. Other receivables, which are included within Accounts Receivable, include receivables from certain content partners and are not material. For the three months ended March 31, 2019 and 2018, the Company Deferred revenue represents contract liabilities that are recorded when cash payments are received or are due in advance of our satisfaction of performance obligations. During the three months ended March 31, 2019 and 2018, we recognized revenues of approximately $31.2 million and $29.2 million, respectively, from amounts included in deferred revenue at the beginning of the respective periods. As of March 31, 2019, approximately $422 million of revenue is expected to be recognized from remaining performance obligations under contracts with customers. We expect to recognize revenue related to approximately 49% of these remaining performance obligations over the next 12 months, with the remaining amounts recognized thereafter. Sales Commissions Sales commissions earned by our sales organization are considered incremental and recoverable costs of obtaining a contract with a customer. T he Company’s sales commission plans for 2018 and 2019 typically include multiple payments, including initial payments in the period a customer contract is obtained and subsequent payments either 15 or 27 months after the initial payment.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	4. INCOME TAXES Income taxes are accounted for using the asset and liability method, whereby deferred tax assets and liabilities are determined based on the temporary differences between the financial statement and tax bases of assets and liabilities measured at tax rates that will be in effect for the year in which the differences are expected to affect taxable income. During the three months ended March 31, 2019 and 2018 three months ended March 31, 2019 and 2018 three months ended March 31, 2019 and 2018

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Stockholders' Equity	5. SHAREHOLDERS’ EQUITY Dividends on Common Stock On February 12, 2018, the Company’s Board of Directors declared a $1.00 per common share special cash dividend, which was paid on April 3, 2018 to shareholders of record on March 6, 2018. Stock Based Compensation The Company has stock awards outstanding under two stock incentive plans: the Company’s 2016 Omnibus Incentive Plan and 2010 Stock Incentive Plan. The Company accounts for its stock based compensation plans using the fair-value based method for costs related to share based payments, including stock options and restricted share units (“RSUs”). During the three months ended March 31, 2019, the Company issued 86,220 RSUs, subject to service-based time vesting, with a weighted average grant date fair value of $27.39 per share, measured based on the closing fair market value of the Company’s stock on the date of grant. During the three months ended March 31, 2018, the Company issued 83,168 RSUs, subject to service-based time vesting, with a weighted average grant date fair value of $24.70 per share, measured based on the closing fair market value of the Company’s stock on the date of grant. During the three months ended June 30, 2018, the Company issued 70,000 performance-based RSUs, the vesting of which occurs over a five-year period and is contingent upon continued service and achieving certain performance criteria established by the Compensation Committee on an annual basis. The performance criteria for 7,000 of these performance-based RSUs was determined in the three months ended June 30, 2018, and was based on 2018 performance, 3,500 of which RSUS vested. In addition, the performance criteria for 10,500 of these performance-based RSUs, along with 3,500 performance-based catch-up RSUs which did not vest based on 2018 performance as noted above but remained eligible for vesting, will be based on 2019 performance. The measurement date for these 10,500 performance-based RSUs, along with the 3,500 catch-up RSUs, was established during the three months ended March 31, 2019, with a grant date fair value of $27.61 per share, measured based on the closing fair market value of the Company’s stock on the date the performance criteria was established. The performance criteria for the remaining 52,500 performance-based RSUs has not yet been determined and will be established on an annual basis in 2020, 2021, and 2022, as applicable; therefore, the measurement date for these performance-based RSUs cannot be determined until the performance criteria have been established. Total stock based compensation expense recognized for the three months ended March 31, 2019 and 2018, which is recorded within continuing operations in the condensed consolidated statements of income, is as follows (in thousands): Three Months Ended March 31, 2019 2018 Cost of revenues (excluding depreciation and amortization) $ 1 $ 8 Product development 53 74 Sales and marketing 56 31 Other general and administrative 406 306 Total stock based compensation expense $ 516 $ 419

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Earnings Per Share	6. EARNINGS PER SHARE Basic earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of potentially dilutive common and common equivalent shares outstanding during the period. Common equivalent shares are composed of incremental common shares issuable upon the exercise of stock options and RSUs subject to vesting. The dilutive effect of common equivalent shares is included in diluted earnings per share by application of the treasury stock method. The total number of common equivalent shares excluded from the calculations of diluted earnings per share, due to their anti-dilutive effect or contingent performance conditions, was approximately 136,000 and 159,000 for the three months ended March 31, 2019 and 2018 The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2019 and 2018 (in thousands, except per share data): Three Months Ended March 31, 2019 2018 Numerator: Income from continuing operations $ 4,780 $ 3,629 Income from discontinued operations 1,194 20,217 Net income $ 5,974 $ 23,846 Denominator: Weighted-average shares outstanding 32,337 32,097 Effect of dilutive shares 40 35 Weighted-average diluted shares 32,377 32,132 Net income per share - basic: Continuing operations $ 0.15 $ 0.11 Discontinued operations 0.03 0.63 Net income per share - basic $ 0.18 $ 0.74 Net income per share - diluted: Continuing operations $ 0.15 $ 0.11 Discontinued operations 0.03 0.63 Net income per share - diluted $ 0.18 $ 0.74

Marketable Securities

Marketable Securities	3 Months Ended
	Mar. 31, 2019
Investments Debt And Equity Securities [Abstract]
Marketable Securities	7. MARKETABLE SECURITIES At March 31, 2019 and December 31, 2018, the fair value of marketable securities, which were all classified as available for sale, included the following (in thousands): March 31, 2019 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Level 2: Corporate debt securities $ 27,235 $ 11 $ (3 ) $ 27,243 Government-sponsored enterprise debt securities 9,078 1 — 9,079 Total $ 36,313 $ 12 $ (3 ) $ 36,322 December 31, 2018 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Level 2: Corporate debt securities $ 31,521 $ — $ (23 ) $ 31,498 Government-sponsored enterprise debt securities 2,999 — — 2,999 Total $ 34,520 $ — $ (23 ) $ 34,497 The carrying amounts reported in the condensed consolidated balance sheet approximate the fair value based on quoted market prices or alternative pricing sources and models utilizing market observable inputs. As of March 31, 2019, the Company does not consider any of its marketable securities to be other than temporarily impaired. During the three months ended March 31, 2019 and 2018

Discontinued Operations

Discontinued Operations	3 Months Ended
	Mar. 31, 2019
Discontinued Operations And Disposal Groups [Abstract]
Discontinued Operations	8. DISCONTINUED OPERATIONS Patient Experience On February 12, 2018, the Company divested its PX business to Press Ganey for $65.2 million in cash (after giving effect to the post-closing working capital adjustment), resulting in a gain, net of tax, of $20.2 million, of which $19.0 million was recorded during the year ended December 31, 2018 and $1.2 million was recorded during the three months ended March 31, 2019. Approximately $6.55 million of the proceeds were held in escrow for a period of time following the closing as a source of recovery for indemnification claims by Press Ganey, of which $6.2 million was released and paid to the Company in April 2019. Approximately $328,000 remains in escrow through August 12, 2019 as a source of recovery for potential indemnification claims. The Company previously recorded the escrow funds as a contingent asset, and estimated the probability of receiving the full escrow amount when determining the gain on the sale. Given substantially all of the escrow has been received, the Company recorded a change in its previous estimate through the “Gain on sale of discontinued operations” caption within the condensed consolidated statement of income for the three months ended March 31, 2019. This sale of the PX business resulted in the divestiture of the Company’s patient experience solutions business segment. The Company has classified the results of its PX business segment as discontinued operations in its condensed consolidated statements of income and cash flows for all periods presented. The financial results of the PX business for the period prior to divestiture during the three months ended March 31, 2018 are presented in discontinued operations in the Company’s condensed consolidated statements of income. The following table presents the financial results of the PX business (in thousands): Three Months Ended March 31, 2018 Revenues, net $ 3,342 Operating costs and expenses: Cost of revenues (excluding depreciation and amortization) 1,982 Product development 554 Sales and marketing 460 Other general and administrative expenses 229 Depreciation and amortization 181 Total operating costs and expenses 3,406 Operating loss (64 ) Other loss — Loss from discontinued operations before income tax provision (64 ) Income tax provision — Loss from discontinued operations, net of income taxes $ (64 )

Business Segments

Business Segments	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Business Segments	9. BUSINESS SEGMENTS The Company provides services to healthcare organizations and other members within the healthcare industry. The Company’s services are focused on the delivery of workforce development products and services (HealthStream Workforce Solutions) and provider credentialing, privileging, and enrollment products and services (HealthStream Provider Solutions). As noted above, the sale of the PX business on February 12, 2018 resulted in the divestiture of the Company’s Patient Experience Solutions segment. Beginning with the first quarter of 2018, the Company classified the results of its Patient Experience Solutions segment as discontinued operations in its condensed consolidated statements of income and cash flows for all periods presented. See Note 8 for additional information. The Company measures segment performance based on operating income before income taxes and prior to the allocation of certain corporate overhead expenses, interest income, interest expense, and depreciation. The Unallocated component below includes corporate functions, such as accounting, human resources, legal, investor relations, information systems, administrative and executive personnel, depreciation, a portion of amortization, and certain other expenses, which are not currently allocated in measuring segment performance. Three Months Ended March 31, Revenues, net: 2019 2018 Workforce Solutions $ 54,295 $ 44,947 Provider Solutions 10,892 9,911 Total revenues, net $ 65,187 $ 54,858 Operating income from continuing operations: Workforce Solutions $ 11,529 $ 9,235 Provider Solutions 1,436 514 Unallocated (7,596 ) (6,019 ) Total operating income from continuing operations $ 5,369 $ 3,730 Segment assets * March 31, 2019 December 31, 2018 Workforce Solutions $ 134,249 $ 104,668 Provider Solutions 143,297 145,637 Unallocated 205,954 191,643 Total assets $ 483,500 $ 441,948 * Segment assets include accounts and unbilled receivables, prepaid and other current assets, other assets, capitalized software development, certain property and equipment, and intangible assets. Cash and cash equivalents and marketable securities are not allocated to individual segments, and are included within Unallocated. A significant portion of property and equipment assets are included within Unallocated.

Business Combination

Business Combination	3 Months Ended
	Mar. 31, 2019
Business Combinations [Abstract]
Business Combination	10. BUSINESS COMBINATION Providigm, LLC On January 10, 2019, the Company acquired the outstanding equity of Providigm, LLC (“Providigm”), a Denver, Colorado based company focusing on quality assurance and performance improvement in healthcare, primarily serving skilled nursing facilities. The Company acquired Providigm to add its comprehensive quality management system, known as “abaqis®,” to its product portfolio and gain customers in the skilled nursing market. The consideration paid for Providigm consisted of approximately $18.0 million in cash, which the Company funded with cash on hand (subject to a post-closing working capital adjustment). In addition, up to an additional $500,000 in cash may be paid by the Company based on the financial performance of Providigm during an 18-month period following closing. Of the purchase price paid by the Company at closing, $500,000 will be held in escrow for a period of time following the closing to serve as a source of recovery for any post-closting working capital adjustment claims in favor of the Company, and an additional $3.65 million will be held in escrow for a period of time following the closing to serve as a source of recovery for certain potential indemnification claims by the Company. The Company incurred approximately $329,000 in transaction costs, which were primarily incurred during the year ended December 31, 2018. The transaction costs were recorded in the “other general and administrative” caption in the condensed consolidated statements of income for such periods. The results of operations for Providigm have been included in the HealthStream Workforce Solutions segment of the Company’s condensed consolidated financial statements from the date of acquisition. A summary of the purchase price is as follows (in thousands): Cash paid at closing $ 13,852 Cash held in escrow 4,150 Total consideration paid $ 18,002 The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands): Accounts and unbilled receivable, net $ 972 Prepaid assets 847 Property and equipment 50 Operating lease right-of-use assets 1,233 Other assets 49 Deferred tax assets 110 Goodwill 9,108 Intangible assets 8,225 Accounts payable and accrued liabilities (1,218 ) Deferred revenue (141 ) Operating lease liabilities (1,233 ) Net assets acquired $ 18,002 The excess of preliminary purchase price over the preliminary fair values of net tangible and intangible assets is recorded as goodwill. The preliminary fair values of tangible and identifiable intangible assets and liabilities are based on management’s estimates and assumptions. The preliminary fair values of assets acquired and liabilities assumed are subject to change during the measurement period (up to one year from the acquisition date) as the Company finalizes the valuation of these items. The primary areas of the preliminary purchase price allocation that are not finalized include working capital, the composition and valuation of intangible assets, goodwill, indemnification asset and liability, and contingent consideration. The goodwill balance is primarily attributed to the assembled workforce, additional market opportunities from offering Providigm’s products, and expected synergies from integrating Providigm with other products or other combined functional areas within the Company. The goodwill balance is deductible for U.S. income tax purposes. The net tangible assets include deferred revenue, which was preliminarily adjusted down from a book value at the acquisition date of $266,000 to an estimated fair value of $141,000. The preliminary $125,000 write-down of deferred revenue will result in lower revenues than would have otherwise been recognized for such services. The acquired assets and liabilities include a $750,000 indemnification asset and liability related to tax liabilities. The purchase agreement also contains a provision for up to $500,000 of additional consideration based on the achievement of financial performance targets by Providigm during an 18-month period following the closing date. Management assessed the likelihood of achieving the financial performance targets, which has been included in the preliminary purchase price allocation The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Preliminary Fair Value Useful life Customer relationships $ 5,500 8 years Developed technology 2,725 4 years Total preliminary intangible assets subject to amortization $ 8,225 The amounts of revenue and operating loss of Providigm included in the Company’s condensed consolidated statement of income from the date of acquisition of January 10, 2019 to the period ending March 31, 2019 are as follows (in thousands): Total revenues $ 1,492 Operating loss $ (398 ) The following unaudited pro forma financial information summarizes the combined results of continuing and discontinued operations of the Company, unless otherwise noted, and Providigm as though the companies were combined as of January 1, 2018 (in thousands, except per share data): Three Months Ended March 31, 2019 2018 Total revenues $ 65,498 $ 60,188 Income from continuing operations $ 4,834 $ 3,423 Net income $ 6,028 $ 23,640 Net income per share - basic $ 0.19 $ 0.74 Net income per share - diluted $ 0.19 $ 0.74 These unaudited pro forma combined results of operations include certain adjustments arising from the acquisition, such as amortization of intangible assets, depreciation of property and equipment, interest expense related to Providigm’s previously outstanding debt, and fair value adjustments of acquired deferred revenue balances. The unaudited pro forma combined results of operations is for informational purposes only and is not indicative of what the Company’s results of operations would have been had the transaction occurred at the beginning of the earliest period presented or to project the Company’s results of operations in any future period.

Debt

Debt	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Debt	11. DEBT Revolving Credit Facility On December 31, 2018, the Company entered into a Second Amendment to its Revolving Credit Agreement, dated as of November 24, 2014 (as amended, the “Revolving Credit Facility”), with SunTrust Bank (“SunTrust”), which extended the maturity date to November 24, 2020. Under the Revolving Credit Facility, the Company may borrow up to $50.0 million, which includes a $5.0 million swing line sub-facility and a $5.0 million letter of credit sub-facility, as well as an accordion feature that allows the Company to increase the Revolving Credit Facility by a total of up to $25.0 million, subject to securing additional commitments from existing lenders or new lending institutions. The obligations under the Revolving Credit Facility are guaranteed by each of the Company’s subsidiaries. At the Company’s election, the borrowings under the Revolving Credit Facility bear interest at either (1) a rate per annum equal to the highest of SunTrust’s prime rate or 0.5% in excess of the Federal Funds Rate or 1.0% in excess of one-month LIBOR (the “Base Rate”), plus an applicable margin, or (2) the one, two, three, or six month per annum LIBOR for deposits in the applicable currency (the “Eurocurrency Rate”), as selected by the Company, plus an applicable margin. The applicable margin for Eurocurrency Rate loans depends on the Company’s funded debt leverage ratio and varies from 1.50% to 2.00%. The applicable margin for Base Rate loans depends on the Company’s funded debt leverage ratio and varies from 0.50% to 1.50%. Commitment fees and letter of credit fees are also payable under the Revolving Credit Facility. Principal is payable in full at maturity on November 24, 2020, and there are no scheduled principal payments prior to maturity. The Company is required to pay a commitment fee ranging between 20 and 30 basis points per annum of the average daily unused portion of the Revolving Credit Facility, depending on the Company’s funded debt leverage ratio. The purpose of the Revolving Credit Facility is for general working capital needs, permitted acquisitions (as defined in the Revolving Credit Facility), and for stock repurchase and/or redemption transactions that the Company may authorize. The Revolving Credit Facility contains certain covenants that, among other things, restrict additional indebtedness, liens and encumbrances, changes to the character of the Company’s business, acquisitions, asset dispositions, mergers and consolidations, sale or discount of receivables, creation or acquisitions of additional subsidiaries, and other matters customarily restricted in such agreements. In addition, the Revolving Credit Facility requires the Company to meet certain financial tests, including, without limitation: • a funded debt leverage ratio (consolidated debt/consolidated EBITDA) of not greater than 3.0 to 1.0; and • an interest coverage ratio (consolidated EBITDA/consolidated interest expense) of not less than 3.0 to 1.0. As of March 31, 2019, the Company was in compliance with all covenants. There were no balances outstanding on the Revolving Credit Facility as of or during the three months ended March 31, 2019.

Leases

Leases	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Leases	12. LEASES Effective January 1, 2019, the Company adopted ASC 842, which requires an entity to recognize a right-of-use (“ROU”) asset and a lease liability on the balance sheet for substantially all leases, including operating leases, using the modified retrospective approach. The Company elected to use the package of practicable expedients which allows companies to not reassess the following: (1) the lease classification for any expired or existing leases, (2) the treatment of initial direct costs as they related to existing leases, and (3) whether expired or existing contracts are or contain leases. The Company did not elect the use of the hindsight practical expedient, but did elect the practical expedient not to separate lease components from non-lease components related to its office space leases. Upon adoption of ASC 842, the Company had non-cancellable operating leases for office space subject to recognition as ROU assets. Accordingly, on January 1, 2019 the Company recorded $4.8 million in ROU assets and $6.4 million in operating lease liabilities (the difference of $1.6 million related to existing deferred rent liabilities as of December 31, 2018 which had the effect of reducing our ROU asset upon adoption). During the first quarter of 2019, the Company acquired an operating lease as part of its acquisition of Providigm, resulting in a $1.2 million ROU asset and lease liability, and another operating lease for office space commenced for the Company’s new corporate headquarters in Nashville, TN, resulting in a $26.5 million ROU asset and lease liability. As of March 31, 2019, the Company does not have any leases that have not yet commenced. The Company does not have any lease contracts that contain: (1) an option to extend that the Company is reasonably certain to exercise, (2) an option to terminate that the Company is reasonably certain not to exercise, or (3) an option to extend (or not to terminate) in which exercise of the option is controlled by the lessor. Additionally, the Company does not have any leases with residual value guarantees or material restrictive covenants. For leases already commenced, the lease term was determined to be the remaining months in the lease term as of January 1, 2019, the date of adoption. The Company has elected not to recognize leases with initial terms of one year or less on the balance sheet. Lease liabilities and their corresponding right-of-use assets have been recorded based on the present value of the future lease payments over the expected lease term. Most of the Company’s lease agreements contain provisions for escalating rent payments over the term of the lease. The Company’s leases do not contain readily determinable implicit discount rates, therefore, the Company must use its incremental borrowing rate to discount the future lease payments based on information available at lease commencement. The incremental borrowing rate was estimated by determining the rate of interest that the Company would have to pay to borrow on a collateralized basis over a similar term an amount equal to the lease payments in a similar economic environment. The Company’s operating lease cost as presented in the “other general and administrative” caption in the condensed consolidated statement of income was approximately $1.2 million for three months ended March 31, 2019. Cash paid for amounts included in the measurement of operating lease liabilities was approximately $724,000 for the three months ended March 31, 2019. As of March 31, 2019, the weighted-average remaining lease term was 11.07 years, and the weighted-average incremental borrowing rate was 6.04%. The table below presents the lease-related assets and liabilities recorded on the balance sheet as of March 31, 2019 (in thousands). Assets Classification Operating lease right-of-use assets Operating lease right of use assets, net $ 31,710 Total leased assets $ 31,710 Liabilities Operating lease liabilities, current Accounts payable and accrued expenses $ 1,309 Operating lease liabilities, noncurrent Operating lease liability, noncurrent 32,390 Total operating lease liabilities $ 33,699 The table below presents the maturities of lease liabilities under non-cancellable leases as of March 31, 2019 (in thousands). 2019 $ 1,789 2020 4,739 2021 4,505 2022 4,124 2023 3,979 Thereafter 28,655 Total undiscounted lease payments 47,791 Less imputed interest 14,092 Total lease liabilities $ 33,699

Non-Marketable Equity Investmen

Non-Marketable Equity Investments	3 Months Ended
	Mar. 31, 2019
Investments Debt And Equity Securities [Abstract]
Non-Marketable Equity Investments	13. NON-MARKETABLE EQUITY INVESTMENTS Non-marketable equity investments are accounted for using the equity method when the Company can exercise significant influence over the investee. The aggregate carrying amount of all equity method investments was $1.4 million and $1.3 million as of March 31, 2019 and December 31, 2018, respectively. Non-marketable equity investments where the Company is not able to exercise significant influence over the investee are accounted for under the cost method. ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10) , became effective for the Company as of January 1, 2018 and requires equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) to be measured at fair value with changes in fair value recognized in net income. The aggregate carrying amount of all cost method investments was $5.4 million and $2.1 million as of March 31, 2019 and December 31, 2018, respectively, which carrying value we evaluate for impairment at each reporting period. Cumulatively, the Company has recorded $1.3 million in reductions to the carrying value of cost method investments due to downward changes in fair value based on observable prices from orderly transactions for similar investments made in the investee. The fair value of cost method investments is not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment.

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Changes And Error Corrections [Abstract]
Accounting Standards Recently Adopted/Not Yet Adopted	Accounting Standards Recently Adopted In February 2016, the FASB issued ASU 2016-02, Leases (“ASC 842”), Accounting Standards Not Yet Adopted In June 2016, the FASB issued ASU 2016-03, Financial Instruments—Credit Losses (“ASC 326”): Measurement of Credit Losses on Financial Instruments

Revenue Recognition And Sales_2

Revenue Recognition And Sales Commissions (Tables)	3 Months Ended
	Mar. 31, 2019
Revenue From Contract With Customer [Abstract]
Schedule of Revenues Included in Continuing Operations Disaggregated by Revenue Source	The following table represents revenues included in continuing operations disaggregated by revenue source for the three months ended March 31, 2019 and 2018 (in thousands). Sales taxes are excluded from revenues. Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Business Segments Workforce Solutions Provider Solutions Consolidated Workforce Solutions Provider Solutions Consolidated Subscription/SaaS $ 52,805 $ 9,080 $ 61,885 $ 43,702 $ 9,032 $ 52,734 Professional services 1,490 1,812 3,302 1,245 879 2,124 Total revenues, net $ 54,295 $ 10,892 $ 65,187 $ 44,947 $ 9,911 $ 54,858

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Stock Based Compensation Expense Recognized Within Continuing Operations in Condensed Consolidated Statements of Income	Total stock based compensation expense recognized for the three months ended March 31, 2019 and 2018, which is recorded within continuing operations in the condensed consolidated statements of income, is as follows (in thousands): Three Months Ended March 31, 2019 2018 Cost of revenues (excluding depreciation and amortization) $ 1 $ 8 Product development 53 74 Sales and marketing 56 31 Other general and administrative 406 306 Total stock based compensation expense $ 516 $ 419

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Computation of Basic and Diluted Earnings Per Share	The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2019 and 2018 (in thousands, except per share data): Three Months Ended March 31, 2019 2018 Numerator: Income from continuing operations $ 4,780 $ 3,629 Income from discontinued operations 1,194 20,217 Net income $ 5,974 $ 23,846 Denominator: Weighted-average shares outstanding 32,337 32,097 Effect of dilutive shares 40 35 Weighted-average diluted shares 32,377 32,132 Net income per share - basic: Continuing operations $ 0.15 $ 0.11 Discontinued operations 0.03 0.63 Net income per share - basic $ 0.18 $ 0.74 Net income per share - diluted: Continuing operations $ 0.15 $ 0.11 Discontinued operations 0.03 0.63 Net income per share - diluted $ 0.18 $ 0.74

Marketable Securities (Tables)

Marketable Securities (Tables)	3 Months Ended
	Mar. 31, 2019
Investments Debt And Equity Securities [Abstract]
Fair Value of Available for Sale Marketable Securities	At March 31, 2019 and December 31, 2018, the fair value of marketable securities, which were all classified as available for sale, included the following (in thousands): March 31, 2019 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Level 2: Corporate debt securities $ 27,235 $ 11 $ (3 ) $ 27,243 Government-sponsored enterprise debt securities 9,078 1 — 9,079 Total $ 36,313 $ 12 $ (3 ) $ 36,322 December 31, 2018 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Level 2: Corporate debt securities $ 31,521 $ — $ (23 ) $ 31,498 Government-sponsored enterprise debt securities 2,999 — — 2,999 Total $ 34,520 $ — $ (23 ) $ 34,497

Discontinued Operations (Tables

Discontinued Operations (Tables)	3 Months Ended
	Mar. 31, 2019
Discontinued Operations And Disposal Groups [Abstract]
Schedule of Discontinued Operations, Income Statement	The following table presents the financial results of the PX business (in thousands): Three Months Ended March 31, 2018 Revenues, net $ 3,342 Operating costs and expenses: Cost of revenues (excluding depreciation and amortization) 1,982 Product development 554 Sales and marketing 460 Other general and administrative expenses 229 Depreciation and amortization 181 Total operating costs and expenses 3,406 Operating loss (64 ) Other loss — Loss from discontinued operations before income tax provision (64 ) Income tax provision — Loss from discontinued operations, net of income taxes $ (64 )

Business Segments (Tables)

Business Segments (Tables)	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Business Segment Information Based on Net Revenues and Operating Income	The following is the Company’s business segment information for the three months ended March 31, 2019 and 2018 and as of March 31, 2019 and December 31, 2018 (in thousands). Three Months Ended March 31, Revenues, net: 2019 2018 Workforce Solutions $ 54,295 $ 44,947 Provider Solutions 10,892 9,911 Total revenues, net $ 65,187 $ 54,858 Operating income from continuing operations: Workforce Solutions $ 11,529 $ 9,235 Provider Solutions 1,436 514 Unallocated (7,596 ) (6,019 ) Total operating income from continuing operations $ 5,369 $ 3,730
Business Segment Information Based on Assets	Segment assets * March 31, 2019 December 31, 2018 Workforce Solutions $ 134,249 $ 104,668 Provider Solutions 143,297 145,637 Unallocated 205,954 191,643 Total assets $ 483,500 $ 441,948 * Segment assets include accounts and unbilled receivables, prepaid and other current assets, other assets, capitalized software development, certain property and equipment, and intangible assets. Cash and cash equivalents and marketable securities are not allocated to individual segments, and are included within Unallocated. A significant portion of property and equipment assets are included within Unallocated.

Business Combination (Tables)

Business Combination (Tables) - Providigm, LLC [Member]	3 Months Ended
	Mar. 31, 2019
Summary of Purchase Price	A summary of the purchase price is as follows (in thousands): Cash paid at closing $ 13,852 Cash held in escrow 4,150 Total consideration paid $ 18,002
Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed	The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands): Accounts and unbilled receivable, net $ 972 Prepaid assets 847 Property and equipment 50 Operating lease right-of-use assets 1,233 Other assets 49 Deferred tax assets 110 Goodwill 9,108 Intangible assets 8,225 Accounts payable and accrued liabilities (1,218 ) Deferred revenue (141 ) Operating lease liabilities (1,233 ) Net assets acquired $ 18,002
Summary of Preliminary Components of Identifiable Intangible Assets and Estimated Useful Lives	The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Preliminary Fair Value Useful life Customer relationships $ 5,500 8 years Developed technology 2,725 4 years Total preliminary intangible assets subject to amortization $ 8,225
Summary of Revenue and Operating Loss Included in Company's Condensed Consolidated Statement of Income from the Date of Acquisition	The amounts of revenue and operating loss of Providigm included in the Company’s condensed consolidated statement of income from the date of acquisition of January 10, 2019 to the period ending March 31, 2019 are as follows (in thousands): Total revenues $ 1,492 Operating loss $ (398 )
Summary of Unaudited Pro Forma Financial Information	The following unaudited pro forma financial information summarizes the combined results of continuing and discontinued operations of the Company, unless otherwise noted, and Providigm as though the companies were combined as of January 1, 2018 (in thousands, except per share data): Three Months Ended March 31, 2019 2018 Total revenues $ 65,498 $ 60,188 Income from continuing operations $ 4,834 $ 3,423 Net income $ 6,028 $ 23,640 Net income per share - basic $ 0.19 $ 0.74 Net income per share - diluted $ 0.19 $ 0.74

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Schedule of Lease-Related Assets and Liabilities Recorded on Balance Sheet	The table below presents the lease-related assets and liabilities recorded on the balance sheet as of March 31, 2019 (in thousands). Assets Classification Operating lease right-of-use assets Operating lease right of use assets, net $ 31,710 Total leased assets $ 31,710 Liabilities Operating lease liabilities, current Accounts payable and accrued expenses $ 1,309 Operating lease liabilities, noncurrent Operating lease liability, noncurrent 32,390 Total operating lease liabilities $ 33,699
Schedule of Maturities of Lease Liabilities Under Non-cancellable Leases	The table below presents the maturities of lease liabilities under non-cancellable leases as of March 31, 2019 (in thousands). 2019 $ 1,789 2020 4,739 2021 4,505 2022 4,124 2023 3,979 Thereafter 28,655 Total undiscounted lease payments 47,791 Less imputed interest 14,092 Total lease liabilities $ 33,699

Basis of Presentation - Additio

Basis of Presentation - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]
Additional net revenue	$ 65,187,000	$ 54,858,000
Additional income from continuing operations	4,780,000	3,629,000
Additional accounts receivable	37,432,000		$ 38,124,000
Workforce Solutions [Member]
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]
Additional net revenue	54,295,000	$ 44,947,000
Workforce Solutions [Member] | Adjustments [Member] | Content Partner Failed to Remit Royalties [Member]
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]
Additional net revenue	861,000		689,000	$ 172,000
Operating expenses	119,000		$ 56,000	$ 63,000
Additional income from continuing operations	744,000
Additional accounts receivable	$ 861,000

Revenue Recognition and Sales_3

Revenue Recognition and Sales Commissions - Schedule of Revenues Included in Continuing Operations Disaggregated by Revenue Source (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 65,187	$ 54,858
Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	54,295	44,947
Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	10,892	9,911
Subscription SaaS Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	61,885	52,734
Subscription SaaS Services [Member] | Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	52,805	43,702
Subscription SaaS Services [Member] | Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	9,080	9,032
Professional Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	3,302	2,124
Professional Services [Member] | Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	1,490	1,245
Professional Services [Member] | Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 1,812	$ 879

Revenue Recognition and Sales_4

Revenue Recognition and Sales Commissions - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue Recognition and Sales Commissions [Line Items]
Revenues recognized in period, included in deferred revenue at beginning of the period	$ 31,200,000	$ 29,200,000
Estimated revenue expected to be recognized in future under contract with customers	422,000,000
Description of sales commission plan		Sales commissions earned by our sales organization are considered incremental and recoverable costs of obtaining a contract with a customer. The Company’s sales commission plans for 2018 and 2019 typically include multiple payments, including initial payments in the period a customer contract is obtained and subsequent payments either 15 or 27 months after the initial payment.
Sales Commissions, amortization term description		Non-commensurate commissions are amortized over the greater of the contract term or expected customer relationship period, limited by the technological obsolescence period of approximately three years.
Sales Commissions, amortization period		3 years
Amortization of deferred commissions	2,121,000	$ 1,827,000
Customer Contracts [Member]
Revenue Recognition and Sales Commissions [Line Items]
Impairment losses on receivables and contract asset	$ 2,000	$ 390,000
Subscription SaaS Services [Member]
Revenue Recognition and Sales Commissions [Line Items]
Description of contracts with customer	Subscription/SaaS contracts are generally non-cancelable, one to five years in length, and billed annually, semi-annually, quarterly, or monthly in advance.
Subscription SaaS Services [Member] | Minimum [Member]
Revenue Recognition and Sales Commissions [Line Items]
Period of contract with customer	1 year
Subscription SaaS Services [Member] | Maximum [Member]
Revenue Recognition and Sales Commissions [Line Items]
Period of contract with customer	5 years

Revenue Recognition and Sales_5

Revenue Recognition and Sales Commissions - Additional Information (Detail 1) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2019-04-01	Mar. 31, 2019
Revenue Recognition and Sales Commissions [Line Items]
Percentage of remaining performance obligations expects revenue	49.00%
Estimated revenue, expected recognition period	12 months

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Taxes Disclosure [Line Items]
Income tax provision	$ 1,411,000	$ 414,000
Effective tax rate for continuing operations	23.00%	10.00%
Accounting Standards Update 2016-09 [Member]
Income Taxes Disclosure [Line Items]
Excess tax benefits related to stock based awards	$ 83,000	$ 636,000

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019Incentive_Plan$ / sharesshares	Jun. 30, 2018shares	Mar. 31, 2018$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend declared date	Feb. 12, 2018
Special cash dividend | $ / shares	$ 1
Dividend payable date	Apr. 3, 2018
Dividend record date	Mar. 6, 2018
Number of incentive plans | Incentive_Plan	2
RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued	86,220		83,168
Weighted average grant date fair value, restricted share unit | $ / shares	$ 27.39		$ 24.70
Performance-based RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued		70,000
Restricted share units vesting period		5 years
Performance-based RSUs [Member] | Performance Criteria Established [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued	10,500	7,000
Weighted average grant date fair value, restricted share unit | $ / shares	$ 27.61
Restricted share units vested		3,500
Restricted share units nonvested	3,500	3,500
Performance-based RSUs [Member] | Performance Criteria Not Yet Established [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued	52,500

Stockholders' Equity - Stock Ba

Stockholders' Equity - Stock Based Compensation Expense Recognized Within Continuing Operations in Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 516	$ 419
Cost of Revenues (Excluding Depreciation and Amortization) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	1	8
Product Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	53	74
Sales and Marketing [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	56	31
Other General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 406	$ 306

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Detail) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Earnings Per Share [Abstract]
Total number of common equivalent shares excluded from the calculations of diluted earnings per share	136,000	159,000

Earnings Per Share - Computatio

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Numerator:
Income from continuing operations	$ 4,780	$ 3,629
Income from discontinued operations	1,194	20,217
Net income	$ 5,974	$ 23,846
Denominator:
Weighted-average shares outstanding	32,337	32,097
Effect of dilutive shares	40	35
Weighted-average diluted shares	32,377	32,132
Net income per share - basic:
Continuing operations	$ 0.15	$ 0.11
Discontinued operations	0.03	0.63
Net income per share - basic	0.18	0.74
Net income per share - diluted:
Continuing operations	0.15	0.11
Discontinued operations	0.03	0.63
Net income per share - diluted	$ 0.18	$ 0.74

Marketable Securities - Fair Va

Marketable Securities - Fair Value of Available for Sale Marketable Securities (Detail) - Level 2 [Member] - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	$ 36,313	$ 34,520
Available for sale securities, Unrealized Gains	12
Available for sale securities, Unrealized Losses	(3)	(23)
Available for sale securities, Fair Value	36,322	34,497
Corporate Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	27,235	31,521
Available for sale securities, Unrealized Gains	11
Available for sale securities, Unrealized Losses	(3)	(23)
Available for sale securities, Fair Value	27,243	31,498
Government-Sponsored Enterprises Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Available for sale securities, Adjusted Cost	9,078	2,999
Available for sale securities, Unrealized Gains	1
Available for sale securities, Fair Value	$ 9,079	$ 2,999

Discontinued Operations - Addit

Discontinued Operations - Additional Information (Detail) - Patient Experience Solutions [Member] - USD ($)	Feb. 12, 2018	Apr. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Aug. 12, 2019
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration received	$ 65,200,000
Gain on sale of business, net of tax	20,200,000		$ 1,200,000	$ 19,000,000
Escrow deposit	$ 6,550,000
Scenario Forecast [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Escrow deposit					$ 328,000
Cash proceeds from escrow		$ 6,200,000

Discontinued Operations - Sched

Discontinued Operations - Schedule of Discontinued Operations Income Statement (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Operating costs and expenses:
Loss from discontinued operations before income tax provision		$ (64)
Income tax provision	$ 426	10,710
Income from discontinued operations	$ 1,194	20,217
Patient Experience Solutions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues, net		3,342
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)		1,982
Product development		554
Sales and marketing		460
Other general and administrative expenses		229
Depreciation and amortization		181
Total operating costs and expenses		3,406
Operating loss		(64)
Loss from discontinued operations before income tax provision		(64)
Income from discontinued operations		$ (64)

Business Segments - Additional

Business Segments - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019
Patient Experience Solutions [Member]
Segment Reporting Information [Line Items]
Date of business segment sold	Feb. 12, 2018

Business Segments - Business Se

Business Segments - Business Segment Information Based on Net Revenues and Operating Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenues, net:
Revenues, net	$ 65,187	$ 54,858
Operating income from continuing operations:
Operating income from continuing operations	5,369	3,730
Workforce Solutions [Member]
Revenues, net:
Revenues, net	54,295	44,947
Provider Solutions [Member]
Revenues, net:
Revenues, net	10,892	9,911
Operating Segments [Member] | Workforce Solutions [Member]
Revenues, net:
Revenues, net	54,295	44,947
Operating income from continuing operations:
Operating income from continuing operations	11,529	9,235
Operating Segments [Member] | Provider Solutions [Member]
Revenues, net:
Revenues, net	10,892	9,911
Operating income from continuing operations:
Operating income from continuing operations	1,436	514
Unallocated [Member]
Operating income from continuing operations:
Operating income from continuing operations	$ (7,596)	$ (6,019)

Business Segments - Business _2

Business Segments - Business Segment Information Based on Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Segment Reporting Information [Line Items]
Total assets	$ 483,500	$ 441,948
Operating Segments [Member] | Workforce Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	134,249	104,668
Operating Segments [Member] | Provider Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	143,297	145,637
Unallocated [Member]
Segment Reporting Information [Line Items]
Total assets	$ 205,954	$ 191,643

Business Combination - Addition

Business Combination - Additional Information (Detail) - Providigm, LLC [Member] - USD ($)	Jan. 10, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Consideration paid for acquisition in cash	$ 18,002,000
Additional contingent consideration	500,000
Transaction costs		$ 329,000
Net tangible assets include deferred revenue book value at acquisition date	266,000
Net tangible assets include deferred revenue fair value at acquisition date	141,000
Write-down of deferred revenue	125,000
Business combination, indemnification assets and liability related to tax liabilities	$ 750,000
Maximum [Member]
Business Acquisition [Line Items]
Preliminary purchase price allocation measurement period from acquisition date	1 year
Recovery of Any Post-Closting Working Capital Adjustment Claims [Member]
Business Acquisition [Line Items]
Purchase price held in escrow	$ 500,000
Recovery of Certain Potential Indemnification Claims [Member]
Business Acquisition [Line Items]
Purchase price held in escrow	$ 3,650,000

Business Combination - Summary

Business Combination - Summary of Purchase Price (Detail) - Providigm, LLC [Member] $ in Thousands	Jan. 10, 2019USD ($)
Business Acquisition [Line Items]
Total consideration paid	$ 18,002
Cash Paid at Closing [Member]
Business Acquisition [Line Items]
Total consideration paid	13,852
Cash Held in Escrow [Member]
Business Acquisition [Line Items]
Total consideration paid	$ 4,150

Business Combination - Summar_2

Business Combination - Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed (Detail) - USD ($)	Mar. 31, 2019	Jan. 10, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill	$ 95,252,000		$ 86,144,000
Providigm, LLC [Member]
Business Acquisition [Line Items]
Accounts and unbilled receivable, net		$ 972,000
Prepaid assets		847,000
Property and equipment		50,000
Operating lease right-of-use assets		1,233,000
Other assets		49,000
Deferred tax assets		110,000
Goodwill		9,108,000
Intangible assets		8,225,000
Accounts payable and accrued liabilities		(1,218,000)
Deferred revenue		(141,000)
Operating lease liabilities		(1,233,000)
Net assets acquired		$ 18,002,000

Business Combination - Summar_3

Business Combination - Summary of Preliminary Components of Identifiable Intangible Assets and Estimated Useful Lives (Detail) - Providigm, LLC [Member] $ in Thousands	Jan. 10, 2019USD ($)
Business Acquisition [Line Items]
Preliminary Fair Value	$ 8,225
Customer Relationships [Member]
Business Acquisition [Line Items]
Preliminary Fair Value	$ 5,500
Useful life	8 years
Developed Technology [Member]
Business Acquisition [Line Items]
Preliminary Fair Value	$ 2,725
Useful life	4 years

Business Combination - Summar_4

Business Combination - Summary of Revenue and Operating Loss Included in Company's Condensed Consolidated Statement of Income from the Date of Acquisition (Detail) - Providigm, LLC [Member] $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Business Acquisition [Line Items]
Total revenues	$ 1,492
Operating loss	$ (398)

Business Combination - Summar_5

Business Combination - Summary of Unaudited Pro Forma Financial Information (Detail) - Providigm, LLC [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Business Acquisition [Line Items]
Total revenues	$ 65,498	$ 60,188
Income from continuing operations	4,834	3,423
Net income	$ 6,028	$ 23,640
Net income per share - basic	$ 0.19	$ 0.74
Net income per share - diluted	$ 0.19	$ 0.74

Debt - Additional Information (

Debt - Additional Information (Detail) - SunTrust Bank [Member] - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Line of Credit Facility [Line Items]
Description of Line of credit facility Covenant	A funded debt leverage ratio (consolidated debt/consolidated EBITDA) of not greater than 3.0 to 1.0; and an interest coverage ratio (consolidated EBITDA/consolidated interest expense) of not less than 3.0 to 1.0.
Minimum [Member]
Line of Credit Facility [Line Items]
Commitment fee paid per annum		0.20%
Maximum [Member]
Line of Credit Facility [Line Items]
Commitment fee paid per annum		0.30%
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Maturity date of Loan agreement		Nov. 24, 2020
Interest rate under credit facility	the borrowings under the Revolving Credit Facility bear interest at either (1) a rate per annum equal to the highest of SunTrust’s prime rate or 0.5% in excess of the Federal Funds Rate or 1.0% in excess of one-month LIBOR (the “Base Rate”), plus an applicable margin, or (2) the one, two, three, or six month per annum LIBOR for deposits in the applicable currency (the “Eurocurrency Rate”), as selected by the Company, plus an applicable margin. The applicable margin for Eurocurrency Rate loans depends on the Company’s funded debt leverage ratio and varies from 1.50% to 2.00%. The applicable margin for Base Rate loans depends on the Company’s funded debt leverage ratio and varies from 0.50% to 1.50%
Maximum borrowing capacity under credit facility		$ 50,000,000
Increase in revolving credit facility		25,000,000
Principal payments prior to maturity		0
Outstanding balance on revolving credit facility	$ 0
Revolving Credit Facility [Member] | Swing Line Sub Facility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility		5,000,000
Revolving Credit Facility [Member] | Letter of Credit Subfacility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility		$ 5,000,000
Revolving Credit Facility [Member] | Federal Funds Effective Swap Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Interest Rate During Period		0.50%
Revolving Credit Facility [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Interest Rate During Period		1.00%
Revolving Credit Facility [Member] | Minimum [Member]
Line of Credit Facility [Line Items]
Interest coverage ratio		300.00%
Revolving Credit Facility [Member] | Minimum [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans		0.50%
Revolving Credit Facility [Member] | Minimum [Member] | Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans		1.50%
Revolving Credit Facility [Member] | Maximum [Member]
Line of Credit Facility [Line Items]
Debt leverage ratio		300.00%
Revolving Credit Facility [Member] | Maximum [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans		1.50%
Revolving Credit Facility [Member] | Maximum [Member] | Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans		2.00%

Leases - Additional Information

Leases - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
Lessee, Lease, Description [Line Items]
Right-of-use assets	$ 31,710,000	$ 4,800,000
Operating lease, liability	33,699,000	$ 6,400,000
Deferred rent liabilities			$ 1,600,000
Operating leases that have not yet commenced	0
Operating lease cost	1,200,000
Cash paid for amounts included in the measurement of operating lease liabilities	$ 724,000
Operating lease, weighted-average remaining lease term	11 years 25 days
Operating lease, weighted-average incremental borrowing rate	6.04%
Nashville, TN [Member]
Lessee, Lease, Description [Line Items]
Right-of-use assets	$ 26,500,000
Operating lease, liability	26,500,000
Providigm, LLC [Member]
Lessee, Lease, Description [Line Items]
Right-of-use assets	1,200,000
Operating lease, liability	$ 1,200,000

Leases - Schedule of Lease-Rela

Leases - Schedule of Lease-Related Assets and Liabilities Recorded on Balance Sheet (Detail) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019
ASSETS
Operating lease right of use assets, net	$ 31,710	$ 4,800
Liabilities
Operating lease liabilities, current	$ 1,309
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent
Operating lease liability, noncurrent	$ 32,390
Total operating lease liabilities	$ 33,699	$ 6,400

Leases - Schedule of Maturities

Leases - Schedule of Maturities of Lease Liabilities Under Non-cancellable Leases (Detail) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019
Leases [Abstract]
2019	$ 1,789
2020	4,739
2021	4,505
2022	4,124
2023	3,979
Thereafter	28,655
Total undiscounted lease payments	47,791
Less imputed interest	14,092
Total lease liabilities	$ 33,699	$ 6,400

Non-Marketable Equity Investm_2

Non-Marketable Equity Investments - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Investments Debt And Equity Securities [Abstract]
Equity method investments	$ 1.4	$ 1.3
Reduction to carrying value of cost method investment due to downward change in fair value	1.3
Aggregate carrying amount of cost method investments	$ 5.4	$ 2.1