HealthStream (HSTM) 10-Q 29 Apr 21 2021 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2021	Apr. 28, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2021
Document Fiscal Year Focus	2021
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 Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		31,552,579
Entity Shell Company	false
Entity File Number	000-27701
Entity Tax Identification Number	62-1443555
Entity Address, Address Line One	500 11th Avenue North
Entity Address, Address Line Two	Suite 1000
Entity Address, City or Town	Nashville
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37203
City Area Code	615
Local Phone Number	301-3100
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	TN
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock (Par Value $0.00)
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 45,348	$ 36,566
Marketable securities	10,622	9,928
Accounts receivable, net of allowance for doubtful accounts of $519 and $549 at March 31, 2021 and December 31, 2020, respectively	33,195	40,726
Accounts receivable - unbilled	3,988	5,374
Prepaid royalties, net of amortization	11,786	9,571
Other prepaid expenses and other current assets	10,038	12,560
Total current assets	114,977	114,725
Property and equipment, net of accumulated depreciation of $20,968 and $19,237 at March 31, 2021 and December 31, 2020, respectively	20,653	22,218
Capitalized software development, net of accumulated amortization of $74,095 and $70,516 at March 31, 2021 and December 31, 2020, respectively	27,190	26,631
Operating lease right of use assets, net	27,276	28,081
Goodwill	181,161	178,440
Deferred tax assets	974	974
Deferred commissions	21,375	19,907
Non-marketable equity investments	7,791	6,845
Other assets	1,999	1,777
Total assets	501,682	500,313
Current liabilities:
Accounts payable and accrued expenses	20,012	29,457
Accrued royalties	8,504	8,809
Deferred revenue	88,390	81,176
Total current liabilities	116,906	119,442
Deferred tax liabilities	16,560	14,523
Deferred revenue, noncurrent	1,518	1,603
Operating lease liability, noncurrent	27,675	28,479
Other long-term liabilities	2,218	2,204
Commitments and contingencies
Shareholders’ equity:
Common stock, no par value, 75,000 shares authorized; 31,553 and 31,493 shares issued and outstanding at March 31, 2021 and December 31, 2020, respectively	272,001	271,784
Retained earnings	64,569	62,277
Accumulated other comprehensive income	235	1
Total shareholders’ equity	336,805	334,062
Total liabilities and shareholders’ equity	501,682	500,313
Customer-Related Intangible Assets [Member]
Current assets:
Intangible assets, net	75,603	76,927
Other Intangible Assets [Member]
Current assets:
Intangible assets, net	$ 22,683	$ 23,788

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Allowance for doubtful accounts, net	$ 519	$ 549
Accumulated depreciation on property and equipment	20,968	19,237
Accumulated amortization on capitalized software development	$ 74,095	$ 70,516
Common stock, no par value
Common stock, shares authorized	75,000,000	75,000,000
Common stock, shares issued	31,553,000	31,493,000
Common stock, shares outstanding	31,553,000	31,493,000
Customer-Related Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 38,938	$ 36,723
Other Intangible Assets [Member]
Accumulated amortization on intangible assets	$ 12,371	$ 10,748

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Revenues, net	$ 63,468	$ 61,572
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)	21,237	20,359
Product development	9,361	7,468
Sales and marketing	8,924	9,188
Other general and administrative expenses	11,493	9,864
Depreciation and amortization	9,153	7,449
Total operating costs and expenses	60,168	54,328
Operating income	3,300	7,244
Other (loss) income, net	(87)	1,706
Income before income tax provision	3,213	8,950
Income tax provision	922	1,858
Net income	$ 2,291	$ 7,092
Net income per share:
Basic	$ 0.07	$ 0.22
Diluted	$ 0.07	$ 0.22
Weighted average shares of common stock outstanding:
Basic	31,504	32,334
Diluted	31,526	32,357

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 2,291	$ 7,092
Other comprehensive income, net of taxes:
Foreign currency translation adjustments	230	(44)
Unrealized gain (loss) on marketable securities	4	(101)
Total other comprehensive income (loss)	234	(145)
Comprehensive income	$ 2,525	$ 6,947

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balance at Dec. 31, 2019	$ 338,168	$ 290,021	$ 48,143	$ 4
Beginning balance, shares at Dec. 31, 2019		32,379
Net income	7,092		7,092
Comprehensive income (loss)	(145)			(145)
Stock based compensation	550	$ 550
Common stock issued under stock plans, net of shares withheld for employee taxes	(373)	$ (373)
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		62
Repurchase of common stock	(9,876)	$ (9,876)
Repurchase of common stock		(438)
Ending balance at Mar. 31, 2020	335,416	$ 280,322	55,235	(141)
Ending balance, shares at Mar. 31, 2020		32,003
Beginning balance at Dec. 31, 2020	$ 334,062	$ 271,784	62,277	1
Beginning balance, shares at Dec. 31, 2020	31,493	31,493
Net income	$ 2,291		2,291
Comprehensive income (loss)	234			234
Stock based compensation	616	$ 616
Common stock issued under stock plans, net of shares withheld for employee taxes	(399)	$ (399)
Common stock issued under stock plans, net of shares withheld for employee taxes, shares		60
Ending balance at Mar. 31, 2021	$ 336,805	$ 272,001	$ 64,569	$ 235
Ending balance, shares at Mar. 31, 2021	31,553	31,553

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
OPERATING ACTIVITIES:
Net income	$ 2,291	$ 7,092
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	9,153	7,449
Stock based compensation	616	550
Amortization of deferred commissions	2,133	2,159
Provision for doubtful accounts	142	288
Deferred income taxes	486	500
Loss on non-marketable equity investments	54	11
Non-cash paid time off expense	(1,011)
Non-cash royalty expense		(3,440)
Change in fair value of non-marketable equity investments		(1,152)
Other	15	47
Changes in operating assets and liabilities:
Accounts and unbilled receivables	7,379	(4,573)
Prepaid royalties	(2,215)	(3,202)
Other prepaid expenses and other current assets	2,521	735
Deferred commissions	(3,602)	(1,602)
Other assets	(76)	134
Accounts payable and accrued expenses	(5,339)	(5,775)
Accrued royalties	(305)	442
Deferred revenue	6,862	6,453
Net cash provided by operating activities	19,104	6,116
INVESTING ACTIVITIES:
Business combinations, net of cash acquired	(731)	(21,421)
Proceeds from maturities of marketable securities	4,500	20,725
Purchases of marketable securities	(5,205)	(14,130)
Payments to acquire non-marketable equity investments	(1,000)
Payments associated with capitalized software development	(5,326)	(4,068)
Purchases of property and equipment	(1,898)	(1,010)
Net cash used in investing activities	(9,660)	(19,904)
FINANCING ACTIVITIES:
Taxes paid related to net settlement of equity awards	(399)	(373)
Repurchase of common stock		(9,876)
Payment of cash dividends	(12)	(30)
Net cash used in financing activities	(411)	(10,279)
Effect of exchange rate changes on cash and cash equivalents	(251)	(46)
Net increase (decrease) in cash and cash equivalents	8,782	(24,113)
Cash and cash equivalents at beginning of period	36,566	131,538
Cash and cash equivalents at end of period	$ 45,348	$ 107,425

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2021
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, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. The Condensed Consolidated Balance Sheet at December 31, 2020 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 Notes thereto for the year ended December 31, 2020 (included in the Company's Annual Report on Form 10-K, filed with the Securities and Exchange Commission on February 25, 2021).

Revenue Recognition and Sales C

Revenue Recognition and Sales Commissions	3 Months Ended
	Mar. 31, 2021
Revenue From Contract With Customer [Abstract]
Revenue Recognition and Sales Commissions	2. 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 disaggregated by revenue source (in thousands). Sales taxes are excluded from revenues. Three Months Ended March 31, 2021 Three Months Ended March 31, 2020 Business Segments Workforce Solutions Provider Solutions Consolidated Workforce Solutions Provider Solutions Consolidated Subscription $ 49,770 $ 10,597 $ 60,367 $ 48,717 $ 9,984 $ 58,701 Professional services 1,477 1,624 3,101 1,107 1,764 2,871 Total revenues, net $ 51,247 $ 12,221 $ 63,468 $ 49,824 $ 11,748 $ 61,572 For the three months ended March 31, 2021 and 2020, 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, 2021 and 2020, we recognized revenues of approximately $33.6 million and $31.6 million, respectively, from amounts included in deferred revenue at the beginning of the respective periods. As of March 31, 2021, approximately $446 million of revenue is expected to be recognized from remaining performance obligations under contracts with customers. We expect to recognize revenue related to approximately 46% of these remaining performance obligations over the next 12 months, with the remaining amounts recognized thereafter. Sales Commissions Sales commissions earned by our sales force are considered incremental and recoverable costs of obtaining a contract with a customer. Under ASC 606, costs to acquire contracts with customers, such as the initial sales commission payment and associated payroll taxes, are capitalized in the period a customer contract is entered into and are amortized consistent with the transfer of the goods or services to the customer over the expected period of benefit, whereas subsequent sales commission payments which require a substantive performance condition of the employee are expensed ratably through the payment date. Capitalized contract costs are included in deferred commissions in the accompanying Condensed Consolidated Balance Sheets. The expected period of benefit is the contract term, except when the capitalized commission is expected to provide economic benefit to the Company for a period longer than the contract term, such as for new customer or incremental sales where renewals are expected and renewal commissions are not commensurate with initial commissions. Non-commensurate commissions are amortized over the greater of the contract term or technological obsolescence period of approximately three years . The Company recorded amortization of deferred commissions of approximately $ 2.1 million and $ 2.2 million for the three months ended March 31, 2021 and 2020 , respectively, which is included in s ales and marketing expenses in the accompanying C ondensed C onsolidated S tatements of I ncome.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	3. 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. The Company computes its interim period provision for income taxes by applying the estimated annual effective tax rate to year-to-date pretax income or loss and adjusts the provision for discrete tax items recorded in the period. During the three months ended March 31, 2021 and 2020 , the Company recorded a provision for income taxes of approximately $0.9 million and $1.9 million, respectively. The Company’s effective tax rate for the three months ended March 31, 2021 and 2020 was 29% and 21%, respectively. During the three months ended March 31, 2020, the Company recorded a $1.2 million change in fair value of non-marketable equity investments as a result of the NurseGrid acquisition, which is not a taxable transaction, resulting in a tax benefit of $0.3 million. The Company recognizes excess tax benefits and tax deficiencies associated with stock based awards as a component of its provision for income taxes. The Company recorded additional income tax expense associated with tax deficiencies of approximately $17,000 and $26,000 during the three months ended March 31, 2021 and 2020, respectively.

Shareholders' Equity

Shareholders' Equity	3 Months Ended
	Mar. 31, 2021
Equity [Abstract]
Shareholders' Equity	4. SHAREHOLDERS’ EQUITY Stock Based Compensation The Company has stock awards outstanding under its 2016 Omnibus Incentive Plan. The Company accounts for its stock based compensation plan using the fair-value based method for costs related to share based payments, including restricted share units (“RSUs”). During the three months ended March 31, 2021, the Company issued 121,551 RSUs, subject to service-based time vesting, with a weighted average grant date fair value of $23.16 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, 2020, the Company issued 111,510 RSUs, subject to service-based time vesting, with a weighted average grant date fair value of $22.96 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 Total stock based compensation expense recognized in the Condensed Consolidated Statements of Income is as follows (in thousands): Three Months Ended March 31, 2021 2020 Cost of revenues (excluding depreciation and amortization) $ 20 $ 7 Product development 102 81 Sales and marketing 65 49 Other general and administrative 429 413 Total stock based compensation expense $ 616 $ 550 Share Repurchase Plan On March 13, 2020, the Company’s Board of Directors authorized a share repurchase program to repurchase up to $30.0 million of outstanding shares of common stock. The share repurchase program expired on March 12, 2021. Under this program, the Company repurchased a total of 957,367 shares in open market purchases at an aggregate fair value of $20.0 million, reflecting an average price per share of $20.89 (excluding the cost of broker commissions). No repurchases occurred during the three months ended March 31, 2021.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Earnings Per Share	5 . 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 148,000 and 106,000 for the three months ended March 31, 2021 and 2020 The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Numerator: Net income $ 2,291 $ 7,092 Denominator: Weighted-average shares outstanding 31,504 32,334 Effect of dilutive shares 22 23 Weighted-average diluted shares 31,526 32,357 Net income per share: Basic $ 0.07 $ 0.22 Diluted $ 0.07 $ 0.22

Marketable Securities

Marketable Securities	3 Months Ended
	Mar. 31, 2021
Investments Debt And Equity Securities [Abstract]
Marketable Securities	6. MARKETABLE SECURITIES The fair value of marketable securities, which were all classified as available for sale and which the Company does not intend to sell nor will the Company be required to sell prior to recovery of their amortized cost basis, included the following (in thousands): March 31, 2021 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Cash and Cash Equivalents Current Marketable Securities Cash $ 45,348 $ — $ — $ 45,348 $ 45,348 $ — Level 2: Time deposits 5,022 — — 5,022 — 5,022 Corporate debt securities 5,604 — (4 ) 5,600 — 5,600 Total $ 55,974 $ — $ (4 ) $ 55,970 $ 45,348 $ 10,622 December 31, 2020 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Cash and Cash Equivalents Current Marketable Securities Cash $ 31,558 $ — $ — $ 31,558 $ 31,558 $ — Level 2: Time deposits 10,021 — — 10,021 5,008 5,013 Corporate debt securities 4,923 — (8 ) 4,915 — 4,915 Total $ 46,502 $ — $ (8 ) $ 46,494 $ 36,566 $ 9,928 The carrying amounts reported in the Condensed Consolidated Balance Sheets approximate the fair value based on quoted market prices or alternative pricing sources and models utilizing market observable inputs. As of March 31, 2021, the Company did not recognize any allowance for credit impairments on its available for sale debt securities. All investments in marketable securities are classified as current assets on the Condensed Consolidated Balance Sheets because the underlying securities mature within one year from the balance sheet date.

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2021
Business Combinations [Abstract]
Business Combinations	7. BUSINESS COMBINATIONS NurseGrid On March 9, 2020, the Company acquired all of the outstanding stock of HcT2 Co. dba NurseGrid (“NurseGrid”), a Portland, Oregon-based healthcare technology company offering NurseGrid Mobile and its corollary application for nurse managers, NurseGrid Enterprise for net cash consideration of approximately $21.5 million, after giving effect to the post-closing working capital adjustment. The Company accounted for this transaction as a business combination achieved in stages which required the Company to remeasure its previously existing minority ownership interest, which was accounted for as a non-marketable equity investment measured using the fair value alternative, to fair value at the acquisition date based on the total enterprise value, adjusting for a control premium. The fair value of the Company’s interest in NurseGrid was $3.6 million at closing, resulting in a gain of $1.2 million, recorded as a change in fair value of non-marketable equity investments in the Company’s Condensed Consolidated Statement of Income during the three months ended March 31, 2020. Additionally, the Company’s previously recorded non-marketable equity investment in NurseGrid was de-recognized from the Company’s Condensed Consolidated Balance Sheet during the same period. Acquisition-related transaction costs were $0.2 million. The financial results of NurseGrid have been included in the Workforce Solutions segment from March 9, 2020 A summary of the purchase price is as follows (in thousands): Cash paid at closing $ 25,485 Post-closing adjustment, net of cash received 33 Cash acquired (4,064 ) Net consideration paid 21,454 Fair value of existing equity interest in NurseGrid 3,623 Total purchase price $ 25,077 The following table summarizes the fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands): Accounts and unbilled receivable, net $ 92 Prepaid and other current assets 155 Operating lease right-of-use assets 50 Deferred tax assets 2,121 Goodwill 21,085 Intangible assets 1,845 Accounts payable and accrued liabilities (143 ) Deferred revenue (78 ) Operating lease liabilities (50 ) Net assets acquired $ 25,077 The excess of purchase price over the fair values of net tangible and intangible assets is recorded as goodwill. The fair values of tangible and identifiable intangible assets and liabilities are based on management’s estimates and assumptions. The primary intangible assets acquired were developed technology and trade name. The fair value estimate for developed technology intangible asset included significant assumptions, including the estimate of employee hours that would be needed to recreate the technology. The fair value estimate for trade name intangible asset included significant assumptions in the prospective financial information, such as projected revenues, royalty rate, and the discount rate. Additionally, these assumptions are forward looking and could be affected by future economic and market conditions. The goodwill balance is primarily attributed to the assembled workforce, future market opportunities to engage and support the NurseGrid Mobile user community, and expected synergies from integrating NurseGrid with other combined functional areas within the Company. The goodwill balance is not deductible for U.S. income tax purposes. The net tangible assets include deferred revenue, which was adjusted down from a book value at the acquisition date of $ 157,000 to an estimated fair value of $ 78,000 . The $ 79,000 write-down of deferred revenue will result in lower revenues than would have otherwise been recognized for such services. The following table sets forth the components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Fair value Useful life Customer relationships $ 35 8 years Developed technology 1,110 5 years Trade name 700 Indefinite Total intangible assets $ 1,845 The following unaudited pro forma financial information summarizes the results of operations of the Company and NurseGrid as though the companies were combined as of January 1, 2019 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Total revenues $ 63,472 $ 61,644 Net income $ 2,295 $ 6,525 Net income per share - basic $ 0.07 $ 0.20 Net income per share - diluted $ 0.07 $ 0.20 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 NurseGrid’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. ShiftWizard On October 12, 2020, the Company acquired all of the outstanding stock of ShiftWizard, Inc., a Raleigh, North Carolina-based healthcare technology company offering a SaaS-based solution that integrates key workforce management capabilities, including scheduling, productivity, and forecasting. The consideration paid for ShiftWizard consisted of $30.5 million in cash after giving effect to the The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands): Cash $ 1,091 Accounts and unbilled receivable, net 1,038 Prepaid assets 106 Operating lease right-of-use assets 183 Property and equipment 50 Indemnification assets 464 Goodwill 19,307 Intangible asset 12,660 Accounts payable and accrued liabilities (600 ) Deferred revenue (1,601 ) Deferred tax liability (1,559 ) Operating lease liabilities (183 ) Indemnification liability (464 ) Net assets acquired $ 30,492 The excess of purchase price over the fair values of net tangible and intangible assets is recorded as goodwill. The 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 continue to be 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 the composition and valuation of income tax attributes . Included in the assets and liabilities is an indemnification asset and liability of $ 0.5 million associated with a Paycheck Protection Program loan pending forgiveness as of the acquisition date that was subsequently forgiven. The primary intangible assets acquired were customer relationships and developed technology. The fair value estimate for customer relationships intangible asset included significant assumptions in the prospective financial information, such as revenue growth, customer attrition, EBITDA margin, and the discount rate. The fair value estimate for developed technology intangible asset included significant assumptions, including the estimate of employee hours that would be needed to recreate the technology. Additionally, these assumptions are forward looking and could be affected by future economic and market conditions. The goodwill balance is primarily attributed to the assembled workforce, additional market opportunities from offering ShiftWizard products, and expected synergies from integrating ShiftWizard with other products or other combined functional areas within the Company. The goodwill balance is not deductible for U.S. income tax purposes. The net tangible assets include deferred revenue, which was adjusted down from a book value at the acquisition date of $ 2.7 million to an estimated fair value of $ 1.6 million. The $ 1.1 million write-down of deferred revenue will result in lower revenues than would have otherwise been recognized for such services. The following table sets forth the components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Fair Value Useful life Customer relationships $ 7,800 18 years Developed technology 4,050 5 years Non-compete 580 1 - 5 years Trade name 230 5 years Total intangible assets $ 12,660 The following unaudited pro forma financial information summarizes the results of operations of the Company and ShiftWizard as though the companies were combined as of January 1, 2019 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Total revenues $ 63,719 $ 62,576 Net income $ 2,493 $ 6,740 Net income per share - basic $ 0.08 $ 0.21 Net income per share - diluted $ 0.08 $ 0.21 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, 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. ANSOS TM On December 2, 2020, the Company acquired all of the equity interests of Change Healthcare’s staff scheduling business, consisting of the ANSOS TM The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands): Cash $ 1,599 Accounts and unbilled receivable, net 10,053 Prepaid assets 233 Operating lease right-of-use assets 888 Property and equipment 66 Deferred tax assets 2,936 Indemnification asset 708 Goodwill 36,963 Intangible assets 32,440 Accounts payable and accrued liabilities (1,693 ) Deferred revenue (14,537 ) Operating lease liabilities (888 ) Deferred tax liability (1,612 ) Uncertain tax position liability (708 ) Net assets acquired $ 66,448 The excess of purchase price over the preliminary fair values of net tangible and intangible assets is recorded as goodwill. The 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 continue to be subject to change during the measurement period (up to one year from the acquisition date) as the Company finalizes the valuation of these items. During the three months ended March 31, 2021, the Company determined that a portion of the acquired accounts receivable balance required an adjustment to net realizable value. Additionally, the Company recorded opening balance sheet deferred tax liabilities related to the allocation of intangible assets to the foreign entities. As a result of these two items coupled with the post-closing working capital adjustment, the Company recorded a measurement period adjustment which increased goodwill by $1.7 million. The measurement period adjustment had no effect on current or prior period earnings. The primary areas of the preliminary purchase price allocation that are not finalized include the composition and valuation of income tax attributes and working capital accounts. Included in the preliminary assets and liabilities acquired is an indemnification asset and an uncertain tax position liability of $0.7 million determined based on management’s estimate of the most likely value related to income tax attributes. The primary intangible assets acquired were customer relationships and developed technology. The fair value estimate for customer relationships intangible asset included significant assumptions regarding prospective financial information with respect to the acquisition, including with respect to revenue growth, customer attrition, EBITDA margin, and the discount rate. The fair value estimate for developed technology intangible asset included significant assumptions, including the estimate of employee hours that would be needed to recreate the technology. Additionally, these assumptions are forward looking and could be affected by future economic and market conditions. The goodwill balance is primarily attributed to the assembled workforce, additional market opportunities from offering ANSOS products, and expected synergies from integrating ANSOS with other products or other combined functional areas within the Company. The portion of goodwill allocated to the U.S. entity is deductible for U.S. income tax purposes (representing 95%). The net tangible assets include deferred revenue, which was adjusted down from a book value at the acquisition date of $17.8 million to an estimated fair value of $14.5 million. The $3.3 million write-down of deferred revenue will result in lower revenues than would have otherwise been recognized for such services. The following table sets forth the components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Fair Value Useful life Customer relationships $ 21,100 11 - 14 years Developed technology 9,800 5 years Trade name 1,540 10 years Total intangible assets $ 32,440 The following unaudited pro forma financial information summarizes the results of operations of the Company and ANSOS as though the companies were combined as of January 1, 2019 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Total revenues $ 64,567 $ 68,437 Net income $ 3,124 $ 8,262 Net income per share - basic $ 0.10 $ 0.26 Net income per share - diluted $ 0.10 $ 0.26 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, 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. Other Business Combinations On December 10, 2020, the Company acquired substantially all of the assets of myClinicalExchange, LLC, a Denver, Colorado-based information technologies company offering a SaaS-based solution that allows healthcare organizations to track, manage, and report the intern and clinical rotation educational requirements of medical, nursing, and allied healthcare students as well as host required documentation for medical residents. The consideration paid for myClinicalExchange consisted of $4.4 million in cash. Acquisition-related transaction costs were $0.1 million. The acquisition is not considered material to the Company’s Financial Statements. The Company accounted for the acquisition as a business combination and has allocated the purchase consideration based on management’s estimates of fair value. The results of operations for myClinicalExchange are included in the Company’s Condensed Consolidated Financial Statements from the date of acquisition and are included in the Workforce Solutions segment. On January 19, 2021, the Company acquired the issued and outstanding equity of ProcessDATA, Ltd. (d/b/a ComplyALIGN and HospitalPORTAL) (“ComplyALIGN”), a Chicago, Illinois-based healthcare technology company offering a SaaS-based policy management system for healthcare organizations, for $2.0 million in cash. The acquisition is not considered material to the Company’s financial statements. The Company accounted for the acquisition as a business combination and has allocated the purchase consideration based on management’s estimates of fair value. Acquisition-related transaction costs were $0.1 million. The results of operations for ComplyALIGN are included in the Company’s Condensed Consolidated Financial Statements from the date of acquisition and are included in the Workforce Solutions segment. During the three months ended March 31, 2021, the carrying amount of goodwill increased by $2.7 million, consisting of a $1.7 million of measurement period adjustment related to ANSOS, $0.6 million of acquired goodwill related to ComplyALIGN, and $0.4 million for the effect of currency translation adjustments.

Business Segments

Business Segments	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Business Segments	8. 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 training, certification, assessment, development, and scheduling products and services (Workforce Solutions) and provider credentialing, privileging, call center, and enrollment products and services (Provider Solutions). 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, gains and losses from equity investments, 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. The following is the Company’s business segment information (in thousands). Three Months Ended March 31, Revenues, net: 2021 2020 Workforce Solutions $ 51,247 $ 49,824 Provider Solutions 12,221 11,748 Total revenues, net $ 63,468 $ 61,572 Operating income: Workforce Solutions $ 9,027 $ 13,370 Provider Solutions 2,055 1,197 Unallocated (7,782 ) (7,323 ) Total operating income $ 3,300 $ 7,244 Segment assets * March 31, 2021 December 31, 2020 Workforce Solutions $ 267,993 $ 270,924 Provider Solutions 136,926 140,490 Unallocated 96,763 88,899 Total assets $ 501,682 $ 500,313 * Segment assets include accounts and unbilled receivables, prepaid royalties, prepaid and other current assets, other assets, capitalized software development, deferred commissions, certain property and equipment, goodwill, and intangible assets. Cash and cash equivalents, marketable securities, non-marketable equity investments, and certain ROU assets are not allocated to individual segments and are included within Unallocated. A significant portion of property and equipment assets are included within Unallocated.

Debt

Debt	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Debt	9 . DEBT Revolving Credit Facility On October 28, 2020, the Company entered into a Third Amendment to Revolving Credit Agreement (Revolving Credit Facility), amending the Revolving Credit Facility dated as of November 24, 2014 with Truist Bank, successor by merger to SunTrust Bank (Truist), extending the maturity date to October 28, 2023. Under the Revolving Credit Facility, the Company may borrow up to $65.0 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. 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 Truist’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 1.75%. The applicable margin for Base Rate loans depends on the Company’s funded debt leverage ratio and varies from 0.50% to 0.75%. Commitment fees and letter of credit fees are also payable under the Revolving Credit Facility. Principal is payable in full at maturity on October 28, 2023, 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 obligations under the Revolving Credit Facility are guaranteed by each of the Company’s subsidiaries. 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, 2021, 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, 2021.

Non-Marketable Equity Investmen

Non-Marketable Equity Investments	3 Months Ended
	Mar. 31, 2021
Investments Debt And Equity Securities [Abstract]
Non-Marketable Equity Investments	10. NON-MARKETABLE EQUITY INVESTMENTS The aggregate carrying amount of non-marketable equity investments accounted for using the measurement alternative for equity investments that do not have readily determinable fair values was $3.9

Revenue Recognition and Sales_2

Revenue Recognition and Sales Commissions (Tables)	3 Months Ended
	Mar. 31, 2021
Revenue From Contract With Customer [Abstract]
Schedule of Revenues Included in Continuing Operations from Contracts with Customers Disaggregated by Revenue Source	The following table represents revenues disaggregated by revenue source (in thousands). Sales taxes are excluded from revenues. Three Months Ended March 31, 2021 Three Months Ended March 31, 2020 Business Segments Workforce Solutions Provider Solutions Consolidated Workforce Solutions Provider Solutions Consolidated Subscription $ 49,770 $ 10,597 $ 60,367 $ 48,717 $ 9,984 $ 58,701 Professional services 1,477 1,624 3,101 1,107 1,764 2,871 Total revenues, net $ 51,247 $ 12,221 $ 63,468 $ 49,824 $ 11,748 $ 61,572

Shareholders' Equity (Tables)

Shareholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2021
Equity [Abstract]
Stock Based Compensation Expense Recognized in Condensed Consolidated Statements of Income	Total stock based compensation expense recognized in the Condensed Consolidated Statements of Income is as follows (in thousands): Three Months Ended March 31, 2021 2020 Cost of revenues (excluding depreciation and amortization) $ 20 $ 7 Product development 102 81 Sales and marketing 65 49 Other general and administrative 429 413 Total stock based compensation expense $ 616 $ 550

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2021
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 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Numerator: Net income $ 2,291 $ 7,092 Denominator: Weighted-average shares outstanding 31,504 32,334 Effect of dilutive shares 22 23 Weighted-average diluted shares 31,526 32,357 Net income per share: Basic $ 0.07 $ 0.22 Diluted $ 0.07 $ 0.22

Marketable Securities (Tables)

Marketable Securities (Tables)	3 Months Ended
	Mar. 31, 2021
Investments Debt And Equity Securities [Abstract]
Fair Value of Available for Sale Marketable Securities	The fair value of marketable securities, which were all classified as available for sale and which the Company does not intend to sell nor will the Company be required to sell prior to recovery of their amortized cost basis, included the following (in thousands): March 31, 2021 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Cash and Cash Equivalents Current Marketable Securities Cash $ 45,348 $ — $ — $ 45,348 $ 45,348 $ — Level 2: Time deposits 5,022 — — 5,022 — 5,022 Corporate debt securities 5,604 — (4 ) 5,600 — 5,600 Total $ 55,974 $ — $ (4 ) $ 55,970 $ 45,348 $ 10,622 December 31, 2020 Adjusted Cost Unrealized Gains Unrealized Losses Fair Value Cash and Cash Equivalents Current Marketable Securities Cash $ 31,558 $ — $ — $ 31,558 $ 31,558 $ — Level 2: Time deposits 10,021 — — 10,021 5,008 5,013 Corporate debt securities 4,923 — (8 ) 4,915 — 4,915 Total $ 46,502 $ — $ (8 ) $ 46,494 $ 36,566 $ 9,928

Business Combinations (Tables)

Business Combinations (Tables)	3 Months Ended
	Mar. 31, 2021
NurseGrid [Member]
Summary of Purchase Price	A summary of the purchase price is as follows (in thousands): Cash paid at closing $ 25,485 Post-closing adjustment, net of cash received 33 Cash acquired (4,064 ) Net consideration paid 21,454 Fair value of existing equity interest in NurseGrid 3,623 Total purchase price $ 25,077
Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed	The following table summarizes the fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands): Accounts and unbilled receivable, net $ 92 Prepaid and other current assets 155 Operating lease right-of-use assets 50 Deferred tax assets 2,121 Goodwill 21,085 Intangible assets 1,845 Accounts payable and accrued liabilities (143 ) Deferred revenue (78 ) Operating lease liabilities (50 ) Net assets acquired $ 25,077
Summary of Components of Identifiable Intangible Assets and Estimated Useful Lives	The following table sets forth the components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Fair value Useful life Customer relationships $ 35 8 years Developed technology 1,110 5 years Trade name 700 Indefinite Total intangible assets $ 1,845
Summary of Unaudited Pro Forma Financial Information	The following unaudited pro forma financial information summarizes the results of operations of the Company and NurseGrid as though the companies were combined as of January 1, 2019 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Total revenues $ 63,472 $ 61,644 Net income $ 2,295 $ 6,525 Net income per share - basic $ 0.07 $ 0.20 Net income per share - diluted $ 0.07 $ 0.20
ShiftWizard [Member]
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): Cash $ 1,091 Accounts and unbilled receivable, net 1,038 Prepaid assets 106 Operating lease right-of-use assets 183 Property and equipment 50 Indemnification assets 464 Goodwill 19,307 Intangible asset 12,660 Accounts payable and accrued liabilities (600 ) Deferred revenue (1,601 ) Deferred tax liability (1,559 ) Operating lease liabilities (183 ) Indemnification liability (464 ) Net assets acquired $ 30,492
Summary of Components of Identifiable Intangible Assets and Estimated Useful Lives	The following table sets forth the components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Fair Value Useful life Customer relationships $ 7,800 18 years Developed technology 4,050 5 years Non-compete 580 1 - 5 years Trade name 230 5 years Total intangible assets $ 12,660
Summary of Unaudited Pro Forma Financial Information	The following unaudited pro forma financial information summarizes the results of operations of the Company and ShiftWizard as though the companies were combined as of January 1, 2019 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Total revenues $ 63,719 $ 62,576 Net income $ 2,493 $ 6,740 Net income per share - basic $ 0.08 $ 0.21 Net income per share - diluted $ 0.08 $ 0.21
ANSOSTM Staff Scheduling Application [Member]
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): Cash $ 1,599 Accounts and unbilled receivable, net 10,053 Prepaid assets 233 Operating lease right-of-use assets 888 Property and equipment 66 Deferred tax assets 2,936 Indemnification asset 708 Goodwill 36,963 Intangible assets 32,440 Accounts payable and accrued liabilities (1,693 ) Deferred revenue (14,537 ) Operating lease liabilities (888 ) Deferred tax liability (1,612 ) Uncertain tax position liability (708 ) Net assets acquired $ 66,448
Summary of Components of Identifiable Intangible Assets and Estimated Useful Lives	The following table sets forth the components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands): Fair Value Useful life Customer relationships $ 21,100 11 - 14 years Developed technology 9,800 5 years Trade name 1,540 10 years Total intangible assets $ 32,440
Summary of Unaudited Pro Forma Financial Information	The following unaudited pro forma financial information summarizes the results of operations of the Company and ANSOS as though the companies were combined as of January 1, 2019 (in thousands, except per share data): Three Months Ended March 31, 2021 2020 Total revenues $ 64,567 $ 68,437 Net income $ 3,124 $ 8,262 Net income per share - basic $ 0.10 $ 0.26 Net income per share - diluted $ 0.10 $ 0.26

Business Segments (Tables)

Business Segments (Tables)	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Business Segment Information Based on Net Revenues and Operating Income	The following is the Company’s business segment information (in thousands). Three Months Ended March 31, Revenues, net: 2021 2020 Workforce Solutions $ 51,247 $ 49,824 Provider Solutions 12,221 11,748 Total revenues, net $ 63,468 $ 61,572 Operating income: Workforce Solutions $ 9,027 $ 13,370 Provider Solutions 2,055 1,197 Unallocated (7,782 ) (7,323 ) Total operating income $ 3,300 $ 7,244
Business Segment Information Based on Assets	Segment assets * March 31, 2021 December 31, 2020 Workforce Solutions $ 267,993 $ 270,924 Provider Solutions 136,926 140,490 Unallocated 96,763 88,899 Total assets $ 501,682 $ 500,313 * Segment assets include accounts and unbilled receivables, prepaid royalties, prepaid and other current assets, other assets, capitalized software development, deferred commissions, certain property and equipment, goodwill, and intangible assets. Cash and cash equivalents, marketable securities, non-marketable equity investments, and certain ROU assets are not allocated to individual segments and are included within Unallocated. A significant portion of property and equipment assets are included within Unallocated.

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, 2021	Mar. 31, 2020
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 63,468	$ 61,572
Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	51,247	49,824
Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	12,221	11,748
Subscription Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	60,367	58,701
Subscription Services [Member] | Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	49,770	48,717
Subscription Services [Member] | Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	10,597	9,984
Professional Services [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	3,101	2,871
Professional Services [Member] | Workforce Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	1,477	1,107
Professional Services [Member] | Provider Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues, net	$ 1,624	$ 1,764

Revenue Recognition and Sales_4

Revenue Recognition and Sales Commissions - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenue Recognition and Sales Commissions [Line Items]
Revenues recognized in period, included in deferred revenue at beginning of the period	$ 33,600	$ 31,600
Estimated revenue expected to be recognized in future under contracts with customers	$ 446,000
Description of sales commission plan	Sales commissions earned by our sales force are considered incremental and recoverable costs of obtaining a contract with a customer.
Sales Commissions, amortization term description	Non-commensurate commissions are amortized over the greater of the contract term or technological obsolescence period of approximately three years.
Sales Commissions, amortization period	3 years
Amortization of deferred commissions	$ 2,133	2,159
Customer Contracts [Member]
Revenue Recognition and Sales Commissions [Line Items]
Impairment losses on receivables and contract asset	$ 100	$ 300

Revenue Recognition and Sales_5

Revenue Recognition and Sales Commissions - Additional Information (Detail 1) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2021-04-01	Mar. 31, 2021
Revenue Recognition and Sales Commissions [Line Items]
Percentage of remaining performance obligations expects revenue	46.00%
Estimated revenue, expected recognition period	12 months

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Taxes Disclosure [Line Items]
Income tax provision (benefit)	$ 922,000	$ 1,858,000
Effective tax rate for continuing operations	29.00%	21.00%
Discrete tax expense	$ 100,000
Additional income tax expense for tax deficiencies associated with stock based awards	$ 17,000	$ 26,000
NurseGrid [Member]
Income Taxes Disclosure [Line Items]
Income tax provision (benefit)		(300,000)
Change in fair value of non-marketable equity investments		$ 1,200,000

Shareholders' Equity - Addition

Shareholders' Equity - Additional Information (Detail) - USD ($)	Mar. 13, 2020	Mar. 31, 2021	Mar. 31, 2020	Jun. 30, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock repurchase program, authorized amount	$ 30,000,000
Stock repurchase program, expired date	Mar. 12, 2021
Share repurchased, shares	957,367
Share repurchased, fair value	$ 20,000,000		$ 9,876,000
Share repurchased, average price per share	$ 20.89
RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued		121,551	111,510
Weighted average grant date fair value, restricted share unit		$ 23.16	$ 22.96
Performance-based RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued		24,500		70,000
Weighted average grant date fair value, restricted share unit		$ 23.01
Restricted share units vesting period				5 years
Restricted share units, incremental performance percentage, year 2018				10.00%
Restricted share units, incremental performance percentage, year 2019				15.00%
Restricted share units, incremental performance percentage, year 2020				20.00%
Restricted share units, incremental performance percentage, year 2021				25.00%
Restricted share units, incremental performance percentage, year 2022				30.00%
Performance-based RSUs [Member] | 2021 Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued				17,500
Performance-based RSUs [Member] | Performance Criteria Not Yet Determined [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued				21,000
Performance-based RSUs [Member] | 2020 Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted share units issued				7,000

Shareholders' Equity - Stock Ba

Shareholders' Equity - Stock Based Compensation Expense Recognized in Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 616	$ 550
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	20	7
Product Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	102	81
Sales and Marketing [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	65	49
Other General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock based compensation expense	$ 429	$ 413

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Detail) - shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share [Abstract]
Total number of common equivalent shares excluded from the calculations of diluted earnings per share	148,000	106,000

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, 2021	Mar. 31, 2020
Numerator:
Net income	$ 2,291	$ 7,092
Denominator:
Weighted-average shares outstanding	31,504	32,334
Effect of dilutive shares	22	23
Weighted-average diluted shares	31,526	32,357
Net income per share:
Basic	$ 0.07	$ 0.22
Diluted	$ 0.07	$ 0.22

Marketable Securities - Fair Va

Marketable Securities - Fair Value of Available for Sale Marketable Securities (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Schedule of Available-for-sale Securities [Line Items]
Adjusted Cost	$ 55,974	$ 46,502
Unrealized Losses	(4)	(8)
Fair Value	55,970	46,494
Cash and Cash Equivalents	45,348	36,566
Current Marketable Securities	10,622	9,928
Cash [Member]
Schedule of Available-for-sale Securities [Line Items]
Adjusted Cost	45,348	31,558
Fair Value	45,348	31,558
Cash and Cash Equivalents	45,348	31,558
Level 2 [Member] | Time Deposits [Member]
Schedule of Available-for-sale Securities [Line Items]
Adjusted Cost	5,022	10,021
Fair Value	5,022	10,021
Cash and Cash Equivalents		5,008
Current Marketable Securities	5,022	5,013
Level 2 [Member] | Corporate Debt Securities [Member]
Schedule of Available-for-sale Securities [Line Items]
Adjusted Cost	5,604	4,923
Unrealized Losses	(4)	(8)
Fair Value	5,600	4,915
Current Marketable Securities	$ 5,600	$ 4,915

Marketable Securities - Additio

Marketable Securities - Additional Information (Detail)	Mar. 31, 2021USD ($)
Amortized Cost And Fair Value Debt Securities [Abstract]
Available for sale debt securities, allowance for credit impairments	$ 0

Business Combinations - Additio

Business Combinations - Additional Information (Detail) - USD ($)	Jan. 19, 2021	Dec. 10, 2020	Dec. 02, 2020	Oct. 12, 2020	Mar. 09, 2020	Mar. 31, 2021	Mar. 31, 2020
Business Acquisition [Line Items]
Net cash consideration						$ 731,000	$ 21,421,000
Increase in goodwill						2,700,000
Goodwill acquired						600,000
Goodwill currency translation						400,000
NurseGrid [Member]
Business Acquisition [Line Items]
Net cash consideration					$ 21,500,000
Fair value of existing equity interest					3,623,000
Gain recognized from remeasurement of equity interest					1,200,000
Acquisition-related transaction costs					200,000
Net tangible assets include deferred revenue book value at acquisition date					157,000
Net tangible assets include deferred revenue fair value at acquisition date					78,000
Write-down of deferred revenue					79,000
Consideration paid for acquisition in cash					$ 25,485,000
ShiftWizard [Member]
Business Acquisition [Line Items]
Net cash consideration				$ 30,500,000
Acquisition-related transaction costs				300,000
Net tangible assets include deferred revenue book value at acquisition date				2,700,000
Net tangible assets include deferred revenue fair value at acquisition date				1,601,000
Write-down of deferred revenue				1,100,000
Business combination, indemnification assets and liability related to paycheck protection program loan				$ 500,000
ShiftWizard [Member] | Maximum [Member]
Business Acquisition [Line Items]
Preliminary purchase price allocation measurement period from acquisition date				1 year
ANSOSTM Staff Scheduling Application [Member]
Business Acquisition [Line Items]
Acquisition-related transaction costs			$ 1,100,000
Net tangible assets include deferred revenue book value at acquisition date			17,800,000
Net tangible assets include deferred revenue fair value at acquisition date			14,537,000
Write-down of deferred revenue			$ 3,300,000
Preliminary purchase price allocation measurement period from acquisition date			1 year
Consideration paid for acquisition in cash			$ 66,400,000
Increase in goodwill						$ 1,700,000
Business combination, indemnification assets and liability related to tax liabilities			$ 700,000
myClinicalExhcange [Member]
Business Acquisition [Line Items]
Acquisition-related transaction costs		$ 100,000
Consideration paid for acquisition in cash		$ 4,400,000
ProcessDATA, Ltd [Member]
Business Acquisition [Line Items]
Acquisition-related transaction costs	$ 100,000
Consideration paid for acquisition in cash	$ 2,000,000

Business Combinations - Summary

Business Combinations - Summary of Purchase Price (Detail) - NurseGrid [Member] $ in Thousands	Mar. 09, 2020USD ($)
Business Acquisition [Line Items]
Cash paid at closing	$ 25,485
Post-closing adjustment, net of cash received	33
Cash acquired	(4,064)
Net consideration paid	21,454
Fair value of existing equity interest in NurseGrid	3,623
Total purchase price	$ 25,077

Business Combinations - Summa_2

Business Combinations - Summary of Preliminary Fair Value of Assets Acquired and Liabilities Assumed (Detail) - USD ($)	Mar. 31, 2021	Dec. 31, 2020	Dec. 02, 2020	Oct. 12, 2020	Mar. 09, 2020
Business Acquisition [Line Items]
Goodwill	$ 181,161,000	$ 178,440,000
Intangible assets				$ 12,660,000
NurseGrid [Member]
Business Acquisition [Line Items]
Accounts and unbilled receivable, net					$ 92,000
Prepaid and other current assets					155,000
Operating lease right-of-use assets					50,000
Deferred tax assets					2,121,000
Goodwill					21,085,000
Intangible assets					1,845,000
Accounts payable and accrued liabilities					(143,000)
Deferred revenue					(78,000)
Operating lease liabilities					(50,000)
Net assets acquired					$ 25,077,000
ShiftWizard [Member]
Business Acquisition [Line Items]
Cash				1,091,000
Accounts and unbilled receivable, net				1,038,000
Prepaid and other current assets				106,000
Operating lease right-of-use assets				183,000
Property and equipment				50,000
Indemnification assets				464,000
Goodwill				19,307,000
Intangible assets				12,660,000
Accounts payable and accrued liabilities				(600,000)
Deferred revenue				(1,601,000)
Deferred tax liability				(1,559,000)
Operating lease liabilities				(183,000)
Indemnification liability				(464,000)
Net assets acquired				$ 30,492,000
ANSOSTM Staff Scheduling Application [Member]
Business Acquisition [Line Items]
Cash			$ 1,599,000
Accounts and unbilled receivable, net			10,053,000
Prepaid and other current assets			233,000
Operating lease right-of-use assets			888,000
Property and equipment			66,000
Deferred tax assets			2,936,000
Indemnification assets			708,000
Goodwill			36,963,000
Intangible assets			32,440,000
Accounts payable and accrued liabilities			(1,693,000)
Deferred revenue			(14,537,000)
Deferred tax liability			(1,612,000)
Operating lease liabilities			(888,000)
Uncertain tax position liability			(708,000)
Net assets acquired			$ 66,448,000

Business Combinations - Summa_3

Business Combinations - Summary of Components of Identifiable Intangible Assets and Estimated Useful Lives (Detail) - USD ($) $ in Thousands	Dec. 02, 2020	Oct. 12, 2020	Mar. 09, 2020
Business Acquisition [Line Items]
Fair value		$ 12,660
Customer Relationships [Member]
Business Acquisition [Line Items]
Fair value		$ 7,800
Useful life		18 years
Developed Technology [Member]
Business Acquisition [Line Items]
Fair value		$ 4,050
Useful life		5 years
Trade Name [Member]
Business Acquisition [Line Items]
Fair value		$ 230
Useful life		5 years
Non-Compete [Member]
Business Acquisition [Line Items]
Fair value		$ 580
Non-Compete [Member] | Minimum [Member]
Business Acquisition [Line Items]
Useful life		1 year
Non-Compete [Member] | Maximum [Member]
Business Acquisition [Line Items]
Useful life		5 years
NurseGrid [Member]
Business Acquisition [Line Items]
Fair value			$ 1,845
NurseGrid [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Fair value			$ 35
Useful life			8 years
NurseGrid [Member] | Developed Technology [Member]
Business Acquisition [Line Items]
Fair value			$ 1,110
Useful life			5 years
NurseGrid [Member] | Trade Name [Member]
Business Acquisition [Line Items]
Fair value			$ 700
ANSOSTM Staff Scheduling Application [Member]
Business Acquisition [Line Items]
Fair value	$ 32,440
ANSOSTM Staff Scheduling Application [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Fair value	$ 21,100
ANSOSTM Staff Scheduling Application [Member] | Customer Relationships [Member] | Minimum [Member]
Business Acquisition [Line Items]
Useful life	11 years
ANSOSTM Staff Scheduling Application [Member] | Customer Relationships [Member] | Maximum [Member]
Business Acquisition [Line Items]
Useful life	14 years
ANSOSTM Staff Scheduling Application [Member] | Developed Technology [Member]
Business Acquisition [Line Items]
Fair value	$ 9,800
Useful life	5 years
ANSOSTM Staff Scheduling Application [Member] | Trade Name [Member]
Business Acquisition [Line Items]
Fair value	$ 1,540
Useful life	10 years

Business Combinations - Summa_4

Business Combinations - Summary of Unaudited Pro Forma Financial Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
NurseGrid [Member]
Business Acquisition [Line Items]
Total revenues	$ 63,472	$ 61,644
Net income	$ 2,295	$ 6,525
Net income per share - basic	$ 0.07	$ 0.20
Net income per share - diluted	$ 0.07	$ 0.20
ShiftWizard [Member]
Business Acquisition [Line Items]
Total revenues	$ 63,719	$ 62,576
Net income	$ 2,493	$ 6,740
Net income per share - basic	$ 0.08	$ 0.21
Net income per share - diluted	$ 0.08	$ 0.21
ANSOSTM Staff Scheduling Application [Member]
Business Acquisition [Line Items]
Total revenues	$ 64,567	$ 68,437
Net income	$ 3,124	$ 8,262
Net income per share - basic	$ 0.10	$ 0.26
Net income per share - diluted	$ 0.10	$ 0.26

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, 2021	Mar. 31, 2020
Revenues, net:
Revenues, net	$ 63,468	$ 61,572
Operating income:
Operating income	3,300	7,244
Workforce Solutions [Member]
Revenues, net:
Revenues, net	51,247	49,824
Provider Solutions [Member]
Revenues, net:
Revenues, net	12,221	11,748
Operating Segments [Member] | Workforce Solutions [Member]
Revenues, net:
Revenues, net	51,247	49,824
Operating income:
Operating income	9,027	13,370
Operating Segments [Member] | Provider Solutions [Member]
Revenues, net:
Revenues, net	12,221	11,748
Operating income:
Operating income	2,055	1,197
Unallocated [Member]
Operating income:
Operating income	$ (7,782)	$ (7,323)

Business Segments - Business _2

Business Segments - Business Segment Information Based on Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Segment Reporting Information [Line Items]
Total assets	$ 501,682	$ 500,313
Operating Segments [Member] | Workforce Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	267,993	270,924
Operating Segments [Member] | Provider Solutions [Member]
Segment Reporting Information [Line Items]
Total assets	136,926	140,490
Unallocated [Member]
Segment Reporting Information [Line Items]
Total assets	$ 96,763	$ 88,899

Debt - Additional Information (

Debt - Additional Information (Detail) - Truist Bank [Member]	3 Months Ended
	Mar. 31, 2021USD ($)
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]
Outstanding balance on revolving credit facility	$ 0
Revolving Credit Facility [Member] | Minimum [Member]
Line of Credit Facility [Line Items]
Interest coverage ratio	300.00%
Revolving Credit Facility [Member] | Maximum [Member]
Line of Credit Facility [Line Items]
Debt leverage ratio	300.00%
Third Amendment [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Maturity date of Loan agreement	Oct. 28, 2023
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 Truist’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 1.75%. The applicable margin for Base Rate loans depends on the Company’s funded debt leverage ratio and varies from 0.50% to 0.75%.
Maximum borrowing capacity under credit facility	$ 65,000,000
Increase in revolving credit facility	25,000,000
Principal payments prior to maturity	0
Third Amendment [Member] | Revolving Credit Facility [Member] | Swing Line Sub Facility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility	5,000,000
Third Amendment [Member] | Revolving Credit Facility [Member] | Letter of Credit Subfacility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity under credit facility	$ 5,000,000
Third Amendment [Member] | 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%
Third Amendment [Member] | Revolving Credit Facility [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Interest Rate During Period	1.00%
Third Amendment [Member] | Revolving Credit Facility [Member] | Minimum [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	0.50%
Third Amendment [Member] | Revolving Credit Facility [Member] | Minimum [Member] | Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	1.50%
Third Amendment [Member] | Revolving Credit Facility [Member] | Maximum [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	0.75%
Third Amendment [Member] | Revolving Credit Facility [Member] | Maximum [Member] | Eurodollar [Member]
Line of Credit Facility [Line Items]
Applicable margin for loans	1.75%

Non-Marketable Equity Investm_2

Non-Marketable Equity Investments - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 09, 2020	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2018	Dec. 31, 2020
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Aggregate carrying amount of non-marketable equity investments		$ 3,900			$ 3,900
Changes in adjustment to carrying value of non-marketable equity investment due to change in fair value			$ (1,152)	$ 1,300
Cumulative downward adjustments to carrying value of non-marketable equity investments		$ 100
NurseGrid [Member]
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Changes in adjustment to carrying value of non-marketable equity investment due to change in fair value	$ 1,200