Tabula Rasa HealthCare (TRHC) 10-Q 8 Nov 19 2019 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Oct. 31, 2019
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2019
Document Transition Report	false
Entity File Number	001-37888
Entity Registrant Name	Tabula Rasa HealthCare, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	46-5726437
Entity Address, Address Line One	228 Strawbridge Drive, Suite 100
Entity Address, City or Town	Moorestown
Entity Address, State or Province	NJ
Entity Address, Postal Zip Code	08057
City Area Code	866
Local Phone Number	648 - 2767
Title of 12(b) Security	Common Stock
Trading Symbol	TRHC
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		22,205,013
Entity Central Index Key	0001651561
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Current assets:
Cash	$ 47,302	$ 20,278
Restricted cash	3,767	4,751
Accounts receivable, net	30,984	27,950
Inventories	3,814	3,594
Prepaid expenses	3,175	2,573
Other current assets	7,643	4,165
Total current assets	96,685	63,311
Property and equipment, net	15,537	11,865
Operating lease right-of-use assets	22,140
Software development costs, net	15,830	8,248
Goodwill	150,790	108,213
Intangible assets, net	196,419	77,206
Deferred income tax assets		75
Note receivable		1,000
Other assets	1,332	1,039
Total assets	498,733	270,957
Current liabilities:
Current portion of long-term debt and finance leases, net	334	945
Current operating lease liabilities	4,214
Acquisition-related contingent consideration		43,397
Accounts payable	11,001	14,830
Accrued expenses and other liabilities	28,015	16,556
Total current liabilities	43,564	75,728
Line of credit		45,000
Long-term debt and finance leases, net	223,208	152
Noncurrent operating lease liabilities	21,231
Long-term acquisition-related contingent consideration	11,500	7,800
Deferred income tax liability	14,371
Other long-term liabilities	93	3,268
Total liabilities	313,967	131,948
Commitments and contingencies (Note 17)
Stockholders' equity:
Preferred stock, $0.0001 par value; 10,000,000 shares authorized; no shares issued and outstanding at September 30, 2019 and December 31, 2018
Common stock, $0.0001 par value; 100,000,000 shares authorized, 22,354,559 and 20,719,297 shares issued and 22,192,109 and 20,557,537 shares outstanding at September 30, 2019 and December 31, 2018, respectively	2	2
Additional paid-in capital	280,739	209,330
Treasury stock, at cost; 162,450 and 161,760 shares at September 30, 2019 and December 31, 2018, respectively	(3,865)	(3,825)
Accumulated deficit	(92,110)	(66,498)
Total stockholders' equity	184,766	139,009
Total liabilities and stockholders' equity	$ 498,733	$ 270,957

CONSOLIDATED BALANCE SHEETS (pa

CONSOLIDATED BALANCE SHEETS (parenthetical) - $ / shares	Sep. 30, 2019	Dec. 31, 2018
CONSOLIDATED BALANCE SHEETS
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	100,000,000	100,000,000
Common stock, shares issued	22,354,559	20,719,297
Common stock, shares outstanding	22,192,109	20,557,537
Treasury stock (in shares)	162,450	161,760

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Revenue:
Revenue	$ 74,270	$ 54,418	$ 211,484	$ 146,960
Cost of revenue, exclusive of depreciation and amortization shown below:
Cost of revenue, exclusive of depreciation and amortization	46,441	35,058	133,265	99,132
Operating expenses:
Research and development	5,902	3,380	16,649	8,515
Sales and marketing	6,884	2,669	18,605	6,985
General and administrative	12,155	7,824	38,781	20,229
Change in fair value of acquisition-related contingent consideration expense (income)	1,510	(8,419)	4,516	40,385
Depreciation and amortization	9,142	4,096	24,519	12,110
Total operating expenses	35,593	9,550	103,070	88,224
(Loss) income from operations	(7,764)	9,810	(24,851)	(40,396)
Interest expense, net	4,441	232	11,442	415
(Loss) income before income taxes	(12,205)	9,578	(36,293)	(40,811)
Income tax benefit	(4,101)	(838)	(10,681)	(4,107)
Net (loss) income	$ (8,104)	$ 10,416	$ (25,612)	$ (36,704)
Net (loss) income per share:
Basic (in dollars per share)	$ (0.39)	$ 0.54	$ (1.25)	$ (1.93)
Diluted (in dollars per share)	$ (0.39)	$ 0.47	$ (1.25)	$ (1.93)
Weighted average common shares outstanding:
Basic (in shares)	20,691,112	19,217,623	20,520,357	18,989,334
Diluted (in shares)	20,691,112	22,288,873	20,520,357	18,989,334
Product
Revenue:
Revenue	$ 34,966	$ 28,045	$ 99,320	$ 82,603
Cost of revenue, exclusive of depreciation and amortization shown below:
Cost of revenue, exclusive of depreciation and amortization	25,931	21,100	74,267	62,007
Service
Revenue:
Revenue	39,304	26,373	112,164	64,357
Cost of revenue, exclusive of depreciation and amortization shown below:
Cost of revenue, exclusive of depreciation and amortization	$ 20,510	$ 13,958	$ 58,998	$ 37,125

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Common Stock	Treasury Stock	Additional Paid-in Capital	Accumulated Deficit	Total
Balance at beginning of period at Dec. 31, 2017	$ 2	$ (959)	$ 144,074	$ (19,229)	$ 123,888
Balance at beginning of period (in shares) at Dec. 31, 2017	19,371,005	(73,466)
Increase (Decrease) in Stockholders' Equity
Common stock offering issuance costs			(2)		(2)
Issuance of restricted stock (in shares)	395,254
Forfeitures of restricted shares (in shares)		(2,474)
Shares repurchased		$ (2,866)			(2,866)
Shares repurchased (in shares)		(80,000)
Exercise of stock options			902		902
Exercise of stock options (in shares)	374,904
Stock based compensation expense			1,945		1,945
Net (loss) income				(18,094)	(18,094)
Balance at end of period at Mar. 31, 2018	$ 2	$ (3,825)	146,919	(37,323)	105,773
Balance at end of period (in shares) at Mar. 31, 2018	20,141,163	(155,940)
Balance at beginning of period at Dec. 31, 2017	$ 2	$ (959)	144,074	(19,229)	123,888
Balance at beginning of period (in shares) at Dec. 31, 2017	19,371,005	(73,466)
Increase (Decrease) in Stockholders' Equity
Shares repurchased		$ (2,866)
Shares repurchased (in shares)		(80,000)
Net (loss) income					(36,704)
Balance at end of period at Sep. 30, 2018	$ 2	$ (3,825)	157,353	(55,933)	97,597
Balance at end of period (in shares) at Sep. 30, 2018	20,512,499	(155,940)
Balance at beginning of period at Mar. 31, 2018	$ 2	$ (3,825)	146,919	(37,323)	105,773
Balance at beginning of period (in shares) at Mar. 31, 2018	20,141,163	(155,940)
Increase (Decrease) in Stockholders' Equity
Issuance of restricted stock (in shares)	23,365
Exercise of stock options			1,253		1,253
Exercise of stock options (in shares)	216,989
Stock based compensation expense			2,180		2,180
Net (loss) income				(29,026)	(29,026)
Balance at end of period at Jun. 30, 2018	$ 2	$ (3,825)	150,352	(66,349)	80,180
Balance at end of period (in shares) at Jun. 30, 2018	20,381,517	(155,940)
Increase (Decrease) in Stockholders' Equity
Common stock offering issuance costs			(7)		(7)
Issuance of common stock in connection with acquisition			3,595		3,595
Issuance of common stock in connection with acquisition (in shares)	45,561
Issuance of restricted stock (in shares)	14,840
Exercise of stock options			417		417
Exercise of stock options (in shares)	70,581
Stock based compensation expense			2,996		2,996
Net (loss) income				10,416	10,416
Balance at end of period at Sep. 30, 2018	$ 2	$ (3,825)	157,353	(55,933)	97,597
Balance at end of period (in shares) at Sep. 30, 2018	20,512,499	(155,940)
Balance at beginning of period at Dec. 31, 2018	$ 2	$ (3,825)	209,330	(66,498)	139,009
Balance at beginning of period (in shares) at Dec. 31, 2018	20,719,297	(161,760)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock in connection with acquisition			9,504		9,504
Issuance of common stock in connection with acquisition (in shares)	149,053
Issuance of common stock awards (in shares)	9,547
Issuance of restricted stock (in shares)	565,840
Exercise of stock options		$ (40)	1,077		1,037
Exercise of stock options (in shares)	82,686	(690)
Issuance of common stock in connection with the settlement of acquisition-related contingent consideration			(609)		(609)
Issuance of common stock in connection with the settlement of acquisition-related contingent consideration (in shares)	614,225
Conversion feature of convertible senior subordinated notes, net of allocated debt issuance costs, net of tax			74,049		74,049
Purchase of convertible note hedges			(101,660)		(101,660)
Sale of warrants in connection with convertible senior subordinated notes			65,910		65,910
Stock based compensation expense			6,852		6,852
Net (loss) income				(10,979)	(10,979)
Balance at end of period at Mar. 31, 2019	$ 2	$ (3,865)	264,453	(77,477)	183,113
Balance at end of period (in shares) at Mar. 31, 2019	22,140,648	(162,450)
Balance at beginning of period at Dec. 31, 2018	$ 2	$ (3,825)	209,330	(66,498)	139,009
Balance at beginning of period (in shares) at Dec. 31, 2018	20,719,297	(161,760)
Increase (Decrease) in Stockholders' Equity
Net (loss) income					(25,612)
Balance at end of period at Sep. 30, 2019	$ 2	$ (3,865)	280,739	(92,110)	184,766
Balance at end of period (in shares) at Sep. 30, 2019	22,354,559	(162,450)
Balance at beginning of period at Mar. 31, 2019	$ 2	$ (3,865)	264,453	(77,477)	183,113
Balance at beginning of period (in shares) at Mar. 31, 2019	22,140,648	(162,450)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock awards (in shares)	30,101
Issuance of restricted stock (in shares)	23,562
Exercise of stock options			499		499
Exercise of stock options (in shares)	49,916
Conversion feature of convertible senior subordinated notes, net of allocated debt issuance costs, net of tax			(47)		(47)
Stock based compensation expense			6,906		6,906
Net (loss) income				(6,529)	(6,529)
Balance at end of period at Jun. 30, 2019	$ 2	$ (3,865)	271,811	(84,006)	183,942
Balance at end of period (in shares) at Jun. 30, 2019	22,244,227	(162,450)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock awards (in shares)	13,867
Exercise of stock options			967		967
Exercise of stock options (in shares)	96,465
Conversion feature of convertible senior subordinated notes, net of allocated debt issuance costs, net of tax			736		736
Stock based compensation expense			7,225		7,225
Net (loss) income				(8,104)	(8,104)
Balance at end of period at Sep. 30, 2019	$ 2	$ (3,865)	$ 280,739	$ (92,110)	$ 184,766
Balance at end of period (in shares) at Sep. 30, 2019	22,354,559	(162,450)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net loss	$ (25,612)	$ (36,704)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation and amortization	24,519	12,110
Amortization of deferred financing costs and debt discount	7,689	66
Deferred taxes	(10,749)	(4,536)
Stock-based compensation	20,983	7,121
Change in fair value of acquisition-related contingent consideration	4,516	40,385
Acquisition-related contingent consideration paid	(24,480)
Other noncash items	12	51
Changes in operating assets and liabilities, net of effect from acquisitions:
Accounts receivable, net	(417)	(7,035)
Inventories	(220)	(818)
Prepaid expenses and other current assets	(2,626)	(4,915)
Other assets	(53)	267
Accounts payable	(5,787)	(5,163)
Accrued expenses and other liabilities	5,474	8,421
Other long-term liabilities	(60)	(7)
Net cash (used in) provided by operating activities	(6,811)	9,243
Cash flows from investing activities:
Purchases of property and equipment	(5,202)	(3,484)
Software development costs	(10,285)	(3,564)
Purchases of intangible assets	(1,202)	(29)
Proceeds from repayment of note receivable	1,000
Acquisitions of businesses, net of cash acquired	(158,762)	(21,981)
Net cash used in investing activities	(174,451)	(29,058)
Cash flows from financing activities:
Payments for repurchase of common stock		(2,866)
Proceeds from exercise of stock options	2,503	2,590
Payments for debt financing costs	(9,632)	(103)
Borrowings on line of credit		26,500
Repayments of line of credit	(45,000)
Payments of equity offering costs		(364)
Payments of acquisition-related contingent consideration	(29,062)	(1,646)
Repayments of long-term debt and finance leases	(757)	(779)
Proceeds from issuance of convertible senior subordinated notes	325,000
Proceeds from sale of warrants	65,910
Purchase of convertible note hedges	(101,660)
Net cash provided by financing activities	207,302	23,332
Net increase in cash and restricted cash	26,040	3,517
Cash and restricted cash, beginning of period	25,029	10,430
Cash and restricted cash, end of period	51,069	13,947
Supplemental disclosure of cash flow information:
Acquisition of equipment under capital leases		442
Additions to property, equipment, and software development purchases included in accounts payable and accrued expenses	803	390
Cash paid for interest	3,177	$ 251
Cash paid for taxes	317
Interest costs capitalized to property and equipment and software development costs, net of depreciation and amortization	$ 248
Stock issued in connection with acquisitions	9,504	3,595

Nature of Business

Nature of Business	9 Months Ended
	Sep. 30, 2019
Nature of Business
Nature of Business	1. Nature of Business ​ Tabula Rasa HealthCare, Inc. (“Company”) provides patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize medication regimens to improve patient outcomes, reduce hospitalizations, lower healthcare costs and manage risk. The Company delivers its solutions through technology enabled products and services for medication risk management (“MRM”) and to support health plan management. The Company serves healthcare organizations that focus on populations with complex healthcare needs and extensive medication requirements. The Company’s cloud-based software solutions provide prescribers, pharmacists, pharmacies and healthcare organizations with sophisticated and innovative tools to better manage the medication-related needs of patients. ​

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2019
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies ​ The Company's significant accounting policies are disclosed in the Company’s audited consolidated financial statements for the year ended December 31, 2018, which are included in the Company’s annual report on Form 10-K for the fiscal year ended December 31, 2018, which was filed with the Securities and Exchange Commission (“SEC”) on March 1, 2019 (“2018 Form 10-K”). Since the date of those audited consolidated financial statements, there have been no changes to the Company's significant accounting policies, including the status of recent accounting pronouncements, other than those detailed below. ​ (a) Basis of Presentation ​ The accompanying unaudited consolidated financial statements of the Company have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) and applicable rules and regulations of the SEC regarding interim financial reporting. The unaudited interim consolidated financial statements have been prepared on the same basis as the annual audited consolidated financial statements and, in the opinion of management, reflect all adjustments (consisting of normal recurring accruals and adjustments), necessary to present fairly the Company's interim consolidated financial position for the periods indicated. The interim results for the three and nine months ended September 30, 2019 are not necessarily indicative of results to be expected for the year ending December 31, 2019, any other interim periods, or any future year or period. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the audited consolidated financial statements and accompanying notes included in the 2018 Form 10-K. ​ (b) Use of Estimates ​ The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. ​ On an ongoing basis, management evaluates its estimates and assumptions, including, but not limited to, those related to: (i) the fair value of assets acquired and liabilities assumed for business combinations, (ii) the recognition and disclosure of contingent liabilities, (iii) the useful lives of long-lived assets (including definite-lived intangible assets), (iv) the evaluation of revenue recognition criteria, (v) assumptions used in the Black-Scholes option-pricing model to determine the fair value of stock-based compensation instruments, (vi) the realizability of long-lived assets including goodwill and intangible assets, (vii) the assumptions used to determine the fair value of right-of-use assets and liabilities for the Company’s leases, and (viii) the assumptions used to determine the fair value of convertible debt instruments and related equity-classified conversion option. These estimates are based on historical data and experience, as well as various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. The Company has engaged and may, in the future, engage third-party valuation specialists to assist with estimates related to the valuation of assets and liabilities acquired. Such estimates often require the selection of appropriate valuation methodologies and models, and significant judgment in evaluating ranges of assumptions and financial inputs. Actual results may differ from those estimates under different assumptions or circumstances. ​ (c) Revenue Recognition ​ The Company evaluates its contractual arrangements to determine the performance obligations and transaction prices. Revenue is allocated to each performance obligation and recognized when the related performance obligation is satisfied. Shipping and handling costs associated with outbound freight after control over a product has transferred to a customer are accounted for as a fulfillment cost and are included in cost of revenue. See Note 3 for additional detail about the Company’s products and service lines. ​ (d) Cost of Product Revenue (exclusive of depreciation and amortization) ​ Cost of product revenue includes all costs directly related to the fulfillment and distribution of prescription drugs as part of the Company’s MRM offerings. Costs consist primarily of the purchase price of the prescription drugs the Company dispenses, expenses to package, dispense and distribute prescription drugs, and expenses associated with the Company's prescription fulfillment centers, including employment costs and stock-based compensation, and expenses related to the hosting of the Company’s technology platforms. Such costs also include direct overhead expenses, as well as allocated miscellaneous overhead costs. The Company allocates miscellaneous overhead costs among functions based on employee headcount. ​ (e) Cost of Service Revenue (exclusive of depreciation and amortization) ​ Cost of service revenue includes all costs directly related to servicing the Company’s MRM service contracts, which primarily consist of labor costs, outside contractors, data acquisition costs, technology services, hosting fees and overhead costs. In addition, service costs include all labor costs, including stock-based compensation expense, directly related to the health plan management and pharmacy cost management services and expenses for claims processing, technology services and overhead costs. ​ (f) Restricted Cash ​ Cash and cash equivalents that are restricted as to withdrawal or use under certain contractual agreements are recorded in restricted cash on the Company’s consolidated balance sheets. As part of the Company’s third party administrative services, which fall under the Company’s health plan management services, the Company holds funds on behalf of its clients. These amounts are recorded as restricted cash with an offsetting liability recorded in accrued expenses and other liabilities on the Company’s consolidated balance sheets. ​ The following table provides a reconciliation of cash and restricted cash reported within the consolidated balance sheets that sum to the total cash and restricted cash as reported in the consolidated statements of cash flows. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ ​ 2019 ​ 2018 Cash ​ $ 47,302 ​ $ 13,080 Restricted cash ​ ​ 3,767 ​ ​ 867 Total cash and restricted cash as presented in the consolidated statement of cash flows ​ $ 51,069 ​ $ 13,947 ​ (g) Accounts Receivable, net ​ Accounts receivable are recorded at the invoiced amount and do not bear interest. The Company maintains an allowance for doubtful accounts for estimated losses inherent in its accounts receivable portfolio. In establishing the required allowance, management considers historical losses adjusted to take into account current market conditions and the Company’s clients’ financial condition, the amount of receivables in dispute and the current receivables aging and current payment patterns. The Company reviews its allowance for doubtful accounts monthly. The allowance for doubtful accounts was $379 and $528 as of September 30, 2019 and December 31, 2018, respectively. ​ (h) Leases ​ The Company determines if an arrangement is a lease at inception. As of January 1, 2019, operating leases are included in operating lease right-of-use (“ROU”) assets, current operating lease liabilities, and noncurrent operating lease liabilities in the consolidated balance sheets. Finance leases are included in property and equipment, net, current portion of long-term debt and finance leases, and long-term debt and finance leases in the consolidated balance sheets. ROU assets represent the Company’s right to use an underlying asset for the lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. ​ ROU assets and liabilities are recognized at the lease commencement date based on the estimated net present value of lease payments over the lease term. As the rate implicit in the lease is not readily determinable for most leases, the Company uses its incremental borrowing rate in determining the net present value of lease payments. The Company estimates its incremental borrowing rate for each lease as of the measurement date with consideration of the risk-free rate for varying maturities corresponding to the remaining lease term, the risk premium attributed to the Company’s credit rating for a secured or collateralized instrument, and comparable borrowings of similarly-rated companies. ​ Leases with an initial term of 12 months or less are not recorded on the balance sheet. The lease expense for short-term leases is recognized on a straight-line basis over the lease term. Many leases include options to renew, with the exercise of lease renewal options at the Company’s sole discretion. The lease terms that include options to renew the lease require such renewal to be included when it is reasonably certain that the Company will exercise such option. The depreciable life of finance lease assets and leasehold improvements is limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. ​ The Company’s lease agreements do not contain any residual value guarantees. The Company has elected to include both lease and nonlease components as a single lease component for its operating leases. ​ (i) Recent Accounting Pronouncements In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2016-02, Leases Targeted Improvements The Company elected the package of practical expedients permitted under the transition guidance, which permits the Company to carry forward its prior conclusions about lease identification, lease classification, and initial direct costs, but did not elect the hindsight practical expedient. ROU assets and liabilities for the Company’ existing leases were recognized on January 1, 2019 based on the estimated net present value of lease payments over the remaining lease term. The adoption of ASU 2016-02 resulted in the recording of lease assets and lease liabilities of $18,469 and $21,173 , respectively, as of January 1, 2019. The standard had no impact on the Company’s opening balance of retained earnings, consolidated net operations or cash flows. See Note 7 for additional information on the Company’s leases. ​ In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326) Measurement of Credit Losses on Financial Instruments, and ASU 2016-13 is effective for financial statements issued for fiscal years beginning after December 15, 2019. . ​ In January 2017, the FASB issued ASU No. 2017-04, Intangibles – Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment ​ In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement ​ In August 2018, the FASB issued ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract

Revenue

Revenue	9 Months Ended
	Sep. 30, 2019
Revenue
Revenue	3. Revenue ​ The Company provides technology-enabled solutions tailored toward the specific needs of the healthcare organizations that it serves. These solutions can be integrated or provided on a standalone basis. Contracts generally have a term of one to five years and in some cases automatically renew at the end of the initial term. In most cases, clients may terminate their contracts with a notice period ranging from 0 to 180 days without cause, thereby limiting the term in which the Company has enforceable rights and obligations. Revenue is recognized in an amount that reflects the consideration that is expected in exchange for the goods or services. The Company uses the practical expedient not to account for significant financing components because the period between recognition and collection does not exceed one year for most of the Company’s contracts. ​ Product Revenue ​ MRM prescription fulfillment services. ​ Service Revenue ​ MRM services ​ Health plan management services ​ Pharmacy cost management services. ​ Disaggregation of revenue ​ In the following table, revenue is disaggregated by major service line. The Company manages its operations and allocates its resources as a single reportable segment. The Company's MRM and health plan management clients consist primarily of healthcare payors, providers, and pharmacies. The Company’s pharmacy cost management clients consist primarily of post-acute care facilities. Substantially all of the Company’s revenue is recognized in the United States (“U.S.”) and substantially all of the Company’s assets are located in the U.S. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ ​ 2019 ​ ​ 2018 ​ ​ 2019 ​ ​ 2018 Major service lines: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ MRM prescription fulfillment services ​ $ 34,966 ​ $ 28,045 ​ $ 99,320 ​ $ 82,603 MRM services ​ ​ 25,810 ​ ​ 15,467 ​ ​ 75,010 ​ ​ 45,821 Health plan management services ​ ​ 8,905 ​ ​ 5,383 ​ ​ 27,205 ​ ​ 10,220 Pharmacy cost management services ​ ​ 4,557 ​ ​ 5,412 ​ ​ 9,803 ​ ​ 8,073 Other services ​ ​ 32 ​ ​ 111 ​ ​ 146 ​ ​ 243 ​ ​ $ 74,270 ​ $ 54,418 ​ $ 211,484 ​ $ 146,960 ​ Contract balances ​ Assets and liabilities related to the Company’s contracts are reported on a contract-by-contract basis at the end of each reporting period. The following table provides information about the Company’s contract assets and contract liabilities from contracts with clients as of September 30, 2019 and December 31, 2018. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ 2019 ​ 2018 Contract assets ​ $ 6,168 ​ $ 3,075 Contract liabilities ​ ​ 4,667 ​ ​ 1,733 ​ Contract assets as of September 30, 2019 consisted of $4,267 related to data analytics contract assets, $984 related to consideration for performance obligations completed related to MRM service contracts but which the Company does not have an unconditional right to the consideration, and $917 related to the gain-share component of completed health plan management services contracts. Contract assets as of December 31, 2018 consisted of $2,913 related to data analytics contract assets and $162 related to the gain-share component of completed health plan management services contracts. Contract assets are included in other current assets on the Company’s consolidated balance sheets. The contract assets are transferred to receivables when the rights to the additional consideration becomes unconditional. ​ The contract liabilities as of September 30, 2019 consisted of $1,735 related to acquired performance obligations for software services contracts associated with the Company’s acquisitions of DoseMe and PrescribeWellness in the first quarter of 2019 (see Note 5), $1,395 related to advanced billings for prescription medications not yet fulfilled or dispensed, $765 related to performance obligations with respect to software maintenance contracts for electronic health records solutions, $602 related to advanced payments received for service obligations on MRM performance guaranteed contracts, and $170 related to unamortized setup fees on health plan management contracts. The contract liabilities as of December 31, 2018 consisted of $858 related to advanced billings for prescription medications not yet fulfilled or dispensed, $730 related to performance obligations with respect to software maintenance contracts for electronic health records solutions, and $145 related to unamortized setup fees on health plan management contracts. ​ Contract liabilities are included in accrued expenses and other current liabilities and in other long-term liabilities on the Company’s consolidated balance sheets. The Company anticipates that it will satisfy most of its performance obligations associated with its contract liabilities within a year. ​ Significant changes in the contract assets and the contract liabilities balances during the nine months ended September 30, 2019 are as follows: ​ ​ ​ ​ ​ ​ ​ September 30, ​ ​ 2019 Contract assets: ​ ​ ​ Contract assets, beginning of period ​ $ 3,075 Decreases due to cash received ​ ​ (5,499) Changes to the contract assets at the beginning of the year as a result of changes in estimates ​ ​ 1,547 Increases, net of reclassifications to receivables ​ ​ 7,045 Contract assets, end of period ​ $ 6,168 ​ ​ ​ ​ Contract liabilities: ​ ​ ​ Contract liabilities, beginning of period ​ $ 1,733 Revenue recognized that was included in the contract liabilities balance at the beginning of the period ​ ​ (1,497) Increases due to cash received, excluding amounts recognized as revenue during the period ​ ​ 2,910 Increases due to business combinations, excluding amounts recognized as revenue during the period ​ ​ 1,521 Contract liabilities, end of period ​ $ 4,667 ​ ​ During the nine months ended September 30, 2018, the Company recognized $1,278 of revenue that was included in the December 31, 2017 contract liability balance of $1,350.

Net (Loss) Income per Share

Net (Loss) Income per Share	9 Months Ended
	Sep. 30, 2019
Net (Loss) Income per Share
Net (Loss) Income per Share	4. Net (Loss) Income per Share ​ Basic net (loss) income per share is computed by dividing net (loss) income attributable to common stockholders by the weighted average number of shares of common stock of the Company outstanding during the period. Diluted net (loss ) income per share is computed by dividing net (loss) income attributable to common stockholders by the weighted average number of shares of common stock outstanding during the period plus the impact of dilutive securities, to the extent that they are not anti-dilutive. ​ The following table presents the calculation of basic and diluted net (loss) income per share for the Company’s common stock: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ 2019 ​ 2018 ​ 2019 ​ 2018 Numerator (basic and diluted): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net (loss) income ​ $ (8,104) ​ $ 10,416 ​ $ (25,612) ​ $ (36,704) Denominator (basic): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted average shares of common stock outstanding, basic ​ ​ 20,691,112 ​ ​ 19,217,623 ​ ​ 20,520,357 ​ ​ 18,989,334 Denominator (diluted): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted average shares of common stock outstanding ​ ​ 20,691,112 ​ ​ 19,217,623 ​ ​ 20,520,357 ​ ​ 18,989,334 Effect of potential dilutive securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted average dilutive effect of stock options ​ ​ — ​ ​ 1,898,543 ​ ​ — ​ ​ — Weighted average dilutive effect of restricted shares ​ ​ — ​ ​ 898,821 ​ ​ — ​ ​ — Weighted average dilutive effect of contingently issuable shares ​ ​ — ​ ​ 273,886 ​ ​ — ​ ​ — Weighted average shares of common stock outstanding, diluted ​ ​ 20,691,112 ​ ​ 22,288,873 ​ ​ 20,520,357 ​ ​ 18,989,334 Net (loss) income per share, basic ​ $ (0.39) ​ $ 0.54 ​ $ (1.25) ​ $ (1.93) Net (loss) income per share, diluted ​ $ (0.39) ​ $ 0.47 ​ $ (1.25) ​ $ (1.93) ​ The following potential common shares, presented based on amounts outstanding as of September 30, 2019 and 2018, were excluded from the calculation of diluted net loss per share for the three months ended September 30, 2019 and the nine months ended September 30, 2019 and 2018 because including them would have had an anti-dilutive effect. ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ 2019 2018 Stock options to purchase common stock 2,840,849 ​ 2,566,855 Unvested restricted stock 1,330,088 ​ 1,063,681 Common stock warrants 4,646,393 ​ — Contingently issuable shares 20,000 ​ 142,679 ​ 8,837,330 ​ 3,773,215 ​ ​ ​

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2019
Acquisitions
Acquisitions	5. Acquisitions ​ 2019 Acquisitions ​ PrescribeWellness ​ On March 5, 2019, the Company entered into, and consummated the transactions contemplated by, a Merger Agreement (“Merger Agreement”) with Prescribe Wellness, LLC, a Nevada limited liability company (“PrescribeWellness”) and Fortis Advisors LLC, a Delaware limited liability company, solely in its capacity as the initial Holder Representative. PrescribeWellness is a leading cloud-based patient engagement solutions company that facilitates collaboration between more than 10,000 pharmacies with patients, payers, providers, and pharmaceutical companies. The Company paid $150,000 in cash consideration upon closing, subject to certain customary adjustments as set forth in the Merger Agreement. A portion of the closing consideration is being held in escrow to secure potential claims for indemnification under the Merger Agreement and in respect of adjustments to the consideration under the Merger Agreement. ​ In connection with the acquisition of PrescribeWellness, the Company incurred direct acquisition costs of $11 and $3,241 for the three and nine months ended September 30, 2019, respectively, which were recorded in general and administrative expenses in the consolidated statements of operations. ​ The fair value of the acquisition consideration, net of post-closing adjustments, was $148,626 paid in cash. ​ The following table summarizes the preliminary allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed at the date of acquisition. ​ ​ ​ ​ ​ Accounts receivable $ 2,608 Prepaid expenses and other current assets ​ ​ 1,345 Property and equipment ​ ​ 1,155 Operating lease right-of-use-assets ​ ​ 1,467 Trade name ​ ​ 4,100 Developed technology ​ ​ 20,000 Patient database ​ ​ 21,700 Client relationships ​ ​ 74,100 Goodwill ​ ​ 30,714 Total assets acquired ​ $ 157,189 ​ ​ ​ ​ Operating lease liabilities ​ ​ (1,467) Trade accounts payable ​ ​ (1,633) Accrued expenses and other liabilities ​ ​ (5,463) Total purchase price ​ $ 148,626 ​ The purchase price was allocated to the tangible assets and identifiable intangible assets acquired and liabilities assumed based on their acquisition-date estimated fair values. The identifiable intangible assets principally included a trade name, developed technology, patient database, and client relationships, all of which are subject to amortization on a straight-line basis and are being amortized over a weighted average of 5, 10, 5, and 14 years, respectively. The weighted average amortization period for acquired intangible assets as of the date of acquisition is 11.4 years. ​ The Company, with the assistance of a third-party appraiser, assessed the fair value of the assets of PrescribeWellness. The fair value of the trade name and developed technology was estimated using the relief from royalty method. The Company derived the hypothetical royalty income from the projected revenues of PrescribeWellness. The fair value of client relationships was estimated using a multi period excess earnings method. To calculate fair value, the Company used cash flows discounted at a rate considered appropriate given the inherent risks associated with each client grouping. The fair value of the patient database was estimated using a cost to replace method. ​ The useful lives of the intangible assets were estimated based on the expected future economic benefit of the assets and are being amortized over the estimated useful life in proportion to the economic benefits consumed using the straight-line method. ​ The amortization of intangible assets is deductible for U.S. income tax purposes. ​ The Company believes the goodwill related to the acquisition of PrescribeWellness resulted from the establishment of new market opportunities while at the same time expanding its service offering to its existing customer base. The goodwill is deductible for income tax purposes. ​ Revenue from PrescribeWellness is primarily comprised of subscription fees for its cloud-based patient engagement solutions. Revenue for these services, and the related costs, is recognized each month as performance obligations are satisfied and costs are incurred, and is included in service revenue and cost of revenue – service cost, respectively, in the Company’s consolidated statements of operations. For the three and nine months ended September 30, 2019, service revenue of $8,271 and $18,381, respectively, from PrescribeWellness was included in the Company’s consolidated statements of operations. Service revenue was recorded net of a reduction of $463 and $1,210 for the three and nine months ended September 30, 2019, respectively, due to the purchase accounting effects of recording deferred revenue at fair value. Net loss of $3,033 and $6,829, which includes amortization of $3,113 and $7,264 associated with acquired intangible assets, from PrescribeWellness was included in the Company’s consolidated statements of operations for the three and nine months ended September 30, 2019, respectively. ​ The Company continues to evaluate the fair value of certain assets acquired and liabilities assumed related to the acquisition. Additional information, which existed as of the acquisition date, but was at that time unknown to the Company, may become known during the remainder of the measurement period. Changes to amounts recorded as a result of the final determination may result in a corresponding adjustment to these assets and liabilities, including goodwill. The determination of the estimated fair values of all assets acquired is expected to be completed within one year from the date of acquisition ​ DoseMe ​ On January 2, 2019, the Company completed the acquisition of all of the outstanding share capital and options to purchase the share capital of DoseMe Holdings Pty Ltd, a proprietary company limited by shares organized under the Laws of Australia (“DoseMe”). DoseMe is the developer of DoseMeRx, an advanced precision dosing tool to help physicians and pharmacists accurately dose patients’ high-risk parenteral (intravenous) medications based on individual needs. The acquisition was made pursuant to a Share Purchase Deed, made and entered into as of November 30, 2018. The consideration for the acquisition was comprised of (i) cash consideration of up to $10,000 paid at closing, subject to certain customary post-closing adjustments as set forth in the Share Purchase Deed, (ii) the issuance of 149,053 shares of the Company’s common stock, and (iii) the potential for a contingent earn out payment of up to $10,000, based on the financial performance of DoseMe. During the third quarter of 2019, the Company elected to accelerate the final payment of the contingent earn out payment and paid $8,750 in cash in full satisfaction of the contingent purchase price consideration. A portion of the cash consideration paid at closing is being held in escrow to secure potential claims by the Company for indemnification under the agreement and in respect of adjustments to the purchase price. ​ In connection with the acquisition of DoseMe, the Company incurred direct acquisition costs of $104 during the nine months ended September 30, 2019, which were recorded in general and administrative expenses in the consolidated statements of operations. No direct acquisition costs were incurred during the three months ended September 30, 2019. ​ The following table summarizes the purchase price consideration based on the estimated acquisition-date fair value of the acquisition consideration. ​ ​ ​ ​ ​ Cash consideration at closing, net of post-closing adjustments ​ $ 10,136 Stock consideration at closing ​ ​ 9,504 Estimated fair value of contingent consideration ​ ​ 8,720 Total fair value of acquisition consideration ​ $ 28,360 ​ The following table summarizes the preliminary allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed at the date of acquisition: ​ ​ ​ ​ ​ Accounts receivable ​ $ 9 Prepaid expenses and other current assets ​ ​ 110 Trade name ​ ​ 89 Developed technology ​ ​ 16,200 Non-competition agreements ​ ​ 500 Goodwill ​ ​ 11,831 Total assets acquired ​ $ 28,739 ​ ​ ​ ​ Trade accounts payable ​ ​ (17) Accrued expenses and other liabilities ​ ​ (362) Total purchase price, including contingent consideration of $8,720 ​ $ 28,360 ​ The purchase price was allocated to the tangible assets and identifiable intangible assets acquired and liabilities assumed based on their acquisition-date estimated fair values. The identifiable intangible assets principally included a trade name, developed technology and non-competition agreements, all of which are subject to amortization on a straight-line basis and are being amortized over a weighted average of 4, 7.5 and 5 years, respectively. The weighted average amortization period for acquired intangible assets as of the date of acquisition is 7.4 years. ​ The Company, with the assistance of a third-party appraiser, assessed the fair value of the assets of DoseMe. The fair value of the trade name was estimated using the relief from royalty method. The Company derived the hypothetical royalty income from the projected revenues of DoseMe. The fair value of the developed technology was estimated using a multi period excess earnings method. To calculate fair value, the Company used cash flows discounted at a rate considered appropriate given the inherent risks associated with the economic return on contributory assets and estimated revenues generated. The fair value of the non-competition agreements was estimated using the discounted earnings method by estimating the potential loss of earnings absent the non-competition agreements, assuming the covenantor competes at different time periods during the life of the agreements. See Note 16 for additional discussion of the fair value assessment of the acquisition-related contingent consideration. ​ The useful lives of the intangible assets were estimated based on the expected future economic benefit of the assets and are being amortized over the estimated useful life in proportion to the economic benefits consumed using the straight-line method. ​ The amortization of intangible assets is deductible for U.S. income tax purposes. ​ The Company believes the goodwill related to the acquisition of DoseMe resulted from gaining a complementary capability that, when combined with the Company’s existing platform, will create significant market opportunity. The goodwill is deductible for U.S. income tax purposes. ​ Revenue from DoseMe is primarily comprised of subscription and license fees for use of DoseMe’s advanced precision dosing software tool. Revenue for these services, and the related costs, is recognized each month as performance obligations are satisfied and costs are incurred, and is included in service revenue and cost of revenue – service cost, respectively, in the Company’s consolidated statements of operations. For the three and nine months ended September 30, 2019, service revenue of $88 and $226, respectively, from DoseMe was included in the Company’s consolidated statements of operations. Net loss of $1,531 and $3,526, which includes amortization of $571 and $1,712 associated with acquired intangible assets, from DoseMe was included in the Company’s consolidated statements of operations for the three and nine months ended September 30, 2019, respectively. ​ The Company continues to evaluate the fair value of certain assets acquired and liabilities assumed related to the acquisition. Additional information, which existed as of the acquisition date, but was at that time unknown to the Company, may become known during the remainder of the measurement period. Changes to amounts recorded as a result of the final determination may result in a corresponding adjustment to these assets and liabilities, including goodwill. The determination of the estimated fair values of all assets acquired is expected to be completed within one year from the date of acquisition. ​ Pro forma ​ The unaudited pro forma results presented below include the results of the aforementioned acquisitions as if the PrescribeWellness and DoseMe acquisitions had been consummated as of January 1, 2018. The unaudited pro forma results presented below also include the results of the 2018 acquisitions of Cognify Inc. (“Cognify), Mediture LLC and eClusive L.L.C (collectively, “Mediture”), and Peak PACE Solutions, LLC (“Peak PACE”) as if these acquisitions had been consummated as of January 1, 2017. The unaudited pro forma results include the amortization associated with acquired intangible assets, interest expense on the debt incurred to fund these acquisitions, insurance expense for additional required business insurance coverage, stock compensation expense related to equity awards granted to employees of the acquired companies, adjustments to revenue for the purchase accounting effects of recording deferred revenue at fair value, and the estimated tax effect of adjustments to income (loss) before income taxes. Material nonrecurring charges, including direct acquisition costs, directly attributable to the transactions are excluded. In addition, the unaudited pro forma results do not include any expected benefits of the acquisitions. Accordingly, the unaudited pro forma results are not necessarily indicative of either future results of operations or results that might have been achieved had the acquisitions been consummated as of January 1, 2018 and January 1, 2017. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2019 ​ 2018 ​ 2019 ​ 2018 Revenue ​ $ 74,270 ​ $ 65,501 ​ $ 217,231 ​ $ 184,286 Net (loss) income ​ ​ (8,104) ​ ​ 4,472 ​ ​ (26,200) ​ ​ (52,361) ​

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 30, 2019
Property and Equipment.
Property and Equipment	6. Property and Equipment ​ Depreciation expense on property and equipment for the three months ended September 30, 2019 and 2018 was $1,083 and $851, respectively. Depreciation expense on property and equipment for the nine months ended September 30, 2019 and 2018 was $3,180 and $2,566, respectively. ​

Leases

Leases	9 Months Ended
	Sep. 30, 2019
Leases
Leases	7. Leases ​ The Company has entered into various operating and finance leases for office space and equipment. The operating leases expire on various dates through 2030, and certain of such leases also contain renewal options and escalation clauses. In addition to the base rent payments, the Company will be obligated to pay a pro rata share of operating expenses and taxes. ​ The components of lease expense were as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ ​ September 30, ​ 2019 2018 ​ 2019 2018 Operating lease cost $ 1,364 ​ $ 817 ​ $ 3,796 ​ $ 2,248 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Finance lease cost: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amortization of leased assets ​ 116 ​ ​ 254 ​ ​ 525 ​ ​ 842 Interest on lease liabilities ​ 16 ​ ​ 27 ​ ​ 43 ​ ​ 97 Total finance lease cost ​ 132 ​ ​ 281 ​ ​ 568 ​ ​ 939 Total lease cost $ 1,496 ​ $ 1,098 ​ $ 4,364 ​ $ 3,187 ​ Operating lease cost includes short-term lease payments and variable lease payments, which are immaterial. ​ Supplemental balance sheet information related to leases was as follows : ​ ​ ​ ​ ​ ​ September 30, 2019 Operating leases: ​ ​ ​ Operating lease right-of-use assets $ 22,140 ​ ​ ​ ​ ​ Current operating lease liabilities $ 4,214 ​ Noncurrent operating lease liabilities ​ 21,231 ​ Total operating lease liabilities $ 25,445 ​ ​ ​ ​ ​ Finance leases: ​ ​ ​ Property and equipment $ 3,477 ​ Accumulated amortization ​ (2,925) ​ Property and equipment, net $ 552 ​ ​ ​ ​ ​ Current obligations of finance leases $ 334 ​ Finance leases, net of current obligations ​ 6 ​ Total finance lease liabilities $ 340 ​ ​ ​ ​ ​ Weighted average remaining lease term (in years): ​ ​ ​ Operating leases ​ 8.6 ​ Finance leases ​ 0.5 ​ ​ ​ ​ ​ Weighted average discount rate: ​ ​ ​ Operating leases ​ 4.43 % Finance leases ​ 6.06 % ​ Supplemental cash flow information related to leases was as follows: ​ ​ ​ ​ ​ Nine Months Ended ​ September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: ​ ​ Operating cash flows for operating leases $ 3,010 Operating cash flows for finance leases ​ 38 Financing cash flows for finance leases ​ 757 ​ ​ ​ Leased assets obtained in exchange for lease liabilities: ​ ​ Operating leases* $ 4,926 Finance leases ​ — ​ *Excludes operating lease assets acquired in connection with the acquisitions of DoseMe and PrescribeWellness. ​ Maturities of lease liabilities as of September 30, 2019 were as follows: ​ ​ ​ ​ ​ ​ ​ ​ Operating leases Finance leases 2019 $ 1,093 ​ $ 192 2020 ​ 4,451 ​ ​ 150 2021 ​ 3,989 ​ ​ 4 2022 ​ 3,489 ​ ​ — 2023 ​ 3,267 ​ ​ — Thereafter ​ 15,365 ​ ​ — Total minimum lease payments ​ 31,654 ​ ​ 346 Less imputed interest ​ (6,209) ​ ​ (6) Present value of lease liabilities ​ 25,445 ​ ​ 340 Less current portion ​ (4,214) ​ ​ (334) Total long-term lease liabilities $ 21,231 ​ $ 6 ​ As of September 30, 2019, the Company has additional operating lease commitments that have not yet commenced of approximately $3,104 for two office spaces in Tucson, Arizona, which are expected to be occupied in January 2020 and have lease terms of six to seven years from the occupancy date. ​ As previously disclosed in the 2018 Form 10-K and under the previous lease accounting standard, future minimum lease payments for operating and finance leases having initial or remaining cancellable lease terms in excess of one year would have been as follows as of December 31, 2018: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Payments due by period ​ ​ ​ Less ​ ​ ​ ​ More ​ ​ ​ ​ ​ than 1 ​ ​ ​ ​ ​ ​ ​ than 5 ​ ​ Total ​ year ​ 1-3 years ​ 3-5 years ​ years Capital leases ​ $ 1,141 ​ $ 987 ​ $ 154 ​ $ — ​ $ — Operating leases ​ ​ 32,367 ​ ​ 3,793 ​ ​ 7,183 ​ ​ 6,114 ​ ​ 15,277 Total ​ $ 33,508 ​ $ 4,780 ​ $ 7,337 ​ $ 6,114 ​ $ 15,277 ​

Software Development Costs

Software Development Costs	9 Months Ended
	Sep. 30, 2019
Software Development Costs
Software Development Costs	8. Software Development Costs ​ The Company capitalizes certain costs incurred in connection with obtaining or developing its proprietary software platforms, which are used to support its service contracts, including external direct costs of material and services, payroll costs for employees directly involved with the software development, and interest expense related to borrowings attributable to software development. As of September 30, 2019 31, ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2019 December 31, 2018 Software development costs $ 25,521 ​ $ 15,278 Less: accumulated amortization ​ (9,691) ​ ​ (7,030) Software development costs, net $ 15,830 ​ $ 8,248 ​ ​ ​ ​ ​ ​ Capitalized software development costs included above not yet subject to amortization $ 4,236 ​ $ 3,500 ​ Amortization expense for the three months ended September 30, 2019 and 2018 was $1,132 and $464, respectively. Amortization expense for the nine months ended September 30, 2019 and 2018 was $2,661 and $1,594, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2019
Goodwill and Intangible Assets
Goodwill and Intangible Assets	9. Goodwill and Intangible Assets ​ The Company’s goodwill and related changes during the nine months ended September 30, 2019 are as follows: ​ ​ ​ ​ ​ Balance at January 1, 2019 $ 108,213 Goodwill from 2019 acquisitions ​ ​ 42,545 Adjustments to goodwill related to prior year acquisitions ​ ​ 32 Balance at September 30, 2019 ​ $ 150,790 ​ Management has not identified any triggering events during the nine months ended September 30, 2019. ​ Intangible assets consisted of the following as of September 30, 2019 and December 31, 2018: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted Average ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amortization Period ​ ​ ​ ​ Accumulated ​ Intangible ​ (in years) Gross Value Amortization Assets, net September 30, 2019 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Trade names ​ 7.0 ​ $ 11,625 ​ $ (3,687) ​ $ 7,938 Client relationships ​ 12.2 ​ ​ 128,169 ​ ​ (18,202) ​ ​ 109,967 Non-competition agreements ​ 5.0 ​ ​ 7,254 ​ ​ (2,941) ​ ​ 4,313 Developed technology ​ 8.0 ​ ​ 68,593 ​ ​ (13,606) ​ ​ 54,987 Patient database ​ 5.0 ​ ​ 21,700 ​ ​ (2,532) ​ ​ 19,168 Domain name ​ 10.0 ​ ​ 59 ​ ​ (13) ​ ​ 46 Total intangible assets ​ ​ ​ $ 237,400 ​ $ (40,981) ​ $ 196,419 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted Average ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amortization Period ​ ​ ​ ​ Accumulated ​ Intangible ​ (in years) Gross Value Amortization Assets, net December 31, 2018 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Trade names ​ 8.0 ​ $ 7,436 ​ $ (2,357) ​ $ 5,079 Client relationships ​ 9.6 ​ ​ 54,069 ​ ​ (10,757) ​ ​ 43,312 Non-competition agreements ​ 5.0 ​ ​ 6,754 ​ ​ (1,885) ​ ​ 4,869 Developed technology ​ 7.2 ​ ​ 31,191 ​ ​ (7,296) ​ ​ 23,895 Domain name ​ 10.0 ​ ​ 59 ​ ​ (8) ​ ​ 51 Total intangible assets ​ ​ ​ $ 99,509 ​ $ (22,303) ​ $ 77,206 ​ Amortization expense for intangible assets for the three months ended September 30, 2019 and 2018 was $6,927 and $2,782, respectively. Amortization expense for intangible assets for the nine months ended September 30, 2019 and 2018 was $18,678 and $7,949, respectively. ​ The estimated amortization expense for each of the next five years and thereafter is as follows: ​ ​ ​ ​ ​ Years Ending December 31, ​ ​ 2019 (October 1 - December 31) $ 6,931 2020 ​ ​ 27,331 2021 ​ ​ 27,214 2022 ​ ​ 26,123 2023 ​ ​ 24,913 Thereafter ​ ​ 83,907 Total estimated amortization expense ​ $ 196,419 ​

Accrued Expenses and Other Liab

Accrued Expenses and Other Liabilities	9 Months Ended
	Sep. 30, 2019
Accrued Expenses and Other Liabilities
Accrued Expenses and Other Liabilities	​ 10. Accrued Expenses and Other Liabilities ​ As of September 30, 2019 and December 31, 2018, accrued expenses and other liabilities consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2019 December 31, 2018 Employee related expenses ​ $ 14,900 ​ $ 6,357 Contract liability ​ ​ 4,574 ​ ​ 1,580 Client funds obligations* ​ ​ 3,767 ​ ​ 4,751 Contract labor ​ ​ 798 ​ ​ 1,563 Interest ​ ​ 713 ​ ​ 121 Deferred rent ​ ​ — ​ ​ 134 Professional fees ​ ​ 837 ​ ​ 442 Royalties expense ​ ​ 34 ​ ​ 588 Other expenses ​ ​ 2,392 ​ ​ 1,020 Total accrued expenses and other liabilities ​ $ 28,015 ​ $ 16,556 ​ *This amount represents clients’ funds held by the Company, with an offsetting amount included in restricted cash.

Lines of Credit and Long-Term D

Lines of Credit and Long-Term Debt	9 Months Ended
	Sep. 30, 2019
Lines of Credit and Long-Term Debt
Lines of Credit and Long-Term Debt	11. Lines of Credit and Long-Term Debt ​ (a) Lines of Credit ​ On September 6, 2017, the Company entered into an Amended and Restated Loan and Security Agreement (as subsequently amended from time to time, the “Amended and Restated 2015 Line of Credit”), whereby the Company amended and restated its revolving line of credit originally entered into with Bridge Bank (now Western Alliance Bank) in 2015. The Amended and Restated 2015 Line of Credit provides for borrowing availability in an aggregate amount up to ​ Interest on the Amended and Restated 2015 Revolving Line of Credit is calculated at a variable rate based upon Western Alliance Bank's prime rate plus an applicable margin which will range from (0.25%) to 0.25% depending on the Company’s leverage ratio, with Western Alliance Bank's prime rate having a floor of 3.5%. Financial covenants under the Amended and Restated 2015 Revolving Line of Credit require that the Company (i) maintain an unrestricted cash and unused availability balance under the Amended and Restated 2015 Revolving Line of Credit of at least $1,500 at all times (the liquidity covenant), (ii) maintain a leverage ratio of less than 2.50:1.00, on a trailing twelve-month basis starting with the twelve-month period ended December 31, 2017, measured quarterly, and (iii) maintain a minimum quarterly earnings before interest, tax depreciation and amortization (“EBITDA”) of at least 75% of the plan approved by the Company’s Board of Directors (“Board”). In addition, the Company may not contract to make capital expenditures, excluding capitalized software development costs and tenant leasehold improvements, greater than $5,000 in any fiscal year without the consent of Western Alliance Bank. As of September 30, 2019, the Company was in compliance with all covenants related to the Amended and Restated 2015 Revolving Line of Credit, and management expects that the Company will be able to maintain compliance with its covenants. ​ As of September 30, 2019, the Company has an outstanding letter of credit of $300 issued pursuant to the Amended and Restated 2015 Line of Credit in connection with the Company’s lease agreement for its office space in Moorestown, NJ. The letter of credit renews annually and expires in September 2027 and reduces amounts available under the Amended and Restated 2015 Revolving Line of Credit. ​ As of September 30, 2019, there were no amounts outstanding under the Amended and Restated 2015 Revolving Line of Credit. As of December 31, 2018, $45,000 was outstanding under the Amended and Restated 2015 Line of Credit. Amounts available for borrowings under the Amended and Restated 2015 Revolving Line of Credit were $59,700 as of September 30, 2019. ​ As of September 30, 2019, the interest rate on the Amended and Restated 2015 Revolving Line of Credit was 5.58% and interest expense was $351 for the nine months ended September 30, 2019. No interest expense was incurred for the three months ended September 30, 2019 as there were no aggregate borrowings outstanding related to the Amended and Restated 2015 Revolving Line of Credit for the three months ended September 30, 2019. As of September 30, 2018, the interest rate on the Amended and Restated 2015 Revolving Line of Credit was 5.32%, and interest expense was $185 and $252 for the three and nine months ended September 30, 2018, respectively. In connection with the Amended and Restated 2015 Revolving Line of Credit (and all predecessor agreements prior to the amendment or the amendment and restatement thereof), the Company recorded deferred financing costs of $643. The Company is amortizing the deferred financing costs to interest expense using the effective-interest method over the term of the Amended and Restated 2015 Revolving Line of Credit and amortized $74 and $183 to interest expense for the three and nine months ended September 30, 2019, respectively, and $25 and $66 to interest expense for the three and nine months ended September 30, 2018, respectively. ​ (b) Convertible senior subordinated notes ​ On February 12, 2019, the Company issued and sold an aggregate principal amount of $325,000 of 1.75% convertible senior subordinated notes (“2026 Notes”) in a private placement pursuant to Rule 144A under the Securities Act of 1933, as amended. The 2026 Notes bear interest at a rate of 1.75% per year, payable semiannually in arrears on February 15 and August 15 of each year, beginning on August 15, 2019. The notes will mature on February 15, 2026, unless earlier converted or repurchased. The initial conversion rate for the notes is 14.2966 shares of the Company’s common stock per $1 principal amount of notes. This conversion rate is equal to an initial conversion price of approximately $69.95 per share of the Company’s common stock. Net proceeds from the 2026 Notes were used to pay the cost of convertible note hedge transactions (described below), repay amounts outstanding under the Amended and Restated 2015 Revolving Line of Credit, fund the PrescribeWellness acquisition (as described in Note 5), fund the payment of the acquisition-related contingent consideration for SinfoníaRx (“SRx”), and for general corporate purposes. ​ Holders may convert all or any portion of their 2026 Notes at any time prior to the close of business on the business day immediately preceding August 15, 2025 only under the following circumstances: (1) during any calendar quarter commencing after March 31, 2019 (and only during such calendar quarter), if the last reported sale price of the Company’s common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; (2) during the five business day period after any five consecutive trading day period (the measurement period) in which the trading price (as defined in the indenture governing the 2026 Notes) per $1 principal amount of 2026 Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of the Company’s common stock and the conversion rate on each such trading day; or (3) upon the occurrence of specified corporate events, including certain distributions, the occurrence of a fundamental change or make-whole fundamental change (as defined in the indenture governing the 2026 Notes) or a transaction resulting in the Company’s common stock converting into other securities or property or assets. On or after August 15, 2025 until the close of business on the first scheduled trading day immediately preceding the maturity date, a holder may convert all or any portion of its 2026 Notes regardless of the foregoing circumstances. Upon conversion, the Company will pay or deliver, as the case may be, shares of our common stock, cash or a combination thereof at the Company’s option. As of September 30, 2019, none of the conditions allowing holders of the 2026 Notes to convert had been met. ​ In accounting for the issuance of the 2026 Notes, the Company separated the 2026 Notes into liability and equity components. With the assistance of a third party valuation specialist, the carrying amount of the liability component was calculated by utilizing a discounted cash flow model of the contractual cash flows that were discounted at a risk-adjusted interest rate in order to estimate the fair value of a similar debt instrument that does not have an associated convertible feature. The carrying amount of the equity component representing the conversion option was $102,900 and was determined by deducting the fair value of the liability component from the par value of the 2026 Notes. The equity component is not remeasured as long as it continues to meet the conditions for equity classification. The initial associated deferred tax effect of $25,884 was recorded as a reduction of additional paid-in capital because the equity component is not currently expected to be deductible for income tax purposes. The excess of the principal amount of the liability component over its carrying amount (“debt discount”) is amortized to interest expense over the term of the 2026 Notes using the effective interest rate method. The effective interest rate over the contractual term of the 2026 Notes was 8.05%. ​ Debt issuance costs related to the 2026 Notes are comprised of discounts and commissions payable to the initial purchasers of $8,937 and third party offering costs of $435. The Company allocated the total amount incurred to the liability and equity components of the 2026 Notes based on their relative values. Issuance costs attributable to the liability component were $6,405 and will be amortized to interest expense using the effective interest method over the contractual term. Issuance costs attributable to the equity component were netted with the equity component in stockholders’ equity. ​ During the three months ended September 30, 2019, the Company recognized $4,449 of interest expense related to the 2026 Notes, of which $1,437 was accrued and $3,012 was non-cash accretion of the debt discounts recorded. During the nine months ended September 30, 2019, the Company recognized $11,108 of interest expense related to the 2026 Notes, of which $3,602 was accrued and $7,506 was non-cash accretion of the debt discounts recorded. During the third quarter of 2019, the Company made a $2,891 interest payment on the 2026 Notes. The 2026 Notes have been, and will be, classified as long-term debt on the Company’s consolidated balance sheets until such Notes are within one year of maturity. The 2026 Notes have a carrying value of $223,202 as of September 30, 2019. Accrued interest payable on the 2026 Notes of $711 as of September 30, 2019 is included in accrued expenses and other liabilities on the consolidated balance sheets. ​ (c) Convertible Note Hedge and Warrant Transactions ​ In connection with the offering of the 2026 Notes, the Company entered into convertible note hedge transactions with affiliates of certain of the initial purchasers (the “option counterparties”) of the 2026 Notes pursuant to the terms of call option confirmations. The Company has the option to purchase a total of 4,646,393 shares of its common stock at a price of approximately $69.95 per share. The total premiums paid for the note hedges were $101,660. The Company also entered into warrant transactions with the option counterparties whereby they have the option to purchase 4,646,393 shares of the Company’s common stock at a price of $105.58 per share. The Company received $65,910 in cash proceeds from the sale of the warrants. As these instruments are considered indexed to the Company's own stock and are considered equity classified, the convertible note hedges and warrants are recorded in stockholders’ equity, are not accounted for as derivatives and are not remeasured each reporting period. The net costs incurred in connection with the convertible note hedge and warrant transactions were recorded as a reduction to additional paid-in capital on the Company’s consolidated balance sheets. The convertible note hedge transactions are expected generally to reduce the potential dilution to the Company’s common stock upon conversion of the 2026 Notes and/or offset any potential cash payments the Company is required to make in excess of the principal amount of converted 2026 Notes, as the case may be. The warrant transactions could separately have a dilutive effect on the Company’s common stock to the extent that the market price per share of the Company’s common stock exceeds the strike price of the warrants. (d) Long-term debt ​ The following table represents the total long-term debt obligations of the Company at September 30, 2019 and December 31, 2018: ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2019 December 31, 2018 Convertible senior subordinated notes ​ $ 325,000 ​ $ — Unamortized discount, including debt issuance costs, on convertible senior subordinated notes ​ ​ (101,798) ​ ​ — Convertible senior subordinated notes, net ​ ​ 223,202 ​ ​ — Finance leases ​ ​ 340 ​ ​ 1,097 Total long-term debt and finance leases, net ​ ​ 223,542 ​ ​ 1,097 Less current portion, net ​ ​ (334) ​ ​ (945) Total long-term debt and finance leases, less current portion, net ​ $ 223,208 ​ $ 152 ​ (e) Other Financing ​ In May 2016, the Company signed a prime vendor agreement with AmerisourceBergen Drug Corporation (“AmerisourceBergen”), which was effective March 2016 and required a monthly minimum purchase obligation of approximately $1,750. This agreement was amended and restated effective May 1, 2016 with a three-year term. The agreement was not renewed upon expiration in April 2019, but the Company continues to purchase from AmerisourceBergen from time-to-time on a purchase order basis. Pursuant to the terms of a security agreement entered into in connection with the prime vendor agreement, which still remains in place, AmerisourceBergen also holds a subordinated security interest in all of the Company’s assets. ​ On March 29, 2019, the Company entered into an Affiliated Pharmacy Agreement and Pharmaceutical Program Supply Agreement with Thrifty Drug Stores, Inc. (“Thrifty Drug Agreements”) to replace the prime vendor agreement with AmerisourceBergen. Pursuant to the terms of the Thrifty Drug Agreements, which are in effect through September 30, 2020, the Company has agreed to purchase not less than 98% of the Company’s total prescription product requirements from Thrifty Drug Stores, Inc. The Company commenced purchasing prescription products under the Thrifty Drug Agreements in May 2019. The Thrifty Drug Agreements authorize Thrifty Drug Stores, Inc. to hold a security interest in all of the products purchased by the Company under the Thrifty Drug Agreements. ​ As of September 30, 2019, the Company had $1,854 due to AmerisourceBergen and Thrifty Drug Stores as a result of prescription drug purchases. As of December 31, 2018, the Company had $5,340 due to AmerisourceBergen as a result of prescription drug purchases.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2019
Income Taxes
Income Taxes	12. Income Taxes ​ For the nine months ended September 30, 2019, the Company recorded an income tax benefit of $10,681, which resulted in an effective tax rate of 29.4%. The tax benefit primarily consists of $5,995 based on the estimated effective tax rate for the full year and $4,072 of windfall tax benefits generated from the vesting of restricted stock, disqualifying dispositions and exercising of nonqualified stock options during the period. ​ For the nine months ended September 30, 2018, the Company recorded an income tax benefit of $4,107, which resulted in an effective tax rate of 10.1%. The tax benefit consists of $4,451 related to windfall tax benefits generated from the vesting of restricted stock, disqualifying dispositions and exercising of nonqualified stock options during the period. The benefit was offset by tax expense of $345 based on the estimated effective tax rate for the full year.

Other Long-term Liabilities

Other Long-term Liabilities	9 Months Ended
	Sep. 30, 2019
Other Long-term Liabilities
Other Long-term Liabilities	13. Other Long-term Liabilities ​ Other long term liabilities as of September 30, 2019 was $93 and represented the long-term portion of contract liabilities for performance obligations related to software maintenance contracts for electronic health records solutions. Other long term liabilities as of December 31, 2018 was $3,268 and primarily represented the long-term portion of deferred rent related to the Company's property leases.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2019
Stockholders' Equity
Stockholders' Equity	14. Stockholders' Equity ​ On April 25, 2017, the Board authorized the Company to repurchase up to $5,000 of its common stock at prevailing market prices, from time to time, through open market, block and privately-negotiated transactions, at such times and in such amounts as management deems appropriate. The Company funds repurchases of its common stock through a combination of cash on hand, cash generated by operations or borrowings under the Amended and Restated 2015 Revolving Line of Credit. During the nine months ended September 30, 2019, the Company did not repurchase any shares of its common stock. During the nine months ended September 30, 2018, the Company repurchased 80,000 shares at an average price of $35.82 per share for a total of $2,866. As of September 30, 2019, $1,175 of common stock remained available for repurchase. ​ In connection with the offering of the 2026 Notes, the Company issued warrants to purchase 4,646,393 shares of the Company’s common stock at a price of $105.58 per share. As of September 30, 2019, no warrants have been exercised and all warrants to purchase shares of the Company’s common stock were outstanding. See Note 11 for additional information related to the 2026 Notes.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2019
Stock-Based Compensation
Stock-Based Compensation	15. Stock-Based Compensation ​ In September 2016, the Company adopted the 2016 Equity Compensation Plan (“2016 Plan”) and merged its 2014 Equity Compensation Plan (“2014 Plan”) into the 2016 Plan. No additional grants were made thereafter under the 2014 Plan. Outstanding grants under the 2014 Plan will continue according to their terms as in effect before the merger with the 2016 Plan, and the shares with respect to outstanding grants under the 2014 Equity Plan will be issued or transferred under the 2016 Plan. During the term of the 2016 Plan, the share reserve will automatically increase on the first trading day in January of each calendar year by an amount equal to the lesser of 5% of the total number of outstanding shares of common stock on the last trading day in December of the prior calendar year or such other number set by the Board. In accordance with the terms of the 2016 Plan, the share reserve increased by 1,027,876 shares on January 2, 2019. As of September 30, 2019, 373,367 shares were available for future grants under the 2016 Plan. ​ Restricted Common Stock ​ The following table summarizes the restricted stock award activity under the 2016 Plan for the nine months ended September 30, 2019: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ average ​ ​ Number ​ grant-date ​ of shares fair value Outstanding at December 31, 2018 ​ 1,070,061 ​ $ 20.61 Granted ​ 589,402 ​ ​ 54.93 Vested ​ (329,375) ​ ​ 19.74 Outstanding at September 30, 2019 ​ 1,330,088 ​ $ 36.04 ​ For the three months ended September 30, 2019 and 2018, $3,550 and $1,074 of expense was recognized related to restricted stock awards, respectively. For the nine months ended September 30, 2019 and 2018, $9,636 and $2,779 of expense was recognized related to restricted stock awards, respectively. As of September 30, 2019, there was unrecognized compensation expense of $33,963 related to non-vested restricted stock awards under the 2016 Plan, which is expected to be recognized over a weighted average period of 3.0 years. ​ Performance-Based Stock Award ​ ​ Other Stock Awards ​ ​ Stock Options ​ The Company recorded $2,849 and $1,299 of stock-based compensation expense related to stock options for the three months ended September 30, 2019 and 2018, respectively. The Company recorded $8,165 and $3,719 of stock-based compensation expense related to stock options for the nine months ended September 30, 2019 and 2018, respectively. The Company records forfeitures as they occur. ​ The estimated fair value of options granted was calculated using a Black-Scholes option-pricing model. The computation of expected life for employees was determined based on the simplified method. The risk-free rate is based on the U.S. Treasury security with terms equal to the expected time of exercise as of the grant date. The Company's common stock had not been publicly traded until its IPO commenced on September 29, 2016; therefore, expected volatility is based on a combination of the historical volatility of the Company’s common stock and the historical volatilities of selected public companies whose services are comparable to that of the Company. The table below sets forth the weighted average assumptions for employee grants during the nine months ended September 30, 2019 and 2018: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, Valuation assumptions: 2019 2018 Expected volatility ​ 69.30 % ​ 58.40 % Expected term (years) ​ 6.03 ​ ​ 6.08 ​ Risk-free interest rate ​ 2.48 % ​ 2.41 % Dividend yield ​ — ​ ​ — ​ ​ The weighted average grant date fair value of employee options granted during the nine months ended September 30, 2019 and 2018 was $34.87 and $19.87 per share, respectively. ​ The following table summarizes stock option activity under the 2016 Plan for the nine months ended September 30, 2019: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ ​ ​ ​ Weighted ​ average ​ ​ ​ ​ ​ ​ ​ average ​ remaining ​ Aggregate ​ ​ Number ​ exercise ​ contractual ​ intrinsic ​ of shares price term value Outstanding at December 31, 2018 ​ 2,490,114 ​ $ 15.70 ​ ​ ​ ​ Granted ​ 689,875 ​ ​ 55.05 ​ ​ ​ ​ ​ Exercised ​ (231,790) ​ ​ 11.63 ​ ​ ​ ​ ​ Forfeited ​ (107,350) ​ ​ 49.04 ​ ​ ​ ​ ​ Outstanding at September 30, 2019 ​ 2,840,849 ​ $ 24.33 ​ 7.0 ​ $ 88,641 Options vested and expected to vest at September 30, 2019 ​ 2,840,849 ​ $ 24.33 ​ 7.0 ​ $ 88,641 Exercisable at September 30, 2019 ​ 1,585,816 ​ $ 11.64 ​ 5.7 ​ $ 68,877 ​ The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the Company’s closing stock price or estimated fair value on the last trading day of the fiscal quarter for those stock options that had exercise prices lower than the fair value of the Company's common stock. This amount changes based on the fair market value of the Company’s stock. The total intrinsic value of options exercised during the nine months ended September 30, 2019 and 2018 was $10,805 and $26,905, respectively. ​ As of September 30, 2019, there was $26,556 of total unrecognized compensation cost related to nonvested stock options granted under the 2016 Plan, which is expected to be recognized over a weighted average period of 3.0 years. ​ Cash received from option exercises for the nine months ended September 30, 2019 and 2018 was $2,503 and $2,590, respectively. ​ The Company recorded total stock-based compensation expense for the three and nine months ended September 30, 2019 and 2018 in the following expense categories of its consolidated statements of operations: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2019 2018 2019 2018 Cost of revenue - product ​ $ 290 ​ $ 171 ​ $ 912 ​ $ 592 Cost of revenue - service ​ ​ 928 ​ ​ 412 ​ ​ 2,906 ​ ​ 1,055 Research and development ​ ​ 2,053 ​ ​ 912 ​ ​ 6,141 ​ ​ 1,431 Sales and marketing ​ ​ 1,132 ​ ​ 401 ​ ​ 3,224 ​ ​ 1,172 General and administrative ​ ​ 2,822 ​ ​ 1,100 ​ ​ 7,800 ​ ​ 2,871 Total stock-based compensation expense ​ $ 7,225 ​ $ 2,996 ​ $ 20,983 ​ $ 7,121 ​

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2019
Fair Value Measurements
Fair Value Measurements	16. Fair Value Measurements ​ The Company’s financial instruments consist of accounts receivable, contract assets, accounts payable, contract liabilities, accrued expenses, acquisition-related contingent consideration, and long-term debt. The carrying values of accounts receivable, contract assets, accounts payable, contract liabilities and accrued expenses are representative of their fair value due to the relatively short-term nature of those instruments. The carrying value of the Company’s line of credit approximates fair value based on the terms of the debt arrangement. See below for additional information on the Company’s convertible senior subordinated notes. ​ The Company has classified liabilities measured at fair value on a recurring basis at September 30, 2019 and December 31, 2018 as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurement ​ ​ at Reporting Date Using ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of ​ Level 1 Level 2 Level 3 September 30, 2019 Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Acquisition-related contingent consideration - long-term ​ $ — ​ $ — ​ $ 11,500 ​ $ 11,500 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurement ​ ​ at Reporting Date Using ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of ​ Level 1 Level 2 Level 3 December 31, 2018 Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Acquisition-related contingent consideration - short-term ​ $ — ​ $ — ​ $ 43,397 ​ $ 43,397 Acquisition-related contingent consideration - long-term ​ ​ — ​ ​ — ​ ​ 7,800 ​ ​ 7,800 ​ ​ $ — ​ $ — ​ $ 51,197 ​ $ 51,197 ​ Acquisition-related contingent consideration is measured at fair value on a recurring basis using unobservable inputs, hence these instruments represent Level 3 measurements within the fair value hierarchy. The acquisition-related contingent consideration liability represents the estimated fair value of the additional cash and equity consideration payable that is contingent upon the achievement of certain financial and performance milestones. In accordance with Accounting Standards Codification 805, Business Combinations, ​ In connection with the acquisition of the SRx business, additional contingent consideration was payable by the Company based on SRx’s EBITDA, as defined in the merger agreement, multiplied by a variable EBITDA multiple, which was based on a formula as set forth in the merger agreement. The SRx acquisition-related contingent consideration, which was liability-classified, was recorded at the estimated fair value at the acquisition date of September 6, 2017. The Company, with the assistance of a third-party appraiser, utilized a Monte Carlo simulation to derive estimates of the contingent consideration payments as of the acquisition date and at each subsequent period. During the three months ended September 30, 2018, the Company recorded a $8,319 remeasurement gain for the change in the fair value of the SRx acquisition-related contingent consideration primarily based on a decrease in SRx’s projected EBITDA for the year. During the nine months ended September 30, 2018, the Company recorded a $40,069 charge for the change in the fair value of the SRx acquisition-related contingent consideration primarily based on an increase in the projected EBITDA multiple used in the contingent consideration payment calculation as a result of an increase in the Company’s market capitalization. As of December 31, 2018, the fair value of the SRx acquisition-related contingent consideration was calculated to be $81,692, of which $39,774 was equity-classified. During the nine months ended September 30, 2019, the Company recorded a $624 charge for the change in fair value of the final SRx acquisition-related contingent consideration amount. During the first quarter of 2019, the Company made the final cash payment of $43,150 and issued 614,225 shares of its common stock, with a fair value of $39,166, in full satisfaction of the SRx acquisition-related contingent consideration payable. ​ The Peak PACE acquisition-related contingent consideration, which was liability-classified, was recorded at the estimated fair value at the acquisition date of May 1, 2018. The contingent consideration payable was based on Peak PACE’s EBITDA, as defined in the asset purchase agreement, multiplied by an EBITDA multiple. The Company, with the assistance of a third-party appraiser, utilized a Monte Carlo simulation to derive estimates of the contingent consideration payments as of the acquisition date and at each subsequent period. During the nine months ended September 30, 2019, the Company recorded a $163 charge for the change in the fair value of the Peak PACE acquisition-related contingent consideration amount. The fair value of the Peak PACE acquisition-related contingent consideration was calculated to be $1,479 as December 31, 2018. The Company made the final cash payment of $1,642 in full satisfaction of the Peak PACE acquisition-related contingent consideration payable during the second quarter of 2019. ​ The Cognify acquisition-related contingent consideration, which is liability-classified, was recorded at the estimated fair value at the acquisition date of October 19, 2018. The contingent consideration payable is based on a multiple of the excess of Cognify’s 2021 revenues and EBITDA over its 2018 revenues and EBITDA, as defined in the stock purchase agreement. The Company, with the assistance of a third-party appraiser, utilizes a Monte Carlo simulation to derive estimates of the contingent consideration payments as of the acquisition date and at each subsequent period. During the three and nine months ended September 30, 2019, the Company recorded a $1,300 and $3,700 charge, respectively, for the change in the fair value of Cognify acquisition-related contingent consideration primarily due to an amendment of the certain definitions used in the calculation of the contingent consideration set forth in the stock purchase agreement and the decreased discount period to the final measurement date. The fair value of the Cognify acquisition-related contingent consideration was calculated to be $11,500 and $7,800 as of September 30, 2019 and December 31, 2018, respectively. The final amount of the contingent consideration liability will be fixed as of December 31, 2021. ​ The DoseMe acquisition-related contingent consideration, which was liability-classified, was recorded at the estimated fair value at the acquisition date of January 2, 2019. The contingent consideration payable was based on a multiple of DoseMe’s revenues associated with signed contracts during the twelve-month period ending November 30, 2019, as defined in the share purchase deed. The Company, with the assistance of a third-party appraiser, utilized a Monte Carlo simulation to derive estimates of the contingent consideration payments as of the acquisition date and at each subsequent period. During the three and nine months ended September 30, 2019, the Company recorded a $210 and $30 charge, respectively, for the change in fair value of the final DoseMe acquisition-related contingent consideration amount. During the third quarter of 2019, the Company elected to accelerate the payment of the contingent consideration and made a final cash payment of $8,750 in full satisfaction of the DoseMe acquisition-related contingent consideration payable. ​ The changes in fair value of the Company’s acquisition-related contingent consideration for the nine months ended September 30, 2019 was as follows: ​ ​ ​ ​ ​ Balance at December 31, 2018 $ 51,197 Acquisition date fair value of the DoseMe contingent consideration ​ ​ 8,720 Cash consideration paid ​ ​ (53,542) Adjustments to fair value measurement ​ ​ 4,516 Adjustment to reclassify amounts settled in cash (previously reflected in equity) ​ ​ 609 Balance at September 30, 2019 ​ $ 11,500 ​ The following table presents the financial instruments that are not carried at fair value but require fair value disclosures as of September 30, 2019: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Face Value Carrying Value Fair Value 1.75% Convertible Senior Subordinated Notes due 2026 (the “2026 Notes”) ​ $ 325,000 ​ $ 223,202 ​ $ 353,909 ​ The fair value of the 2026 Notes at each balance sheet date is determined based on recent quoted market prices for these notes which is a level 2 measurement. As discussed in Note 11, the 2026 Notes are carried at their aggregate face value of $325,000, less any unaccreted debt discount and unamortized debt issuance costs.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2019
Commitments and Contingencies
Commitments and Contingencies	17. Commitments and Contingencies ​ The Company is not currently involved in any significant claims or legal actions that, in the opinion of management, will have a material adverse impact on the Company.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2019
Accounting policies
Basis of Presentation	(a) Basis of Presentation ​ The accompanying unaudited consolidated financial statements of the Company have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) and applicable rules and regulations of the SEC regarding interim financial reporting. The unaudited interim consolidated financial statements have been prepared on the same basis as the annual audited consolidated financial statements and, in the opinion of management, reflect all adjustments (consisting of normal recurring accruals and adjustments), necessary to present fairly the Company's interim consolidated financial position for the periods indicated. The interim results for the three and nine months ended September 30, 2019 are not necessarily indicative of results to be expected for the year ending December 31, 2019, any other interim periods, or any future year or period. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the audited consolidated financial statements and accompanying notes included in the 2018 Form 10-K.
Use of Estimates	(b) Use of Estimates ​ The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. ​ On an ongoing basis, management evaluates its estimates and assumptions, including, but not limited to, those related to: (i) the fair value of assets acquired and liabilities assumed for business combinations, (ii) the recognition and disclosure of contingent liabilities, (iii) the useful lives of long-lived assets (including definite-lived intangible assets), (iv) the evaluation of revenue recognition criteria, (v) assumptions used in the Black-Scholes option-pricing model to determine the fair value of stock-based compensation instruments, (vi) the realizability of long-lived assets including goodwill and intangible assets, (vii) the assumptions used to determine the fair value of right-of-use assets and liabilities for the Company’s leases, and (viii) the assumptions used to determine the fair value of convertible debt instruments and related equity-classified conversion option. These estimates are based on historical data and experience, as well as various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. The Company has engaged and may, in the future, engage third-party valuation specialists to assist with estimates related to the valuation of assets and liabilities acquired. Such estimates often require the selection of appropriate valuation methodologies and models, and significant judgment in evaluating ranges of assumptions and financial inputs. Actual results may differ from those estimates under different assumptions or circumstances.
Revenue Recognition	(c) Revenue Recognition ​ The Company evaluates its contractual arrangements to determine the performance obligations and transaction prices. Revenue is allocated to each performance obligation and recognized when the related performance obligation is satisfied. Shipping and handling costs associated with outbound freight after control over a product has transferred to a customer are accounted for as a fulfillment cost and are included in cost of revenue. See Note 3 for additional detail about the Company’s products and service lines.
Restricted Cash	(f) Restricted Cash ​ Cash and cash equivalents that are restricted as to withdrawal or use under certain contractual agreements are recorded in restricted cash on the Company’s consolidated balance sheets. As part of the Company’s third party administrative services, which fall under the Company’s health plan management services, the Company holds funds on behalf of its clients. These amounts are recorded as restricted cash with an offsetting liability recorded in accrued expenses and other liabilities on the Company’s consolidated balance sheets. ​ The following table provides a reconciliation of cash and restricted cash reported within the consolidated balance sheets that sum to the total cash and restricted cash as reported in the consolidated statements of cash flows. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ ​ 2019 ​ 2018 Cash ​ $ 47,302 ​ $ 13,080 Restricted cash ​ ​ 3,767 ​ ​ 867 Total cash and restricted cash as presented in the consolidated statement of cash flows ​ $ 51,069 ​ $ 13,947
Accounts Receivable, net	(g) Accounts Receivable, net ​ Accounts receivable are recorded at the invoiced amount and do not bear interest. The Company maintains an allowance for doubtful accounts for estimated losses inherent in its accounts receivable portfolio. In establishing the required allowance, management considers historical losses adjusted to take into account current market conditions and the Company’s clients’ financial condition, the amount of receivables in dispute and the current receivables aging and current payment patterns. The Company reviews its allowance for doubtful accounts monthly. The allowance for doubtful accounts was $379 and $528 as of September 30, 2019 and December 31, 2018, respectively. ​
Leases	(h) Leases ​ The Company determines if an arrangement is a lease at inception. As of January 1, 2019, operating leases are included in operating lease right-of-use (“ROU”) assets, current operating lease liabilities, and noncurrent operating lease liabilities in the consolidated balance sheets. Finance leases are included in property and equipment, net, current portion of long-term debt and finance leases, and long-term debt and finance leases in the consolidated balance sheets. ROU assets represent the Company’s right to use an underlying asset for the lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. ​ ROU assets and liabilities are recognized at the lease commencement date based on the estimated net present value of lease payments over the lease term. As the rate implicit in the lease is not readily determinable for most leases, the Company uses its incremental borrowing rate in determining the net present value of lease payments. The Company estimates its incremental borrowing rate for each lease as of the measurement date with consideration of the risk-free rate for varying maturities corresponding to the remaining lease term, the risk premium attributed to the Company’s credit rating for a secured or collateralized instrument, and comparable borrowings of similarly-rated companies. ​ Leases with an initial term of 12 months or less are not recorded on the balance sheet. The lease expense for short-term leases is recognized on a straight-line basis over the lease term. Many leases include options to renew, with the exercise of lease renewal options at the Company’s sole discretion. The lease terms that include options to renew the lease require such renewal to be included when it is reasonably certain that the Company will exercise such option. The depreciable life of finance lease assets and leasehold improvements is limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. ​ The Company’s lease agreements do not contain any residual value guarantees. The Company has elected to include both lease and nonlease components as a single lease component for its operating leases. ​
Recent Accounting Pronouncements	(i) Recent Accounting Pronouncements In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2016-02, Leases Targeted Improvements The Company elected the package of practical expedients permitted under the transition guidance, which permits the Company to carry forward its prior conclusions about lease identification, lease classification, and initial direct costs, but did not elect the hindsight practical expedient. ROU assets and liabilities for the Company’ existing leases were recognized on January 1, 2019 based on the estimated net present value of lease payments over the remaining lease term. The adoption of ASU 2016-02 resulted in the recording of lease assets and lease liabilities of $18,469 and $21,173 , respectively, as of January 1, 2019. The standard had no impact on the Company’s opening balance of retained earnings, consolidated net operations or cash flows. See Note 7 for additional information on the Company’s leases. ​ In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326) Measurement of Credit Losses on Financial Instruments, and ASU 2016-13 is effective for financial statements issued for fiscal years beginning after December 15, 2019. . ​ In January 2017, the FASB issued ASU No. 2017-04, Intangibles – Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment ​ In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement ​ In August 2018, the FASB issued ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract
Product
Accounting policies
Cost of Revenue	(d) Cost of Product Revenue (exclusive of depreciation and amortization) ​ Cost of product revenue includes all costs directly related to the fulfillment and distribution of prescription drugs as part of the Company’s MRM offerings. Costs consist primarily of the purchase price of the prescription drugs the Company dispenses, expenses to package, dispense and distribute prescription drugs, and expenses associated with the Company's prescription fulfillment centers, including employment costs and stock-based compensation, and expenses related to the hosting of the Company’s technology platforms. Such costs also include direct overhead expenses, as well as allocated miscellaneous overhead costs. The Company allocates miscellaneous overhead costs among functions based on employee headcount. ​
Service
Accounting policies
Cost of Revenue	(e) Cost of Service Revenue (exclusive of depreciation and amortization) ​ Cost of service revenue includes all costs directly related to servicing the Company’s MRM service contracts, which primarily consist of labor costs, outside contractors, data acquisition costs, technology services, hosting fees and overhead costs. In addition, service costs include all labor costs, including stock-based compensation expense, directly related to the health plan management and pharmacy cost management services and expenses for claims processing, technology services and overhead costs.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2019
Summary of Significant Accounting Policies
Schedule of reconciliation of cash and restricted cash	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ ​ 2019 ​ 2018 Cash ​ $ 47,302 ​ $ 13,080 Restricted cash ​ ​ 3,767 ​ ​ 867 Total cash and restricted cash as presented in the consolidated statement of cash flows ​ $ 51,069 ​ $ 13,947

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2019
Revenue
Schedule of disaggregation of revenue	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ ​ 2019 ​ ​ 2018 ​ ​ 2019 ​ ​ 2018 Major service lines: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ MRM prescription fulfillment services ​ $ 34,966 ​ $ 28,045 ​ $ 99,320 ​ $ 82,603 MRM services ​ ​ 25,810 ​ ​ 15,467 ​ ​ 75,010 ​ ​ 45,821 Health plan management services ​ ​ 8,905 ​ ​ 5,383 ​ ​ 27,205 ​ ​ 10,220 Pharmacy cost management services ​ ​ 4,557 ​ ​ 5,412 ​ ​ 9,803 ​ ​ 8,073 Other services ​ ​ 32 ​ ​ 111 ​ ​ 146 ​ ​ 243 ​ ​ $ 74,270 ​ $ 54,418 ​ $ 211,484 ​ $ 146,960
Schedule of contract assets and contract liabilities from contracts with customers	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ 2019 ​ 2018 Contract assets ​ $ 6,168 ​ $ 3,075 Contract liabilities ​ ​ 4,667 ​ ​ 1,733 ​
Schedule of significant changes in the contract assets and the contract liabilities balances	​ ​ ​ ​ ​ ​ ​ September 30, ​ ​ 2019 Contract assets: ​ ​ ​ Contract assets, beginning of period ​ $ 3,075 Decreases due to cash received ​ ​ (5,499) Changes to the contract assets at the beginning of the year as a result of changes in estimates ​ ​ 1,547 Increases, net of reclassifications to receivables ​ ​ 7,045 Contract assets, end of period ​ $ 6,168 ​ ​ ​ ​ Contract liabilities: ​ ​ ​ Contract liabilities, beginning of period ​ $ 1,733 Revenue recognized that was included in the contract liabilities balance at the beginning of the period ​ ​ (1,497) Increases due to cash received, excluding amounts recognized as revenue during the period ​ ​ 2,910 Increases due to business combinations, excluding amounts recognized as revenue during the period ​ ​ 1,521 Contract liabilities, end of period ​ $ 4,667

Net (Loss) Income per Share (Ta

Net (Loss) Income per Share (Tables)	9 Months Ended
	Sep. 30, 2019
Net (Loss) Income per Share
Schedule of calculation of basic and diluted net (loss) income per share	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ ​ 2019 ​ 2018 ​ 2019 ​ 2018 Numerator (basic and diluted): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net (loss) income ​ $ (8,104) ​ $ 10,416 ​ $ (25,612) ​ $ (36,704) Denominator (basic): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted average shares of common stock outstanding, basic ​ ​ 20,691,112 ​ ​ 19,217,623 ​ ​ 20,520,357 ​ ​ 18,989,334 Denominator (diluted): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted average shares of common stock outstanding ​ ​ 20,691,112 ​ ​ 19,217,623 ​ ​ 20,520,357 ​ ​ 18,989,334 Effect of potential dilutive securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted average dilutive effect of stock options ​ ​ — ​ ​ 1,898,543 ​ ​ — ​ ​ — Weighted average dilutive effect of restricted shares ​ ​ — ​ ​ 898,821 ​ ​ — ​ ​ — Weighted average dilutive effect of contingently issuable shares ​ ​ — ​ ​ 273,886 ​ ​ — ​ ​ — Weighted average shares of common stock outstanding, diluted ​ ​ 20,691,112 ​ ​ 22,288,873 ​ ​ 20,520,357 ​ ​ 18,989,334 Net (loss) income per share, basic ​ $ (0.39) ​ $ 0.54 ​ $ (1.25) ​ $ (1.93) Net (loss) income per share, diluted ​ $ (0.39) ​ $ 0.47 ​ $ (1.25) ​ $ (1.93)
Schedule of shares excluded from the calculation of diluted net loss per share attributable to common stockholders	​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ 2019 2018 Stock options to purchase common stock 2,840,849 ​ 2,566,855 Unvested restricted stock 1,330,088 ​ 1,063,681 Common stock warrants 4,646,393 ​ — Contingently issuable shares 20,000 ​ 142,679 ​ 8,837,330 ​ 3,773,215

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2019
Schedule of proforma results	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2019 ​ 2018 ​ 2019 ​ 2018 Revenue ​ $ 74,270 ​ $ 65,501 ​ $ 217,231 ​ $ 184,286 Net (loss) income ​ ​ (8,104) ​ ​ 4,472 ​ ​ (26,200) ​ ​ (52,361)
Prescribe Wellness
Schedule of allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities	​ ​ ​ ​ ​ Accounts receivable $ 2,608 Prepaid expenses and other current assets ​ ​ 1,345 Property and equipment ​ ​ 1,155 Operating lease right-of-use-assets ​ ​ 1,467 Trade name ​ ​ 4,100 Developed technology ​ ​ 20,000 Patient database ​ ​ 21,700 Client relationships ​ ​ 74,100 Goodwill ​ ​ 30,714 Total assets acquired ​ $ 157,189 ​ ​ ​ ​ Operating lease liabilities ​ ​ (1,467) Trade accounts payable ​ ​ (1,633) Accrued expenses and other liabilities ​ ​ (5,463) Total purchase price ​ $ 148,626
DoseMe
Schedule of purchase price consideration	​ ​ ​ ​ ​ Cash consideration at closing, net of post-closing adjustments ​ $ 10,136 Stock consideration at closing ​ ​ 9,504 Estimated fair value of contingent consideration ​ ​ 8,720 Total fair value of acquisition consideration ​ $ 28,360
Schedule of allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities	​ ​ ​ ​ ​ Accounts receivable ​ $ 9 Prepaid expenses and other current assets ​ ​ 110 Trade name ​ ​ 89 Developed technology ​ ​ 16,200 Non-competition agreements ​ ​ 500 Goodwill ​ ​ 11,831 Total assets acquired ​ $ 28,739 ​ ​ ​ ​ Trade accounts payable ​ ​ (17) Accrued expenses and other liabilities ​ ​ (362) Total purchase price, including contingent consideration of $8,720 ​ $ 28,360

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2019
Leases
Summary of components of lease expense	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ ​ September 30, ​ 2019 2018 ​ 2019 2018 Operating lease cost $ 1,364 ​ $ 817 ​ $ 3,796 ​ $ 2,248 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Finance lease cost: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amortization of leased assets ​ 116 ​ ​ 254 ​ ​ 525 ​ ​ 842 Interest on lease liabilities ​ 16 ​ ​ 27 ​ ​ 43 ​ ​ 97 Total finance lease cost ​ 132 ​ ​ 281 ​ ​ 568 ​ ​ 939 Total lease cost $ 1,496 ​ $ 1,098 ​ $ 4,364 ​ $ 3,187
Summary of supplemental balance sheet information related to leases	​ ​ ​ ​ ​ ​ September 30, 2019 Operating leases: ​ ​ ​ Operating lease right-of-use assets $ 22,140 ​ ​ ​ ​ ​ Current operating lease liabilities $ 4,214 ​ Noncurrent operating lease liabilities ​ 21,231 ​ Total operating lease liabilities $ 25,445 ​ ​ ​ ​ ​ Finance leases: ​ ​ ​ Property and equipment $ 3,477 ​ Accumulated amortization ​ (2,925) ​ Property and equipment, net $ 552 ​ ​ ​ ​ ​ Current obligations of finance leases $ 334 ​ Finance leases, net of current obligations ​ 6 ​ Total finance lease liabilities $ 340 ​ ​ ​ ​ ​ Weighted average remaining lease term (in years): ​ ​ ​ Operating leases ​ 8.6 ​ Finance leases ​ 0.5 ​ ​ ​ ​ ​ Weighted average discount rate: ​ ​ ​ Operating leases ​ 4.43 % Finance leases ​ 6.06 %
Summary of supplemental cash flow information related to leases	​ ​ ​ ​ ​ Nine Months Ended ​ September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: ​ ​ Operating cash flows for operating leases $ 3,010 Operating cash flows for finance leases ​ 38 Financing cash flows for finance leases ​ 757 ​ ​ ​ Leased assets obtained in exchange for lease liabilities: ​ ​ Operating leases* $ 4,926 Finance leases ​ —
Summary of maturities of operating lease liabilities	Maturities of lease liabilities as of September 30, 2019 were as follows: ​ ​ ​ ​ ​ ​ ​ ​ Operating leases Finance leases 2019 $ 1,093 ​ $ 192 2020 ​ 4,451 ​ ​ 150 2021 ​ 3,989 ​ ​ 4 2022 ​ 3,489 ​ ​ — 2023 ​ 3,267 ​ ​ — Thereafter ​ 15,365 ​ ​ — Total minimum lease payments ​ 31,654 ​ ​ 346 Less imputed interest ​ (6,209) ​ ​ (6) Present value of lease liabilities ​ 25,445 ​ ​ 340 Less current portion ​ (4,214) ​ ​ (334) Total long-term lease liabilities $ 21,231 ​ $ 6 ​
Summary of maturities of finance lease liabilities	Maturities of lease liabilities as of September 30, 2019 were as follows: ​ ​ ​ ​ ​ ​ ​ ​ Operating leases Finance leases 2019 $ 1,093 ​ $ 192 2020 ​ 4,451 ​ ​ 150 2021 ​ 3,989 ​ ​ 4 2022 ​ 3,489 ​ ​ — 2023 ​ 3,267 ​ ​ — Thereafter ​ 15,365 ​ ​ — Total minimum lease payments ​ 31,654 ​ ​ 346 Less imputed interest ​ (6,209) ​ ​ (6) Present value of lease liabilities ​ 25,445 ​ ​ 340 Less current portion ​ (4,214) ​ ​ (334) Total long-term lease liabilities $ 21,231 ​ $ 6
Summary of future minimum lease payments for finance leases	As previously disclosed in the 2018 Form 10-K and under the previous lease accounting standard, future minimum lease payments for operating and finance leases having initial or remaining cancellable lease terms in excess of one year would have been as follows as of December 31, 2018: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Payments due by period ​ ​ ​ Less ​ ​ ​ ​ More ​ ​ ​ ​ ​ than 1 ​ ​ ​ ​ ​ ​ ​ than 5 ​ ​ Total ​ year ​ 1-3 years ​ 3-5 years ​ years Capital leases ​ $ 1,141 ​ $ 987 ​ $ 154 ​ $ — ​ $ — Operating leases ​ ​ 32,367 ​ ​ 3,793 ​ ​ 7,183 ​ ​ 6,114 ​ ​ 15,277 Total ​ $ 33,508 ​ $ 4,780 ​ $ 7,337 ​ $ 6,114 ​ $ 15,277
Summary of future minimum lease payments for operating leases	​ As previously disclosed in the 2018 Form 10-K and under the previous lease accounting standard, future minimum lease payments for operating and finance leases having initial or remaining cancellable lease terms in excess of one year would have been as follows as of December 31, 2018: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Payments due by period ​ ​ ​ Less ​ ​ ​ ​ More ​ ​ ​ ​ ​ than 1 ​ ​ ​ ​ ​ ​ ​ than 5 ​ ​ Total ​ year ​ 1-3 years ​ 3-5 years ​ years Capital leases ​ $ 1,141 ​ $ 987 ​ $ 154 ​ $ — ​ $ — Operating leases ​ ​ 32,367 ​ ​ 3,793 ​ ​ 7,183 ​ ​ 6,114 ​ ​ 15,277 Total ​ $ 33,508 ​ $ 4,780 ​ $ 7,337 ​ $ 6,114 ​ $ 15,277

Software Development Costs (Tab

Software Development Costs (Tables)	9 Months Ended
	Sep. 30, 2019
Software Development Costs
Schedule of capitalized software costs	​ ​ ​ ​ ​ ​ ​ ​ September 30, 2019 December 31, 2018 Software development costs $ 25,521 ​ $ 15,278 Less: accumulated amortization ​ (9,691) ​ ​ (7,030) Software development costs, net $ 15,830 ​ $ 8,248 ​ ​ ​ ​ ​ ​ Capitalized software development costs included above not yet subject to amortization $ 4,236 ​ $ 3,500

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2019
Goodwill and Intangible Assets
Schedule of goodwill	​ ​ ​ ​ ​ Balance at January 1, 2019 $ 108,213 Goodwill from 2019 acquisitions ​ ​ 42,545 Adjustments to goodwill related to prior year acquisitions ​ ​ 32 Balance at September 30, 2019 ​ $ 150,790
Schedule of intangible assets	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted Average ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amortization Period ​ ​ ​ ​ Accumulated ​ Intangible ​ (in years) Gross Value Amortization Assets, net September 30, 2019 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Trade names ​ 7.0 ​ $ 11,625 ​ $ (3,687) ​ $ 7,938 Client relationships ​ 12.2 ​ ​ 128,169 ​ ​ (18,202) ​ ​ 109,967 Non-competition agreements ​ 5.0 ​ ​ 7,254 ​ ​ (2,941) ​ ​ 4,313 Developed technology ​ 8.0 ​ ​ 68,593 ​ ​ (13,606) ​ ​ 54,987 Patient database ​ 5.0 ​ ​ 21,700 ​ ​ (2,532) ​ ​ 19,168 Domain name ​ 10.0 ​ ​ 59 ​ ​ (13) ​ ​ 46 Total intangible assets ​ ​ ​ $ 237,400 ​ $ (40,981) ​ $ 196,419 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted Average ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Amortization Period ​ ​ ​ ​ Accumulated ​ Intangible ​ (in years) Gross Value Amortization Assets, net December 31, 2018 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Trade names ​ 8.0 ​ $ 7,436 ​ $ (2,357) ​ $ 5,079 Client relationships ​ 9.6 ​ ​ 54,069 ​ ​ (10,757) ​ ​ 43,312 Non-competition agreements ​ 5.0 ​ ​ 6,754 ​ ​ (1,885) ​ ​ 4,869 Developed technology ​ 7.2 ​ ​ 31,191 ​ ​ (7,296) ​ ​ 23,895 Domain name ​ 10.0 ​ ​ 59 ​ ​ (8) ​ ​ 51 Total intangible assets ​ ​ ​ $ 99,509 ​ $ (22,303) ​ $ 77,206
Schedule of estimated amortization expense	​ ​ ​ ​ ​ Years Ending December 31, ​ ​ 2019 (October 1 - December 31) $ 6,931 2020 ​ ​ 27,331 2021 ​ ​ 27,214 2022 ​ ​ 26,123 2023 ​ ​ 24,913 Thereafter ​ ​ 83,907 Total estimated amortization expense ​ $ 196,419

Accrued Expenses and Other Li_2

Accrued Expenses and Other Liabilities (Tables)	9 Months Ended
	Sep. 30, 2019
Accrued Expenses and Other Liabilities
Schedule of accrued expenses and other liabilities	​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2019 December 31, 2018 Employee related expenses ​ $ 14,900 ​ $ 6,357 Contract liability ​ ​ 4,574 ​ ​ 1,580 Client funds obligations* ​ ​ 3,767 ​ ​ 4,751 Contract labor ​ ​ 798 ​ ​ 1,563 Interest ​ ​ 713 ​ ​ 121 Deferred rent ​ ​ — ​ ​ 134 Professional fees ​ ​ 837 ​ ​ 442 Royalties expense ​ ​ 34 ​ ​ 588 Other expenses ​ ​ 2,392 ​ ​ 1,020 Total accrued expenses and other liabilities ​ $ 28,015 ​ $ 16,556 ​ *This amount represents clients’ funds held by the Company, with an offsetting amount included in restricted cash.

Lines of Credit and Long-Term_2

Lines of Credit and Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2019
Lines of Credit and Long-Term Debt
Schedule of long-term debt obligations	​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2019 December 31, 2018 Convertible senior subordinated notes ​ $ 325,000 ​ $ — Unamortized discount, including debt issuance costs, on convertible senior subordinated notes ​ ​ (101,798) ​ ​ — Convertible senior subordinated notes, net ​ ​ 223,202 ​ ​ — Finance leases ​ ​ 340 ​ ​ 1,097 Total long-term debt and finance leases, net ​ ​ 223,542 ​ ​ 1,097 Less current portion, net ​ ​ (334) ​ ​ (945) Total long-term debt and finance leases, less current portion, net ​ $ 223,208 ​ $ 152

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2019
Stock-Based Compensation
Summary of restricted stock award activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ average ​ ​ Number ​ grant-date ​ of shares fair value Outstanding at December 31, 2018 ​ 1,070,061 ​ $ 20.61 Granted ​ 589,402 ​ ​ 54.93 Vested ​ (329,375) ​ ​ 19.74 Outstanding at September 30, 2019 ​ 1,330,088 ​ $ 36.04
Schedule of weighted average assumptions for employee grants	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, Valuation assumptions: 2019 2018 Expected volatility ​ 69.30 % ​ 58.40 % Expected term (years) ​ 6.03 ​ ​ 6.08 ​ Risk-free interest rate ​ 2.48 % ​ 2.41 % Dividend yield ​ — ​ ​ — ​
Summary of stock option activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ ​ ​ ​ Weighted ​ average ​ ​ ​ ​ ​ ​ ​ average ​ remaining ​ Aggregate ​ ​ Number ​ exercise ​ contractual ​ intrinsic ​ of shares price term value Outstanding at December 31, 2018 ​ 2,490,114 ​ $ 15.70 ​ ​ ​ ​ Granted ​ 689,875 ​ ​ 55.05 ​ ​ ​ ​ ​ Exercised ​ (231,790) ​ ​ 11.63 ​ ​ ​ ​ ​ Forfeited ​ (107,350) ​ ​ 49.04 ​ ​ ​ ​ ​ Outstanding at September 30, 2019 ​ 2,840,849 ​ $ 24.33 ​ 7.0 ​ $ 88,641 Options vested and expected to vest at September 30, 2019 ​ 2,840,849 ​ $ 24.33 ​ 7.0 ​ $ 88,641 Exercisable at September 30, 2019 ​ 1,585,816 ​ $ 11.64 ​ 5.7 ​ $ 68,877
Schedule of recorded stock-based compensation expense related to stock options	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ September 30, ​ September 30, ​ 2019 2018 2019 2018 Cost of revenue - product ​ $ 290 ​ $ 171 ​ $ 912 ​ $ 592 Cost of revenue - service ​ ​ 928 ​ ​ 412 ​ ​ 2,906 ​ ​ 1,055 Research and development ​ ​ 2,053 ​ ​ 912 ​ ​ 6,141 ​ ​ 1,431 Sales and marketing ​ ​ 1,132 ​ ​ 401 ​ ​ 3,224 ​ ​ 1,172 General and administrative ​ ​ 2,822 ​ ​ 1,100 ​ ​ 7,800 ​ ​ 2,871 Total stock-based compensation expense ​ $ 7,225 ​ $ 2,996 ​ $ 20,983 ​ $ 7,121

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2019
Fair Value Measurements
Schedule of classified liabilities measured at fair value on recurring basis	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurement ​ ​ at Reporting Date Using ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of ​ Level 1 Level 2 Level 3 September 30, 2019 Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Acquisition-related contingent consideration - long-term ​ $ — ​ $ — ​ $ 11,500 ​ $ 11,500 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fair Value Measurement ​ ​ at Reporting Date Using ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance as of ​ Level 1 Level 2 Level 3 December 31, 2018 Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Acquisition-related contingent consideration - short-term ​ $ — ​ $ — ​ $ 43,397 ​ $ 43,397 Acquisition-related contingent consideration - long-term ​ ​ — ​ ​ — ​ ​ 7,800 ​ ​ 7,800 ​ ​ $ — ​ $ — ​ $ 51,197 ​ $ 51,197
Schedule of reconciliation of liability measured at fair value on recurring basis using significant unobservable inputs (Level 3)	​ ​ ​ ​ ​ Balance at December 31, 2018 $ 51,197 Acquisition date fair value of the DoseMe contingent consideration ​ ​ 8,720 Cash consideration paid ​ ​ (53,542) Adjustments to fair value measurement ​ ​ 4,516 Adjustment to reclassify amounts settled in cash (previously reflected in equity) ​ ​ 609 Balance at September 30, 2019 ​ $ 11,500
Schedule of carrying value and fair value of financial instruments	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Face Value Carrying Value Fair Value 1.75% Convertible Senior Subordinated Notes due 2026 (the “2026 Notes”) ​ $ 325,000 ​ $ 223,202 ​ $ 353,909

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Dec. 31, 2017
Summary of Significant Accounting Policies
Cash	$ 47,302	$ 20,278	$ 13,080
Restricted cash	3,767	4,751	867
Total cash and restricted cash as presented in the consolidated statement of cash flows	$ 51,069	$ 25,029	$ 13,947	$ 10,430

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Accounts Receivable, net (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Accounts Receivable, net
Allowance for doubtful accounts	$ 379	$ 528

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Leases (Details) - USD ($) $ in Thousands	Jan. 01, 2019	Sep. 30, 2019
Recent Accounting Pronouncements
Lease, Practical Expedients, Package	true
Lease, Practical Expedient, Use of Hindsight	false
Net lease assets		$ 22,140
Lease liabilities		$ 25,445
ASU 2016-02
Recent Accounting Pronouncements
Change in Accounting Principle, Accounting Standards Update, Adopted	true
ASU 2016-02 | Restatement
Recent Accounting Pronouncements
Net lease assets	$ 18,469
Lease liabilities	$ 21,173

Revenue - General (Details)

Revenue - General (Details)	9 Months Ended
	Sep. 30, 2019
Minimum
Contract with customer
Contract term	1 year
Termination notice period	0 days
Maximum
Contract with customer
Contract term	5 years
Termination notice period	180 days
Pharmacy cost management services
Contract with customer
Collection period after data submission	180 days

Revenue - Disaggregation (Detai

Revenue - Disaggregation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of revenue
Revenue	$ 74,270	$ 54,418	$ 211,484	$ 146,960
MRM prescription fulfillment services
Disaggregation of revenue
Revenue	34,966	28,045	99,320	82,603
MRM services
Disaggregation of revenue
Revenue	25,810	15,467	75,010	45,821
Health plan management services
Disaggregation of revenue
Revenue	8,905	5,383	27,205	10,220
Pharmacy cost management services
Disaggregation of revenue
Revenue	4,557	5,412	9,803	8,073
Other services
Disaggregation of revenue
Revenue	$ 32	$ 111	$ 146	$ 243

Revenue - Contract balances (De

Revenue - Contract balances (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018	Dec. 31, 2017
Contract balances
Contract assets	$ 6,168	$ 3,075
Contract liabilities	4,667	1,733	$ 1,350
Data analysis
Contract balances
Contract assets	4,267	2,913
Software services
Contract balances
Contract liabilities	1,735
Prescription medications
Contract balances
Contract liabilities	1,395	858
Software maintenance
Contract balances
Contract liabilities	765	730
MRM services
Contract balances
Contract assets	984
Contract liabilities	602
Health plan management services
Contract balances
Contract assets	917	162
Contract liabilities	$ 170	$ 145

Revenue - Change in contract ba

Revenue - Change in contract balances (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Contract assets:
Contract assets, beginning of period	$ 3,075
Decreases due to cash received	(5,499)
Changes to the contract assets at the beginning of the year as a result of changes in estimates	1,547
Increases, net of reclassifications to receivables	7,045
Contract assets, end of period	6,168
Contract liabilities:
Contract liabilities, beginning of period	1,733	$ 1,350
Revenue recognized that was included in the contract liabilities balance at the beginning of the period	(1,497)	$ (1,278)
Increases due to cash received, excluding amounts recognized as revenue during the period	2,910
Increases due to business combinations, excluding amounts recognized as revenue during the period	1,521
Contract liabilities, end of period	$ 4,667

Net (Loss) Income per Share - E

Net (Loss) Income per Share - EPS (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Numerator (basic and diluted):
Net (loss) income, basic	$ (8,104)	$ 10,416	$ (25,612)	$ (36,704)
Net (loss) income, diluted	$ (8,065)	$ 10,416	$ (25,573)	$ (36,704)
Denominator (basic):
Weighted average shares of common stock outstanding	20,691,112	19,217,623	20,520,357	18,989,334
Denominator (diluted):
Weighted average shares of common stock outstanding	20,691,112	19,217,623	20,520,357	18,989,334
Effect of potential dilutive securities:
Weighted average dilutive effect of contingently issuable shares		273,886
Weighted average shares of common stock outstanding, diluted	20,691,112	22,288,873	20,520,357	18,989,334
Net (loss) income per share, basic (in dollars per share)	$ (0.39)	$ 0.54	$ (1.25)	$ (1.93)
Net (loss) income per share, diluted (in dollars per share)	$ (0.39)	$ 0.47	$ (1.25)	$ (1.93)
Stock options
Effect of potential dilutive securities:
Weighted average dilutive effect of share-based awards		1,898,543
Restricted stock
Effect of potential dilutive securities:
Weighted average dilutive effect of share-based awards		898,821

Net (Loss) Income per Share - A

Net (Loss) Income per Share - Anti-dilutive Securities (Details) - shares	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Securities excluded from the calculation of diluted net loss per share attributable to common stockholders
Amount of antidilutive securities excluded from computation of earnings per share	8,837,330	3,773,215
Stock options
Securities excluded from the calculation of diluted net loss per share attributable to common stockholders
Amount of antidilutive securities excluded from computation of earnings per share	2,840,849	2,566,855
Restricted stock
Securities excluded from the calculation of diluted net loss per share attributable to common stockholders
Amount of antidilutive securities excluded from computation of earnings per share	1,330,088	1,063,681
Common stock warrants
Securities excluded from the calculation of diluted net loss per share attributable to common stockholders
Amount of antidilutive securities excluded from computation of earnings per share	4,646,393
Contingently issuable shares
Securities excluded from the calculation of diluted net loss per share attributable to common stockholders
Amount of antidilutive securities excluded from computation of earnings per share	20,000	142,679

Acquisitions - Prescribe Wellne

Acquisitions - Prescribe Wellness (Details) $ in Thousands	Mar. 05, 2019USD ($)company	Sep. 30, 2019USD ($)	Jun. 30, 2019USD ($)	Mar. 31, 2019USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2018USD ($)	Dec. 31, 2018USD ($)
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Goodwill		$ 150,790						$ 150,790		$ 108,213
Revenue		74,270			$ 54,418			211,484	$ 146,960
Net income (loss)		(8,104)	$ (6,529)	$ (10,979)	10,416	$ (29,026)	$ (18,094)	(25,612)	(36,704)
Amortization expense		6,927			$ 2,782			$ 18,678	$ 7,949
Trade name
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Weighted average amortization period								7 years		8 years
Developed technology
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Weighted average amortization period								8 years		7 years 2 months 12 days
Patient database
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Weighted average amortization period								5 years
Prescribe Wellness
Acquisition
Cash consideration	$ 150,000
Direct acquisition costs		11						$ 3,241
Purchase price consideration
Cash consideration at closing, net of post-closing adjustments	148,626
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Accounts receivable	2,608
Prepaid expenses and other current assets	1,345
Property and equipment	1,155
Operating lease right-of-use-assets	1,467
Goodwill	30,714
Total assets acquired	157,189
Operating lease liabilities	(1,467)
Trade accounts payable	(1,633)
Accrued expenses and other liabilities	(5,463)
Total purchase price	$ 148,626
Weighted average amortization period	11 years 4 months 24 days
Revenue		$ 8,271						$ 18,381
Revenue from Contract with Customer, Product and Service		us-gaap:ServiceMember						us-gaap:ServiceMember
Reduction to revenue recorded due to purchase accounting effects of recording deferred revenue at fair value		$ (463)						$ (1,210)
Net income (loss)		(3,033)						(6,829)
Amortization expense		$ 3,113						$ 7,264
Prescribe Wellness | Minimum
Acquisition
Number of pharmacies with which acquiree facilitates collaboration | company	10,000
Prescribe Wellness | Trade name
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 4,100
Weighted average amortization period	5 years
Prescribe Wellness | Developed technology
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 20,000
Weighted average amortization period	10 years
Prescribe Wellness | Patient database
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 21,700
Weighted average amortization period	5 years
Prescribe Wellness | Client relationships intangible asset
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 74,100
Weighted average amortization period	14 years

Acquisitions - DoseMe (Details)

Acquisitions - DoseMe (Details) - USD ($) $ in Thousands	Jan. 02, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Goodwill		$ 150,790						$ 150,790		$ 108,213
Revenue		74,270			$ 54,418			211,484	$ 146,960
Net income (loss)		(8,104)	$ (6,529)	$ (10,979)	10,416	$ (29,026)	$ (18,094)	(25,612)	(36,704)
Amortization expense		6,927			$ 2,782			$ 18,678	$ 7,949
Trade name
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Weighted average amortization period								7 years		8 years
Developed technology
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Weighted average amortization period								8 years		7 years 2 months 12 days
Non-competition agreement
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Weighted average amortization period								5 years		5 years
DoseMe
Acquisition
Issuance of common stock (in shares)	149,053
Cash payment for acquisition-related contingent consideration		8,750
Direct acquisition costs		0						$ 104
Purchase price consideration
Cash consideration at closing, net of post-closing adjustments	$ 10,136
Stock consideration at closing	9,504
Estimated fair value of contingent consideration	8,720
Total fair value of acquisition consideration	28,360
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Accounts receivable	9
Prepaid expenses and other current assets	110
Goodwill	11,831
Total assets acquired	28,739
Trade accounts payable	(17)
Accrued expenses and other liabilities	(362)
Total purchase price	28,360
Acquisition-related contingent consideration	$ 8,720
Weighted average amortization period	7 years 4 months 24 days
Revenue		$ 88						$ 226
Revenue from Contract with Customer, Product and Service		us-gaap:ServiceMember						us-gaap:ServiceMember
Net income (loss)		$ (1,531)						$ (3,526)
Amortization expense		$ 571						$ 1,712
DoseMe | Maximum
Acquisition
Cash consideration	$ 10,000
Contingent earn out payment	10,000
DoseMe | Trade name
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 89
Weighted average amortization period	4 years
DoseMe | Developed technology
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 16,200
Weighted average amortization period	7 years 6 months
DoseMe | Non-competition agreement
Allocation of the purchase price based on the estimated fair values of the assets acquired and liabilities assumed
Intangible assets	$ 500
Weighted average amortization period	5 years

Acquisitions - Pro forma (unaud

Acquisitions - Pro forma (unaudited) (Details) - 2018 and 2019 Acquisitions - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Acquisition
Revenue	$ 74,270	$ 65,501	$ 217,231	$ 184,286
Net (loss) income	$ (8,104)	$ 4,472	$ (26,200)	$ (52,361)

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Property and Equipment.
Depreciation	$ 1,083	$ 851	$ 3,180	$ 2,566

Leases - Components of Lease Ex

Leases - Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Components of lease expense
Operating lease cost	$ 1,364		$ 3,796
Operating lease cost		$ 817		$ 2,248
Finance lease cost
Amortization of leased assets	116		525
Amortization of leased assets		254		842
Interest on lease liabilities	16		43
Interest on lease liabilities		27		97
Total finance lease cost	132		568
Total finance lease cost		281		939
Total lease cost	$ 1,496		$ 4,364
Total lease cost		$ 1,098		$ 3,187

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet Information (Details) $ in Thousands	Sep. 30, 2019USD ($)
Operating leases
Operating lease right-of-use assets	$ 22,140
Current operating lease liabilities	4,214
Noncurrent operating lease liabilities	21,231
Total operating lease liabilities	25,445
Finance leases
Current obligations of finance leases	334
Finance leases, net of current obligations	6
Total finance lease liabilities	$ 340
Weighted average remaining lease term (in years): Operating leases	8 years 7 months 6 days
Weighted average remaining lease term (in years): Finance leases	6 months
Weighted average discount rate: Operating leases (as a percent)	4.43%
Weighted average discount rate: Finance leases (as a percent)	6.06%
Office space and equipment, Finance leases
Finance leases
Property and equipment	$ 3,477
Accumulated amortization	(2,925)
Property and equipment, net	$ 552

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flow Information (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Leases
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases	$ 3,010
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for finance leases	38
Cash paid for amounts included in the measurement of lease liabilities: Financing cash flows for finance leases	757
Office space and equipment, excluding lease assets acquired in DoseMe and PrescribeWellness acquisitions
Leases
Leased assets obtained in exchange for lease liabilities: Operating leases	$ 4,926

Leases - Maturities of Lease Li

Leases - Maturities of Lease Liabilities (Details) $ in Thousands	Sep. 30, 2019USD ($)
Operating leases
2019	$ 1,093
2020	4,451
2021	3,989
2022	3,489
2023	3,267
Thereafter	15,365
Total minimum lease payments	31,654
Less: imputed interest	(6,209)
Present value of lease liabilities	25,445
Less current portion	(4,214)
Total long-term lease liabilities	21,231
Finance leases
2019	192
2020	150
2021	4
Total minimum lease payments	346
Less: imputed interest	(6)
Present value of lease liabilities	340
Less current portion	(334)
Total long-term lease liabilities	$ 6

Leases - Additional Operating L

Leases - Additional Operating Lease Commitments (Details) - Arizona $ in Thousands	Sep. 30, 2019USD ($)item
Leases
Additional operating lease commitments that have not yet commenced | $	$ 3,104
Number of office spaces | item	2
Minimum
Leases
Lease term for operating lease commitments that have not yet commenced	6 years
Maximum
Leases
Lease term for operating lease commitments that have not yet commenced	7 years

Leases - Future minimum lease p

Leases - Future minimum lease payments - 2018 (Details) $ in Thousands	Dec. 31, 2018USD ($)
Future minimum lease payments for capital leases
Capital leases total	$ 1,141
Less than 1 year	987
1 - 3 years	154
Future minimum lease payments for operating leases
Operating leases total	32,367
Less than 1 year	3,793
1 - 3 years	7,183
3 - 5 years	6,114
More than 5 years	15,277
Future minimum lease payments for capital and operating leases
Leases total	33,508
Less than 1 year	4,780
1 - 3 years	7,337
3 - 5 years	6,114
More than 5 years	$ 15,277

Software Development Costs (Det

Software Development Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Software Development Costs
Software development costs	$ 25,521		$ 25,521		$ 15,278
Less: accumulated amortization	(9,691)		(9,691)		(7,030)
Software development costs, net	15,830		15,830		8,248
Capitalized software development costs included above not yet subject to amortization	4,236		4,236		$ 3,500
Amortization expense	$ 1,132	$ 464	$ 2,661	$ 1,594

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Goodwill and related changes
Goodwill at beginning of period	$ 108,213
Goodwill from acquisitions	42,545
Adjustments to goodwill related to prior year acquisitions	32
Goodwill at end of period	$ 150,790

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Intangible assets (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Intangible Assets
Gross Value	$ 237,400		$ 237,400		$ 99,509
Accumulated Amortization	(40,981)		(40,981)		(22,303)
Intangible Assets, net	196,419		196,419		$ 77,206
Amortization expense	6,927	$ 2,782	$ 18,678	$ 7,949
Trade name
Intangible Assets
Weighted Average Amortization Period			7 years		8 years
Gross Value	11,625		$ 11,625		$ 7,436
Accumulated Amortization	(3,687)		(3,687)		(2,357)
Intangible Assets, net	7,938		$ 7,938		$ 5,079
Client relationships
Intangible Assets
Weighted Average Amortization Period			12 years 2 months 12 days		9 years 7 months 6 days
Gross Value	128,169		$ 128,169		$ 54,069
Accumulated Amortization	(18,202)		(18,202)		(10,757)
Intangible Assets, net	109,967		$ 109,967		$ 43,312
Non-competition agreement
Intangible Assets
Weighted Average Amortization Period			5 years		5 years
Gross Value	7,254		$ 7,254		$ 6,754
Accumulated Amortization	(2,941)		(2,941)		(1,885)
Intangible Assets, net	4,313		$ 4,313		$ 4,869
Developed technology
Intangible Assets
Weighted Average Amortization Period			8 years		7 years 2 months 12 days
Gross Value	68,593		$ 68,593		$ 31,191
Accumulated Amortization	(13,606)		(13,606)		(7,296)
Intangible Assets, net	54,987		$ 54,987		$ 23,895
Patient database
Intangible Assets
Weighted Average Amortization Period			5 years
Gross Value	21,700		$ 21,700
Accumulated Amortization	(2,532)		(2,532)
Intangible Assets, net	19,168		$ 19,168
Domain name
Intangible Assets
Weighted Average Amortization Period			10 years		10 years
Gross Value	59		$ 59		$ 59
Accumulated Amortization	(13)		(13)		(8)
Intangible Assets, net	$ 46		$ 46		$ 51

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Amortization (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Estimated amortization expense
2019 (October 1 - December 31)	$ 6,931
2020	27,331
2021	27,214
2022	26,123
2023	24,913
Thereafter	83,907
Total estimated amortization expense	$ 196,419	$ 77,206

Accrued Expenses and Other Li_3

Accrued Expenses and Other Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Accrued Expenses and Other Liabilities
Employee related expenses	$ 14,900	$ 6,357
Contract liability	4,574	1,580
Client funds obligations	3,767	4,751
Contract labor	798	1,563
Interest	713	121
Deferred rent		134
Professional fees	837	442
Royalties expense	34	588
Other expenses	2,392	1,020
Total accrued expenses and other liabilities	$ 28,015	$ 16,556

Lines of Credit and Long-Term_3

Lines of Credit and Long-Term Debt - Lines of Credit (Details) - 2015 Revolving Line - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2017	Dec. 31, 2018
Lines of Credit
Maximum borrowing capacity	$ 60,000		$ 60,000
Sublimit of loan	1,000		1,000
Unrestricted cash and unused availability balance	1,500		$ 1,500
Trailing period			12 months		12 months
Letter of credit outstanding	300		$ 300
Aggregate borrowings outstanding	0		0			$ 45,000
Amounts available for borrowings	$ 59,700		$ 59,700
Interest rate (as a percent)	5.58%	5.32%	5.58%	5.32%
Interest expense	$ 0	$ 185	$ 351	$ 252
Deferred financing costs	643		643
Amortization of deferred financing costs to interest expense	74	$ 25	$ 183	$ 66
Aggregate borrowings outstanding during the period	$ 0
Prime Rate
Lines of Credit
Floor rate (as a percent)			3.50%
Minimum
Lines of Credit
Minimum EBITDA (as a percent)			75.00%
Minimum | Prime Rate
Lines of Credit
Spread on variable rate (as a percent)			(0.25%)
Maximum
Lines of Credit
Leverage ratio			2.50
Maximum capital expenditure			$ 5,000
Maximum | Prime Rate
Lines of Credit
Spread on variable rate (as a percent)			0.25%

Lines of Credit and Long-Term_4

Lines of Credit and Long-Term Debt - Convertible Senior Subordinated Notes (Details) $ / shares in Units, $ in Thousands	Feb. 12, 2019USD ($)$ / shares	Sep. 30, 2019USD ($)	Sep. 30, 2019USD ($)D	Sep. 30, 2018USD ($)	Dec. 31, 2018USD ($)
Lines of Credit and Long-Term Debt
Cash paid for interest			$ 3,177	$ 251
Long term debt, net		$ 223,202	223,202
Accrued interest payable		713	713		$ 121
Convertible Senior Subordinated Notes
Lines of Credit and Long-Term Debt
Aggregate borrowings	$ 325,000	$ 325,000	$ 325,000
Interest rate (as a percent)	1.75%	1.75%	1.75%
Initial conversion rate	0.0142966
Initial conversion price | $ / shares	$ 69.95
Carrying amount of the equity component representing the conversion option	$ 102,900
Deferred tax effect	$ 25,884
Effective interest rate	8.05%
Debt issuance costs	$ 8,937
Third party offering costs	435
Issuance costs attributable to the liability component	$ 6,405
Interest expense		$ 4,449	$ 11,108
Increase in accrued interest		1,437	3,602
Non-cash accretion of the debt discounts		3,012	7,506
Cash paid for interest		2,891
Long term debt, net		223,202	223,202
Accrued interest payable		711	$ 711
Debt Conversion Scenario One | Convertible Senior Subordinated Notes
Lines of Credit and Long-Term Debt
Trading days | D			20
Consecutive trading days | D			30
Stock price trigger percentage (as a percent)			130.00%
Debt Conversion Scenario Two | Convertible Senior Subordinated Notes
Lines of Credit and Long-Term Debt
Trading days | D			5
Consecutive trading days | D			5
Principal amount		$ 1	$ 1
Stock price trigger percentage (as a percent)			98.00%

Lines of Credit and Long-Term_5

Lines of Credit and Long-Term Debt - Convertible Note Hedge and Warrant Transactions (Details) - USD ($) $ / shares in Units, $ in Thousands	Feb. 12, 2019	Sep. 30, 2019
Lines of Credit and Long-Term Debt
Proceeds from Issuance of Warrants		$ 65,910
Convertible note warrant
Lines of Credit and Long-Term Debt
Option to purchase	4,646,393
Exercise price (in dollars per share)	$ 105.58
Proceeds from Issuance of Warrants	$ 65,910
Note hedges
Lines of Credit and Long-Term Debt
Option to purchase	4,646,393
Exercise price (in dollars per share)	$ 69.95
Premiums paid for the note hedges	$ 101,660

Lines of Credit and Long-Term_6

Lines of Credit and Long-Term Debt - Long-term debt (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Capital Lease Obligations
Long term debt, gross	$ 325,000
Unamortized discount, including debt issuance costs, on convertible senior subordinated notes	(101,798)
Long term debt, net	223,202
Finance leases	340
Capital leases		$ 1,097
Total long-term debt and finance leases, net	223,542	1,097
Less current portion, net	(334)	(945)
Total long-term debt and finance leases, less current portion, net	$ 223,208	$ 152

Lines of Credit and Long-Term_7

Lines of Credit and Long-Term Debt - Other Financing (Details) - USD ($) $ in Thousands	Mar. 29, 2019	May 31, 2016	Sep. 30, 2019	Dec. 31, 2018
AmerisourceBergen and Thrifty Drug Stores, Inc.
Other Financing
Amount due as a result of prescription drug purchases			$ 1,854
AmerisourceBergen
Other Financing
Monthly minimum purchase obligation		$ 1,750
Purchase obligation, period		3 years
Amount due as a result of prescription drug purchases				$ 5,340
Thrifty Drug Stores, Inc.
Other Financing
Purchase obligation (as a percent)	98.00%

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Taxes
Income tax (benefit)	$ (4,101)	$ (838)	$ (10,681)	$ (4,107)
Effective tax rate (as a percent)			29.40%	10.10%
Tax (benefit) based on estimated effective tax rate for the full year			$ (5,995)
Income tax benefit, Tax windfall			$ (4,072)	$ (4,451)
Offset by tax expense based on estimated annual effective tax rate expected				$ 345

Other Long-term Liabilities (De

Other Long-term Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Other Long-term Liabilities
Other long-term liabilities	$ 93	$ 3,268

Stockholders' Equity - Common S

Stockholders' Equity - Common Stock Repurchase (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended
	Mar. 31, 2018	Sep. 30, 2018	Sep. 30, 2019	Apr. 25, 2017
Common Stock Repurchase
Average price per share (in dollars per share)		$ 35.82
Shares repurchased (in dollars)	$ 2,866
Treasury Stock
Common Stock Repurchase
Shares repurchased (in shares)	80,000	80,000
Shares repurchased (in dollars)	$ 2,866	$ 2,866
Common Stock
Common Stock Repurchase
Number of shares authorized to be repurchased				$ 5,000
Common stock available for repurchase			$ 1,175

Stockholders' Equity - Warrants

Stockholders' Equity - Warrants (Details) - Convertible note warrant - $ / shares	9 Months Ended
	Sep. 30, 2019	Feb. 12, 2019
Warrants
Number of shares called by warrants issued		4,646,393
Exercise price (in dollars per share)		$ 105.58
Shares issued from exercise of warrants	0

Stock-Based Compensation - Plan

Stock-Based Compensation - Plans (Details) - shares	Jan. 02, 2019	Sep. 30, 2016	Sep. 30, 2019
2014 Plan
Stock-Based Compensation
Granted (in shares)			0
2016 Plan
Stock-Based Compensation
Automatic increase on share reserve (as a percent)		5.00%
Additional shares authorized	1,027,876
Available for future grant (in shares)			373,367

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Common Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Weighted average grant date fair value
Total stock-based compensation expense (in dollars)	$ 7,225	$ 2,996	$ 20,983	$ 7,121
Restricted stock
Number of shares
Outstanding at beginning of period (in shares)			1,070,061
Granted (in shares)			589,402
Vested (in shares)			(329,375)
Outstanding at end of period (in shares)	1,330,088		1,330,088
Weighted average grant date fair value
Outstanding at beginning of period (in dollars per share)			$ 20.61
Granted (in dollars per share)			54.93
Vested to common stock (in dollars per share)			19.74
Outstanding at end of period (in dollars per share	$ 36.04		$ 36.04
Total stock-based compensation expense (in dollars)	$ 3,550	$ 1,074	$ 9,636	$ 2,779
Unrecognized compensation expense (in dollars)	$ 33,963		$ 33,963
Weighted average period expected to be recognized			3 years

Stock-Based Compensation - Perf

Stock-Based Compensation - Performance Based Stock Award (Details) - USD ($) $ / shares in Units, $ in Thousands	Aug. 06, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Stock-Based Compensation
Stock- based stock awards expense		$ 7,225	$ 2,996	$ 20,983	$ 7,121
Performance Based Stock Award
Stock-Based Compensation
Granted (in shares)	50,000			25,000
Weighted average grant-date fair value (in dollars per share)	$ 61.85
Stock- based stock awards expense		339		$ 1,653
Unrecognized compensation expense (in dollars)		$ 55		$ 55

Stock-Based Compensation - Othe

Stock-Based Compensation - Other Stock Awards (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Stock-Based Compensation
Total stock-based compensation expense (in dollars)	$ 7,225	$ 2,996	$ 20,983	$ 7,121
Other stock awards
Stock-Based Compensation
Granted (in shares)			28,515
Weighted average grant-date fair value (in dollars per share)			$ 53.62
Total stock-based compensation expense (in dollars)	$ 487		$ 1,529

Stock-Based Compensation - Opti

Stock-Based Compensation - Options Valuation (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Stock-Based Compensation
Total stock-based compensation expense (in dollars)	$ 7,225	$ 2,996	$ 20,983	$ 7,121
Stock options
Stock-Based Compensation
Total stock-based compensation expense (in dollars)	$ 2,849	$ 1,299	$ 8,165	$ 3,719
Stock options | Share-based Payment Arrangement, Employee
Valuation assumptions:
Expected volatility (as a percent)			69.30%	58.40%
Expected term (years)			6 years 10 days	6 years 29 days
Risk-free interest rate (as a percent)			2.48%	2.41%
Weighted average grant-date fair value (in dollars per share)			$ 34.87	$ 19.87

Stock-Based Compensation - Op_2

Stock-Based Compensation - Options Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Number of shares
Outstanding at beginning of period (in shares)	2,490,114
Granted (in shares)	689,875
Exercised (in shares)	(231,790)
Forfeited (in shares)	(107,350)
Outstanding at end of the period (in shares)	2,840,849
Options vested and expected to vest at end of the period (in shares)	2,840,849
Exercisable at end of period (in shares)	1,585,816
Weighted average exercise price
Outstanding at beginning of period (in dollars per share)	$ 15.70
Granted (in dollars per share)	55.05
Exercised (in dollars per share)	11.63
Forfeited (in dollars per share)	49.04
Outstanding at end of period (in dollars per share)	24.33
Options vested and expected to vest at end of period (in dollars per share)	24.33
Exercisable at end of period (in dollars per share)	$ 11.64
Weighted average remaining contractual term
Outstanding	7 years
Options vested and expected to vest at of the period	7 years
Exercisable	5 years 8 months 12 days
Aggregate intrinsic value
Outstanding (in dollars)	$ 88,641
Options vested and expected to vest at end of period (in dollars)	88,641
Exercisable (in dollars)	68,877
Additional disclosures
Intrinsic value of options exercised (in dollars)	10,805	$ 26,905
Proceeds from stock options exercised (in dollars)	2,503	$ 2,590
Stock options
Additional disclosures
Total unrecognized compensation cost (in dollars)	$ 26,556
Weighted average period expected to be recognized	3 years

Stock-Based Compensation - Expe

Stock-Based Compensation - Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Stock-based compensation expense
Total stock-based compensation expense (in dollars)	$ 7,225	$ 2,996	$ 20,983	$ 7,121
Cost of revenue - product
Stock-based compensation expense
Total stock-based compensation expense (in dollars)	290	171	912	592
Cost of revenue - service
Stock-based compensation expense
Total stock-based compensation expense (in dollars)	928	412	2,906	1,055
Research and development
Stock-based compensation expense
Total stock-based compensation expense (in dollars)	2,053	912	6,141	1,431
Sales and marketing
Stock-based compensation expense
Total stock-based compensation expense (in dollars)	1,132	401	3,224	1,172
General and administrative
Stock-based compensation expense
Total stock-based compensation expense (in dollars)	$ 2,822	$ 1,100	$ 7,800	$ 2,871

Fair Value Measurements - Liabi

Fair Value Measurements - Liabilities (Details) - Recurring - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Fair Value Measurements
Acquisition-related contingent consideration - short-term		$ 43,397
Acquisition-related contingent consideration - long-term		7,800
Liabilities	$ 11,500	51,197
Level 3
Fair Value Measurements
Acquisition-related contingent consideration - short-term		43,397
Acquisition-related contingent consideration - long-term		7,800
Liabilities	$ 11,500	$ 51,197

Fair Value Measurements - Conti

Fair Value Measurements - Contingent consideration rollforward (Details) - USD ($) $ in Thousands	Jan. 02, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Change in fair value
Change in fair value of acquisition-related contingent consideration expense (income)		$ 1,510			$ (8,419)	$ 4,516	$ 40,385
Change in fair value using significant unobservable inputs (Level 3):
Balance at beginning of period				$ 51,197		51,197
Acquisition date fair value of contingent consideration						8,720
Cash consideration paid						(53,542)
Adjustments to fair value measurement						4,516
Adjustment to reclassify amounts settled in cash (previously reflected in equity)						609
Balance at end of period		11,500				11,500
SinfoniaRx
Change in fair value
Change in fair value of acquisition-related contingent consideration expense (income)					$ 8,319	624	$ 40,069
Contingent consideration								$ 81,692
Contingent consideration equity-classified								39,774
Cash payment for acquisition-related contingent consideration				$ 43,150
Issuance of common stock (in shares)				614,225
Value of shares to be issued				$ 39,166
Peak PACE Solutions
Change in fair value
Change in fair value of acquisition-related contingent consideration expense (income)						163
Cash payment for acquisition-related contingent consideration			$ 1,642
Contingent consideration liability								1,479
Cognify, Inc
Change in fair value
Change in fair value of acquisition-related contingent consideration expense (income)		1,300				3,700
Contingent consideration liability		11,500				11,500		$ 7,800
DoseMe
Change in fair value
Change in fair value of acquisition-related contingent consideration expense (income)		210				$ (30)
Cash payment for acquisition-related contingent consideration		$ 8,750
Issuance of common stock (in shares)	149,053

Fair Value Measurements - Finan

Fair Value Measurements - Financial Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Feb. 12, 2019
Fair Value Measurements
Amount before unaccreted debt discount and unamortized debt issuance costs	$ 325,000
Convertible Senior Subordinated Notes
Fair Value Measurements
Interest rate (as a percent)	1.75%	1.75%
Face value	$ 325,000	$ 325,000
Amount before unaccreted debt discount and unamortized debt issuance costs	325,000
Convertible Senior Subordinated Notes | Carrying Value
Fair Value Measurements
Debt instrument	223,202
Convertible Senior Subordinated Notes | Fair Value
Fair Value Measurements
Debt instrument	$ 353,909