Medpace (MEDP) 10-Q 26 Oct 21 2021 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Oct. 22, 2021
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Trading Symbol	MEDP
Entity Registrant Name	Medpace Holdings, Inc.
Entity Central Index Key	0001668397
Entity Current Reporting Status	Yes
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		35,939,191
Entity File Number	001-37856
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	32-0434904
Entity Address, Address Line One	5375 Medpace Way
Entity Address, City or Town	Cincinnati
Entity Address, State or Province	OH
Entity Address, Postal Zip Code	45227
City Area Code	513
Local Phone Number	579-9911
Security Exchange Name	NASDAQ
Title of 12(b) Security	Common Stock $0.01 par value
Entity Interactive Data Current	Yes
Document Quarterly Report	true
Document Transition Report	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 398,387	$ 277,766
Accounts receivable and unbilled, net (includes $3.2 million and $2.6 million with related parties at September 30, 2021 and December 31, 2020, respectively)	186,378	160,962
Prepaid expenses and other current assets	56,455	34,923
Total current assets	641,220	473,651
Property and equipment, net	87,703	85,017
Operating lease right-of-use assets	125,428	113,809
Goodwill	662,396	662,396
Intangible assets, net	42,639	46,474
Deferred income taxes	1,272	536
Other assets	16,485	8,794
Total assets	1,577,143	1,390,677
Current liabilities:
Accounts payable (includes $0.3 million and $0.2 million with related parties at September 30, 2021 and December 31, 2020, respectively)	25,052	26,552
Accrued expenses	158,211	134,367
Advanced billings (includes $7.1 million and $6.5 million with related parties at September 30, 2021 and December 31, 2020, respectively)	303,848	255,664
Other current liabilities	30,071	23,527
Total current liabilities	517,182	440,110
Operating lease liabilities	128,211	115,143
Deferred income tax liability	17,604	13,551
Other long-term liabilities	16,061	16,094
Total liabilities	679,058	584,898
Commitments and contingencies (see Note 11)
Shareholders’ equity:
Preferred stock - $0.01 par-value; 5,000,000 shares authorized; no shares issued and outstanding at September 30, 2021 and December 31, 2020, respectively	0	0
Common stock - $0.01 par-value; 250,000,000 shares authorized at September 30, 2021 and December 31, 2020, respectively; 35,939,191 and 35,519,989 shares issued and outstanding at September 30, 2021 and December 31, 2020, respectively	359	355
Treasury stock - 185,000 shares at September 30, 2021 and December 31, 2020, respectively	(5,578)	(5,578)
Additional paid-in capital	721,597	695,904
Retained earnings	184,950	115,229
Accumulated other comprehensive loss	(3,243)	(131)
Total shareholders’ equity	898,085	805,779
Total liabilities and shareholders’ equity	$ 1,577,143	$ 1,390,677

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Statement Of Financial Position [Abstract]
Accounts receivable, unbilled services with related parties	$ 3.2	$ 2.6
Accounts payable includes related parties	0.3	0.2
Advanced billings with related parties	$ 7.1	$ 6.5
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock shares authorized	5,000,000	5,000,000
Preferred stock shares issued	0	0
Preferred stock shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock shares authorized	250,000,000	250,000,000
Common stock shares issued	35,939,191	35,519,989
Common stock shares outstanding	35,939,191	35,519,989
Treasury stock shares	185,000	185,000

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenue, net (includes $8.7 million and $3.4 million with related parties for the three months ended September 30, 2021 and 2020, respectively, and $23.9 million and $11.6 million with related parties for the nine months ended September 30, 2021 and 2020, respectively)	$ 295,567	$ 230,373	$ 833,825	$ 666,247
Operating expenses:
Total direct costs	208,474	156,214	593,654	470,373
Selling, general and administrative	28,046	22,796	80,757	69,775
Depreciation	4,056	2,991	11,819	8,118
Amortization	1,278	1,950	3,835	5,927
Total operating expenses	241,854	183,951	690,065	554,193
Income from operations	53,713	46,422	143,760	112,054
Other income, net:
Miscellaneous income, net	1,064	584	2,253	1,440
Interest (expense) income, net	(41)	(16)	(82)	336
Total other income, net	1,023	568	2,171	1,776
Income before income taxes	54,736	46,990	145,931	113,830
Income tax provision	6,162	5,530	14,117	19,312
Net income	$ 48,574	$ 41,460	$ 131,814	$ 94,518
Net income per share attributable to common shareholders:
Basic	$ 1.35	$ 1.16	$ 3.67	$ 2.64
Diluted	$ 1.29	$ 1.09	$ 3.49	$ 2.50
Weighted average common shares outstanding:
Basic	35,816	35,552	35,822	35,654
Diluted	37,519	37,763	37,641	37,715
Direct Costs
Operating expenses:
Total direct costs	$ 112,540	$ 87,577	$ 322,160	$ 262,997
Reimbursable Out of Pocket Costs
Operating expenses:
Total direct costs	$ 95,934	$ 68,637	$ 271,494	$ 207,376

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenue Net
Revenue with related parties	$ 8.7	$ 3.4	$ 23.9	$ 11.6

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 48,574	$ 41,460	$ 131,814	$ 94,518
Other comprehensive income
Foreign currency translation adjustments, net of taxes	(1,483)	1,100	(3,112)	618
Comprehensive income	$ 47,091	$ 42,560	$ 128,702	$ 95,136

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (UNAUDITED) - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Income (Loss)
Balance at Dec. 31, 2019	$ 726,283	$ 360	$ (6,030)	$ 666,585	$ 68,109	$ (2,741)
Net income	28,954				28,954
Foreign currency translation	(988)					(988)
Stock-based compensation expense	5,445			5,445
Stock options exercised	1,343	1		1,342
Repurchases of common stock	(43,238)	(6)			(43,232)
Balance at Mar. 31, 2020	717,799	355	(6,030)	673,372	53,831	(3,729)
Balance at Dec. 31, 2019	726,283	360	(6,030)	666,585	68,109	(2,741)
Net income	94,518
Foreign currency translation	618
Balance at Sep. 30, 2020	791,629	357	(6,030)	687,618	111,807	(2,123)
Balance at Mar. 31, 2020	717,799	355	(6,030)	673,372	53,831	(3,729)
Net income	24,104				24,104
Foreign currency translation	506					506
Stock-based compensation expense	2,616			2,616
Stock options exercised	633			633
Repurchases of common stock	(7,589)	(1)			(7,588)
Balance at Jun. 30, 2020	738,069	354	(6,030)	676,621	70,347	(3,223)
Net income	41,460				41,460
Foreign currency translation	1,100					1,100
Stock-based compensation expense	2,762			2,762
Stock options exercised	8,238	3		8,235
Balance at Sep. 30, 2020	791,629	357	(6,030)	687,618	111,807	(2,123)
Balance at Dec. 31, 2020	805,779	355	(5,578)	695,904	115,229	(131)
Net income	43,306				43,306
Foreign currency translation	(2,135)					(2,135)
Stock-based compensation expense	2,871			2,871
Stock options exercised	9,106	4		9,102
Balance at Mar. 31, 2021	858,927	359	(5,578)	707,877	158,535	(2,266)
Balance at Dec. 31, 2020	805,779	355	(5,578)	695,904	115,229	(131)
Net income	131,814
Foreign currency translation	(3,112)
Balance at Sep. 30, 2021	898,085	359	(5,578)	721,597	184,950	(3,243)
Balance at Mar. 31, 2021	858,927	359	(5,578)	707,877	158,535	(2,266)
Net income	39,934				39,934
Foreign currency translation	506					506
Stock-based compensation expense	3,570			3,570
Stock options exercised	5,102	2		5,100
Repurchases of common stock	(56,157)	(3)			(56,154)
Balance at Jun. 30, 2021	851,882	358	(5,578)	716,547	142,315	(1,760)
Net income	48,574				48,574
Foreign currency translation	(1,483)					(1,483)
Stock-based compensation expense	4,047			4,047
Stock options exercised	1,004	1		1,003
Repurchases of common stock	(5,939)				(5,939)
Balance at Sep. 30, 2021	$ 898,085	$ 359	$ (5,578)	$ 721,597	$ 184,950	$ (3,243)

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 131,814	$ 94,518
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	11,819	8,118
Amortization	3,835	5,927
Stock-based compensation expense	10,488	10,823
Noncash lease expense	11,878	9,968
Deferred income tax provision	3,299	6,911
Amortization and adjustment of deferred credit	(501)	(531)
Other	213	(85)
Changes in assets and liabilities:
Accounts receivable and unbilled, net	(25,046)	21,400
Prepaid expenses and other current assets	(22,049)	(9,820)
Accounts payable	2,150	(5,611)
Accrued expenses	24,691	7,619
Advanced billings	48,184	10,355
Lease liabilities	(11,335)	(7,507)
Other assets and liabilities, net	2,993	1,093
Net cash provided by operating activities	192,433	153,178
CASH FLOWS FROM INVESTING ACTIVITIES:
Property and equipment expenditures	(19,155)	(23,554)
Other	(3,093)	74
Net cash used in investing activities	(22,248)	(23,480)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from stock option exercises	15,212	8,753
Repurchases of common stock	(62,096)	(50,827)
Net cash used in financing activities	(46,884)	(42,074)
EFFECT OF EXCHANGE RATES ON CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	(2,680)	(317)
INCREASE IN CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	120,621	87,307
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — Beginning of period	277,766	131,920
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — End of period	398,387	219,227
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION—
Acquisition of property and equipment—non-cash	$ 5,424	$ 10,732

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation	(1) Basis of Presentation Description of Business Medpace Holdings, Inc. (together with its subsidiaries, “Medpace” or the “Company”), a Delaware corporation, is a global provider of clinical research-based drug and medical device development services. The Company partners with pharmaceutical, biotechnology, and medical device companies in the development and execution of clinical trials. The Company’s drug development services focus on full service Phase I-IV clinical development services and include development plan design, project management, regulatory affairs, clinical monitoring, data management and analysis, pharmacovigilance new drug application submissions, post-marketing clinical support, laboratory services, clinical human pharmacology, imaging services, and electrocardiography reading support for clinical trials. The Company’s operations are principally based in North America, Europe, and Asia. Unaudited Interim Financial Information The interim condensed consolidated financial statements include the accounts of the Company, are prepared in conformity with U.S. generally accepted accounting principles (“GAAP”), and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The preparation of the interim condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results and outcomes could differ from management’s estimates and assumptions. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. Share Repurchases In the first quarter of 2020, the Board of Directors approved an increase in the stock repurchase authorization by $ 50.0 million. In the fourth quarter of 2020, the Board approved the stock repurchase authorization up to $ 150.0 million. In the second quarter of 2021, the Board approved an increase of $ 150.0 million to the stock repurchase program bringing the total repurchase authorization up to $ 300.0 million. During the three and nine months ended September 30, 2021, the Company repurchased 34,624 shares and 377,783 shares for $ 5.9 million and $ 62.1 million, respectively. There were no share repurchases during the three months ended September 30, 2020. During the nine months ended September 30, 2020, the Company repurchased and 772,125 shares for $ 50.8 million. As of September 30, 2021, the Company has remaining authorization of $ 190.5 million under the repurchase program. Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, with all amounts paid in excess of par value reflected within Retained earnings in the Company’s condensed consolidated balance sheets. The repurchase program may be suspended or discontinued at any time without notice. Recently Adopted Accounting Standards In December 2019, the FASB issued ASU 2019-12, “Simplifying the Accounting for Income Taxes.” The new guidance includes several provisions to reduce the complexity of accounting for income taxes for financial reporting purposes and increasing consistency and clarity for financial statement readers. The new guidance is effective for public entities for fiscal years, and the related interim periods, beginning after December 15, 2020. The Company adopted this standard in the first quarter of 2021 and it had no material impact on the condensed consolidated financial statements.

Net Income Per Share

Net Income Per Share	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Net Income Per Share	(2) Net Income Per Share Basic and diluted earnings or loss per share (“EPS”) are computed using the two-class method, which is an earnings allocation that determines EPS for each class of common stock and participating securities according to dividends declared and participation rights in undistributed earnings. The Company’s Restricted Stock Awards (“RSA”) are considered participating securities because they are legally issued at the date of grant and holders are entitled to receive non-forfeitable dividends during the vesting term. The computation of diluted EPS includes additional common shares, such as unvested Restricted Stock Units (“RSU”) and stock options with exercise prices less than the average market price of the Company’s common stock during the period (“in-the-money options”), which would be considered outstanding. This assumes that additional shares would have to be issued in cases where the exercise price of stock options is less than the value of the common stock being acquired because the cash proceeds received from the stock option holder would not be sufficient to acquire that same number of shares. The Company does not compute diluted EPS in cases where the inclusion of such additional shares would be anti-dilutive in effect. The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2021 and 2020 (in thousands, except for earnings per share): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Weighted-average shares: Common shares outstanding 35,816 35,552 35,822 35,654 RSAs 112 116 114 95 Total weighted-average shares 35,928 35,668 35,936 35,749 Earnings per common share—Basic Net income $ 48,574 $ 41,460 $ 131,814 $ 94,518 Less: Undistributed earnings allocated to RSAs ( 151 ) ( 135 ) ( 419 ) ( 252 ) Net income available to common shareholders—Basic $ 48,423 $ 41,325 $ 131,395 $ 94,266 Net income per common share—Basic $ 1.35 $ 1.16 $ 3.67 $ 2.64 Basic weighted-average common shares outstanding 35,816 35,552 35,822 35,654 Effect of diluted shares 1,703 2,211 1,819 2,061 Diluted weighted-average shares outstanding 37,519 37,763 37,641 37,715 Net income per common share—Diluted $ 1.29 $ 1.09 $ 3.49 $ 2.50 During the three and nine months ended September 30, 2020 , the Company had 4,800 and 204,205 stock options, respectively, that were excluded due to the exercise price exceeding the average fair value of the Company’s common stock during the period.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Fair Value Measurements	(3) Fair Value Measurements The Company follows accounting guidance related to fair value measurements that defines fair value, establishes a framework for measuring fair value, and establishes a hierarchy for inputs used in measuring fair value. This hierarchy maximizes the use of “observable” inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. The hierarchy specifies three levels based on the inputs, as follows: Level 1: Valuations based on quoted prices in active markets for identical assets or liabilities. Level 2: Valuations based on directly observable inputs or unobservable inputs corroborated by market data. Level 3: Valuations based on unobservable inputs supported by little or no market activity representing management’s determination of assumptions of how market participants would price the assets or liabilities. The fair value of financial instruments such as cash and cash equivalents, accounts receivable and unbilled, net, accounts payable, accrued expenses and advanced billings approximate their carrying amounts due to their short term maturities. The Company does not have any recurring fair value measurements as of September 30, 2021 . There were no transfers between Level 1, Level 2 or Level 3 during the three and nine months ended September 30, 2021 or September 30, 2020 .

Contract Assets and Contract Li

Contract Assets and Contract Liabilities	9 Months Ended
	Sep. 30, 2021
Revenue From Contract With Customer [Abstract]
Contract Assets and Contract Liabilities	(4) Contract Assets and Contract Liabilities Contract assets and liabilities are reflected in the Company’s condensed consolidated balance sheets within the accounts reflected below. Contract Assets Accounts receivable represent amounts due from the Company’s customers who are concentrated primarily in the pharmaceutical, biotechnology, and medical device industries. Unbilled represents revenue recognized to date that has not been billed or is not yet contractually billable to the customer. In general, amounts become billable upon the achievement of negotiated contractual events, in accordance with predetermined payment schedules or when a reimbursable expense has been incurred. Amounts classified to unbilled are those billable to customers within one year from the respective balance sheet date. Accounts receivable and unbilled, net consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Accounts receivable $ 145,297 $ 137,912 Unbilled receivables 41,279 23,396 Less: allowance for doubtful accounts ( 198 ) ( 346 ) Total accounts receivable and unbilled, net $ 186,378 $ 160,962 Contract Liabilities Advanced billings represent cash received from customers, or billed amounts per an agreed upon payment schedule, in advance of services being performed or revenue being recognized. Advanced billings consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Advanced billings $ 303,848 $ 255,664 As of September 30, 2021 , we had approximately $ 1.9 billion of performance obligations remaining to be performed for active projects.

Intangible Assets, Net

Intangible Assets, Net	9 Months Ended
	Sep. 30, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	(5) Intangible Assets, Net Intangible assets, net consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Intangible assets: Finite-lived intangible assets: Carrying amount: Customer relationships 145,051 145,051 Accumulated amortization: Customer relationships ( 134,058 ) ( 130,223 ) Total finite-lived intangible assets, net 10,993 14,828 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 42,639 $ 46,474 As of September 30, 2021, estimated amortization expense of the Company’s intangible assets for each of the next five years and thereafter is as follows (in thousands): Amortization Remainder of 2021 $ 1,279 2022 3,353 2023 2,199 2024 1,443 2025 946 Later years 1,773 $ 10,993

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2021
Payables And Accruals [Abstract]
Accrued Expenses	(6) Accrued Expenses Accrued expenses consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Employee compensation and benefits $ 49,239 $ 40,208 Project related reimbursable expenses 98,833 87,092 Other 10,139 7,067 Total accrued expenses $ 158,211 $ 134,367

Debt

Debt	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Debt	(7) Debt On September 30, 2019, the Company obtained an unsecured credit facility in an aggregate principal amount up to $ 50.0 million (the “Credit Facility”) through its wholly owned subsidiaries, Medpace, Inc., as borrower, and Medpace IntermediateCo, Inc., as guarantor. Outstanding balances under the Credit Facility bear interest at a rate of LIBOR plus 100 basis points (1.00%). On March 30, 2020, the Company amended the credit facility to extend its expiration date to March 31, 2021 and add provisions for alternative interest rates when certain interbank market offered rates are not available. On March 29, 2021 the Company amended the credit facility expiration date to March 31, 2022 . As of September 30, 2021 , there were no outstanding borrowings under the Credit Facility and $ 0.2 million in letters of credit outstanding related to certain operating lease obligations, which are secured by the Credit Facility.

Leases

Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases	(8) Leases The Company enters into leases for real estate and equipment. Real estate leases are for our corporate office space and laboratories around the world. Real estate leases have remaining lease terms of less than 1 year to 19 years. Many of the Company’s leases include options to extend the leases on a month to month basis or for set periods for up to 20 years. Many leases also include options to terminate the leases within 1 year or per other contractual terms. The components of lease expense were as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Operating lease cost $ 5,941 $ 5,514 $ 17,488 $ 14,153 Variable lease cost 1,749 1,386 4,565 3,456 Supplemental cash flow information related to the leases was as follows (in thousands): Nine Months Ended September 30, 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,847 $ 9,328 Right-of-use assets obtained in exchange for lease obligations: Operating leases 24,251 66,796 Supplemental balance sheet information related to the leases was as follows (in thousands): As of September 30, December 31, 2021 2020 Operating lease right-of-use assets $ 125,428 $ 113,809 Other current liabilities $ 14,958 $ 15,890 Operating lease liabilities 128,211 115,143 Total operating lease liabilities $ 143,169 $ 131,033 Weighted Average Remaining Lease Term (years) Operating leases 12.5 12.9 Weighted Average Discount Rate Operating leases 5.6 % 5.9 % Lease payments due related to lease liabilities as of September 30, 2021 were as follows (in thousands): Related Party Non-Related Parties Total Operating Leases Operating Leases Operating Leases Remainder of 2021 $ 2,714 $ 3,318 $ 6,032 2022 10,899 10,114 21,013 2023 11,025 8,686 19,711 2024 11,154 6,263 17,417 2025 11,286 4,679 15,965 Later years 118,410 9,932 128,342 Total lease payments 165,488 42,992 208,480 Less: imputed interest ( 60,523 ) ( 4,788 ) ( 65,311 ) Total $ 104,965 $ 38,204 $ 143,169 As of September 30, 2021 , we have several additional leases with contractual obligations, which have not yet commenced, with future payment of $ 5.9 million.

Shareholder's Equity and Stock-

Shareholder's Equity and Stock-Based Compensation	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Shareholder's Equity and Stock-Based Compensation	(9) Shareholder’s Equity and Stock-Based Compensation The Company granted 351,784 awards to employees under the 2016 Incentive Award Plan during the nine months ended September 30, 2021 , consisting of 74,725 RSU and 205,086 stock option awards vesting after four and a half years , 14,403 RSU awards vesting after four years , and 57,570 stock option awards vesting after two years . The Company granted an additional 10,932 stock option awards, vesting after one year , to non-employee directors under the 2016 Incentive Award Plan, during the nine months ended September 30, 2021 . The Company granted 347,197 awards to employees under the 2016 Incentive Award Plan during the nine months ended September 30, 2020 , consisting of 20,724 RSA and 119,768 RSU vesting after four years , 4,800 stock option awards and 2,500 RSU vesting after three years , and 199,405 fully-vested stock option awards. The Company granted an additional 23,148 stock option awards, vesting after one year , to non-employee directors under the 2016 Incentive Award Plan, during the nine months ended September 30, 2020. Award Activity The following table sets forth the Company’s stock option activity: Nine Months Ended September 30, 2021 Weighted Average Stock Options Exercise Price Outstanding - beginning of period 2,500,727 $ 43.26 Granted 273,588 $ 166.65 Exercised ( 677,985 ) $ 22.44 Cancelled/Forfeited ( 25,933 ) $ 48.33 Expired ( 12,545 ) $ 14.41 Outstanding - end of period 2,057,852 $ 66.64 Exercisable - end of period 1,336,714 $ 55.69 The following table sets forth the Company’s RSA/RSU activity: Nine Months Ended September 30, 2021 Shares/Units Outstanding and unvested - beginning of period 695,562 Granted 89,128 Vested ( 119,000 ) Forfeited ( 62,337 ) Outstanding and unvested - end of period 603,353 Cumulative vested shares - end of period 2,032,916 Stock-based compensation expense recognized in the condensed consolidated statements of operations related to all outstanding stock based compensation awards is summarized below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Total direct costs $ 2,607 $ 1,898 $ 6,841 $ 5,678 Selling, general and administrative 1,440 864 3,647 5,145 Total stock-based compensation expense $ 4,047 $ 2,762 $ 10,488 $ 10,823

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes	(10) Income Taxes The Company’s effective income tax rate was 11.3 % and 11.8 % for the three months ended September 30, 2021 and 2020, respectively. The Company’s effective income tax rate was 9.7 % and 17.0 % for the nine months ended September 30, 2021 and 2020, respectively. The Company’s effective income tax rate for the three and nine months ended September 30, 2021 varied from the U.S. statutory rate of 21 % primarily due to the impact of state taxes, which was favorably offset by excess tax benefits recognized from share-based compensation.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	(11) Commitments and Contingencies Legal Proceedings The Company is involved in legal proceedings from time to time in the ordinary course of its business, including employment claims and claims related to other business transactions. The Company cannot predict with certainty the outcome of such proceedings, but it believes that adequate reserves have been recorded and losses already recognized with respect to such proceedings, which were immaterial as of September 30, 2021 and December 31, 2020. There is a reasonable possibility that a loss exceeding amounts already recognized may be incurred related to these actions; however, the Company believes that such potential losses were immaterial as of September 30, 2021. Purchase Commitments The Company has several minimum purchase commitments for project related supplies totaling $ 12.2 million as of September 30, 2021 . In return for the commitment, Medpace receives preferential pricing. The commitments expire at various times through 2027.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2021
Related Party Transactions [Abstract]
Related Party Transactions	(12) Related Party Transactions Employee Loans The Company periodically extends short term loans or advances to employees, typically upon commencement of employment. Total receivables as a result of these employee advances of $ 0.2 million existed at September 30, 2021 and December 31, 2020, respectively, and are included in the Prepaid expenses and other current assets and Other assets line items of the condensed consolidated balance sheets, respectively, depending on the contractual repayment date. Service Agreement LIB Therapeutics LLC and subsidiaries (“LIB”) Certain executives and employees of the Company, including the chief executive officer, are members of LIB’s board of managers. The Company entered into a MSA dated November 24, 2015 with LIB, a company that engages in research, development, marketing and commercialization of pharmaceutical drugs. Subsequently, the Company and LIB have entered into several task orders for the Company to perform clinical trial related services. The Company recognized total revenue from LIB of $ 2.3 million and $ 0.6 million during the three months ended September 30, 2021 and 2020 , respectively, and $ 5.6 million and $ 2.0 million during the nine months ended September 30, 2021 and 2020, respectively, in the Company’s condensed consolidated statements of operations. As of September 30, 2021 and December 31, 2020 , respectively, the Company had Advanced billings from LIB of $ 1.7 million and $ 0.7 million in the condensed consolidated balance sheets. In addition, as of September 30, 2021 and December 31, 2020 , respectively, the Company had Accounts receivable and unbilled, net from LIB of $ 0.4 million and $ 0.3 million in the condensed consolidated balance sheets. CinRX Pharma and subsidiaries (“CinRx”) Certain executives and employees of the Company, including the chief executive officer, are members of CinRx’s board of managers and/or have equity investments in CinRx, a biotech company. The Company and CinRx have entered into several task orders for the Company to perform clinical trial related services. The Company recognized total revenue from CinRx of $ 6.4 million and $ 2.7 million during the three months ended September 30, 2021 and 2020 , respectively, and $ 18.3 million and $ 9.5 million during the nine months ended September 30, 2021 and 2020, respectively, in the Company’s condensed consolidated statements of operations. As of September 30, 2021 and December 31, 2020 , respectively, the Company had Advanced billings from CinRx of $ 5.4 million and $ 5.8 million in the condensed consolidated balance sheets. As of September 30, 2021 and December 31, 2020 the Company had Accounts receivable and unbilled, net from CinRx of $ 2.8 million and $ 2.2 million, respectively, in the condensed consolidated balance sheets. The Summit Hotel (“The Summit”) The Summit Hotel, located on the Medpace campus, is owned by the chief executive officer, and managed by an unrelated hospitality management entity. Medpace incurs travel lodging and meeting expenses at The Summit. Medpace incurred expenses of $ 0.2 million and less than $ 0.1 million during the three months ended September 30, 2021 and 2020, respectively, and $ 0.3 million and $ 0.2 million during the nine months ended September 30, 2021 and 2020 at The Summit, respectively. Leased Real Estate Headquarters Lease The Company entered into an operating lease for its corporate headquarters with an entity that is wholly owned by the chief executive officer of the Company. The Company has evaluated its relationship with the related party and concluded that the related party is not a variable interest entity because the Company has no direct ownership interest or relationship other than the lease. The lease for headquarters is for an initial term of twelve years through November 2022 with a renewal option for one 10-year term at prevailing market rates. In Q3 2021, the Company accounted for the renewal option, as it became reasonably certain it would be exercised per the agreement, by extending the lease term through November 2032. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for its corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. Operating lease cost recognized for the three months ended September 30, 2021 and 2020 was $ 0.6 million and $ 0.5 , respectively, and $ 1.6 million and $ 1.5 million for the nine months ended September 30, 2021 and 2020, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at September 30, 2021 and December 31, 2020 were $ 20.1 million and $ 3.5 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at September 30, 2021 were $ 1.5 million and $ 18.6 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2020 were $ 1.9 million and $ 1.6 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. In 2018, Medpace, Inc. entered into a multi-year lease agreement governing future occupancy of additional office space in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The Company began to occupy the premises in the second quarter of fiscal year 2020. The lease expires in 2040 and the Company has two 10-year options to extend the term of the lease. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the three months ended September 30, 2021 and 2020 was $ 1.5 million and $ 1.3 million, respectively, and $ 4.3 million and $ 2.2 million for the nine months ended September 30, 2021 and 2020, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at September 30, 2021 and December 31, 2020 were $ 55.4 million and $ 56.6 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at September 30, 2021 were $ 0.9 million and $ 66.2 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2020 were $ 0.7 million and $ 66.8 million, respectively and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The Company entered into two multi-year lease agreements governing the occupancy of space of two buildings in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The Company assumed occupancy in 2012 and the leases expire in 2027 with the Company having one 10-year option to extend the lease term. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the leases are operating leases. Operating lease cost recognized for the three months ended September 30, 2021 and 2020 was $ 0.9 million, respectively, and $ 2.7 million for the nine months ended September 30, 2021 and 2020, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at September 30, 2021 and December 31, 2020 were $ 17.8 million and $ 19.7 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at September 30, 2021 were $ 2.6 million and $ 15.3 million, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2020 were $ 2.4 million and $ 17.2 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. Travel Services The Company incurs expenses for travel services for company executives provided by private aviation charter companies which in 2020 was a company owned by the chief executive officer and the executive vice president of operations of the Company and commencing in 2021 is a company controlled by the chief executive officer of the Company (each a “private aviation charter”). The Company may contract directly with the private aviation charter for the use of its aircraft or indirectly through a third party aircraft management and jet charter company (the “Aircraft Management Company”). The travel services provided are primarily for business purposes, with certain personal travel paid for as part of the executives’ compensation arrangements. The Aircraft Management Company also makes the private aviation charter aircraft available to third parties. The Company incurred travel expenses of $ 0.4 million and $ 0.2 million during the three months ended September 30, 2021 and 2020, respectively, and $ 0.9 million and $ 0.6 million during the nine months ended September 30, 2021 and 2020, respectively, related to these travel services. These travel expenses are recorded in Selling, general and administrative in the Company’s condensed consolidated statements of operations. As of September 30, 2021 and December 31, 2020, the Company had Accounts payable to the Aircraft Management Company of $ 0.2 million and less than $ 0.1 million, respectively, in the condensed consolidated balance sheets.

Entity Wide Disclosures

Entity Wide Disclosures	9 Months Ended
	Sep. 30, 2021
Entity Wide Disclosures [Abstract]
Entity Wide Disclosures	(13) Entity Wide Disclosures Revenue by Category The following table disaggregates our revenue by major source (in thousands): Three months Ended Nine months Ended September 30, September 30, 2021 2020 2021 2020 Therapeutic Area Oncology $ 94,724 $ 68,633 $ 267,110 $ 203,474 Other 64,088 55,541 197,146 151,306 Metabolic 42,133 29,617 112,771 95,902 AVAI 27,032 27,243 84,043 75,377 Cardiology 34,736 27,593 86,538 75,247 Central Nervous System 32,854 21,746 86,217 64,941 Total revenue $ 295,567 $ 230,373 $ 833,825 $ 666,247

Basis of Presentation (Policies

Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial Information The interim condensed consolidated financial statements include the accounts of the Company, are prepared in conformity with U.S. generally accepted accounting principles (“GAAP”), and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The preparation of the interim condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results and outcomes could differ from management’s estimates and assumptions. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020.
Share Repurchases	Share Repurchases In the first quarter of 2020, the Board of Directors approved an increase in the stock repurchase authorization by $ 50.0 million. In the fourth quarter of 2020, the Board approved the stock repurchase authorization up to $ 150.0 million. In the second quarter of 2021, the Board approved an increase of $ 150.0 million to the stock repurchase program bringing the total repurchase authorization up to $ 300.0 million. During the three and nine months ended September 30, 2021, the Company repurchased 34,624 shares and 377,783 shares for $ 5.9 million and $ 62.1 million, respectively. There were no share repurchases during the three months ended September 30, 2020. During the nine months ended September 30, 2020, the Company repurchased and 772,125 shares for $ 50.8 million. As of September 30, 2021, the Company has remaining authorization of $ 190.5 million under the repurchase program. Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, with all amounts paid in excess of par value reflected within Retained earnings in the Company’s condensed consolidated balance sheets. The repurchase program may be suspended or discontinued at any time without notice.
Recently Adopted Accounting Standards	Recently Adopted Accounting Standards In December 2019, the FASB issued ASU 2019-12, “Simplifying the Accounting for Income Taxes.” The new guidance includes several provisions to reduce the complexity of accounting for income taxes for financial reporting purposes and increasing consistency and clarity for financial statement readers. The new guidance is effective for public entities for fiscal years, and the related interim periods, beginning after December 15, 2020. The Company adopted this standard in the first quarter of 2021 and it had no material impact on the condensed consolidated financial statements.

Net Income Per Share (Tables)

Net Income Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Schedule of Reconciliation of Denominators and Additional Shares that are Excluded from the Calculation of EPS	The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2021 and 2020 (in thousands, except for earnings per share): Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 Weighted-average shares: Common shares outstanding 35,816 35,552 35,822 35,654 RSAs 112 116 114 95 Total weighted-average shares 35,928 35,668 35,936 35,749 Earnings per common share—Basic Net income $ 48,574 $ 41,460 $ 131,814 $ 94,518 Less: Undistributed earnings allocated to RSAs ( 151 ) ( 135 ) ( 419 ) ( 252 ) Net income available to common shareholders—Basic $ 48,423 $ 41,325 $ 131,395 $ 94,266 Net income per common share—Basic $ 1.35 $ 1.16 $ 3.67 $ 2.64 Basic weighted-average common shares outstanding 35,816 35,552 35,822 35,654 Effect of diluted shares 1,703 2,211 1,819 2,061 Diluted weighted-average shares outstanding 37,519 37,763 37,641 37,715 Net income per common share—Diluted $ 1.29 $ 1.09 $ 3.49 $ 2.50

Contract Assets and Contract _2

Contract Assets and Contract Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Revenue From Contract With Customer [Abstract]
Summary of Company's Contract Asset and Contract Liability	Accounts receivable and unbilled, net consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Accounts receivable $ 145,297 $ 137,912 Unbilled receivables 41,279 23,396 Less: allowance for doubtful accounts ( 198 ) ( 346 ) Total accounts receivable and unbilled, net $ 186,378 $ 160,962 Advanced billings consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Advanced billings $ 303,848 $ 255,664

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	9 Months Ended
	Sep. 30, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets, Net	Intangible assets, net consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Intangible assets: Finite-lived intangible assets: Carrying amount: Customer relationships 145,051 145,051 Accumulated amortization: Customer relationships ( 134,058 ) ( 130,223 ) Total finite-lived intangible assets, net 10,993 14,828 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 42,639 $ 46,474
Schedule of Estimated Amortization Expense of Intangible Assets	As of September 30, 2021, estimated amortization expense of the Company’s intangible assets for each of the next five years and thereafter is as follows (in thousands): Amortization Remainder of 2021 $ 1,279 2022 3,353 2023 2,199 2024 1,443 2025 946 Later years 1,773 $ 10,993

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2021
Payables And Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consisted of the following (in thousands): As of September 30, December 31, 2021 2020 Employee compensation and benefits $ 49,239 $ 40,208 Project related reimbursable expenses 98,833 87,092 Other 10,139 7,067 Total accrued expenses $ 158,211 $ 134,367

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Summary of Components of Lease Expense	The components of lease expense were as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Operating lease cost $ 5,941 $ 5,514 $ 17,488 $ 14,153 Variable lease cost 1,749 1,386 4,565 3,456
Summary of Supplemental Cash Flow Information Related to Leases	Supplemental cash flow information related to the leases was as follows (in thousands): Nine Months Ended September 30, 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 11,847 $ 9,328 Right-of-use assets obtained in exchange for lease obligations: Operating leases 24,251 66,796
Summary of Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to the leases was as follows (in thousands): As of September 30, December 31, 2021 2020 Operating lease right-of-use assets $ 125,428 $ 113,809 Other current liabilities $ 14,958 $ 15,890 Operating lease liabilities 128,211 115,143 Total operating lease liabilities $ 143,169 $ 131,033 Weighted Average Remaining Lease Term (years) Operating leases 12.5 12.9 Weighted Average Discount Rate Operating leases 5.6 % 5.9 %
Schedule of Lease Payments Due Related To Lease Liabilities	Lease payments due related to lease liabilities as of September 30, 2021 were as follows (in thousands): Related Party Non-Related Parties Total Operating Leases Operating Leases Operating Leases Remainder of 2021 $ 2,714 $ 3,318 $ 6,032 2022 10,899 10,114 21,013 2023 11,025 8,686 19,711 2024 11,154 6,263 17,417 2025 11,286 4,679 15,965 Later years 118,410 9,932 128,342 Total lease payments 165,488 42,992 208,480 Less: imputed interest ( 60,523 ) ( 4,788 ) ( 65,311 ) Total $ 104,965 $ 38,204 $ 143,169

Shareholder's Equity and Stoc_2

Shareholder's Equity and Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Schedule of Stock Option Activity	The following table sets forth the Company’s stock option activity: Nine Months Ended September 30, 2021 Weighted Average Stock Options Exercise Price Outstanding - beginning of period 2,500,727 $ 43.26 Granted 273,588 $ 166.65 Exercised ( 677,985 ) $ 22.44 Cancelled/Forfeited ( 25,933 ) $ 48.33 Expired ( 12,545 ) $ 14.41 Outstanding - end of period 2,057,852 $ 66.64 Exercisable - end of period 1,336,714 $ 55.69
Schedule of RSA/RSU Activity	The following table sets forth the Company’s RSA/RSU activity: Nine Months Ended September 30, 2021 Shares/Units Outstanding and unvested - beginning of period 695,562 Granted 89,128 Vested ( 119,000 ) Forfeited ( 62,337 ) Outstanding and unvested - end of period 603,353 Cumulative vested shares - end of period 2,032,916
Summary of Stock-Based Compensation Expense Recognized in Statements of Operations Related to All Outstanding Stock Based Compensation Awards	Stock-based compensation expense recognized in the condensed consolidated statements of operations related to all outstanding stock based compensation awards is summarized below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Total direct costs $ 2,607 $ 1,898 $ 6,841 $ 5,678 Selling, general and administrative 1,440 864 3,647 5,145 Total stock-based compensation expense $ 4,047 $ 2,762 $ 10,488 $ 10,823

Entity Wide Disclosures (Tables

Entity Wide Disclosures (Tables)	9 Months Ended
	Sep. 30, 2021
Entity Wide Disclosures [Abstract]
Summary of Revenue by Major Source	The following table disaggregates our revenue by major source (in thousands): Three months Ended Nine months Ended September 30, September 30, 2021 2020 2021 2020 Therapeutic Area Oncology $ 94,724 $ 68,633 $ 267,110 $ 203,474 Other 64,088 55,541 197,146 151,306 Metabolic 42,133 29,617 112,771 95,902 AVAI 27,032 27,243 84,043 75,377 Cardiology 34,736 27,593 86,538 75,247 Central Nervous System 32,854 21,746 86,217 64,941 Total revenue $ 295,567 $ 230,373 $ 833,825 $ 666,247

Basis of Presentation - Additio

Basis of Presentation - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Jun. 30, 2021	Dec. 31, 2020	Mar. 31, 2020
Basis Of Presentation [Line Items]
Repurchases of shares, value			$ 62,096	$ 50,827
Share Repurchase Program
Basis Of Presentation [Line Items]
Stock repurchase program, authorized amount						$ 150,000
Stock repurchase program, additional amount authorized					$ 150,000		$ 50,000
Repurchases of shares	34,624	0	377,783	772,125
Repurchases of shares, value	$ 5,900		$ 62,100	$ 50,800
Remaining amount of repurchase program	$ 190,500		$ 190,500
Share Repurchase Program | Maximum
Basis Of Presentation [Line Items]
Stock repurchase program, authorized amount					$ 300,000

Net Income Per Share - Schedule

Net Income Per Share - Schedule of Reconciliation of Denominators and Additional Shares that are Excluded from the Calculation of EPS (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020
Weighted-average shares:
Basic weighted-average common shares outstanding	35,816			35,552			35,822	35,654
Total weighted-average shares	35,928			35,668			35,936	35,749
Earnings per common share—Basic
Net income	$ 48,574	$ 39,934	$ 43,306	$ 41,460	$ 24,104	$ 28,954	$ 131,814	$ 94,518
Net income available to common shareholders—Basic	$ 48,423			$ 41,325			$ 131,395	$ 94,266
Net income per common share—Basic	$ 1.35			$ 1.16			$ 3.67	$ 2.64
Basic weighted-average common shares outstanding	35,816			35,552			35,822	35,654
Effect of diluted shares	1,703			2,211			1,819	2,061
Diluted weighted-average shares outstanding	37,519			37,763			37,641	37,715
Net income per common share—Diluted	$ 1.29			$ 1.09			$ 3.49	$ 2.50
RSAs
Weighted-average shares:
Basic weighted-average common shares outstanding	112			116			114	95
Earnings per common share—Basic
Less: Undistributed earnings allocated to RSAs	$ (151)			$ (135)			$ (419)	$ (252)
Basic weighted-average common shares outstanding	112			116			114	95
Common Stock
Weighted-average shares:
Basic weighted-average common shares outstanding	35,816			35,552			35,822	35,654
Earnings per common share—Basic
Basic weighted-average common shares outstanding	35,816			35,552			35,822	35,654

Net Income Per Share - Addition

Net Income Per Share - Additional Information (Details) - shares	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2020
Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of diluted EPS	4,800	204,205

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair value measurements transfers between level 1, level 2 or level 3	$ 0	$ 0	$ 0	$ 0

Contract Assets and Contract _3

Contract Assets and Contract Liabilities - Summary of Accounts Receivable and Unbilled, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Revenue From Contract With Customer [Abstract]
Accounts receivable	$ 145,297	$ 137,912
Unbilled receivables	41,279	23,396
Less: allowance for doubtful accounts	(198)	(346)
Total accounts receivable and unbilled, net	$ 186,378	$ 160,962

Contract Assets and Contract _4

Contract Assets and Contract Liabilities - Summary of Advanced Billings (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Revenue From Contract With Customer [Abstract]
Advanced billings	$ 303,848	$ 255,664

Contract Assets and Contract _5

Contract Assets and Contract Liabilities - Additional Information (Details) $ in Billions	Sep. 30, 2021USD ($)
Revenue From Contract With Customer [Abstract]
Performance obligations remaining to be performed	$ 1.9

Intangible Assets, Net - Schedu

Intangible Assets, Net - Schedule of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Accumulated amortization:
Total finite-lived intangible assets, net	$ 10,993	$ 14,828
Trade name (indefinite-lived)	31,646	31,646
Total intangible assets, net	42,639	46,474
Customer Relationships
Finite-lived intangible assets:
Total finite-lived intangible assets	145,051	145,051
Accumulated amortization:
Total accumulated amortization	$ (134,058)	$ (130,223)

Intangible Assets, Net - Sche_2

Intangible Assets, Net - Schedule of Estimated Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Remainder of 2021	$ 1,279
2022	3,353
2023	2,199
2024	1,443
2025	946
Later years	1,773
Total finite-lived intangible assets, net	$ 10,993	$ 14,828

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Accrued Liabilities And Other Liabilities [Abstract]
Employee compensation and benefits	$ 49,239	$ 40,208
Project related reimbursable expenses	98,833	87,092
Other	10,139	7,067
Total accrued expenses	$ 158,211	$ 134,367

Debt - Additional Information (

Debt - Additional Information (Details) - Credit Facility - USD ($)	Mar. 29, 2021	Mar. 30, 2020	Sep. 30, 2019	Sep. 30, 2021
Debt Instrument [Line Items]
Debt instrument, basis points			1.00%
Credit facility, expiration date	Mar. 31, 2022	Mar. 31, 2021
Outstanding borrowings				$ 0
Outstanding letters of credit				$ 200,000
Maximum
Debt Instrument [Line Items]
Debt instrument, principal amount			$ 50,000,000

Leases - Additional Information

Leases - Additional Information (Details) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)
Lessee Lease Description [Line Items]
Lease not yet commenced, future payments	$ 5.9
Real Estate and Equipment
Lessee Lease Description [Line Items]
Lease renewal term, operating lease	20 years
Description of option to extend the lease	Many of the Company’s leases include options to extend the leases on a month to month basis or for set periods for up to 20 years.
Operating lease, existense of option to extend	true
Description of option to terminate the lease	Many leases also include options to terminate the leases within 1 year or per other contractual terms.
Lessee, operating lease, existence of option to terminate	true
Real Estate and Equipment | Maximum
Lessee Lease Description [Line Items]
Operating lease, options to terminate lease term	1 year
Real Estate | Minimum
Lessee Lease Description [Line Items]
Remaining lease term, operating lease	1 year
Real Estate | Maximum
Lessee Lease Description [Line Items]
Remaining lease term, operating lease	19 years

Leases - Summary of Components

Leases - Summary of Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Lease Cost [Abstract]
Operating lease cost	$ 5,941	$ 5,514	$ 17,488	$ 14,153
Variable lease cost	$ 1,749	$ 1,386	$ 4,565	$ 3,456

Leases - Summary of Supplementa

Leases - Summary of Supplemental Cash Flow Information Related to Leases (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 11,847	$ 9,328
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 24,251	$ 66,796

Leases - Summary of Supplemen_2

Leases - Summary of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Assets And Liabilities Lessee [Abstract]
Operating lease right-of-use assets	$ 125,428	$ 113,809
Other current liabilities	$ 14,958	$ 15,890
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other current liabilities	Other current liabilities
Operating lease liabilities	$ 128,211	$ 115,143
Total operating lease liabilities	$ 143,169	$ 131,033
Weighted Average Remaining Lease Term (years)
Operating leases	12 years 6 months	12 years 10 months 24 days
Weighted Average Discount Rate
Operating leases	5.60%	5.90%

Leases - Schedule of Lease Paym

Leases - Schedule of Lease Payments Due Related To Lease Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2021	$ 6,032
2022	21,013
2023	19,711
2024	17,417
2025	15,965
Later years	128,342
Total lease payments	208,480
Less: imputed interest	(65,311)
Total	143,169	$ 131,033
Related Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2021	2,714
2022	10,899
2023	11,025
2024	11,154
2025	11,286
Later years	118,410
Total lease payments	165,488
Less: imputed interest	(60,523)
Total	104,965
Non-Related Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2021	3,318
2022	10,114
2023	8,686
2024	6,263
2025	4,679
Later years	9,932
Total lease payments	42,992
Less: imputed interest	(4,788)
Total	$ 38,204

Shareholder's Equity and Stoc_3

Shareholder's Equity and Stock-Based Compensation - Additional Information (Details) - shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	273,588
2016 Incentive Award Plan | Granted to Employees
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Awards granted to employees	351,784	347,197
2016 Incentive Award Plan | Vesting After Four and a Half Years | Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	205,086
Award vesting period	4 years 6 months
2016 Incentive Award Plan | Vesting After Four and a Half Years | Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Award vesting period	4 years 6 months
Shares granted	74,725
2016 Incentive Award Plan | Vesting After Two Years | Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	57,570
Award vesting period	2 years
2016 Incentive Award Plan | Vesting After One Year | Non Employee Directors
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted	10,932	23,148
Award vesting period	1 year	1 year
2016 Incentive Award Plan | Vesting After Four Years | Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Award vesting period	4 years	4 years
Shares granted	14,403	119,768
2016 Incentive Award Plan | Vesting After Four Years | Restricted Stock Awards (RSA)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Award vesting period		4 years
Shares granted		20,724
2016 Incentive Award Plan | Vesting After Three Years | Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted		4,800
Award vesting period		3 years
2016 Incentive Award Plan | Vesting After Three Years | Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Award vesting period		3 years
Shares granted		2,500
2016 Incentive Award Plan | Fully-vested Awards
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options granted		199,405

Shareholder's Equity and Stoc_4

Shareholder's Equity and Stock-Based Compensation - Schedule of Stock Option Activity (Details)	9 Months Ended
	Sep. 30, 2021$ / sharesshares
Equity [Abstract]
Number of Stock Options, Outstanding - beginning of period | shares	2,500,727
Number of Stock Options, Granted | shares	273,588
Number of Stock Options, Exercised | shares	(677,985)
Number of Stock Options, Cancelled/Forfeited | shares	(25,933)
Number of Stock Options, Expired | shares	(12,545)
Number of Stock Options, Outstanding - end of period | shares	2,057,852
Number of Stock Options, Exercisable - end of period | shares	1,336,714
Weighted Average Exercise Price, Outstanding - beginning of period | $ / shares	$ 43.26
Weighted Average Exercise Price, Granted | $ / shares	166.65
Weighted Average Exercise Price, Exercised | $ / shares	22.44
Weighted Average Exercise Price, Cancelled/Forfeited | $ / shares	48.33
Weighted Average Exercise Price, Expired | $ / shares	14.41
Weighted Average Exercise Price, Outstanding - end of period | $ / shares	66.64
Weighted Average Exercise Price, Exercisable - end of period | $ / shares	$ 55.69

Shareholder's Equity and Stoc_5

Shareholder's Equity and Stock-Based Compensation - Schedule of RSA/RSU Activity (Details) - RSA/RSU	9 Months Ended
	Sep. 30, 2021shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Outstanding and unvested - beginning of period	695,562
Granted	89,128
Vested	(119,000)
Forfeited	(62,337)
Outstanding and unvested - end of period	603,353
Cumulative vested shares - end of period	2,032,916

Shareholder's Equity and Stoc_6

Shareholder's Equity and Stock-Based Compensation - Summary of Stock-Based Compensation Expense Recognized in Statements of Operations Related to All Outstanding Stock Based Compensation Awards (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 4,047	$ 2,762	$ 10,488	$ 10,823
Total Direct Costs
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	2,607	1,898	6,841	5,678
Selling, General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 1,440	$ 864	$ 3,647	$ 5,145

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Effective income tax rate	11.30%	11.80%	9.70%	17.00%
U.S. statutory rate	21.00%		21.00%

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)
Commitments And Contingencies Disclosure [Abstract]
Minimum purchase commitments for project related supplies	$ 12.2

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)RenewalOptionAgreementBuilding	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Related Party Transaction [Line Items]
Advanced billings	$ 7,100		$ 7,100		$ 6,500
Accounts receivable and unbilled, net	3,200		3,200		2,600
Operating lease cost recognized	5,941	$ 5,514	17,488	$ 14,153
Operating lease right-of-use assets	125,428		125,428		113,809
Current portion of lease liability	14,958		14,958		15,890
Long-term portion of lease liabilities	128,211		128,211		115,143
Accounts payable	300		300		200
Employee Loans | Prepaid Expenses and Other Current Assets and Other Assets
Related Party Transaction [Line Items]
Employee advances receivables	200		200		200
Service Agreement | LIB
Related Party Transaction [Line Items]
Advanced billings	1,700		1,700		700
Accounts receivable and unbilled, net	400		400		300
Service Agreement | LIB | Revenue Net
Related Party Transaction [Line Items]
Revenue with related parties	2,300	600	5,600	2,000
Service Agreement | CinRx Pharma and Subsidiaries
Related Party Transaction [Line Items]
Advanced billings	5,400		5,400		5,800
Accounts receivable and unbilled, net	2,800		2,800		2,200
Service Agreement | CinRx Pharma and Subsidiaries | Revenue Net
Related Party Transaction [Line Items]
Revenue with related parties	6,400	2,700	18,300	9,500
Service Agreement | The Summit
Related Party Transaction [Line Items]
Expenses incurred	$ 200		$ 300	200
Service Agreement | The Summit | Maximum
Related Party Transaction [Line Items]
Expenses incurred		100
Leased Real Estate | Chief Executive Officer
Related Party Transaction [Line Items]
Term of lease	12 years		12 years
Lease expiration period			2022-11
Number of lease renewal, 10-year option | RenewalOption			1
Lease term upon renewal	10 years		10 years
Lease term reassessment Description			In Q3 2021, the Company accounted for the renewal option, as it became reasonably certain it would be exercised per the agreement, by extending the lease term through November 2032.
Leased Real Estate | Chief Executive Officer | Direct Costs and Selling, General And Administrative
Related Party Transaction [Line Items]
Operating lease cost recognized	$ 600	500	$ 1,600	1,500
Leased Real Estate | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Number of lease renewal, 10-year option | RenewalOption			2
Lease term upon renewal	10 years		10 years
Lease expiration year			2040
Number of lease agreements | Agreement			1
Leased Real Estate | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Number of lease renewal, 10-year option | RenewalOption			1
Lease term upon renewal	10 years		10 years
Lease expiration year			2027
Number of lease agreements | Agreement			2
Number of buildings | Building			2
Lease occupancy year			2012
Leased Real Estate | Chief Executive Officer And Immediate Family | Direct Costs and Selling, General And Administrative | Office Space
Related Party Transaction [Line Items]
Operating lease cost recognized	$ 1,500	1,300	$ 4,300	2,200
Leased Real Estate | Chief Executive Officer And Immediate Family | Direct Costs and Selling, General And Administrative | Building
Related Party Transaction [Line Items]
Operating lease cost recognized	900	900	2,700	2,700
Leased Real Estate | Operating Lease Right-of-Use Assets | Chief Executive Officer
Related Party Transaction [Line Items]
Operating lease right-of-use assets	20,100		20,100		3,500
Leased Real Estate | Operating Lease Right-of-Use Assets | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Operating lease right-of-use assets	55,400		55,400		56,600
Leased Real Estate | Operating Lease Right-of-Use Assets | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Operating lease right-of-use assets	17,800		17,800		19,700
Leased Real Estate | Other Current Liabilities | Chief Executive Officer
Related Party Transaction [Line Items]
Current portion of lease liability	1,500		1,500		1,900
Leased Real Estate | Other Current Liabilities | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Current portion of lease liability	900		900		700
Leased Real Estate | Other Current Liabilities | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Current portion of lease liability	2,600		2,600		2,400
Leased Real Estate | Operating Lease Liabilities | Chief Executive Officer
Related Party Transaction [Line Items]
Long-term portion of lease liabilities	18,600		18,600		1,600
Leased Real Estate | Operating Lease Liabilities | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Long-term portion of lease liabilities	66,200		66,200		66,800
Leased Real Estate | Operating Lease Liabilities | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Long-term portion of lease liabilities	15,300		15,300		17,200
Travel Services
Related Party Transaction [Line Items]
Accounts payable	200		200
Travel Services | Maximum
Related Party Transaction [Line Items]
Accounts payable					$ 100
Travel Services | Chief Executive Officer
Related Party Transaction [Line Items]
Travel expenses with related party	$ 400	$ 200	$ 900	$ 600

Entity Wide Disclosures - Summa

Entity Wide Disclosures - Summary of Revenue by Major Source (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation Of Revenue [Line Items]
Total revenue	$ 295,567	$ 230,373	$ 833,825	$ 666,247
Oncology
Disaggregation Of Revenue [Line Items]
Total revenue	94,724	68,633	267,110	203,474
Other
Disaggregation Of Revenue [Line Items]
Total revenue	64,088	55,541	197,146	151,306
Metabolic
Disaggregation Of Revenue [Line Items]
Total revenue	42,133	29,617	112,771	95,902
AVAI
Disaggregation Of Revenue [Line Items]
Total revenue	27,032	27,243	84,043	75,377
Central Nervous System
Disaggregation Of Revenue [Line Items]
Total revenue	32,854	21,746	86,217	64,941
Cardiology
Disaggregation Of Revenue [Line Items]
Total revenue	$ 34,736	$ 27,593	$ 86,538	$ 75,247