Medpace (MEDP) 10-Q 25 Jul 23 2023 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2023	Jul. 21, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	001-37856
Entity Registrant Name	Medpace Holdings, Inc.
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
Title of 12(b) Security	Common Stock $0.01 par value
Trading Symbol	MEDP
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		30,562,773
Entity Central Index Key	0001668397
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 39,138	$ 28,265
Accounts receivable and unbilled, net (includes $4.6 million and $7.7 million with related parties at June 30, 2023 and December 31, 2022, respectively)	275,058	253,404
Prepaid expenses and other current assets	64,731	52,293
Total current assets	378,927	333,962
Property and equipment, net	114,817	109,849
Operating lease right-of-use assets	139,863	139,068
Goodwill	662,396	662,396
Intangible assets, net	36,908	38,008
Deferred income taxes	51,766	48,083
Other assets	22,261	21,129
Total assets	1,406,938	1,352,495
Current liabilities:
Accounts payable (includes $4.7 million and $0.3 million with related parties at June 30, 2023 and December 31, 2022, respectively)	33,608	33,069
Accrued expenses	231,925	210,125
Advanced billings (includes $14.3 million and $8.8 million with related parties at June 30, 2023 and December 31, 2022, respectively)	490,557	462,729
Short-term debt	55,000	50,000
Other current liabilities (includes $9.0 million and $12.5 million with related parties at June 30, 2023 and December 31, 2022, respectively)	41,347	47,547
Total current liabilities	852,437	803,470
Operating lease liabilities	139,390	138,867
Deferred income tax liability	1,098	1,070
Other long-term liabilities	22,953	22,701
Total liabilities	1,015,878	966,108
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 June 30, 2023 and December 31, 2022, respectively	0	0
Common stock - $0.01 par-value; 250,000,000 shares authorized at June 30, 2023 and December 31, 2022, respectively; 30,562,773 and 31,091,694 shares issued and outstanding at June 30, 2023 and December 31, 2022, respectively	306	309
Treasury stock - 70,573 and 71,573 shares at June 30, 2023 and December 31, 2022, respectively	(12,322)	(12,497)
Additional paid-in capital	785,292	770,794
Accumulated deficit	(371,022)	(359,827)
Accumulated other comprehensive loss	(11,194)	(12,392)
Total shareholders’ equity	391,060	386,387
Total liabilities and shareholders’ equity	$ 1,406,938	$ 1,352,495

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Accounts receivable and unbilled, net	$ 275,058	$ 253,404
Accounts payable	33,608	33,069
Advanced billings	490,557	462,729
Other current liabilities (includes $9.0 million and $12.5 million with related parties at June 30, 2023 and December 31, 2022, respectively)	$ 41,347	$ 47,547
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock shares authorized (in shares)	5,000,000	5,000,000
Preferred stock shares issued (in shares)	0	0
Preferred stock shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock shares authorized (in shares)	250,000,000	250,000,000
Common stock shares issued (in shares)	30,562,773	31,091,694
Common stock shares outstanding (in shares)	30,562,773	31,091,694
Treasury stock (in shares)	70,573	71,573
Related Party
Accounts receivable and unbilled, net	$ 4,600	$ 7,700
Accounts payable	4,700	300
Advanced billings	14,300	8,800
Other current liabilities (includes $9.0 million and $12.5 million with related parties at June 30, 2023 and December 31, 2022, respectively)	$ 9,000	$ 12,500

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenue, net (includes $13.3 million and $17.2 million with related parties for the three months ended June 30, 2023 and 2022, respectively, and $29.1 million and $30.5 million with related parties for the six months ended June 30, 2023 and 2022, respectively)	$ 460,868	$ 351,207	$ 894,942	$ 682,154
Operating expenses:
Total direct costs	336,551	252,211	640,436	484,481
Selling, general and administrative	39,404	33,215	77,431	62,581
Depreciation	5,970	4,707	11,378	8,977
Amortization	550	838	1,100	1,676
Total operating expenses	382,475	290,971	730,345	557,715
Income from operations	78,393	60,236	164,597	124,439
Other (expense) income, net:
Miscellaneous (expense) income, net	(1,283)	2,311	(596)	3,378
Interest expense, net	(1,366)	(548)	(2,227)	(494)
Total other (expense) income, net	(2,649)	1,763	(2,823)	2,884
Income before income taxes	75,744	61,999	161,774	127,323
Income tax provision	14,676	12,639	27,812	16,652
Net income	$ 61,068	$ 49,360	$ 133,962	$ 110,671
Net income per share attributable to common shareholders:
Earnings per share, basic (in dollars per share)	$ 2	$ 1.52	$ 4.35	$ 3.28
Earnings per share, diluted (in dollars per share)	$ 1.93	$ 1.46	$ 4.20	$ 3.16
Weighted average common shares outstanding:
Weighted average number of shares outstanding, basic (in shares)	30,537	32,493	30,771	33,696
Weighted average number of shares outstanding, diluted (in shares)	31,575	33,695	31,864	35,034
Total revenue
Revenue, net (includes $13.3 million and $17.2 million with related parties for the three months ended June 30, 2023 and 2022, respectively, and $29.1 million and $30.5 million with related parties for the six months ended June 30, 2023 and 2022, respectively)	$ 460,868	$ 351,207	$ 894,942	$ 682,154
Direct Costs
Operating expenses:
Total direct costs	158,526	132,118	309,594	257,552
Reimbursable Out of Pocket Costs
Operating expenses:
Total direct costs	$ 178,025	$ 120,093	$ 330,842	$ 226,929

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Operations (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Total revenue	$ 460,868	$ 351,207	$ 894,942	$ 682,154
Related Party
Total revenue	$ 13,300	$ 17,200	$ 29,100	$ 30,500

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 61,068	$ 49,360	$ 133,962	$ 110,671
Other comprehensive income
Foreign currency translation adjustments, net of taxes	120	(3,584)	1,198	(5,126)
Comprehensive income	$ 61,188	$ 45,776	$ 135,160	$ 105,545

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	(Accumulated Deficit) Retained Earnings	Accumulated Other Comprehensive Loss
Balance, beginning of period at Dec. 31, 2021	$ 952,928	$ 360	$ (5,427)	$ 727,857	$ 234,984	$ (4,846)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	61,311				61,311
Foreign currency translation	(1,542)					(1,542)
Stock-based compensation expense	4,372			4,372
Stock options exercised	13,897	3		13,894
Repurchases of common stock	(425,950)	(27)	(14,243)		(411,680)
Retirement of treasury stock	0		5,427		(5,427)
Balance, end of period at Mar. 31, 2022	605,016	336	(14,243)	746,123	(120,812)	(6,388)
Balance, beginning of period at Dec. 31, 2021	952,928	360	(5,427)	727,857	234,984	(4,846)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	110,671
Foreign currency translation	(5,126)
Balance, end of period at Jun. 30, 2022	283,252	309	(14,243)	753,300	(446,142)	(9,972)
Balance, beginning of period at Mar. 31, 2022	605,016	336	(14,243)	746,123	(120,812)	(6,388)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	49,360				49,360
Foreign currency translation	(3,584)					(3,584)
Stock-based compensation expense	5,653			5,653
Stock options exercised	1,524			1,524
Repurchases of common stock	(374,717)	(27)			(374,690)
Balance, end of period at Jun. 30, 2022	283,252	309	(14,243)	753,300	(446,142)	(9,972)
Balance, beginning of period at Dec. 31, 2022	386,387	309	(12,497)	770,794	(359,827)	(12,392)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	72,894				72,894
Foreign currency translation	1,078					1,078
Stock-based compensation expense	5,438			5,438
Stock options exercised	2,463	4		2,459
Repurchases of common stock	(120,998)	(7)			(120,991)
Re-issuance of treasury stock	0		175		(175)
Balance, end of period at Mar. 31, 2023	347,262	306	(12,322)	778,691	(408,099)	(11,314)
Balance, beginning of period at Dec. 31, 2022	386,387	309	(12,497)	770,794	(359,827)	(12,392)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	133,962
Foreign currency translation	1,198
Balance, end of period at Jun. 30, 2023	391,060	306	(12,322)	785,292	(371,022)	(11,194)
Balance, beginning of period at Mar. 31, 2023	347,262	306	(12,322)	778,691	(408,099)	(11,314)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	61,068				61,068
Foreign currency translation	120					120
Stock-based compensation expense	4,906			4,906
Stock options exercised	1,696	1		1,695
Repurchases of common stock	(23,992)	(1)			(23,991)
Balance, end of period at Jun. 30, 2023	$ 391,060	$ 306	$ (12,322)	$ 785,292	$ (371,022)	$ (11,194)

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 133,962	$ 110,671
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	11,378	8,977
Amortization	1,100	1,676
Stock-based compensation expense	10,344	10,025
Noncash lease expense	9,659	8,959
Deferred income tax benefit	(3,709)	(1,439)
Other	(899)	(633)
Changes in assets and liabilities:
Accounts receivable and unbilled, net	(21,734)	(39,059)
Prepaid expenses and other current assets	(11,831)	(18,789)
Accounts payable	2,341	2,552
Accrued expenses	21,259	15,643
Advanced billings	27,828	56,727
Lease liabilities	(9,379)	(7,705)
Other assets and liabilities, net	(7,725)	(4,730)
Net cash provided by operating activities	162,594	142,875
CASH FLOWS FROM INVESTING ACTIVITIES:
Property and equipment expenditures	(17,959)	(20,457)
Other	(11)	(1,878)
Net cash used in investing activities	(17,970)	(22,335)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from stock option exercises	4,127	15,421
Repurchases of common stock	(144,020)	(800,667)
Proceeds from revolving loan	105,000	299,200
Payments on revolving loan	(100,000)	(49,500)
Net cash used in financing activities	(134,893)	(535,546)
EFFECT OF EXCHANGE RATES ON CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	1,142	(3,747)
INCREASE (DECREASE) IN CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	10,873	(418,753)
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — Beginning of period	28,265	461,304
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — End of period	39,138	42,551
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION —
Acquisition of property and equipment—non-cash	$ 5,848	$ 7,441

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	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, 2022. Share Repurchases In 2018, the Board of Directors approved a stock repurchase program which has been amended several times to increase the aggregate amount of the stock repurchase authorization. During the three and six months ended June 30, 2022, the Company repurchased 2,717,379 shares and 5,463,244 shares for $374.6 million and $800.5 million, respectively. In the fourth quarter of 2022, the Board approved a new stock repurchase program of up to $500.0 million. During the three and six months ended June 30, 2023, the Company repurchased 126,281 shares and 781,068 shares for $23.9 million and $144.0 million, respectively. As of June 30, 2023, we have remaining authorization of $308.8 million under the new repurchase program.

Net Income Per Share

Net Income Per Share	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Net Income Per Share	Net Income Per ShareBasic 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 six months ended June 30, 2023 and 2022 (in thousands, except for earnings per share): Three Months Ended Six Months Ended 2023 2022 2023 2022 Weighted-average shares: Common shares outstanding 30,537 32,493 30,771 33,696 RSAs 21 21 21 21 Total weighted-average shares 30,558 32,514 30,792 33,717 Earnings per common share—Basic Net income $ 61,068 $ 49,360 $ 133,962 $ 110,671 Less: Undistributed earnings allocated to RSAs (41) (31) (90) (68) Net income available to common shareholders—Basic $ 61,027 $ 49,329 $ 133,872 $ 110,603 Net income per common share—Basic $ 2.00 $ 1.52 $ 4.35 $ 3.28 Basic weighted-average common shares outstanding 30,537 32,493 30,771 33,696 Effect of diluted shares 1,038 1,202 1,093 1,338 Diluted weighted-average shares outstanding 31,575 33,695 31,864 35,034 Net income per common share—Diluted $ 1.93 $ 1.46 $ 4.20 $ 3.16 During the three and six months ended June 30, 2023, the Company had (in thousands) 16.7 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. During the three and six months ended June 30, 2022, the Company had (in thousands) 274.4 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	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	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 material recurring fair value measurements as of June 30, 2023. There were no transfers between Level 1, Level 2 or Level 3 during the three and six months ended June 30, 2023 or June 30, 2022.

Contract Assets and Contract Li

Contract Assets and Contract Liabilities	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Contract Assets and Contract Liabilities	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 June 30, December 31, Accounts receivable $ 243,560 $ 213,169 Unbilled receivables 31,668 40,405 Less: allowance for doubtful accounts (170) (170) Total accounts receivable and unbilled, net $ 275,058 $ 253,404 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 June 30, December 31, Advanced billings $ 490,557 $ 462,729 As of June 30, 2023, we had approximately $2.9 billion of performance obligations remaining to be performed for active projects.

Intangible Assets, Net

Intangible Assets, Net	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	Intangible Assets, Net Intangible assets, net consisted of the following (in thousands): As of June 30, December 31, Intangible assets: Finite-lived intangible assets: Carrying amount: Customer relationships 145,051 145,051 Accumulated amortization: Customer relationships (139,789) (138,689) Total finite-lived intangible assets, net 5,262 6,362 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 36,908 $ 38,008 As of June 30, 2023, 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 2023 $ 1,099 2024 1,443 2025 946 2026 620 2027 577 2028 577 $ 5,262

Accrued Expenses

Accrued Expenses	6 Months Ended
	Jun. 30, 2023
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consisted of the following (in thousands): As of June 30, December 31, Employee compensation and benefits $ 57,341 $ 71,197 Project related reimbursable expenses 164,835 128,416 Other 9,749 10,512 Total accrued expenses $ 231,925 $ 210,125

Short-Term Debt

Short-Term Debt	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Short-Term Debt	Short-term Debt Short-term debt consisted of the following (in thousands): As of June 30, December 31, Credit facility $ 55,000 $ 50,000 Short-term debt $ 55,000 $ 50,000 Principal payments on Short-term debt are due as follows (in thousands): 2023 (remaining) — 2024 55,000 Total $ 55,000 The estimated fair value of the Company’s debt based on Level 2 inputs using the market approach, which is primarily based on rates at which the debt is traded among financial institutions, approximates the carrying value as of June 30, 2023 and December 31, 2022. On September 30, 2019 (the “Closing Date”), the Company obtained an unsecured credit facility in an aggregate principal amount up to $50.0 million (as amended from time to time, the “Credit Facility”) through its wholly owned subsidiaries, Medpace, Inc., as borrower (the “Borrower”), and Medpace IntermediateCo, Inc., as guarantor (the “Guarantor”). On the Closing Date, the Borrower and lender entered into a Loan Agreement (as it may be amended from time to time, the “Loan Agreement”) providing for the Credit Facility, and the Guarantor executed a Guaranty Agreement providing for its guarantee of the payment and performance of the obligations under the Loan Agreement. On March 15, 2022, the Company entered into Amendment No. 4 to the Loan Agreement, which increased the aggregate principal amount that may be borrowed under the facility’s line of credit to up to $250.0 million. On March 31, 2023, the Company entered into Amendment No. 5 to the Loan Agreement, which changed the aggregate principal amount that may be borrowed under the facility’s line of credit to up to $150.0 million, adjusted the interest rate and fee charged on the credit facility and extended the expiration date of revolving credit note to March 29, 2024. The Credit Facility bears interest at a rate of the sum of The Secured Overnight Financing Rate (SOFR) plus 125 basis points (1.25%) or the highest of the Prime Rate, the sum of the Overnight Bank Funding Rate plus 50 basis points (0.50%) and the sum of Daily Simple SOFR plus 100 basis points (1.00%). As of June 30, 2023, the Credit Facility interest rate was 6.3%. The Loan Agreement contains other customary loan terms, representations and warranties, and affirmative and negative covenants, in each case, subject to customary limitations, exceptions and exclusions. The Loan Agreement contains certain events of default, including, among others, non-payment of principal or interest and breach of the covenants. As of June 30, 2023, there were $0.2 million in letters of credit outstanding related to certain operating lease obligations, which are secured by the Credit Facility.

Leases

Leases	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Leases	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 17 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Operating lease cost $ 6,954 $ 6,375 $ 13,635 $ 12,875 Variable lease cost 1,835 2,097 4,172 4,113 Supplemental cash flow information related to the leases was as follows (in thousands): Six Months Ended June 30, 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 9,599 $ 8,257 Right-of-use assets obtained in exchange for lease obligations: Operating leases 10,061 18,222 Supplemental balance sheet information related to the leases was as follows (in thousands): As of June 30, December 31, Operating lease right-of-use assets - related parties $ 86,097 $ 86,356 Operating lease right-of-use assets - non-related parties 53,766 52,712 Operating lease right-of-use assets $ 139,863 $ 139,068 Other current liabilities - related parties 5,457 5,409 Other current liabilities - non-related parties 14,529 13,863 Other current liabilities $ 19,986 $ 19,272 Operating lease liabilities - related parties 93,484 93,393 Operating lease liabilities - non-related parties 45,906 45,474 Operating lease liabilities 139,390 138,867 Total operating lease liabilities $ 159,376 $ 158,139 Weighted Average Remaining Lease Term (years) Operating leases 10.7 11.1 Weighted Average Discount Rate Operating leases 5.4 % 5.2 % Lease payments due related to lease liabilities as of June 30, 2023 were as follows (in thousands): Related Party Operating Leases Non-Related Parties Operating Leases Total Operating Leases Remainder of 2023 $ 5,632 $ 8,358 $ 13,990 2024 11,412 14,938 26,350 2025 11,607 12,923 24,530 2026 11,807 10,653 22,460 2027 10,839 7,477 18,316 Later years 100,278 12,171 112,449 Total lease payments 151,575 66,520 218,095 Less: imputed interest (52,634) (6,085) (58,719) Total $ 98,941 $ 60,435 $ 159,376

Shareholder's Equity and Stock-

Shareholder's Equity and Stock-Based Compensation	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Shareholder's Equity and Stock-Based Compensation	Shareholder’s Equity and Stock-Based CompensationThe Company granted 28,412 awards to employees under the 2016 Incentive Award Plan during the six months ended June 30, 2023, consisting of 27,162 RSU and 1,250 stock option awards having four year vesting schedules. The Company granted an additional 11,187 stock option awards to non-employee directors under the 2016 Incentive Award Plan, during the six months ended June 30, 2023. These awards are scheduled to vest on the earlier of (a) the day immediately preceding the date of the first annual meeting following the date of grant and (b) the first anniversary of the date of grant, subject to the non-employee director continuing in service through the applicable vesting date. Award Activity The following table sets forth the Company’s stock option activity: Six Months Ended June 30, 2023 Stock Options Weighted Average Outstanding - beginning of period 1,629,148 $ 89.71 Granted 12,437 $ 211.25 Exercised (129,108) $ 32.21 Cancelled/Forfeited/Expired (8,500) $ 188.55 Outstanding - end of period 1,503,977 $ 95.09 Exercisable - end of period 1,059,805 $ 70.46 The following table sets forth the Company’s RSA/RSU activity: Six Months Ended Shares/Units Outstanding and unvested - beginning of period 523,377 Granted 27,162 Vested (123,039) Forfeited (14,755) Outstanding and unvested - end of period 412,745 Cumulative vested shares - end of period 2,352,955 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Total direct costs $ 2,558 $ 3,125 $ 5,498 $ 5,565 Selling, general and administrative 2,348 2,528 4,846 4,460 Total stock-based compensation expense $ 4,906 $ 5,653 $ 10,344 $ 10,025

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThe Company’s effective income tax rate was 19.4% and 20.4% for the three months ended June 30, 2023 and 2022, respectively. The Company's effective income tax rate was 17.2% and 13.1% for the six months ended June 30, 2023 and 2022, respectively. The Company’s effective income tax rate for the three months ended June 30, 2023 and the six months ended June 30, 2023 varied from the U.S. statutory rate of 21% primarily due to the impact of the state taxes, which was favorably offset by excess tax benefits recognized from share-based compensation and tax benefits related to Foreign Derived Intangible Income (FDII).

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	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 June 30, 2023 and December 31, 2022. 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 June 30, 2023. Purchase Commitments

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2023
Related Party Transactions [Abstract]
Related Party Transactions	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 $0.3 million existed at June 30, 2023 and December 31, 2022, 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 $9.7 million during the three months ended June 30, 2023 and 2022, respectively, and $23.0 million and $17.1 million during the six months ended June 30, 2023 and 2022, respectively, in the Company’s condensed consolidated statements of operations. As of June 30, 2023 and December 31, 2022, respectively, the Company had Advanced billings from LIB of $11.6 million and $7.4 million in the condensed consolidated balance sheets. In addition, as of June 30, 2023 and December 31, 2022, respectively, the Company had Accounts receivable and unbilled, net from LIB of $3.1 million and $5.5 million in the condensed consolidated balance sheets. The Company had Other current liabilities with LIB of $9.0 million and $12.5 million in the consolidated balance sheets at June 30, 2023 and December 31, 2022. CinRX Pharma, subsidiaries and affiliates (“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 $3.6 million and $7.5 million during the three months ended June 30, 2023 and 2022, respectively, and $6.1 million and $13.3 million during the six months ended June 30, 2023 and 2022, respectively, in the Company’s condensed consolidated statements of operations. As of June 30, 2023 and December 31, 2022, respectively, the Company had Advanced billings from CinRx of $2.7 million and $1.4 million in the condensed consolidated balance sheets. As of June 30, 2023 and December 31, 2022 the Company had Accounts receivable and unbilled, net from CinRx of $1.6 million and $2.2 million, respectively, in the condensed consolidated balance sheets. Certain affiliates of CinRx included in previous reported quarters are no longer disclosed due to changes in the affiliate relationships. 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 $0.1 million and less than $0.1 million during the three months ended June 30, 2023 and 2022, respectively, and $0.2 million and $0.1 million during the six months ended June 30, 2023 and 2022 at The Summit, respectively. Leased Real Estate Campus Headquarters Leases The Company entered into an operating lease for the occupancy of office space in a building in Cincinnati, Ohio 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 was renewed in the first quarter of fiscal year 2023 for a term of ten years through December 2032 with a renewal option for one 10-year term at prevailing market rates. 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 June 30, 2023 and 2022 was $0.7 million and $0.5 million and $1.3 million and $1.1 million for the six months ended June 30, 2023 and 2022, 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 June 30, 2023 and December 31, 2022 were $20.2 million and $18.2 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2023 were $1.4 million and $18.9 million, respectively, 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, 2022 were $1.5 million and $16.7 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 June 30, 2023 and 2022 was $1.4 million and $2.8 million for the six months ended June 30, 2023 and 2022. 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 June 30, 2023 and December 31, 2022 were $52.7 million and $53.5 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2023 were $1.2 million and $64.2 million, respectively, 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, 2022 were $1.1 million and $64.8 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 June 30, 2023 and 2022 was $0.9 million and $1.8 million for the six months ended June 30, 2023 and 2022. 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 June 30, 2023 and December 31, 2022 were $13.3 million and $14.6 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at June 30, 2023 were $2.9 million and $10.4 million, respectively, 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, 2022 were $2.8 million and $11.9 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 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.

Entity Wide Disclosures

Entity Wide Disclosures	6 Months Ended
	Jun. 30, 2023
Entity Wide Disclosures [Abstract]
Entity Wide Disclosures	Entity Wide Disclosures Revenue by Category The following table disaggregates our revenue by major source (in thousands): Three Months Ended Six Months Ended 2023 2022 2023 2022 Therapeutic Area Oncology $ 147,089 $ 115,542 $ 289,040 $ 220,755 Other 101,055 73,555 188,159 143,972 Metabolic 87,860 55,600 174,700 103,716 Cardiology 51,130 42,027 97,747 79,423 Central Nervous System 37,726 38,906 76,423 77,393 AVAI 36,008 25,577 68,873 56,895 Total revenue $ 460,868 $ 351,207 $ 894,942 $ 682,154

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Pay vs Performance Disclosure
Net income	$ 61,068	$ 72,894	$ 49,360	$ 61,311	$ 133,962	$ 110,671

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	6 Months Ended
	Jun. 30, 2023 shares	Jun. 30, 2023 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		During the three months ended June 30, 2023, no director or officer of the Company adopted or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408(a) of Regulation S-K, other than on May 1, 2023, Medpace Investors, LLC (“MPI”) adopted a Rule 10b5-1 trading arrangement that is intended to satisfy the affirmative defense of Rule 10b5-1(c) for the sale of up to 500,000 shares of the Company’s common stock until September 14, 2024. August J. Troendle, Chief Executive Officer and Chairman of the Board of the Company, is the sole manager and controlling unit holder of MPI and has sole voting and investment control with respect to the securities held by MPI. Mr. Troendle may be deemed to indirectly beneficially own the securities of the Company held by MPI but disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein.
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
August J. Troendle [Member]
Trading Arrangements, by Individual
Name	August J. Troendle
Title	Chief Executive Officer and Chairman of the Board of the Company
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	May 1, 2023
Arrangement Duration	502 days
Aggregate Available	500,000	500,000

Basis of Presentation (Policies

Basis of Presentation (Policies)	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial InformationThe 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, 2022.
Share Repurchases	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, except for a small portion which were retained as Treasury Shares on the condensed consolidated statements of shareholders' equity. Retired share repurchase amounts paid in excess of par value are reflected within Accumulated deficit/Retained earnings in the Company’s condensed consolidated balance sheets.

Net Income Per Share (Tables)

Net Income Per Share (Tables)	6 Months Ended
	Jun. 30, 2023
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 six months ended June 30, 2023 and 2022 (in thousands, except for earnings per share): Three Months Ended Six Months Ended 2023 2022 2023 2022 Weighted-average shares: Common shares outstanding 30,537 32,493 30,771 33,696 RSAs 21 21 21 21 Total weighted-average shares 30,558 32,514 30,792 33,717 Earnings per common share—Basic Net income $ 61,068 $ 49,360 $ 133,962 $ 110,671 Less: Undistributed earnings allocated to RSAs (41) (31) (90) (68) Net income available to common shareholders—Basic $ 61,027 $ 49,329 $ 133,872 $ 110,603 Net income per common share—Basic $ 2.00 $ 1.52 $ 4.35 $ 3.28 Basic weighted-average common shares outstanding 30,537 32,493 30,771 33,696 Effect of diluted shares 1,038 1,202 1,093 1,338 Diluted weighted-average shares outstanding 31,575 33,695 31,864 35,034 Net income per common share—Diluted $ 1.93 $ 1.46 $ 4.20 $ 3.16

Contract Assets and Contract _2

Contract Assets and Contract Liabilities (Tables)	6 Months Ended
	Jun. 30, 2023
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 June 30, December 31, Accounts receivable $ 243,560 $ 213,169 Unbilled receivables 31,668 40,405 Less: allowance for doubtful accounts (170) (170) Total accounts receivable and unbilled, net $ 275,058 $ 253,404 Advanced billings consisted of the following (in thousands): As of June 30, December 31, Advanced billings $ 490,557 $ 462,729

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets, Net	Intangible assets, net consisted of the following (in thousands): As of June 30, December 31, Intangible assets: Finite-lived intangible assets: Carrying amount: Customer relationships 145,051 145,051 Accumulated amortization: Customer relationships (139,789) (138,689) Total finite-lived intangible assets, net 5,262 6,362 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 36,908 $ 38,008
Schedule of Estimated Amortization Expense of Intangible Assets	As of June 30, 2023, 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 2023 $ 1,099 2024 1,443 2025 946 2026 620 2027 577 2028 577 $ 5,262

Accrued Expenses (Tables)

Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2023
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consisted of the following (in thousands): As of June 30, December 31, Employee compensation and benefits $ 57,341 $ 71,197 Project related reimbursable expenses 164,835 128,416 Other 9,749 10,512 Total accrued expenses $ 231,925 $ 210,125

Short-Term Debt (Tables)

Short-Term Debt (Tables)	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Schedule of Debt	Short-term debt consisted of the following (in thousands): As of June 30, December 31, Credit facility $ 55,000 $ 50,000 Short-term debt $ 55,000 $ 50,000
Schedule of Principal Payments on Debt	Principal payments on Short-term debt are due as follows (in thousands): 2023 (remaining) — 2024 55,000 Total $ 55,000

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Summary of Components of Lease Expense	The components of lease expense were as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Operating lease cost $ 6,954 $ 6,375 $ 13,635 $ 12,875 Variable lease cost 1,835 2,097 4,172 4,113
Summary of Supplemental Cash Flow Information Related to Leases	Supplemental cash flow information related to the leases was as follows (in thousands): Six Months Ended June 30, 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 9,599 $ 8,257 Right-of-use assets obtained in exchange for lease obligations: Operating leases 10,061 18,222
Summary of Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to the leases was as follows (in thousands): As of June 30, December 31, Operating lease right-of-use assets - related parties $ 86,097 $ 86,356 Operating lease right-of-use assets - non-related parties 53,766 52,712 Operating lease right-of-use assets $ 139,863 $ 139,068 Other current liabilities - related parties 5,457 5,409 Other current liabilities - non-related parties 14,529 13,863 Other current liabilities $ 19,986 $ 19,272 Operating lease liabilities - related parties 93,484 93,393 Operating lease liabilities - non-related parties 45,906 45,474 Operating lease liabilities 139,390 138,867 Total operating lease liabilities $ 159,376 $ 158,139 Weighted Average Remaining Lease Term (years) Operating leases 10.7 11.1 Weighted Average Discount Rate Operating leases 5.4 % 5.2 %
Schedule of Lease Payments Due Related To Lease Liabilities	Lease payments due related to lease liabilities as of June 30, 2023 were as follows (in thousands): Related Party Operating Leases Non-Related Parties Operating Leases Total Operating Leases Remainder of 2023 $ 5,632 $ 8,358 $ 13,990 2024 11,412 14,938 26,350 2025 11,607 12,923 24,530 2026 11,807 10,653 22,460 2027 10,839 7,477 18,316 Later years 100,278 12,171 112,449 Total lease payments 151,575 66,520 218,095 Less: imputed interest (52,634) (6,085) (58,719) Total $ 98,941 $ 60,435 $ 159,376

Shareholder's Equity and Stoc_2

Shareholder's Equity and Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Share-Based Payment Arrangement, Activity	The following table sets forth the Company’s stock option activity: Six Months Ended June 30, 2023 Stock Options Weighted Average Outstanding - beginning of period 1,629,148 $ 89.71 Granted 12,437 $ 211.25 Exercised (129,108) $ 32.21 Cancelled/Forfeited/Expired (8,500) $ 188.55 Outstanding - end of period 1,503,977 $ 95.09 Exercisable - end of period 1,059,805 $ 70.46
Schedule of RSA/RSU Activity	The following table sets forth the Company’s RSA/RSU activity: Six Months Ended Shares/Units Outstanding and unvested - beginning of period 523,377 Granted 27,162 Vested (123,039) Forfeited (14,755) Outstanding and unvested - end of period 412,745 Cumulative vested shares - end of period 2,352,955
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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Total direct costs $ 2,558 $ 3,125 $ 5,498 $ 5,565 Selling, general and administrative 2,348 2,528 4,846 4,460 Total stock-based compensation expense $ 4,906 $ 5,653 $ 10,344 $ 10,025

Entity Wide Disclosures (Tables

Entity Wide Disclosures (Tables)	6 Months Ended
	Jun. 30, 2023
Entity Wide Disclosures [Abstract]
Disaggregation of Revenue by Major Source	The following table disaggregates our revenue by major source (in thousands): Three Months Ended Six Months Ended 2023 2022 2023 2022 Therapeutic Area Oncology $ 147,089 $ 115,542 $ 289,040 $ 220,755 Other 101,055 73,555 188,159 143,972 Metabolic 87,860 55,600 174,700 103,716 Cardiology 51,130 42,027 97,747 79,423 Central Nervous System 37,726 38,906 76,423 77,393 AVAI 36,008 25,577 68,873 56,895 Total revenue $ 460,868 $ 351,207 $ 894,942 $ 682,154

Basis of Presentation - Narrati

Basis of Presentation - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Basis Of Presentation [Line Items]
Repurchases of shares, value			$ 144,020	$ 800,667
2022 Share Repurchase Program
Basis Of Presentation [Line Items]
Repurchases of shares (in shares)	126,281		781,068
Repurchases of shares, value	$ 23,900		$ 144,000
2022 Share Repurchase Program | Maximum
Basis Of Presentation [Line Items]
Stock repurchase program, authorized amount					$ 500,000
Stock repurchase program, remaining amount	$ 308,800		$ 308,800
Share Repurchase Program
Basis Of Presentation [Line Items]
Repurchases of shares (in shares)		2,717,379		5,463,244
Repurchases of shares, value		$ 374,600		$ 800,500

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				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Weighted-average shares:
Basic weighted-average common shares outstanding (in shares)	30,537		32,493		30,771	33,696
Weighted average number of common and restricted shares outstanding basic (in shares)	30,558		32,514		30,792	33,717
Earnings per common share—Basic
Net income	$ 61,068	$ 72,894	$ 49,360	$ 61,311	$ 133,962	$ 110,671
Net income available to common shareholders—Basic	$ 61,027		$ 49,329		$ 133,872	$ 110,603
Net income per common share, basic (in dollars per share)	$ 2		$ 1.52		$ 4.35	$ 3.28
Basic weighted-average common shares outstanding (in shares)	30,537		32,493		30,771	33,696
Effect of diluted shares (in shares)	1,038		1,202		1,093	1,338
Diluted weighted-average shares outstanding (in shares)	31,575		33,695		31,864	35,034
Net income per common share, diluted (in dollars per share)	$ 1.93		$ 1.46		$ 4.20	$ 3.16
RSAs
Weighted-average shares:
Basic weighted-average common shares outstanding (in shares)	21		21		21	21
Earnings per common share—Basic
Less: Undistributed earnings allocated to RSAs	$ (41)		$ (31)		$ (90)	$ (68)
Basic weighted-average common shares outstanding (in shares)	21		21		21	21
Common Stock
Weighted-average shares:
Basic weighted-average common shares outstanding (in shares)	30,537		32,493		30,771	33,696
Earnings per common share—Basic
Basic weighted-average common shares outstanding (in shares)	30,537		32,493		30,771	33,696

Net Income Per Share - Narrativ

Net Income Per Share - Narrative (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from computation of diluted EPS	16,700	274,400	16,700	274,400

Contract Assets and Contract _3

Contract Assets and Contract Liabilities - Summary of Accounts Receivable and Unbilled, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Accounts receivable	$ 243,560	$ 213,169
Unbilled receivables	31,668	40,405
Less: allowance for doubtful accounts	(170)	(170)
Total accounts receivable and unbilled, net	$ 275,058	$ 253,404

Contract Assets and Contract _4

Contract Assets and Contract Liabilities - Summary of Advanced Billings (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Advanced billings	$ 490,557	$ 462,729

Contract Assets and Contract _5

Contract Assets and Contract Liabilities - Narrative (Details) $ in Billions	Jun. 30, 2023 USD ($)
Revenue from Contract with Customer [Abstract]
Performance obligations remaining to be performed	$ 2.9

Intangible Assets, Net - Schedu

Intangible Assets, Net - Schedule of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Accumulated amortization:
Total finite-lived intangible assets, net	$ 5,262	$ 6,362
Trade name (indefinite-lived)	31,646	31,646
Total intangible assets, net	36,908	38,008
Customer Relationships
Finite-lived intangible assets:
Finite-lived intangible assets, gross	145,051	145,051
Accumulated amortization:
Total accumulated amortization	$ (139,789)	$ (138,689)

Intangible Assets, Net - Sche_2

Intangible Assets, Net - Schedule of Estimated Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2023	$ 1,099
2024	1,443
2025	946
2026	620
2027	577
2028	577
Total finite-lived intangible assets, net	$ 5,262	$ 6,362

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Employee compensation and benefits	$ 57,341	$ 71,197
Project related reimbursable expenses	164,835	128,416
Other	9,749	10,512
Total accrued expenses	$ 231,925	$ 210,125

Short-Term Debt - Schedule of D

Short-Term Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Short-Term Debt [Line Items]
Short-term debt	$ 55,000	$ 50,000
Credit facility
Short-Term Debt [Line Items]
Short-term debt	$ 55,000	$ 50,000

Short-Term Debt- Schedule of Pr

Short-Term Debt- Schedule of Principal Payments on Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
2023 (remaining)	$ 0
2024	55,000
Short-term debt	$ 55,000	$ 50,000

Short-Term Debt - Narrative (De

Short-Term Debt - Narrative (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Mar. 15, 2022	Sep. 30, 2019
Debt Instrument [Line Items]
Outstanding letters of credit	$ 0.2
Credit facility
Debt Instrument [Line Items]
Aggregate principal amount borrowed under line of credit facility		$ 150	$ 250
Credit facility, interest rate at period end	6.30%
Credit facility | The Secured Overnight Financing Rate
Debt Instrument [Line Items]
Debt instrument, basis points	1.25%
Credit facility | Overnight Bank Funding Rate
Debt Instrument [Line Items]
Debt instrument, basis points	0.50%
Credit facility | Daily Simple SOFR
Debt Instrument [Line Items]
Debt instrument, basis points	1%
Maximum | Credit facility
Debt Instrument [Line Items]
Debt instrument, principal amount				$ 50

Leases - Narrative (Details)

Leases - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Lessee Lease Description [Line Items]
Lease not yet commenced, future payments	$ 0.6
Minimum | Real Estate
Lessee Lease Description [Line Items]
Remaining lease term, operating lease	1 year
Maximum | Real Estate
Lessee Lease Description [Line Items]
Remaining lease term, operating lease	17 years
Maximum | Real Estate and Equipment
Lessee Lease Description [Line Items]
Lease renewal term, operating lease	20 years
Operating lease, options to terminate lease term	1 year

Leases - Summary of Components

Leases - Summary of Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Leases [Abstract]
Operating lease cost	$ 6,954	$ 6,375	$ 13,635	$ 12,875
Variable lease cost	$ 1,835	$ 2,097	$ 4,172	$ 4,113

Leases - Summary of Supplementa

Leases - Summary of Supplemental Cash Flow Information Related to Leases (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 9,599	$ 8,257
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 10,061	$ 18,222

Leases - Summary of Supplemen_2

Leases - Summary of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Leases, Supplemental Balance Sheet Information [Line Items]
Operating lease right-of-use assets	$ 139,863	$ 139,068
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other current liabilities (includes $9.0 million and $12.5 million with related parties at June 30, 2023 and December 31, 2022, respectively)	Other current liabilities (includes $9.0 million and $12.5 million with related parties at June 30, 2023 and December 31, 2022, respectively)
Other current liabilities	$ 19,986	$ 19,272
Operating lease liabilities	139,390	138,867
Total operating lease liabilities	$ 159,376	$ 158,139
Weighted Average Remaining Lease Term (years)
Operating leases	10 years 8 months 12 days	11 years 1 month 6 days
Weighted Average Discount Rate
Operating leases	5.40%	5.20%
Related Party
Leases, Supplemental Balance Sheet Information [Line Items]
Operating lease right-of-use assets	$ 86,097	$ 86,356
Other current liabilities	5,457	5,409
Operating lease liabilities	93,484	93,393
Total operating lease liabilities	98,941
Nonrelated Party
Leases, Supplemental Balance Sheet Information [Line Items]
Operating lease right-of-use assets	53,766	52,712
Other current liabilities	14,529	13,863
Operating lease liabilities	45,906	$ 45,474
Total operating lease liabilities	$ 60,435

Leases - Schedule of Lease Paym

Leases - Schedule of Lease Payments Due Related To Lease Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2023	$ 13,990
2024	26,350
2025	24,530
2026	22,460
2027	18,316
Later years	112,449
Total lease payments	218,095
Less: imputed interest	(58,719)
Total	159,376	$ 158,139
Related Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2023	5,632
2024	11,412
2025	11,607
2026	11,807
2027	10,839
Later years	100,278
Total lease payments	151,575
Less: imputed interest	(52,634)
Total	98,941
Nonrelated Party
Operating Lease Liabilities Payments Due [Line Items]
Remainder of 2023	8,358
2024	14,938
2025	12,923
2026	10,653
2027	7,477
Later years	12,171
Total lease payments	66,520
Less: imputed interest	(6,085)
Total	$ 60,435

Shareholder's Equity and Stoc_3

Shareholder's Equity and Stock-Based Compensation - Narrative (Details)	6 Months Ended
	Jun. 30, 2023 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted (in shares)	12,437
2016 Incentive Award Plan | Granted to Employees
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Awards granted to employees (in shares)	28,412
2016 Incentive Award Plan | Stock Options | Non Employee Directors
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted (in shares)	11,187
2016 Incentive Award Plan | Vesting After Four Years | Restricted Stock Units (RSU)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares granted (in shares)	27,162
Award vesting period	4 years
2016 Incentive Award Plan | Vesting After Four Years | Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted (in shares)	1,250
Award vesting period	4 years

Shareholder's Equity and Stoc_4

Shareholder's Equity and Stock-Based Compensation - Schedule of Stock Option Activity (Details)	6 Months Ended
	Jun. 30, 2023 $ / shares shares
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding [Roll Forward]
Number of stock options, outstanding - beginning of period (in shares) | shares	1,629,148
Number of stock options, granted (in shares) | shares	12,437
Number of stock options, exercised (in shares) | shares	(129,108)
Number of stock options, cancelled/forfeited/expired (in shares) | shares	(8,500)
Number of stock options, outstanding - end of period (in shares) | shares	1,503,977
Number of stock options, exercisable (in shares) | shares	1,059,805
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Weighted average exercise price, outstanding - beginning of period (in dollars per share) | $ / shares	$ 89.71
Weighted average exercise price, granted (in dollars per share) | $ / shares	211.25
Weighted average exercise price, exercised (in dollars per share) | $ / shares	32.21
Weighted average exercise price, cancelled/forfeited/expired (in dollars per share) | $ / shares	188.55
Weighted average exercise price, outstanding - end of period (in dollars per share) | $ / shares	95.09
Weighted average exercise price, exercisable - end of period (in dollars per share) | $ / shares	$ 70.46

Shareholder's Equity and Stoc_5

Shareholder's Equity and Stock-Based Compensation - Schedule of RSA/RSU Activity (Details) - RSA/RSU	6 Months Ended
	Jun. 30, 2023 shares
Share-Based Compensation Arrangement by Share-Based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Outstanding and unvested - beginning of period (in shares)	523,377
Granted (in shares)	27,162
Vested (in shares)	(123,039)
Forfeited (in shares)	(14,755)
Outstanding and unvested - end of period (in shares)	412,745
Cumulative vested shares - end of period (in shares)	2,352,955

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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 4,906	$ 5,653	$ 10,344	$ 10,025
Total Direct Costs
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	2,558	3,125	5,498	5,565
Selling, General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 2,348	$ 2,528	$ 4,846	$ 4,460

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Tax Disclosure [Abstract]
Effective income tax rate	19.40%	20.40%	17.20%	13.10%
U.S. statutory rate	21%		21%

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Minimum purchase commitments for project related supplies	$ 17.1

Related Party Transactions - Na

Related Party Transactions - Narrative (Details) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2023 USD ($)	Mar. 31, 2023 renewal_option	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($) building renewal_option Agreement	Jun. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Related Party Transaction [Line Items]
Total revenue	$ 460,868		$ 351,207	$ 894,942	$ 682,154
Advanced billings	490,557			490,557		$ 462,729
Accounts receivable and unbilled, net	275,058			275,058		253,404
Other current liabilities	41,347			41,347		47,547
Operating lease cost recognized	6,954		6,375	13,635	12,875
Operating lease right-of-use assets	139,863			139,863		139,068
Current portion of lease liability	19,986			19,986		19,272
Long-term portion of lease liabilities	139,390			139,390		138,867
Accounts payable	33,608			33,608		33,069
Related Party
Related Party Transaction [Line Items]
Total revenue	13,300		17,200	29,100	30,500
Advanced billings	14,300			14,300		8,800
Accounts receivable and unbilled, net	4,600			4,600		7,700
Other current liabilities	9,000			9,000		12,500
Operating lease right-of-use assets	86,097			86,097		86,356
Current portion of lease liability	5,457			5,457		5,409
Long-term portion of lease liabilities	93,484			93,484		93,393
Accounts payable	4,700			4,700		300
Employee Loans | Related Party
Related Party Transaction [Line Items]
Prepaid expenses, other current assets, and other assets	300			300		300
Service Agreement | Related Party | LIB
Related Party Transaction [Line Items]
Advanced billings	11,600			11,600		7,400
Accounts receivable and unbilled, net	3,100			3,100		5,500
Other current liabilities	9,000			9,000		12,500
Service Agreement | Related Party | CinRx Pharma and Subsidiaries
Related Party Transaction [Line Items]
Advanced billings	2,700			2,700		1,400
Accounts receivable and unbilled, net	1,600			1,600		2,200
Service Agreement | Related Party | The Summit
Related Party Transaction [Line Items]
Expenses (less than for the three months ended June 30, 2022)	100		100	200	100
Service Agreement | Related Party | Total revenue | LIB
Related Party Transaction [Line Items]
Total revenue	9,700		9,700	23,000	17,100
Service Agreement | Related Party | Total revenue | CinRx Pharma and Subsidiaries
Related Party Transaction [Line Items]
Total revenue	3,600		7,500	6,100	13,300
Leased Real Estate | Related Party | Chief Executive Officer
Related Party Transaction [Line Items]
Operating lease right-of-use assets	20,200			20,200		18,200
Current portion of lease liability	1,400			1,400		1,500
Long-term portion of lease liabilities	$ 18,900			$ 18,900		16,700
Leased Real Estate | Related Party | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Number of lease renewal, 10-year option | renewal_option				2
Lease term upon renewal	10 years			10 years
Operating lease right-of-use assets	$ 52,700			$ 52,700		53,500
Current portion of lease liability	1,200			1,200		1,100
Long-term portion of lease liabilities	$ 64,200			$ 64,200		64,800
Leased Real Estate | Related Party | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Number of lease renewal, 10-year option | renewal_option				1
Lease term upon renewal	10 years			10 years
Operating lease right-of-use assets	$ 13,300			$ 13,300		14,600
Current portion of lease liability	2,900			2,900		2,800
Long-term portion of lease liabilities	10,400			$ 10,400		11,900
Number of lease agreements | Agreement				2
Number of buildings | building				2
Leased Real Estate | Related Party | Direct Costs and Selling, General And Administrative | Chief Executive Officer
Related Party Transaction [Line Items]
Operating lease cost recognized	700		500	$ 1,300	1,100
Leased Real Estate | Related Party | Direct Costs and Selling, General And Administrative | Chief Executive Officer And Immediate Family | Office Space
Related Party Transaction [Line Items]
Operating lease cost recognized	1,400		1,400	2,800	2,800
Leased Real Estate | Related Party | Direct Costs and Selling, General And Administrative | Chief Executive Officer And Immediate Family | Building
Related Party Transaction [Line Items]
Operating lease cost recognized	900		900	1,800	1,800
Leased Real Estate | Chief Executive Officer
Related Party Transaction [Line Items]
Term of lease		10 years
Number of lease renewal, 10-year option | renewal_option		1
Lease term upon renewal		10 years
Travel Services | Related Party
Related Party Transaction [Line Items]
Accounts payable	400			400		$ 300
Travel Services | Related Party | Chief Executive Officer
Related Party Transaction [Line Items]
Travel expenses	$ 400		$ 600	$ 800	$ 1,000

Entity Wide Disclosures - Summa

Entity Wide Disclosures - Summary of Revenue by Major Source (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation Of Revenue [Line Items]
Total revenue	$ 460,868	$ 351,207	$ 894,942	$ 682,154
Oncology
Disaggregation Of Revenue [Line Items]
Total revenue	147,089	115,542	289,040	220,755
Other
Disaggregation Of Revenue [Line Items]
Total revenue	101,055	73,555	188,159	143,972
Metabolic
Disaggregation Of Revenue [Line Items]
Total revenue	87,860	55,600	174,700	103,716
Cardiology
Disaggregation Of Revenue [Line Items]
Total revenue	51,130	42,027	97,747	79,423
Central Nervous System
Disaggregation Of Revenue [Line Items]
Total revenue	37,726	38,906	76,423	77,393
AVAI
Disaggregation Of Revenue [Line Items]
Total revenue	36,008	25,577	68,873	56,895
Total revenue
Disaggregation Of Revenue [Line Items]
Total revenue	$ 460,868	$ 351,207	$ 894,942	$ 682,154